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

The Role of Neighborhood Socioeconomic Status in Institutionalization of Home Health Care Patients With and Without Alzheimer's Disease and Related Dementias

OBJECTIVES

To assess whether neighborhood socioeconomic status (SES) moderates the association between Alzheimer's disease and related dementias (ADRD) and successful discharge to the community. In addition, to explore whether the role of neighborhood SES on successