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Kaneva M, Malyutina S, Moiseenko V, Kudryavtsev A. Seasonal differences in participation and time spent in physical activity in Russia: The Know Your Heart survey. Int J Health Plann Manage 2024; 39:1530-1550. [PMID: 39054640 DOI: 10.1002/hpm.3826] [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: 03/16/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
This study aimed to assess the levels and investigate socioeconomic, demographic, and health-related predictors of winter and summer physical activity (PA) in Russia using the data from the Know Your Heart population survey conducted in Novosibirsk and Arkhangelsk (2015-2018; n = 5068; aged 35-69 years). Employing a series of probit, Tobit, and the Cragg models, we separated the predictors of the probability of participating in leisure-time PA from the predictors of time spent in PA. Our study showed that financial constraints limited males' participation in winter PA (probability of participation decreased by 12 percentage points) and females' engagement in winter and summer PA (decrease in the number of hours of practicing PA by approximately 1 h a week). Education, self-reported health, smoking, and cues to action had different impacts on both probability and time spent in PA in winter and summer. We also found significant gender differences in participation and time spent in PA across seasons. Older age, poor health, and smoking were greater obstacles to PA for males compared to females both in winter and summer. However, males were more likely to follow physician's advice to lose weight and take up physical exercise. Information campaigns that promote physical activities, including those that are free of charge, are needed to help limit barriers to PA for people with low socioeconomic status and individuals with little or no exercise experience. Also, making sports more accessible to citizens by providing free and low-cost sports facilities can increase their participation and time spent in PA, improving individual health and productivity.
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Affiliation(s)
- Maria Kaneva
- Department of Regional and Municipal Governance, Institute of Economics and Industrial Engineering of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Sofia Malyutina
- Lab of Etiopathogenesis and Clinics of Internal Diseases, Institute of Internal and Preventive Medicine-Branch of Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Victoria Moiseenko
- Department of Regional and Municipal Governance, Institute of Economics and Industrial Engineering of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Alexander Kudryavtsev
- International Research Competence Centre, Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
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Høyer-Kruse J, Schmidt EB, Hansen AF, Pedersen MRL. The interplay between social environment and opportunities for physical activity within the built environment: a scoping review. BMC Public Health 2024; 24:2361. [PMID: 39215315 PMCID: PMC11363614 DOI: 10.1186/s12889-024-19733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The association between social and built environments plays a crucial role in influencing physical activity levels. However, a thorough understanding of their combined impact remains unclear. This scoping review seeks to clarify the interplay between social environments and opportunities for physical activity within different built environments, with a particular focus on the implications of socioeconomic status and urban planning on physical activity participation. METHODS We conducted a systematic literature search across several databases to identify studies exploring the associations between social factors, built environment characteristics, and physical activity levels. The inclusion criteria were studies published in English between 2000 and 2022, encompassing urban, suburban, and rural contexts. Thematic analysis was employed to categorise studies based on the specific aspects of the built environment they investigated (walking infrastructure, cycling infrastructure, parks and open spaces, and sports facilities) and the social determinants they examined. RESULTS A total of 72 studies were included in the review, illustrating a multifaceted relationship between access to physical activity opportunities and social determinants such as socioeconomic status, community engagement, and urban design. The findings highlight the significant role of socioeconomic factors and the quality of PA infrastructure in promoting or hindering PA across communities. Effective urban planning was identified as crucial in providing expanded physical activity opportunities, notably through more pedestrian-friendly environments, comprehensive cycling infrastructure, and accessible green spaces and sports facilities. CONCLUSIONS This review emphasises the significant impact of socioeconomic status and urban planning on access to physical activity opportunities. This underscores the necessity for urban planning policies to adopt an inclusive approach, considering the varied needs of different population groups to ensure equitable access to physical activity resources. Such strategies are crucial for public health initiatives aimed at enhancing physical activity levels across diverse community sectors, offering a potential avenue to alleviate health disparities associated with inactivity.
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Affiliation(s)
- Jens Høyer-Kruse
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, 5230, Denmark
| | - Eva Berthelsen Schmidt
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, 5230, Denmark
| | - Anne Faber Hansen
- Department of Teaching and Dissemination, University Library of Southern Denmark, Odense M, 5230, Denmark
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Zuo W, Cheng B, Feng X, Zhuang X. Relationship between urban green space and mental health in older adults: mediating role of relative deprivation, physical activity, and social trust. Front Public Health 2024; 12:1442560. [PMID: 39267636 PMCID: PMC11390600 DOI: 10.3389/fpubh.2024.1442560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 08/12/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction The importance of improving older adults' mental health is increasing worldwide with the rapid development of the aging process. Green space is an important part of the urban built environment, demonstrates a deep connection with the mental health of older adults, and its internal mechanisms have been widely studied. This study analyzed the influence of urban green spaces on the mental health of older adults via three factors: relative deprivation, physical activity, and social trust. Methods Based on the 2018 China Labor Dynamics Survey, a multi-level structural equation model was used to explore the mediating roles of relative deprivation, physical activity, social trust in urban green spaces, and the mental health of older adults. Results Urban green space was positively correlated with the mental health of older adults. Relative deprivation and physical activities played a mediating role between urban green space and the mental health of older adults. Discussion An increase in urban green spaces can help increase the number of older adults obtaining green space resources, and help them maintain good mental health. Secondly, older adults with a relatively homogeneous environment have more equal opportunities to obtain urban green space resources, which helps to reduce the comparison of older adults in access to green space resources and reduce the adverse impact of relative deprivation on their mental health. Additionally, increasing urban green spaces can encourage older adults to engage in physical activities and improve their mental health. Finally, we suggest improving the accessibility, fairness, and quality of green spaces, paying attention to the psychological needs of older adults, encouraging older adults to engage in physical activities in green spaces, and taking various measures to enhance the positive role of green space on the mental health of older adults.
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Affiliation(s)
- Wen Zuo
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, China
| | - Bin Cheng
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, China
| | - Xinyan Feng
- School of Business, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Xuefang Zhuang
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, China
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Hetland RA, Wilsgaard T, Hopstock LA, Ariansen I, Johansson J, Jacobsen BK, Grimsgaard S. Social inequality in prevalence of NCD risk factors: a cross-sectional analysis from the population-based Tromsø Study 2015-2016. BMJ Open 2024; 14:e080611. [PMID: 38688673 PMCID: PMC11086291 DOI: 10.1136/bmjopen-2023-080611] [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: 10/06/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE We aimed to examine associations between educational level, serving as an indicator of socioeconomic position, and prevalence of WHO-established leading behavioural and biological risk factors for non-communicable diseases (NCDs), in middle-aged to older women and men. DESIGN Population-based cross-sectional study. SETTING All inhabitants of the municipality of Tromsø, Norway, aged ≥40 years, were invited to the seventh survey (2015-2016) of the Tromsø Study; an ongoing population-based cohort study. PARTICIPANTS Of the 32 591 invited; 65% attended, and a total of 21 069 women (53%) and men aged 40-99 years were included in our study. OUTCOME MEASURES We assessed associations between educational level and NCD behavioural and biological risk factors: daily smoking, physical inactivity (sedentary in leisure time), insufficient fruit/vegetable intake (<5 units/day), harmful alcohol use (>10 g/day in women, >20 g/day in men), hypertension, obesity, intermediate hyperglycaemia and hypercholesterolaemia. These were expressed as odds ratios (OR) per unit decrease in educational level, with 95% CIs, in women and men. RESULTS In women (results were not significantly different in men), we observed statistically significant associations between lower educational levels and higher odds of daily smoking (OR 1.69; 95% CI 1.60 to 1.78), physical inactivity (OR 1.38; 95% CI 1.31 to 1.46), insufficient fruit/vegetable intake (OR 1.54, 95% CI 1.43 to 1.66), hypertension (OR 1.25; 95% CI 1.20 to 1.30), obesity (OR 1.23; 95% CI 1.18 to 1.29), intermediate hyperglycaemia (OR 1.12; 95% CI 1.06 to 1.19), and hypercholesterolaemia (OR 1.07; 95% CI 1.03 to 1.12), and lower odds of harmful alcohol use (OR 0.75; 95% CI 0.72 to 0.78). CONCLUSION We found statistically significant educational gradients in women and men for all WHO-established leading NCD risk factors within a Nordic middle-aged to older general population. The prevalence of all risk factors increased at lower educational levels, except for harmful alcohol use, which increased at higher educational levels.
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Affiliation(s)
- Rebecca A Hetland
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Lovan P, Saez-Clarke E, Graefe B, Messiah SE, Prado G. Parent childhood experiences, parenting strategies, and youth health-related outcomes in Hispanic families with unhealthy weight: An intergenerational study. Eat Behav 2024; 53:101870. [PMID: 38460202 PMCID: PMC11144088 DOI: 10.1016/j.eatbeh.2024.101870] [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: 07/18/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
We aimed to examine whether (a) parents' childhood family mealtime experiences (CFM) (e.g., mealtime communication-based stress) and parents' socio-demographic characteristics (e.g., education level) predict parents' health-related parenting strategies (e.g., discipline), (b) health-related parenting strategies for eating and physical activity predict youth's health-related outcomes (e.g., dietary intake), (c) parenting strategies mediate the relationship between CFM and youth outcomes. A path model was used to examine the above-mentioned relationships. Data were obtained from the baseline assessment of a randomized clinical trial evaluating the efficacy of a family-based intervention to promote quality diet and increase physical activity. Participants were 280 Hispanic youth (52.1 % female, Mage = 13.01 ± 0.83) with unhealthy weight (MBody Mass Index %tile = 94.55 ± 4.15) and their parents (88.2 % female, Mage = 41.87 ± 6.49). Results indicated that childhood mealtime communication-based stress and mealtime structure were positively associated with control. Appearance weight control was positively associated with monitoring, discipline, limit-setting, and reinforcement. Parental mealtime control had positive associations with discipline, control, and limit-setting. Emphasis on mother's weight was positively associated with reinforcement. We also found positive associations between parental monitoring and youth's physical QOL and between parental discipline and fruits and vegetables intake. No mediating effect was found. Findings demonstrated significant effects of parents' childhood experience on parenting strategies, which in turn was associated with the youths' health-related outcomes. These results suggest the intergenerational effects of parent's childhood experience on their youth's health-related outcomes.
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Affiliation(s)
- Padideh Lovan
- School of Nursing and Health Studies, University of Miami, Miami, FL 33146, United States; Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33146, United States.
| | - Estefany Saez-Clarke
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33146, United States; Department of Psychology, University of Miami, Miami, FL 33146, United States.
| | - Beck Graefe
- Department of Educational and Psychological Studies, University of Miami, Miami, FL 33146, United States.
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Science, The University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX 75207, United States; Center for Pediatric Population Health, University of Texas Health Science Center, School of Public Health, Dallas, TX 75207, United States; Department of Pediatrics, McGovern Medical School, Houston, TX 77030, United States.
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Miami, FL 33146, United States.
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Bell Z, Porcellato L, Holland P, Morris A, Smith C, Haines C, Graves L. A systematic scoping review of health-promoting interventions for contact centre employees examined through a behaviour change wheel lens. PLoS One 2024; 19:e0298150. [PMID: 38457379 PMCID: PMC10923409 DOI: 10.1371/journal.pone.0298150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/17/2024] [Indexed: 03/10/2024] Open
Abstract
PURPOSE Social determinants of health and poor working conditions contribute to excessive sickness absence and attrition in contact centre advisors. With no recent review conducted, the current scoping review is needed to investigate the volume, effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. This will inform the adoption and implementation of evidence-based practice, and future research. METHODS Searches conducted across four databases (MEDLINE, PsycInfo, CINAHL, Web of Science) and reference checking in February 2023 identified health-promoting interventions for contact centre advisors. Extracted and coded data from eligible interventions were systematically synthesised using the nine intervention functions of the Behaviour Change Wheel and behaviour change technique taxonomy. RESULTS This scoping review identified a low number of high quality and peer-reviewed health-promoting intervention studies for contact centre advisors (28 studies since 2002). Most interventions were conducted in high-income countries with office-based advisors, predominantly using environmental restructuring and training strategies to improve health. Most interventions reported positive effectiveness results for the primary intended outcomes, which were broadly organised into: i) health behaviours (sedentary behaviour, physical activity, smoking); ii) physical health outcomes (musculoskeletal health, visual health, vocal health, sick building syndrome); iii) mental health outcomes (stress, job control, job satisfaction, wellbeing). Few interventions evaluated acceptability and feasibility. CONCLUSION There is little evidence on the effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. Evidence is especially needed in low-to-middle income countries, and for remote/hybrid, nightshift, older and disabled advisors.
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Affiliation(s)
- Zoe Bell
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Lorna Porcellato
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Paula Holland
- Division of Health Research, Lancaster University, Lancaster, Lancashire, United Kingdom
| | - Abigail Morris
- Division of Health Research, Lancaster University, Lancaster, Lancashire, United Kingdom
| | - Chloe Smith
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Charlotte Haines
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Lee Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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Heimrich KG, Schönenberg A, Prell T. Social deprivation and exclusion in Parkinson's disease: a cross-sectional and longitudinal study. BMJ Open 2023; 13:e074618. [PMID: 38159947 PMCID: PMC11150781 DOI: 10.1136/bmjopen-2023-074618] [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: 04/11/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE To describe prevalence and associated factors of social deprivation in people with Parkinson's disease (PwPD). DESIGN Cross-sectional and longitudinal cohort study. SETTING Data were taken from the Survey of Health, Ageing and Retirement in Europe (SHARE), a multidisciplinary, cross-national and longitudinal research project. PARTICIPANTS Community-dwelling adults from waves 5 (2013, n=66 188) and 6 (2015, n=68 186) of the SHARE dataset. After longitudinal analyses, participants in wave 5 can be retrospectively divided into the following three subgroups: PwPD at wave 5 (n=559), people newly reported PD from wave 5 to wave 6 (prodromal PD; n=215) and people without PD (n=46 737). OUTCOME MEASURES The prevalence and associated factors of social deprivation in PD, its impact on quality of life (QoL) and its onset within the course of PD. RESULTS PwPD had higher indices for material and social deprivation than non-PD participants, and 20% of PwPD were at risk of social exclusion. Social deprivation alone accounted for 35% and material deprivation for 21% of QoL variance and remained significant predictors of QoL after adjustment for cofactors. Social deprivation and risk of social exclusion were already increased in people with prodromal PD, and accordingly preceded PD diagnosis in wave 6. CONCLUSIONS For the treatment of PD, we should consider the impact of social deprivation and exclusion on QoL and their association with mental and physical functioning. However, the relevance of social deprivation as a prodromal phenomenon requires further investigation.
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Affiliation(s)
| | - Aline Schönenberg
- Department of Geriatrics, University Hospital Halle, Halle (Saale), Sachsen-Anhalt, Germany
| | - Tino Prell
- Department of Geriatrics, University Hospital Halle, Halle (Saale), Sachsen-Anhalt, Germany
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Bush KJ, Papacosta AO, Lennon LT, Rankin J, Whincup PH, Wannamethee SG, Ramsay SE. Influence of neighborhood-level socioeconomic deprivation and individual socioeconomic position on risk of developing type 2 diabetes in older men: a longitudinal analysis in the British Regional Heart Study cohort. BMJ Open Diabetes Res Care 2023; 11:e003559. [PMID: 37907278 PMCID: PMC10619023 DOI: 10.1136/bmjdrc-2023-003559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/06/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Evidence from longitudinal studies on the influence of neighborhood socioeconomic deprivation in older age on the development of type 2 diabetes mellitus (T2DM) is limited. This study investigates the prospective associations of neighborhood-level deprivation and individual socioeconomic position (SEP) with T2DM incidence in older age. RESEARCH DESIGN AND METHODS The British Regional Heart Study studied 4252 men aged 60-79 years in 1998-2000. Neighborhood-level deprivation was based on the Index of Multiple Deprivation quintiles for participants' 1998-2000 residential postcode. Individual SEP was defined as social class based on longest-held occupation. A cumulative score of individual socioeconomic factors was derived. Incident T2DM cases were ascertained from primary care records; prevalent cases were excluded. Cox proportional hazard models were used to examine the associations. RESULTS Among 3706 men, 368 incident cases of T2DM were observed over 18 years. The age-adjusted T2DM risk increased from the least deprived quintile to the most deprived: HR per quintile increase 1.14 (95% CI 1.06 to 1.23) (p=0.0005). The age-adjusted T2DM HR in social class V (lowest) versus social class I (highest) was 2.45 (95% CI 1.36 to 4.42) (p=0.001). Both associations attenuated but remained significant on adjustment for other deprivation measures, becoming non-significant on adjustment for body mass index and T2DM family history. T2DM risk increased with cumulative individual adverse socioeconomic factors: HR per point increase 1.14 (95% CI 1.05 to 1.24). CONCLUSIONS Inequalities in T2DM risk persist in later life, both in relation to neighborhood-level and individual-level socioeconomic factors. Underlying modifiable risk factors continue to need to be addressed in deprived older age populations to reduce disease burden.
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Affiliation(s)
- Kathryn J Bush
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - A Olia Papacosta
- Primary Care and Population Health, University College London, London, UK
| | - Lucy T Lennon
- Primary Care and Population Health, University College London, London, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - S Goya Wannamethee
- Primary Care and Population Health, University College London, London, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Paudel S, Ahmadi M, Phongsavan P, Hamer M, Stamatakis E. Do associations of physical activity and sedentary behaviour with cardiovascular disease and mortality differ across socioeconomic groups? A prospective analysis of device-measured and self-reported UK Biobank data. Br J Sports Med 2023; 57:921-929. [PMID: 36754587 PMCID: PMC10359566 DOI: 10.1136/bjsports-2022-105435] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To examine if individual-level and area-level socioeconomic status (SES) modifies the association of moderate-to-vigorous physical activity (MVPA), domain-specific physical activity and sedentary behaviour with all-cause mortality (ACM) and incident cardiovascular disease (CVD). METHODS We used self-reported (International Physical Activity Questionnaire short form) and accelerometer-measured physical activity and sedentary behaviour data from the UK Biobank. We created an individual-level composite SES index using latent class analysis of household income, education and employment status. The Townsend Index was the measure of area-level SES. Cox proportional hazards regression models stratified across SES were used. RESULTS In 328 228 participants (mean age 55.9 (SD 8.1) years, 45% men) with an average follow-up of 12.1 (1.4) years, 18 033 deaths and 98 922 incident CVD events occurred. We found an increased ACM risk of low physical activity and high sedentary behaviour and an increased incident CVD risk of low accelerometer-measured moderate-to-vigorous physical activity (ACCEL_MVPA) and high sitting time. We observed statistically significant interactions for all exposures in ACM analyses by individual-level SES (p<0.05) but only for screen time in area-level SES-ACM analysis (p<0.001). Compared with high self-reported moderate-to-vigorous physical activity (IPAQ_MVPA), adjusted ACM HRs for low IPAQ_MVPA were 1.14 (95% CI 1.05 to .25), 1.15 (95% CI 1.06 to 1.24) and 1.22 (95% CI 1.13 to 1.31) in high, medium and low individual-level SES, respectively. There were higher detrimental associations of low ACCEL_MVPA with decreasing area-level SES for both outcomes and of high screen time with ACM in low area-level SES. CONCLUSION We found modest evidence suggesting that the detrimental associations of low MVPA and high screen time with ACM and incident CVD are accentuated in low SES groups.
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Affiliation(s)
- Susan Paudel
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Ahmadi
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, Prevention Research Collaboration, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Hamer
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, UK
| | - Emmanuel Stamatakis
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Rowlands AV, Dempsey PC, Maylor B, Razieh C, Zaccardi F, Davies MJ, Khunti K, Yates T. Self-reported walking pace: A simple screening tool with lowest risk of all-cause mortality in those that 'walk the talk'. J Sports Sci 2023:1-9. [PMID: 37183448 DOI: 10.1080/02640414.2023.2209762] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
To determine whether the association between self-reported walking pace and all-cause mortality (ACM) persists across categories of accelerometer-assessed physical activity status. Data from 93,709 UK Biobank participants were included. Physical activity was assessed using wrist-worn accelerometers for 7-days. Participants accumulating <150 min/week moderate-to-vigorous- activity were classed as "inactive", ≥150 min/week moderate (≥3 METs) activity as "somewhat active" excluding those with ≥150 min/week upper-moderate-to-vigorous activity (≥4.3 METs), who were classed as "high-active". Over a 6.3 y (median) follow-up, 2,173 deaths occurred. More than half of slow walkers were "inactive", but only 26% of steady and 12% of brisk walkers. Associations between walking pace and ACM were consistent with those for activity. "High active" brisk walkers had the lowest risk of ACM (Hazard Ratio (HR) 0.22; 95% CI: 0.17,0.28), relative to "inactive" slow walkers. Within those classed as "inactive", steady (HR 0.54; 0.46,0.64) and brisk walkers (HR 0.42; 0.34,0.52) had lower risk than slow walkers. In conclusion, self-reported walking pace was associated with accelerometer-assessed physical activity with both exposures having similar associations with ACM. "inactive", steady, and brisk walkers had lower ACM risk than slow walkers. The pattern was similar for "High active" participants. Overall, "High active" brisk walkers had lowest risk.
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Affiliation(s)
- Alex V Rowlands
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Paddy C Dempsey
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Physical Activity & Behavioural Epidemiology Laboratories, Baker Heart & Diabetes Institute, Melbourne, Australia
| | - Benjamin Maylor
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Cameron Razieh
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- NIHR Applied Research Collaboration - East Midlands (ARC-EM), Leicester General Hospital, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
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Women carry the weight of deprivation on physical inactivity: Moderated mediation analyses in a European sample of adults over 50 Years of age. SSM Popul Health 2022; 20:101272. [PMID: 36387017 PMCID: PMC9641026 DOI: 10.1016/j.ssmph.2022.101272] [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: 05/10/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Deprived people are less physically active than privileged individuals. However, pathways underlying the association between deprivation and physical activity remain overlooked. We examined whether the association between deprivation and physical activity was mediated by body mass index (BMI). Consistent with an intersectional perspective (how the combination of belongingness to vulnerable social categories widens inequalities), we tested whether gender moderated this mediating pathway and hypothesized that the mediating effect of BMI would be stronger among women (vs men). Large-scale longitudinal data from 20,961 adults 50 years of age or older (57% women) from the Survey of Health, Ageing and Retirement in Europe were used. Social and material deprivation were measured by questionnaire, BMI and physical activity were reported from two to six years later. Simple mediation models showed that BMI partly mediated the association of material (total effect c = -0.14, proportion of mediated effect = 8%) and of social deprivation (c = -0.24, proportion of mediated effect = 4%) with physical activity. Moderated mediation models revealed that this mediating pathway was moderated by gender. The effect of deprivation on BMI was stronger among women (vs men), with BMI mediating 18% and 7% of the association of material and social deprivation with physical activity among women (vs 4% and 2% among men). Lower levels of physical activity observed among deprived older adults could be partly attributed to a higher BMI. Critically, this mechanism was exacerbated among women, reinforcing the need to understand how deprivation and gender interact to predict health behaviors. Body mass index mediates the association of material and social deprivation with physical activity. This mediating pattern is more pronounced among women, relative to men. The association between deprivation and a higher body mass index is exacerbated among women, compared to men.
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12
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Doan T, Yu P, LaBond C, Gong C, Strazdins L. Time for Physical Activity: Different, Unequal, Gendered. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:37-54. [PMID: 35236152 DOI: 10.1177/00221465211028910] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We investigate time inequity as an explanatory mechanism for gendered physical activity disparity. Our mixed-effect generalized linear model with two-stage residual inclusion framework uses longitudinal data, capturing differing exchanges and trade-offs in time resources. The first stage estimates within-household exchanges of paid and family work hours. Estimates show that men's employment increases women's family work hours while reducing their own, whereas women's employment weakly affects men's family time. Incorporating unequal household exchange into the second stage reveals that as women's paid or family work hours increase, physical activity goes down. In contrast, men's physical activity is unaffected by paid work hours, and family time appears protective. Control over work time further underscores gendered time exchange: Men's activity increases with own or partner's control, whereas women's increases only with their own. Our approach reveals how men's and women's unequal capability to use time creates differing trade-offs between work, family, and physical activity, generating health inequity.
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Affiliation(s)
- Tinh Doan
- Australian National University, Canberra, ACT, Australia
| | - Peng Yu
- Commonwealth Department of Social Services, Canberra, ACT, Australia
| | | | - Cathy Gong
- Australian National University, Canberra, ACT, Australia
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Fatigue in Persons With Heart Failure: A Systematic Literature Review and Meta-Synthesis Using the Biopsychosocial Model of Health. J Card Fail 2022; 28:283-315. [PMID: 34329719 PMCID: PMC8795245 DOI: 10.1016/j.cardfail.2021.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/27/2021] [Accepted: 07/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Fatigue is a common and distressing symptom of heart failure (HF) and has important implications for patient-reported and clinical outcomes. Despite being a common and bothersome symptom, fatigue has been understudied in HF. We sought to synthesize existing literature on fatigue in HF through a systematic literature review guided by the biopsychosocial model of health. METHODS AND RESULTS A systematic search of the literature was performed on March 18, 2020, using Pubmed, Embase, and CINAHL. Full-text, primary research articles, written in English, in which fatigue was a primary symptom of interest in adults with a diagnosis of HF, were included. The search yielded 1138 articles; 33 articles that met inclusion criteria were selected for extraction and synthesis. Biological and psychological factors associated with fatigue were New York Heart Association functional class, hemoglobin level, history of stroke, and depression. However, there are limited HF-specific factors linked to fatigue. Social factors related to fatigue included social roles, relationship strain, and loneliness and isolation. Few nonpharmacologic interventions have been tested by show some promise for alleviating fatigue in HF. Studies show conflicting evidence related to the prognostic implications of fatigue. CONCLUSIONS Important biological correlates of fatigue were identified; however, psychological and social variables were limited to qualitative description. There is need for expanded models to better understand the complex physiologic nature of fatigue in HF. Additionally, more research is needed to (1) define the relationships between fatigue and both psychological and social factors, (2) better describe the prognostic implications of fatigue, and (3) develop more therapeutic approaches to alleviate fatigue with the goal of improving overall quality of life.
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Reece LJ, Owen K, Graney M, Jackson C, Shields M, Turner G, Wellington C. Barriers to initiating and maintaining participation in parkrun. BMC Public Health 2022; 22:83. [PMID: 35027014 PMCID: PMC8759213 DOI: 10.1186/s12889-022-12546-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
Interventions that increase population physical activity are required to promote health and wellbeing. parkrun delivers community-based, 5 km events worldwide yet 43% who register never participate in a parkrun event. This research had two objectives; i) explore the demographics of people who register for parkrun in United Kingdom, Australia, Ireland, and don't initiate or maintain participation ii) understand the barriers to participating in parkrun amongst these people. Mandatory data at parkrun registration provided demographic characteristics of parkrun registrants. A bespoke online survey distributed across the three countries captured the reasons for not participating or only participating once. Of 680,255 parkrun registrants between 2017 and 19, 293,542 (43%) did not participate in any parkrun events and 147,148 (22%) only participated in one parkrun event. Females, 16-34 years and physically inactive were more likely to not participate or not return to parkrun. Inconvenient start time was the most frequently reported barrier to participating, with females more likely than males to report the psychological barrier of feeling too unfit to participate. Co-creating strategies with and for people living with a chronic disease, women, young adults, and physically inactive people, could increase physical activity participation within parkrun.
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Affiliation(s)
- L. J. Reece
- SPRINTER Research Group, Prevention Research Collaboration, School of Public health, Charles Perkins Centre, University of Sydney, Sydney, NSW Australia
| | - K. Owen
- SPRINTER Research Group, Prevention Research Collaboration, School of Public health, Charles Perkins Centre, University of Sydney, Sydney, NSW Australia
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15
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Candio P, Meads D, Hill AJ, Bojke L. Does providing everyone with free-of-charge organised exercise opportunities work in public health? Health Policy 2022; 126:129-142. [PMID: 35034767 DOI: 10.1016/j.healthpol.2022.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Population-level initiatives of free-of-charge organised exercise have been implemented to encourage residents to take up regular physical activity. However, there exists a paucity of evidence on the ability of these interventions to attract and engage residents, especially targeted subgroups. Seeking to contribute to this evidence base, we evaluated a proportionate universal programme providing free exercise sessions, Leeds Let's Get Active. METHODS Descriptive statistics were used to summarise the programme data and participants. Time to event, count and logistic regression models examined how different population subgroups engaged with the programme in terms of number of entries, weekly participation rates and drop-off patterns. RESULTS 51,874 adult residents registered to the programme and provided baseline data (2013-2016). A small proportion (1.6%) attended the free sessions on a weekly basis. Higher participation rates were estimated for the groups of males, retired and non-inactive participants. A neighbourhood-level deprivation status was found to have no marginal effect on the level and frequency of participation, but to be negatively associated with participation drop-off (HR 0.93, 95% CI 0.89-0.97, p = 0.001). CONCLUSIONS Providing everyone with free-of-charge organised exercise opportunities in public leisure centres located in deprived areas can attract large volumes of residents, but may not sufficiently encourage adults, especially inactive residents and those living in disadvantaged neighbourhoods, to take up regular exercise.
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Affiliation(s)
- Paolo Candio
- Centre for Economics of Obesity, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Leeds Institute of Health Sciences, University of Leeds, United Kingdom.
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, United Kingdom
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, United Kingdom
| | - Laura Bojke
- Centre for Health Economics, University of York, United Kingdom
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Saint-Onge K, Bernard P, Kingsbury C, Houle J. Older Public Housing Tenants' Capabilities for Physical Activity Described Using Walk-Along Interviews in Montreal, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11647. [PMID: 34770160 PMCID: PMC8583507 DOI: 10.3390/ijerph182111647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022]
Abstract
Older public housing tenants experience various factors associated with physical inactivity and are locally dependent on their environment to support their physical activity. A better understanding of the person-environment fit for physical activity could highlight avenues to improve access to physical activity for this subgroup of the population. The aim of this study was to evaluate older public housing tenants' capabilities for physical activity in their residential environment using a socioecological approach. We conducted individual semi-structured walk-along interviews with 26 tenants (female = 18, male = 8, mean age = 71.96 years old). Living in housing developments exclusively for adults aged 60 years or over in three neighborhoods in the city of Montreal, Canada. A hybrid thematic analysis produced five capabilities for physical activity: Political, financial, social, physical, and psychological. Themes spanned across ecological levels including individual, public housing, community, and government. Tenant committees appear important to physical activity promotion. Participants called for psychosocial interventions to boost their capability for physical activity as well as greater implication from the housing authority and from government. Results further support a call for intersectoral action to improve access to physical activity for less affluent subgroups of the population such as older public housing tenants.
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Affiliation(s)
- Kadia Saint-Onge
- Department of Psychology, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada;
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
| | - Paquito Bernard
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC H2L 2C4, Canada
| | - Célia Kingsbury
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC H2L 2C4, Canada
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada;
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
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The Effect of A Weight-Loss Diet in Women Doing Reformer Pilates: A 12-Week Evaluation. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.1004825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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18
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Kyriakidou Y, Cooper I, Kraev I, Lange S, Elliott BT. Preliminary Investigations Into the Effect of Exercise-Induced Muscle Damage on Systemic Extracellular Vesicle Release in Trained Younger and Older Men. Front Physiol 2021; 12:723931. [PMID: 34650440 PMCID: PMC8507150 DOI: 10.3389/fphys.2021.723931] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/31/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Exercise-induced muscle damage (EIMD) results in transient muscle inflammation, strength loss, and muscle soreness and may cause subsequent exercise avoidance. Research has recently proven that skeletal muscle can also release extracellular vesicles (EVs) into the circulation following a bout of exercise. However, EV’s potential role, including as a biomarker, in the response to eccentric resistance exercise stimulus remains unclear. Methods: Twelve (younger, n=7, 27.0±1.5years and older, n=5, 63.0±1.0years) healthy, physically active males, undertaking moderate, regular physical activity (3–5 times per week) performed a unilateral high intensity eccentric exercise protocol. Venous plasma was collected for assessment of EVs and creatine kinase (CK) prior to EIMD, immediately after EIMD, and 1–72h post-EIMD, and maximal voluntary isometric contraction (MVIC) and delayed onset muscle soreness (DOMS) were assessed at all time points, except 1 and 2h post-EIMD. Results: A significant effect of both time (p=0.005) and group (p<0.001) was noted for MVIC, with younger participants’ MVIC being higher throughout. Whilst a significant increase was observed in DOMS in the younger group (p=0.014) and in the older group (p=0.034) following EIMD, no significant differences were observed between groups. CK was not different between age groups but was altered following the EIMD (main effect of time p=0.026), with increased CK seen immediately post-, at 1 and 2h post-EIMD. EV count tended to be lower in older participants at rest, relative to younger participants (p=0.056), whilst EV modal size did not differ between younger and older participants pre-EIMD. EIMD did not substantially alter EV modal size or EV count in younger or older participants; however, the alteration in EV concentration (ΔCount) and EV modal size (ΔMode) between post-EIMD and pre-EIMD negatively associated with CK activity. No significant associations were noted between MVIC or DOMS and either ΔCount or ΔMode of EVs at any time point. Conclusion: These findings suggest that profile of EV release, immediately following exercise, may predict later CK release and play a role in the EIMD response. Exercise-induced EV release profiles may therefore serve as an indicator for subsequent muscle damage.
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Affiliation(s)
- Yvoni Kyriakidou
- Translational Physiology Research Group, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Isabella Cooper
- Translational Physiology Research Group, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Igor Kraev
- Electron Microscopy Suite, Faculty of Science, Technology, Engineering and Mathematics, Open University, Milton Keynes, United Kingdom
| | - Sigrun Lange
- Tissue Architecture and Regeneration Research Group, School of Life Sciences, University of Westminster, London, United Kingdom
| | - Bradley T Elliott
- Translational Physiology Research Group, School of Life Sciences, University of Westminster, London, United Kingdom
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19
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Haake S, Heller B, Schneider P, Smith R, Green G. The influence of neighbourhood equity on parkrunners in a British city. Health Promot Int 2021; 37:6364848. [PMID: 34486666 DOI: 10.1093/heapro/daab138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Physical activity benefits both physical and mental health. Specific events may augment participation in physical activity at a population level. Parkrun is a popular, free, weekly, timed 5 km run or walk in public spaces located in five continents. However, these events may be distributed inequitably, possibly reinforcing inequities in health. As a prelude to a comprehensive analysis of a larger dataset, we explore a hypothesis that participation in parkrun is influenced by the socio-economic characteristics of both parkrunners and their park. Two parkruns, 4.5 km apart, were selected in the city of Sheffield in the United Kingdom. Defined by indices of multiple deprivation, Castle parkrun is located in an economically deprived neighbourhood and Hallam parkrun is in a prosperous area of the city. Parkrunners were defined by applying these same indices to the neighbourhood of home registration. Results: (i) the prosperous Hallam catchment area produced over five times more parkrun participants than Castle; (ii) compared with Castle, Hallam parkrun attracted more participants from both catchment areas; (iii) consequently, Hallam parkrun had seven times more participants than Castle parkrun. Conclusion: establishing parkruns in deprived areas is a necessary but not sufficient prerequisite for equity of participation in this heath promoting activity.
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Affiliation(s)
- Steve Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park, 2 Old Road. Sheffield S9 3TU, UK
| | - Ben Heller
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park, 2 Old Road. Sheffield S9 3TU, UK
| | - Paul Schneider
- School for Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
| | - Rob Smith
- School for Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK
| | - Geoff Green
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park, 2 Old Road. Sheffield S9 3TU, UK
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20
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Smith RA, Schneider PP, Cosulich R, Quirk H, Bullas AM, Haake SJ, Goyder E. Socioeconomic inequalities in distance to and participation in a community-based running and walking activity: A longitudinal ecological study of parkrun 2010 to 2019. Health Place 2021; 71:102626. [PMID: 34333371 PMCID: PMC8522482 DOI: 10.1016/j.healthplace.2021.102626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/07/2023]
Abstract
Objectives To conduct a longitudinal ecological analysis of the distance to and participation in free weekly outdoor physical activity events (parkrun) in England from 2010 to 2019, and related socioeconomic and ethnic inequalities, to inform policies to support participation in physically active community events. Methods We calculate distance to the nearest parkrun event for each English Lower Layer Super Output Area (LSOA) each month from January 2010 to December 2019. We then report the trends in distance to and participation in parkrun by Index of Multiple Deprivation quintile. We also report trends in the Relative Index of Inequality (RII) by deprivation for participation and distance to nearest event. We go on to investigate trends in LSOA level determinants (e.g. deprivation and ethnic density) of parkrun participation between 2010 and 2019, using multivariable Poisson regression models. Results Mean distance to the nearest parkrun event decreased from 34.1 km in 2010, to 4.6 km in 2019. Throughout the period, parkrun events tended to be situated closer to deprived areas compared to less deprived areas. Participation rates increased superlinearly (greater than linear increase) from 2010 to 2013 before slowing to linear growth. Participation over the period exhibits a clear socioeconomic gradient, with people from deprived areas having consistently lower participation rates over the period. parkrun participation rates became more equal between 2010 and 2013 (RII improved from 189 to 39), before stabilising at an RII between 32.9 and 39.6 from 2014 to 2019. The results of the Poisson regression model validate this finding; the coefficients on IMD score initially increased from −0.050 in 2010 to −0.038 in 2013, and then remained relatively stable to 2019 (−0.035). Conclusions Over the past 10 years, geodesic distance to the nearest parkrun decreased from a mean of 34 km to 5 km. In 2010, there was equality between the least and most deprived areas but by 2017 the distance of the most deprived areas was 29% that of the least deprived. Participation was shown to have increased over the past 10 years which can be split into two distinct phases: from 2010 to 2013 participation increased super-linearly and inequality in participation fell dramatically; from 2013 to 2019 participation increased linearly, and inequality in participation remained stable. Despite parkrun's ambitions of creating inclusive events and engaging with deprived communities, the socioeconomic gradient in participation rates remained high and stable since 2013. Gaining a better understanding of the reasons why parkrun grew so quickly may be useful for other physical activity movements, while further analysis of the relatively lower participation rates in areas with higher socioeconomic deprivation is important for developing initiatives to encourage physical activity in these communities. Geographical access to & participation in parkrun in England improved every year from 2010 to 2019. However, the rate of improvement slowed down, especially after 2013. New events reduced distance to parkrun in high deprivation areas more than low deprivation areas. Socioeconomic inequalities in participation fell from 2010 to 2013 and stabilised after.
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Affiliation(s)
- Robert A Smith
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK.
| | - Paul P Schneider
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
| | - Rami Cosulich
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
| | - Helen Quirk
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
| | - Alice M Bullas
- Sports Engineering, Sport and Physical Activity Research Centre, Sheffield Hallam University, S10 2LW, UK
| | - Steve J Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park, Sheffield, S9 3TU, UK
| | - Elizabeth Goyder
- School of Health and Related Research, 30 Regents Court, Sheffield, S1 4DA, UK
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21
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Farina N, Williams A, Clarke K, Hughes LJ, Thomas S, Lowry RG, Banerjee S. Barriers, motivators and facilitators of physical activity in people with dementia and their family carers in England: dyadic interviews. Aging Ment Health 2021; 25:1115-1124. [PMID: 32067474 DOI: 10.1080/13607863.2020.1727852] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Physical activity may have a number of physical and mental health benefits for people with dementia and their carers. However, there is limited evidence about factors that influence physical activity participation in these groups. This study therefore looks at the barriers, facilitators and motivators of physical activity in people with dementia, from both the perspective of the person with dementia and their carer. METHOD Thirty participants (15 sets of community-dwelling people with dementia and their family carers) were recruited from the South East of England. The participants took part in semi-structured dyadic interviews about their views of physical activity. Interviews were analysed using inductive thematic analysis at an individual level and comparisons were made between the groups. RESULTS Common motivator themes across persons with dementia and family carers were emotional and physical wellbeing, and social connectedness. Physical health was seen as a common barrier in both groups. Physical activity in the person with dementia was encouraged and supported by the family carer. For the carer, their caring role, and limited time acted as barriers to their participation. CONCLUSION Themes such as social connectedness, positive emotion and health were seen as key motivators to physical activity, which indicate that people with dementia and carers use physical activity as a means to maintain and improve their quality of life. Supporting family members to better facilitate such activities could encourage physical activity in people with dementia.
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Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Alice Williams
- Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Kirsty Clarke
- Global and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Laura J Hughes
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
| | - Serena Thomas
- Research and Development, Sussex Partnership NHS Foundation Trust, Hove, UK
| | - Ruth G Lowry
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
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Huikari S, Junttila H, Ala-Mursula L, Jämsä T, Korpelainen R, Miettunen J, Svento R, Korhonen M. Leisure-time physical activity is associated with socio-economic status beyond income - Cross-sectional survey of the Northern Finland Birth Cohort 1966 study. ECONOMICS AND HUMAN BIOLOGY 2021; 41:100969. [PMID: 33429255 DOI: 10.1016/j.ehb.2020.100969] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/24/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
We apply neoclassical economic modelling augmented with behavioral aspects to provide a detailed empirical investigation into indicators of socio-economic status (SES) as determinants of leisure-time physical activity. We utilize the data from the Northern Finland Birth Cohort 1966 obtained at the most recent time point during 2012-2014 (response rate 67 %), at which time the participants were approximately 46 years old. Our final study sample consists of 3,335 employed participants (1520 men, 1815 women; 32.3 % of the target population). We apply logistic regression methods for estimating how the probability of being physically active is related to various indicators of socio-economic status, taking into account physical activity at work and individual lifestyle, family- and health-related factors. Overall, our findings show that belonging to a higher socio-economic group, whether defined by income level, educational attainment, or occupational status, is associated with higher leisure-time physical activity. However, when we analyze different socio-economic groups, defined in terms of education, income and occupation, separately, we find that income is not a significant determinant of leisure-time physical activity within any of the particular SES groups. Further, we find that leisure-time physical activity is negatively associated with higher screen time (i.e., watching TV and sitting at a computer), and other aspects of unhealthy lifestyle, and positively associated with self-assessed health. In addition, we note that proxies for individual motivational factors and childhood physical activity, such as the grade point average and the grade achieved in physical education when leaving basic education, are strongly correlated with leisure-time physical activity in middle age among men, but not among women. Our results are in line with behavioral economics reasoning that social comparisons and environments affect behaviors. We emphasize the importance of considering behavioral economic factors when designing policies to promote physical activity.
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Affiliation(s)
- Sanna Huikari
- Department of Economics, Accounting and Finance, University of Oulu, P.O. Box 4600, FIN-90014, University of Oulu, Finland.
| | - Hanna Junttila
- Department of Physical Medicine and Rehabilitation, University of Oulu, P.O. Box 4600, FIN-90014, University of Oulu, Finland
| | - Leena Ala-Mursula
- Center for Life Course Health Research, P.O. Box 5000, FIN-90014, University of Oulu, Finland
| | - Timo Jämsä
- Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, FIN-90014, University of Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, FIN-90220, Oulu, Finland
| | - Raija Korpelainen
- Center for Life Course Health Research, P.O. Box 5000, FIN-90014, University of Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland; Department of Sport and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Albertinkatu 18A, P.O. Box 365, 90100, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, P.O. Box 5000, FIN-90014, University of Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Rauli Svento
- Department of Economics, Accounting and Finance, University of Oulu, P.O. Box 4600, FIN-90014, University of Oulu, Finland
| | - Marko Korhonen
- Department of Economics, Accounting and Finance, University of Oulu, P.O. Box 4600, FIN-90014, University of Oulu, Finland
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Candio P, Meads D, Hill AJ, Bojke L. Taking a local government perspective for economic evaluation of a population-level programme to promote exercise. Health Policy 2021; 125:651-657. [PMID: 33750575 DOI: 10.1016/j.healthpol.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/26/2021] [Accepted: 02/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In order to tackle the issue of physical inactivity, local governments have implemented population-level programmes to promote exercise. While evidence is accumulating on the cost-effectiveness of these interventions, studies have typically adopted a health sector perspective for economic evaluation. This approach has been challenged as it does not allow for key concerns by local governments, which are primary stakeholders, to be addressed. OBJECTIVES To show how taking a local government perspective for economic evaluation can be implemented in practice and this may affect the economic conclusions. METHODS Based on data from a case study, the health equity impact of the intervention and its opportunity cost from a service provider viewpoint were assessed. The cost-effectiveness implications of a change in perspective were subsequently estimated by means of scenario analysis. FINDINGS The intervention was found to provide adult residents living in the most deprived city areas with greater health benefits compared with the rest of the population. However, a negative net equity impact was found in the short-term. The opportunity cost of the intervention was estimated to be substantially lower than its financial cost (£2.77 per person/year), with significant implications for decision-making. CONCLUSIONS Taking a local government perspective can affect the conclusions drawn from the economic evaluation of population-level programmes to promote exercise, and therefore influence decision making.
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Affiliation(s)
- Paolo Candio
- Health Economics Research Centre, University of Oxford, 0X37LF Oxford, UK; Leeds Institute of Health Sciences, University of Leeds, LS29JT Leeds, UK.
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, LS29JT Leeds, UK
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, LS29JT Leeds, UK
| | - Laura Bojke
- Centre for Health Economics, University of York, YO105DD Heslington, UK
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Wärnberg J, Pérez-Farinós N, Benavente-Marín JC, Gómez SF, Labayen I, G. Zapico A, Gusi N, Aznar S, Alcaraz PE, González-Valeiro M, Serra-Majem L, Terrados N, Tur JA, Segú M, Lassale C, Homs C, Oses M, González-Gross M, Sánchez-Gómez J, Jiménez-Zazo F, Marín-Cascales E, Sevilla-Sánchez M, Herrera-Ramos E, Pulgar S, Bibiloni MDM, Sancho-Moron O, Schröder H, Barón-López FJ. Screen Time and Parents' Education Level Are Associated with Poor Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study. J Clin Med 2021; 10:795. [PMID: 33669366 PMCID: PMC7920265 DOI: 10.3390/jcm10040795] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/31/2021] [Accepted: 02/07/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this study is to evaluate if screen time and parents' education levels are associated with adherence to a Mediterranean dietary pattern. This cross-sectional study analyzed a representative sample of 3333 children and adolescents (8 to 16 years) included in the Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS) study in Spain (which ran from March 2019 to February 2020). Data on screen time (television, computer, video games, and mobile phone) per day, Mediterranean diet adherence, daily moderate or vigorous physical activity, and parents' education levels were gathered using questionnaires. A descriptive study of the variables according to sex and parents' education level was performed. Logistic regression models (adjusted by sex and weight status) were fitted to evaluate the independent association between screen time and Kids' level of adherence to the Mediterranean diet (KIDMED) index, as well as some of its items. A greater amount of screen time was associated with worse adherence to the Mediterranean diet; a lower consumption of fruit, vegetables, fish, legumes, and nuts; and a greater consumption of fast food, sweets, and candies. A lower parents' education level was associated with worse adherence to the Mediterranean diet. It is necessary to promote the responsible, limited use of screen time, especially in children with parents with a lower education level.
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Affiliation(s)
- Julia Wärnberg
- Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain; (J.W.); (J.C.B.-M.); (F.J.B.-L.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
| | - Napoleón Pérez-Farinós
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
- Epi-Phaan Research Group, School of Medicine, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
| | - Juan Carlos Benavente-Marín
- Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain; (J.W.); (J.C.B.-M.); (F.J.B.-L.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
| | - Santiago Felipe Gómez
- Programs, Gasol Foundation, Sant Boi de Llobregat, 08830 Barcelona, Spain; (S.F.G.); (C.H.)
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25198 Lleida, Spain
| | - Idoia Labayen
- ELIKOS Group, Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Instituto de Investigación Sanitaria de Navarra, Public University of Navarre, 31006 Pamplona, Spain; (I.L.); (M.O.)
| | - Augusto G. Zapico
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politecnica de Madrid, 28040 Madrid, Spain;
- Department of Didactics of Language, Arts and Physical Education, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (N.G.); (J.S.-G.)
| | - Susana Aznar
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45071 Toledo, Spain; (S.A.); (F.J.-Z.)
| | - Pedro Emilio Alcaraz
- Research Center for High Performance Sport, San Antonio Catholic University of Murcia, 30830 Murcia, Spain; (P.E.A.); (E.M.-C.)
- Faculty of Sport Sciences, San Antonio Catholic University of Murcia, 30107 Murcia, Spain
| | - Miguel González-Valeiro
- Faculty of Sports Sciences and Physical Education, Universidade da Coruña, 15179 A Coruña, Spain; (M.G.-V.); (M.S.-S.)
| | - Lluís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain;
| | - Nicolás Terrados
- Regional Unit of Sports Medicine–Municipal Sports Foundation of Avilés and Health Research Institute of the Principality of Asturias (ISPA), 33401 Avilés, Spain; (N.T.); (S.P.)
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
- Research Group of Community Nutrition and Oxidative Stress, University of the Balearic Islands and IDISBA, 07122 Palma de Mallorca, Spain
| | - Marta Segú
- Probitas Foundation, 08022 Barcelona, Spain; (M.S.); (O.S.-M.)
| | - Camille Lassale
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Institute for Medical Research (IMIM), 08003 Barcelona, Spain;
| | - Clara Homs
- Programs, Gasol Foundation, Sant Boi de Llobregat, 08830 Barcelona, Spain; (S.F.G.); (C.H.)
- Global Research on Wellbeing (GRoW), Blanquerna Ramon Llull University Faculty of Health Sciences, 08025 Barcelona, Spain
| | - Maddi Oses
- ELIKOS Group, Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Instituto de Investigación Sanitaria de Navarra, Public University of Navarre, 31006 Pamplona, Spain; (I.L.); (M.O.)
| | - Marcela González-Gross
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politecnica de Madrid, 28040 Madrid, Spain;
| | - Jesús Sánchez-Gómez
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain; (N.G.); (J.S.-G.)
| | - Fabio Jiménez-Zazo
- PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha-Toledo Campus, 45071 Toledo, Spain; (S.A.); (F.J.-Z.)
| | - Elena Marín-Cascales
- Research Center for High Performance Sport, San Antonio Catholic University of Murcia, 30830 Murcia, Spain; (P.E.A.); (E.M.-C.)
| | - Marta Sevilla-Sánchez
- Faculty of Sports Sciences and Physical Education, Universidade da Coruña, 15179 A Coruña, Spain; (M.G.-V.); (M.S.-S.)
| | - Estefanía Herrera-Ramos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain;
| | - Susana Pulgar
- Regional Unit of Sports Medicine–Municipal Sports Foundation of Avilés and Health Research Institute of the Principality of Asturias (ISPA), 33401 Avilés, Spain; (N.T.); (S.P.)
| | - María del Mar Bibiloni
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
- Research Group of Community Nutrition and Oxidative Stress, University of the Balearic Islands and IDISBA, 07122 Palma de Mallorca, Spain
| | | | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Institute for Medical Research (IMIM), 08003 Barcelona, Spain;
- Centro de Investigación Biomédica en Red Fisiopatología de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
| | - F. Javier Barón-López
- Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain; (J.W.); (J.C.B.-M.); (F.J.B.-L.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain; (L.S.-M.); (J.A.T.); (C.L.); (M.G.-G.); (M.d.M.B.)
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Shang X, Peng W, Wu J, He M, Zhang L. Leading determinants for multimorbidity in middle-aged Australian men and women: A nine-year follow-up cohort study. Prev Med 2020; 141:106260. [PMID: 33017600 DOI: 10.1016/j.ypmed.2020.106260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/14/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023]
Abstract
Although socioeconomic, behavioural, psychological, and biological factors have been individually linked to multimorbidity, data on the importance of these factors are limited. Our study aimed to determine the leading predictors for multimorbidity of chronic conditions in middle-aged Australian adults using machine learning methods. We included 53,867 participants aged 45-64 years from the 45 and Up Study who were free of eleven predefined chronic conditions at baseline (2006-2009) in the analysis. Incident multimorbidity was defined by the co-existence of ≥2, ≥3, or ≥ 4 conditions during follow-up until December 31, 2016. The five leading predictors for multimorbidity in men were age (7.2-20.5% of total variance), body mass index (6.5-15.4%), smoking (4.0-8.3%), chicken intake (3.6-7.5%), and red meat intake (4.6-6.3%) across the three definitions. Leading predictors varied across the three definitions in women, but the four common ones were body mass index (6.3-20.1%), age (6.2-16.4%), chicken intake (4.1-8.3%), and red meat intake (4.2-4.7%). The ten leading modifiable health factors accounted for 39.4-46.1% of total variance across the three definitions. Men with 6-10 health factors had 46-54% lower risks for multimorbidity compared with those reporting ≤2. The corresponding percentage for women was 45-52%. Non-behavioural factors including psychological distress, low education and income and high relative economic disadvantage were among the leading risk factors for multimorbidity. In conclusion, modifications on behavioural factors including diets, physical activity, smoking, alcohol consumption may reduce the risk of multimorbidity in middle-aged adults, whereas individuals with low socioeconomic status or psychological distress are at the highest priority for intervention.
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Affiliation(s)
- Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; School of Behavioural and Health Sciences, Australian Catholic University, Australia; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Australia
| | - Wei Peng
- Research Centre for Data Analytics and Cognition, La Trobe University, Melbourne, Australia
| | - Jinrong Wu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; State Key Laboratory of Ophthalmology, National Clinical Research Center, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health, Science Center, Xi'an, Shaanxi, China; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia; Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China..
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26
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Schneider PP, Smith RA, Bullas AM, Quirk H, Bayley T, Haake SJ, Brennan A, Goyder E. Multiple deprivation and geographic distance to community physical activity events - achieving equitable access to parkrun in England. Public Health 2020; 189:48-53. [PMID: 33157459 PMCID: PMC7762722 DOI: 10.1016/j.puhe.2020.09.002] [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: 05/31/2020] [Revised: 08/25/2020] [Accepted: 09/04/2020] [Indexed: 11/15/2022]
Abstract
Objectives To evaluate geographic access to free weekly outdoor physical activity events (‘parkrun’) in England, with a particular focus on deprived communities, and to identify optimal locations for future events to further maximise access. Study design This study is a cross-sectional ecological analysis of the socio-economic disparities in geographic access to parkrun events in England in late 2018. Methods We combined geolocation data on all English Lower Layer Super Output Areas and parkrun events to calculate geodesic distances to the nearest event for more than 32,000 communities in England. We use this measure of geographic access to summarise the relationship between access and socio-economic deprivation, measured using the index of multiple deprivation. We then used geographic coordinates of public green spaces in England to conduct a simple location-allocation analysis to identify 200 locations for future event locations that would maximise access. Results In England, 69% of the population live within 5 km of one of the 465 parkrun events. There is a small negative correlation between distance and deprivation, indicating that access is slightly better in more socio-economically deprived areas. Setting up an additional 200 events in optimal locations would improve access: the average distance to the nearest parkrun event would improve by 1.22 km, from 4.65 km to 3.43 km, and approximately 82% of the English population would live within 5 km of a parkrun event. Conclusion Over two-thirds of the English population live within 5 km of a parkrun event, and contrary to our expectation, we find that geographic access is slightly better for those living in more deprived communities. Creating additional events may improve geographic access, but effective strategies will still be needed to increase engagement in new and existing events by those living in socio-economically deprived areas. Parkrun in a grass-roots movement that organises free weekly 5 km running and walking events. In England, the median distance to the nearest parkrun event was 3.4 km; 69% of the population lived within 5 km of an event. Access showed no negative socio-economic gradient. In fact, people in deprived communities had better geographic access. Sport England provided funding to set up 200 new events. We identified optimal locations, to further maximise public access.
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Affiliation(s)
- P P Schneider
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - R A Smith
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - A M Bullas
- Centre for Sports Engineering Research, Sheffield Hallam University, Sheffield, UK
| | - H Quirk
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - T Bayley
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - S J Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - A Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E Goyder
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Shang X, Peng W, Hill E, Szoeke C, He M, Zhang L. Incidence, Progression, and Patterns of Multimorbidity in Community-Dwelling Middle-Aged Men and Women. Front Public Health 2020; 8:404. [PMID: 33014956 PMCID: PMC7461897 DOI: 10.3389/fpubh.2020.00404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Determining the incidence, progression, and patterns of multimorbidity are important for the prevention, management, and treatment of concurrence of multiple conditions. This study aimed to analyze major multimorbidity patterns and the association of the onset of a primary condition or combinations of a primary and a secondary condition with the progression to subsequent conditions. Methods: We included 53,867 participants aged 45-64 years from the 45 and Up Study who were free of 10 predefined chronic conditions at baseline (2006-2009). The incidence of multimorbidity (coexistence of ≥2, ≥3, and ≥4 conditions) was identified using the claims database until December 31, 2016. The primary, secondary, tertiary, and quaternary condition for each participant was defined according to its temporal order of onset. Results: During a mean 9-years follow-up, the cumulative incidence of primary, secondary, tertiary, and quaternary conditions was 49.6, 23.7, 9.0, and 2.9%, respectively. The time to develop a subsequent condition decreased with the accumulation of conditions (P < 0.0001). Two concurrent cardiometabolic disorders (CMDs, 30.4%) and CMDs clustered with musculoskeletal disorders (15.2%), mental disorders (13.5%), asthma (12.0%), or cancer (8.7%) were the five most common multimorbidity patterns. CMDs tended to occur prior to mental or musculoskeletal disorders but after the onset of cancers or asthma. Compared with all participants who developed cancer as a primary condition, individuals who experienced mental disorders/neurodegenerative disorders and a comorbidity as cardiovascular disease, hypertension, dyslipidemia, diabetes, asthma, or osteoarthritis were 3.36-10.87 times more likely to develop cancer as a tertiary condition. Individuals with neurodegenerative disorders and a comorbidity as hypertension, dyslipidemia, osteoarthritis, or asthma were 5.14-14.15 times more likely to develop mental disorders as a tertiary condition. Conclusions: A high incidence of multimorbidity in middle-aged adults was observed and CMDs were most commonly seen in multimorbidity patterns. There may be accelerated aging after a primary condition occurs. Our findings also reveal a potential preventative window to obviate the development of secondary or tertiary conditions.
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Affiliation(s)
- Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.,Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC, Australia
| | - Wei Peng
- Research Centre for Data Analytics and Cognition, La Trobe University, Melbourne, VIC, Australia
| | - Edward Hill
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC, Australia.,Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Cassandra Szoeke
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC, Australia
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.,China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC, Australia
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Cholerton R, Breckon J, Butt J, Quirk H. Experiences Influencing Walking Football Initiation in 55- to 75-Year-Old Adults: A Qualitative Study. J Aging Phys Act 2020; 28:521-533. [PMID: 31825889 DOI: 10.1123/japa.2019-0123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 11/18/2022]
Abstract
Adults aged 55 and older are least likely to play sport. Despite research suggesting this population experiences physical and psychological benefits when doing so, limited research focuses on older adult sport initiation, especially in "adapted sports" such as walking football. The aim of this study was to explore initiation experiences of walking football players between 55 and 75 years old. Semistructured interviews took place with 17 older adults playing walking football for 6 months minimum (Mage = 64). Inductive analysis revealed six higher order themes representing preinitiation influences. Eight further higher order themes were found, relating to positive and negative experiences during initiation. Fundamental influences preinitiation included previous sporting experiences and values and perceptions. Emergent positive experiences during initiation included mental development and social connections. Findings highlight important individual and social influences when initiating walking football, which should be considered when encouraging 55- to 75-year-old adults to play adapted sport. Policy and practice recommendations are discussed.
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Shang X, Hodge AM, Peng W, He M, Zhang L. Are Leading Risk Factors for Cancer and Mental Disorders Multimorbidity Shared by These Two Individual Conditions in Community-Dwelling Middle-Aged Adults? Cancers (Basel) 2020; 12:E1700. [PMID: 32604790 PMCID: PMC7352661 DOI: 10.3390/cancers12061700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/27/2022] Open
Abstract
Data on the leading shared risk factors of cancer and mental disorders are limited. We included 98,958 participants (54.8% women) aged 45-64 years from the 45 and Up Study who were free of cancer, depression, and anxiety at baseline (2006-2009). The incidence of cancer, mental disorders, and multimorbidity (concurrent cancer and mental disorders) was identified using claim databases during follow-up until 31 December 2016. During a nine-year follow-up, the cumulative incidence of cancer, mental disorders, and multimorbidity was 8.8%, 17.4%, and 2.2%, respectively. Participants with cancer were 3.41 times more likely to develop mental disorders, while individuals with mental disorders were 3.06 times more likely to develop cancer than people without these conditions. The shared risk factors for cancer and mental disorders were older age, female gender, smoking, psychological distress, low fruit intake, poor/fair self-rated health, hypertension, arthritis, asthma, and diabetes. Low education, low income, overweight/obesity, and family history of depression were risk factors for mental disorders and multimorbidity but not cancer. In conclusion, smoking, low fruit intake, and obesity are key modifiable factors for the prevention of cancer and mental disorders. Individuals with poor/fair self-rated health, high psychological distress, asthma, hypertension, arthritis, or diabetes should be targeted for the prevention and screening of cancer and mental disorders.
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Affiliation(s)
- Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia;
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC 3002, Australia
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC 3050, Australia
| | - Allison M. Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC 3004, Australia;
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Wei Peng
- Research Centre for Data Analytics and Cognition, La Trobe University, Melbourne, VIC 3083, Australia;
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia;
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC 3002, Australia
- State Key Laboratory of Ophthalmology, National Clinical Research Center, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC 3002, Australia;
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 760061, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia
- School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University, Melbourne, VIC 3004, Australia
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Fluharty ME, Pinto Pereira SM, Benzeval M, Hamer M, Jefferis B, Griffiths LJ, Cooper R, Bann D. Educational differentials in key domains of physical activity by ethnicity, age and sex: a cross-sectional study of over 40 000 participants in the UK household longitudinal study (2013-2015). BMJ Open 2020; 10:e033318. [PMID: 31964672 PMCID: PMC7045199 DOI: 10.1136/bmjopen-2019-033318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/06/2019] [Accepted: 12/31/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess whether educational differentials in three key physical activity (PA) domains vary by age, sex and ethnicity. DESIGN National cross-sectional survey. SETTING UK. PARTICIPANTS Altogether 40 270 participants, aged 20 years and over, from the UK Household Longitudinal Study with information on education, PA and demographics collected in 2013-2015. OUTCOME MEASURES Participation in active travel (AT), occupational activity (OA) and leisure time physical activity (LTPA) at the time of assessment. RESULTS Lower educational attainment was associated with higher AT and OA, but lower weekly LTPA activity; these associations were modified by sex, ethnicity and age. Education-related differences in AT were larger for women-the difference in predicted probability of activity between the highest and the lowest education groups was -10% in women (95% CI: -11.9% to 7.9%) and -3% in men (-4.8% to -0.4%). Education-related differences in OA were larger among men -35% (-36.9% to -32.4%) than women -17% (-19.4% to -15.0%). Finally, education-related differences in moderate-to-vigorous LTPA varied by ethnicity; for example, differences were 17% (16.2% to 18.7%) for white individuals compared with 6% (0.6% to 11.6%) for black individuals. CONCLUSIONS Educational differences in PA vary by domain and are modified by age, sex and ethnicity. A better understanding of physically inactive subgroups may aid development of interventions to both increase activity levels and reduce health inequalities.
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Affiliation(s)
- Meg E Fluharty
- Centre for Longitudinal Studies, University College London, London, UK
| | - Snehal M Pinto Pereira
- UCL Research Department of Epidemiology & Public Health, University College London Institute of Child Health, London, UK
| | - Michaela Benzeval
- Institute for Social and Economic Research, University of Essex, Colchester, UK
| | - Mark Hamer
- Division of Surgery & Interventional Science, University College London, London, UK
| | - Barbara Jefferis
- Department of Primary Care and Population Health, University College London, London, UK
| | - Lucy J Griffiths
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, Swansea, UK
| | - Rachel Cooper
- Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - David Bann
- Centre for Longitudinal Studies, University College London, London, UK
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Shang X, Wang W, Keel S, Wu J, He M, Zhang L. Leading Determinants for Disease-Free Status in Community-Dwelling Middle-Aged Men and Women: A 9-Year Follow-Up Cohort Study. Front Public Health 2019; 7:320. [PMID: 31781526 PMCID: PMC6857185 DOI: 10.3389/fpubh.2019.00320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/17/2019] [Indexed: 01/10/2023] Open
Abstract
Background: Identifying leading determinants for disease-free status may provide evidence for action priorities, which is imperative for public health with an expanding aged population worldwide. This study aimed to identify leading determinants, especially modifiable factors for disease-free status using machine learning methods. Methods: We included 52,036 participants aged 45–64 years from the 45 and Up Study who were free of 13 predefined chronic conditions at baseline (2006–2009). Disease-free status was defined as participants aging from 45–64 years at baseline to 55–75 years at the end of the follow-up (December 31, 2016) without developing any of the 13 chronic conditions. We used machine learning methods to evaluate the importance of 40 potential predictors and analyzed the association between the number of leading modifiable healthy factors and disease-free status. Results: Disease-free status was found in about half of both men and women during a mean 9-year follow-up. The five most common leading predictors were body mass index (6.4–9.5% of total variance), self-rated health (5.2–8.2%), self-rated quality of life (4.1–6.8%), red meat intake (4.5–6.5%), and chicken intake (4.5–5.9%) in both genders. Modifiable behavioral factors including body mass index, diets, smoking, alcohol consumption, and physical activity, contributed to 37.2–40.3% of total variance. Participants having six or more modifiable health factors were 1.63–8.76 times more likely to remain disease-free status and had 0.60–2.49 more disease-free years (out of 9-year follow-up) than those having two or fewer. Non-behavioral factors including low levels of education and income and high relative socioeconomic disadvantage, were leading risk factors for disease-free status. Conclusions: Body mass index, diets, smoking, alcohol consumption, and physical activity are key factors for disease-free status promotion. Individuals with low socioeconomic status are more in need of care.
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Affiliation(s)
- Xianwen Shang
- Department of Surgery, Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.,Department of Medicine-Royal Melbourne Hospital, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Stuart Keel
- Department of Surgery, Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Jinrong Wu
- Department of Surgery, Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Mingguang He
- Department of Surgery, Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Zhang
- Department of Surgery, Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.,Faculty of Medicine, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China.,China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
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Shang X, Peng W, Hill E, Szoeke C, He M, Zhang L. Incidence of Medication-Treated Depression and Anxiety Associated with Long-Term Cancer, Cardiovascular Disease, Diabetes and Osteoarthritis in Community-dwelling Women and Men. EClinicalMedicine 2019; 15:23-32. [PMID: 31709411 PMCID: PMC6833452 DOI: 10.1016/j.eclinm.2019.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Long-term cancer, cardiovascular disease, diabetes and osteoarthritis may increase the risk of mental disorders, but which was more harmful and whether the associations differed between genders is unclear. METHODS We included 115,094 participants (54.3% women) aged 45-64 years from the 45 and Up Study who were free of depression, anxiety, and Parkinson's disease at baseline (2006-2009). The incidence of depression and anxiety was identified using claim databases during follow-up until December 2016. Cox regression models were used to examine the association of cancer, cardiovascular disease, diabetes, and osteoarthritis at baseline with incident depression and anxiety. FINDINGS During a mean eight-year follow-up (958,785 person-year), the cumulative incidence of depression and anxiety was 12.5% and 5.9% in the healthy population. Hazard ratios ([HRs] (95% CI) versus healthy population) for incident depression associated with long-term cancer, cardiovascular disease, diabetes, and osteoarthritis were 1.19 (95% CI: 1.13-1.25), 1.08 (1.00-1.16)), 1.18 (1.09-1.28), and 1.94 (1.80-2.10), respectively. The corresponding HRs (95% CIs) for incident anxiety were 1.11 (1.03-1.20), 1.26 (1.14-1.39), 1.10 (0.98-1.24), and 2.01 (1.80-2.23), respectively. The positive association between cancer and incident depression was more evident in men (HR (95% CI): 1.24 (1.13-1.35) than in women (1.14 (1.07-1.21). Long-term diabetes was an independent risk factor for incident anxiety in men (1.21 (1.02-1.44) but not in women (1.09 (0.93-1.28)). INTERPRETATION Long-term osteoarthritis, cardiovascular disease, and cancer were independent risk factors for incident depression and anxiety in both genders with osteoarthritis having the highest relative risk.
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Affiliation(s)
- Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Australia
| | - Wei Peng
- Research Centre for Data Analytics and Cognition, La Trobe University, Melbourne, Australia
| | - Edward Hill
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Australia
| | - Cassandra Szoeke
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Australia
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
- Correspondence to: M. He, Centre for Eye Research Australia, University of Melbourne, Level 7, 32 Gisborne Street, East Melbourne, VIC 3002, Australia.
| | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
- Correspondence to: L. Zhang, China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China.
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Sousa AS, Mendes J, Guerra RS, Padrão P, Moreira P, Santos A, Borges N, Afonso C, Martins C, Ferro G, Amaral TF. Sitting time and associated factors among Portuguese older adults: results from Nutrition UP 65. Eur J Ageing 2019; 17:321-330. [PMID: 32904787 DOI: 10.1007/s10433-019-00532-y] [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: 12/31/2022] Open
Abstract
Older adults are particularly susceptible to sedentary behaviours. Sitting time has been increasingly referred to as a potentially modifiable risk factor in the prevention of chronic diseases. Identifying factors associated with sitting time, particularly those that are modifiable, will allow for more effective public health strategies. This study aimed to describe sitting time among Portuguese older adults and to evaluate associated factors. A cross-sectional study including 1423 older adults ≥ 65 years old was conducted. Sitting time was assessed with the International Physical Activity Questionnaire. Socio-demographic, health, anthropometric and functional variables were collected. Bivariate and multivariate linear regression models were conducted to study the association between these variables and sitting time. The median of sitting time was 300 min/day (interquartile range = 240 min/day), which is equal to 5 h/day. The following factors were directly associated with longer sitting time: being male, age ≥ 80 years, living in Central or Southern Portugal, being retired from work, as well as presenting low physical activity, obesity or longer time to walk 4.6 metres. On the other hand, being married, having higher education and higher household income were inversely associated with longer sitting time. It can be concluded that Portuguese older adults spend a considerable amount of time sitting per day. Potentially modifiable risk factors associated with longer sitting time in this population were related to nutritional status and functional ability.
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Affiliation(s)
- Ana Sofia Sousa
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Faculty of Health Sciences (Nutrition Sciences), Fernando Pessoa University, Praça de 9 de Abril 349, 4249-004 Porto, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, IP Leiria, Rua General Norton de Matos, Apartado 4133, 2411-901 Leiria, Portugal
| | - Joana Mendes
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Rita S Guerra
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,Faculty of Health Sciences (Nutrition Sciences), Fernando Pessoa University, Praça de 9 de Abril 349, 4249-004 Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal.,The Research Centre in Physical Activity, Health and Leisure, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - Alejandro Santos
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,I3S - Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Nuno Borges
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Cátia Martins
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Graça Ferro
- Alto Minho Local Health Unit, EPE, Estrada de Santa Luzia, 4904-858 Viana do Castelo, Portugal
| | - Teresa F Amaral
- Faculty of Nutrition and Food Science, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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Do Birds of a Feather Flock Together Within a Team-Based Physical Activity Intervention? A Social Network Analysis. J Phys Act Health 2019; 16:745-751. [PMID: 31319396 DOI: 10.1123/jpah.2018-0585] [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] [Received: 10/09/2018] [Revised: 04/10/2019] [Accepted: 05/12/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Homophily is the tendency to associate with friends similar to ourselves. This study explored the effects of homophily on team formation in a physical activity challenge in which "captains" signed up their Facebook friends to form teams. METHODS This study assessed whether participants (n = 430) were more similar to their teammates than to nonteammates with regard to age, sex, education level, body mass index, self-reported and objectively measured physical activity, and negative emotional states; and whether captains were more similar to their own teammates than to nonteammates. Variability indices were calculated for each team, and a hypothetical variability index, representing that which would result from randomly assembled teams, was also calculated. RESULTS Within-team variability was less than that for random teams for all outcomes except education level and depression, with differences (SDs) ranging from +0.15 (self-reported physical activity) to +0.47 (age) (P < .001 to P = .001). Captains were similar to their teammates except in regard to age, with captains being 2.6 years younger (P = .003). CONCLUSIONS Results support hypotheses that self-selected teams are likely to contain individuals with similar characteristics, highlighting potential to leverage team-based health interventions to target specific populations by instructing individuals with risk characteristics to form teams to help change behavior.
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Byrne L, Ogden K, Lee S, Ahuja K, Watson G, Bauman A, Fell J. Mixed-method evaluation of a community-wide physical activity program in Launceston, Australia. Health Promot J Austr 2019; 30 Suppl 1:104-115. [PMID: 30869810 DOI: 10.1002/hpja.241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 02/25/2019] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Physical inactivity is a leading risk factor for disease burden and premature mortality. Interventions to increase physical activity are common, though few examples of multi-strategy, wide-scale community programs exist. Active Launceston is a community-wide program aimed at improving health and well-being through physical activity. We report on the process evaluation of Active Launceston and changes in community physical activity participation between 2008 and 2015, as a measure of program effectiveness. METHODS Mixed-method evaluation of Active Launceston combined process evaluation-consisting of participant numbers, socio-demographic characteristics, campaign awareness, focus groups and stakeholder interviews-with impact evaluation consisting of a random-sample cross-sectional serial telephone survey. RESULTS Active Launceston attracted 11 887 attendees, participating in 30 342 sessions, amounting to 38 088 hours of physical activity between 2008 and 2015. Participant focus groups highlighted benefits including increased engagement in exercise, better health and social connectedness. While telephone surveys found the proportion of people participating in any physical activity in the last 12 months to be similar between the 3 years (2008, 77.7%; 2012, 77.1%; 2015, 73.6%), a higher proportion participated in vigorous physical activity in 2012 and 2015 compared to 2008 (P < 0.01), when adjusting for age and gender differences. A higher proportion also achieved sufficient activity for health in 2015 compared to 2008 (P = 0.01). CONCLUSIONS Mixed-method evaluation suggests Active Launceston is an effective community-wide program supporting community members to engage in regular physical activity and increase levels of social engagement. SO WHAT?: This work provides a model for implementing high-reach, community-wide interventions that improve physical activity outcomes.
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Affiliation(s)
- Lucy Byrne
- University of Tasmania, Launceston, TAS, Australia
| | | | - Simone Lee
- University of Tasmania, Launceston, TAS, Australia
| | - Kiran Ahuja
- University of Tasmania, Launceston, TAS, Australia
| | - Greig Watson
- University of Tasmania, Launceston, TAS, Australia
| | | | - James Fell
- University of Tasmania, Launceston, TAS, Australia
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36
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Using Photovoice to Examine Physical Activity in the Urban Context and Generate Policy Recommendations: The Heart Healthy Hoods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050749. [PMID: 30832269 PMCID: PMC6427388 DOI: 10.3390/ijerph16050749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 12/27/2022]
Abstract
A current challenge in physical activity research is engaging citizens with co-creating policies that support physical activity participation. Using Photovoice, a participatory action research method, the objectives of this study were to: 1) Identify community perceptions of urban built, social, and political/economic environment factors associated with physical activity; and 2) generate community-driven policy recommendations to increase physical activity. Two districts in Madrid of varying socio-economic status (SES) were selected. Overall, 24 residents participated in 4 groups stratified by sex and district (6 participants per group). Groups met weekly for 4 weeks to discuss and analyze their photographs. Participants coded photographs into categories, which were then regrouped into broader themes. The categories were transformed into policy recommendations using an adaptation of the logical framework approach. Participants took 161 photos, which were classified into 61 categories and 14 broader themes (e.g., active transportation, sport in the city). After this, participants generated a set of 34 policy recommendations to improve the urban environment to support physical activity (e.g., to redistribute sports facilities). Collaboration between citizens and researchers led to a deeper understanding of the community perceptions of urban built, social, and political/economic environment factors associated with physical activity in two districts of Madrid, while engaging citizens in recommending public policies.
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Service Evaluation of an Exercise on Referral Scheme for Adults with Existing Health Conditions in the United Kingdom. Int J Behav Med 2019; 25:304-311. [PMID: 29143251 DOI: 10.1007/s12529-017-9699-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This paper outlines a service evaluation of an exercise referral scheme for adults suffering from a variety of physical or mental health conditions or who were deemed are at risk of developing such conditions. The evaluation aimed to assess the impact of the scheme at increasing physical activity and at reducing BMI and waist circumference. METHOD This was a retrospective evaluation looking at levels of physical activity and changes to anthropometric measures over a period of 6 months. Each participant self-reported their levels of physical activity for the previous 7 days at three time points: baseline (T1), at 12-week exit from the scheme (T2), and at 6-month follow-up (T3). Waist circumference and BMI were also recorded by either a health professional or self-reported at these time points. RESULTS Six hundred seventy participants were referred during the evaluation period, of whom 494 were eligible. Of those 494, 211 completed the 12-week scheme and 135 completed a 6-month follow-up. Significant increases in levels of physical activity were recorded between T1 and T2 and between T1 and T3. Furthermore, significant reductions in waist circumference were noted between T1 and T2 and between T1 and T3, and BMI significantly decreased between T1 and T2 but significantly increased between T2 and T3. CONCLUSION The service has proven effective at increasing levels of physical activity among participants and has had a positive impact on waist circumference and body for clients who remain engaged with the programme.
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Work environment mediates a large part of social inequalities in the incidence of several common cardiovascular risk factors: Findings from the Gazel cohort. Soc Sci Med 2018; 216:59-66. [DOI: 10.1016/j.socscimed.2018.09.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 01/10/2023]
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de Jong LD, Peters AD, Gawler S, Chalmers N, Henderson C, Hooper J, Laventure R, McLean L, Skelton DA. The appeal of the Functional Fitness MOT to older adults and health professionals in an outpatient setting: a mixed-method feasibility study. Clin Interv Aging 2018; 13:1815-1829. [PMID: 30275688 PMCID: PMC6156115 DOI: 10.2147/cia.s173481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To understand the views and perceptions regarding the Functional Fitness MOT (FFMOT), a battery of functional tests followed by a brief motivational interview, of both the older people undergoing it and the health professionals delivering it. Patients and methods Physically inactive older adults (n=29) underwent the FFMOT and subsequently attended focus groups to share their perceptions of it and to discuss the barriers, motivators, health behavior change, and scope to improve physical activity (PA) levels. PA levels were recorded at baseline and again at 12 weeks together with a post-intervention questionnaire concerning behavior change. Participating physiotherapists and technical instructors were interviewed. Results Most participants felt they had learned about their abilities and comparisons with their peers, had a change in perception about the importance of good balance and strength, and felt the FFMOT helped raise their awareness of local and self-directed physical activity opportunities. Most felt their awareness of the need for PA had not changed, but 25% of participants started a new organized PA opportunity. The health professionals perceived the FFMOT as being easy to administer, educating, and motivating for participants to increase their PA. Space, time, finances, and insecurity about having the necessary skills to conduct the FFMOTs were seen as barriers in implementing the FFMOT in daily practice. Conclusion Over half of those offered the FFMOT accepted it, suggesting it is appealing. However, most participants felt they were already active enough and that their awareness of the need for PA had not changed. There were positive perceptions of the FFMOT from both professionals and older people, but both felt the FFMOT could be held in a community venue. The overall findings suggest that the FFMOT is feasible in the clinical setting, but its effectiveness has yet to be determined.
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Affiliation(s)
- Lex D de Jong
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK, .,School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Andy D Peters
- Delivering Better Care Hub, Western General Hospital, Edinburgh, UK
| | - Sheena Gawler
- Research Department of Primary Care and Population Health, University College London, London, UK.,Later Life Training Ltd, Killin, UK,
| | - Nina Chalmers
- Edinburgh Community Physiotherapy Service, Edinburgh, UK
| | | | - Julie Hooper
- Edinburgh Community Physiotherapy Service, Edinburgh, UK
| | - Robert Laventure
- Later Life Training Ltd, Killin, UK, .,British Heart Foundation National Centre for Physical Activity and Health, Loughborough, UK
| | - Laura McLean
- Edinburgh Community Physiotherapy Service, Edinburgh, UK
| | - Dawn A Skelton
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK, .,Later Life Training Ltd, Killin, UK,
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Koohsari MJ, Nakaya T, Oka K. Activity-Friendly Built Environments in a Super-Aged Society, Japan: Current Challenges and toward a Research Agenda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092054. [PMID: 30235862 PMCID: PMC6163734 DOI: 10.3390/ijerph15092054] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 11/17/2022]
Abstract
There is a growing recognition of the role of built environment attributes, such as streets, shops, greenways, parks, and public transportation stations, in supporting people’s active behaviors. In particular, surrounding built environments may have an important role in supporting healthy active aging. Nevertheless, little is known about how built environments may influence active lifestyles in “super-aged societies”. More robust evidence-based research is needed to identify how where people live influences their active behaviors, and how to build beneficial space in the context of super-aged societies. This evidence will also be informative for the broader international context, where having an aging society will be the inevitable future. This commentary sought to move this research agenda forward by identifying key research issues and challenges in examining the role of built environment attributes on active behaviors in Japan, which is experiencing the longest healthy life expectancy, but rapid “super-aging”, with the highest proportion of old adults among its population in the world.
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Affiliation(s)
- Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan.
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Australia.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia.
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai City 980-0845, Japan.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan.
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Mondor L, Cohen D, Khan AI, Wodchis WP. Income inequalities in multimorbidity prevalence in Ontario, Canada: a decomposition analysis of linked survey and health administrative data. Int J Equity Health 2018. [PMID: 29941034 DOI: 10.1186/s12939‐018‐0800‐6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The burden of multimorbidity is a growing clinical and health system problem that is known to be associated with socioeconomic status, yet our understanding of the underlying determinants of inequalities in multimorbidity and longitudinal trends in measured disparities remains limited. METHODS We included all adult respondents from four cycles of the Canadian Community Health Survey (CCHS) (between 2005 to 2011/12), linked at the individual-level to health administrative data in Ontario, Canada (pooled n = 113,627). Multimorbidity was defined at each survey response as having ≥2 (of 17) high impact chronic conditions, based on claims data. Using a decomposition method of the Erreygers-corrected concentration index (CErreygers), we measured household income inequality and the contribution of the key determinants of multimorbidity (including socio-demographic, socio-economic, lifestyle and health system factors) to these disparities. Differences over time are described. We tested for statistically significant changes to measured inequality using the slope index (SII) and relative index of inequality (RII) with a 2-way interaction on pooled data. RESULTS Multimorbidity prevalence in 2011/12 was 33.5% and the CErreygers was - 0.085 (CI: -0.108 to - 0.062), indicating a greater prevalence among lower income groups. In decomposition analyses, income itself accounted more than two-thirds (69%) of this inequality. Age (21.7%), marital status (15.2%) and physical inactivity (10.9%) followed, and the contribution of these factors increased from baseline (2005 CCHS survey) with the exception of age. Other lifestyle factors, including heavy smoking and obesity, had minimal contribution to measured inequality (1.8 and 0.4% respectively). Tests for trends (SII/RII) across pooled survey data were not statistically significant (p = 0.443 and 0.405, respectively), indicating no change in inequalities in multimorbidity prevalence over the study period. CONCLUSIONS A pro-rich income gap in multimorbidity has persisted in Ontario from 2005 to 2011/12. These empirical findings suggest that to advance equality in multimorbidity prevalence, policymakers should target chronic disease prevention and control strategies focused on older adults, non-married persons and those that are physically inactive, in addition to addressing income disparities directly.
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Affiliation(s)
- Luke Mondor
- Institute for Clinical Evaluative Sciences (ICES), G1 06 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.,Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON, M5T 3M6, Canada
| | - Deborah Cohen
- Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON, M5T 3M6, Canada.,School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G Z53, Canada
| | - Anum Irfan Khan
- Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON, M5T 3M6, Canada.,Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON, M5T 3M6, Canada
| | - Walter P Wodchis
- Institute for Clinical Evaluative Sciences (ICES), G1 06 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada. .,Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON, M5T 3M6, Canada. .,Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON, M5T 3M6, Canada. .,Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada.
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Mondor L, Cohen D, Khan AI, Wodchis WP. Income inequalities in multimorbidity prevalence in Ontario, Canada: a decomposition analysis of linked survey and health administrative data. Int J Equity Health 2018; 17:90. [PMID: 29941034 PMCID: PMC6019796 DOI: 10.1186/s12939-018-0800-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/11/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The burden of multimorbidity is a growing clinical and health system problem that is known to be associated with socioeconomic status, yet our understanding of the underlying determinants of inequalities in multimorbidity and longitudinal trends in measured disparities remains limited. METHODS We included all adult respondents from four cycles of the Canadian Community Health Survey (CCHS) (between 2005 to 2011/12), linked at the individual-level to health administrative data in Ontario, Canada (pooled n = 113,627). Multimorbidity was defined at each survey response as having ≥2 (of 17) high impact chronic conditions, based on claims data. Using a decomposition method of the Erreygers-corrected concentration index (CErreygers), we measured household income inequality and the contribution of the key determinants of multimorbidity (including socio-demographic, socio-economic, lifestyle and health system factors) to these disparities. Differences over time are described. We tested for statistically significant changes to measured inequality using the slope index (SII) and relative index of inequality (RII) with a 2-way interaction on pooled data. RESULTS Multimorbidity prevalence in 2011/12 was 33.5% and the CErreygers was - 0.085 (CI: -0.108 to - 0.062), indicating a greater prevalence among lower income groups. In decomposition analyses, income itself accounted more than two-thirds (69%) of this inequality. Age (21.7%), marital status (15.2%) and physical inactivity (10.9%) followed, and the contribution of these factors increased from baseline (2005 CCHS survey) with the exception of age. Other lifestyle factors, including heavy smoking and obesity, had minimal contribution to measured inequality (1.8 and 0.4% respectively). Tests for trends (SII/RII) across pooled survey data were not statistically significant (p = 0.443 and 0.405, respectively), indicating no change in inequalities in multimorbidity prevalence over the study period. CONCLUSIONS A pro-rich income gap in multimorbidity has persisted in Ontario from 2005 to 2011/12. These empirical findings suggest that to advance equality in multimorbidity prevalence, policymakers should target chronic disease prevention and control strategies focused on older adults, non-married persons and those that are physically inactive, in addition to addressing income disparities directly.
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Affiliation(s)
- Luke Mondor
- Institute for Clinical Evaluative Sciences (ICES), G1 06 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
- Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Deborah Cohen
- Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON M5T 3M6 Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G Z53 Canada
| | - Anum Irfan Khan
- Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON M5T 3M6 Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Walter P. Wodchis
- Institute for Clinical Evaluative Sciences (ICES), G1 06 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
- Health System Performance Research Network (HSPRN), 155 College St 4th Floor, Toronto, ON M5T 3M6 Canada
- Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6 Canada
- Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, ON L5B 1B8 Canada
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Kapteyn A, Banks J, Hamer M, Smith JP, Steptoe A, van Soest A, Koster A, Htay Wah S. What they say and what they do: comparing physical activity across the USA, England and the Netherlands. J Epidemiol Community Health 2018; 72:471-476. [PMID: 29643112 PMCID: PMC5969391 DOI: 10.1136/jech-2017-209703] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 01/06/2018] [Accepted: 01/10/2018] [Indexed: 11/05/2022]
Abstract
Background Physical activity (PA) is important for maintaining health, but there are fundamental unanswered questions on how best it should be measured. Methods We measured PA in the Netherlands (n=748), the USA (n=540) and England (n=254), both by a 7 day wrist-worn accelerometer and by self-reports. The self-reports included a global self-report on PA and a report on the frequency of vigorous, moderate and mild activity. Results The self-reported data showed only minor differences across countries and across groups within countries (such as different age groups or working vs non-working respondents). The accelerometer data, however, showed large differences; the Dutch and English appeared to be much more physically active than Americans h (For instance, among respondents aged 50 years or older 38% of Americans are in the lowest activity quintile of the Dutch distribution). In addition, accelerometer data showed a sharp decline of PA with age, while no such pattern was observed in self-reports. The differences between objective measures and self-reports occurred for both types of self-reports. Conclusion It is clear that self-reports and objective measures tell vastly different stories, suggesting that across countries people use different response scales when answering questions about how physically active they are.
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Affiliation(s)
- Arie Kapteyn
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
| | - James Banks
- University of Manchester and Institute for Fiscal Studies, London, UK
| | - Mark Hamer
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Andrew Steptoe
- Department of Epidemiology, University College London, London, UK
| | - Arthur van Soest
- Department of Econometrics, Tilburg University, Tilburg, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Saw Htay Wah
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA
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Høgsbro C, Davidsen M, Sørensen J. Long-term sickness absence from work due to physical inactivity: A registry-based study. Scand J Public Health 2018; 46:306-313. [PMID: 29366394 DOI: 10.1177/1403494817751328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim of this study was to explore the relationship between leisure-time physical inactivity and long-term sickness absence in a representative sample of individuals aged 16-54 years, within the labour market and in good health. It was hypothesised that physically inactive individuals have a higher risk of long-term sickness absence and longer duration of sickness absence. METHODS The study population was identified from the National Health and Morbidity Survey, 2010. Weekly data on long-term sickness absence were obtained from the National Register on Social Transfer Payments (the DREAM registry). The association of incidence and duration of long-term sickness absence with physical inactivity was explored using logistic and Poisson regression. Data were fitted to models with levels of physical activity, demographic, social and lifestyle characteristics as independent variables. A combined hurdle model was used to estimate the difference in mean number of absence weeks. RESULTS Logistic regression showed that physically inactive individuals had a 27% higher incidence of long-term sickness absence compared with physically active individuals. The Poisson regression showed that long-term sickness absence was only slightly shorter (1 week less) for moderately active individuals compared with inactive individuals. The hurdle model estimated longer absence periods for inactive individuals (additional 2.5 weeks) in comparison with moderately and highly active individuals. CONCLUSIONS The study showed that physically inactive individuals have a higher incidence of long-term absence and that physically inactive individuals have longer periods with sickness absence than moderately and highly active individuals. When adjustments for social and health behaviour were included, the estimated associations became statistically insignificant.
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Affiliation(s)
- Cecilie Høgsbro
- 1 COHERE - Centre for Health Economics Research, University of Southern Denmark, Denmark
| | - Michael Davidsen
- 2 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jan Sørensen
- 1 COHERE - Centre for Health Economics Research, University of Southern Denmark, Denmark.,3 Healthcare Outcome Research Centre, Royal College of Surgeons in Ireland, Ireland
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Gullón P, Bilal U, Cebrecos A, Badland HM, Galán I, Franco M. Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project. Int J Health Geogr 2017; 16:21. [PMID: 28587623 PMCID: PMC5461703 DOI: 10.1186/s12942-017-0095-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/31/2017] [Indexed: 11/29/2022] Open
Abstract
Background Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics. Methods All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts. Results Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on. Conclusion Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas. Electronic supplementary material The online version of this article (doi:10.1186/s12942-017-0095-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro Gullón
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Usama Bilal
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA
| | - Alba Cebrecos
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - Hannah M Badland
- Center for Urban Research, RMIT University, Melbourne, 3000, VIC, Australia
| | - Iñaki Galán
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA.
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Hudson NA, Mrozik JH, White R, Northend K, Moore S, Lister K, Rayner K. Community football teams for people with intellectual disabilities in secure settings: “They take you off the ward, it was like a nice day, and then you get like medals at the end”. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:213-225. [DOI: 10.1111/jar.12359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Rose White
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
| | | | - Steve Moore
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
| | - Katherine Lister
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
| | - Kelly Rayner
- Tees, Esk and Wear Valleys NHS Foundation Trust; Middlesbrough UK
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48
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Williams O. Identifying adverse effects of area-based health policy: An ethnographic study of a deprived neighbourhood in England. Health Place 2017; 45:85-91. [DOI: 10.1016/j.healthplace.2017.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 11/30/2022]
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Gonzalo-Almorox E, Urbanos-Garrido RM. Decomposing socio-economic inequalities in leisure-time physical inactivity: the case of Spanish children. Int J Equity Health 2016; 15:106. [PMID: 27406235 PMCID: PMC4942941 DOI: 10.1186/s12939-016-0394-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical inactivity is associated with an increased risk of all-cause mortality and entails a substantial economic burden for health systems. Also, the analysis of inequality in lifestyles for young populations may contribute to reduce health inequalities during adulthood. This paper examines the income-related inequality regarding leisure-time physical inactivity in Spanish children. METHODS In this cross-sectional study based on the Spanish National Health Survey for 2011-12, concentration indices are estimated to measure socioeconomic inequalities in leisure-time physical inactivity. A decomposition analysis is performed to determine the factors that explain income-related inequalities. RESULTS There is a significant socioeconomic gradient favouring the better-off associated with leisure-time physical inactivity amongst Spanish children, which is more pronounced in the case of girls. Income shows the highest contribution to total inequality, followed by education of the head of the household. The contribution of several factors (education, place of residence, age) significantly differs by gender. CONCLUSIONS There is an important inequity in the distribution of leisure-time physical inactivity. Public policies aimed at promoting physical activity for children should prioritize the action into the most disadvantaged subgroups of the population. As the influence of determinants of health styles significantly differ by gender, this study points out the need of addressing the research on income-related inequalities in health habits from a gender perspective.
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Affiliation(s)
| | - Rosa M. Urbanos-Garrido
- />Department of Public Finance, School of Economics, Complutense University of Madrid, Campus de Somosaguas s/n, 28223 Pozuelo de Alarcón, Spain
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Flowers EP, Freeman P, Gladwell VF. A cross-sectional study examining predictors of visit frequency to local green space and the impact this has on physical activity levels. BMC Public Health 2016; 16:420. [PMID: 27207300 PMCID: PMC4875629 DOI: 10.1186/s12889-016-3050-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 04/29/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Lack of physical activity (PA) is a growing public health concern. There is a growing body of literature that suggests a positive relationship may exist between the amount of local green space near one's home and PA levels. For instance, park proximity has been shown to predict PA levels amongst certain populations. However, there is little evidence for the role of relatedness towards nature and perceptions of local green space on this relationship. The aim of this study was to examine, in a National UK sample, whether subjective indices associated with local green space were better predictors of visit frequency to local green space and PA levels compared to objectively measured quantity of local green space. METHODS A cross-sectional survey was designed. From a random sample, 2079 working age adults responded to an online survey in September 2011. Demographics, self-reported PA, objective measures of the local environment (including local green space, road coverage, and environmental deprivation), were assessed in conjunction with perceptions of local green space and nature relatedness. Quantity of local green space was assessed by cross-referencing respondents' home postcodes with general land use databases. Regression models were conducted to assess which of our independent variables best predicted visit frequency to local green space and/or meeting PA guidelines. In addition, an ordinal regression was run to examine the relationship between visit frequency to local green space and the likelihood of meeting national PA guidelines. RESULTS Nature relatedness was the strongest predictor for both visit frequency to local green space and meeting PA guidelines. Results show that perceived quality is a better predictor of visit frequency to local green space than objective quantity of local green space. The odds of achieving the recommended amount of PA was over four times greater for people who visited local green space once per week compared to never going (OR 4.151; 95 % CI, 2.40 to 7.17). CONCLUSIONS These results suggest that perceptions of local green space and nature relatedness play an important role in the relationship between local green space and PA. Considering the known health benefits of PA, our results are potentially important for public health interventions, policy making and environmental planning.
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Affiliation(s)
- Elliott P Flowers
- School of Biological Sciences, University of Essex, Colchester, CO4 3SQ, UK.
| | - Paul Freeman
- School of Biological Sciences, University of Essex, Colchester, CO4 3SQ, UK
| | - Valerie F Gladwell
- School of Biological Sciences, University of Essex, Colchester, CO4 3SQ, UK
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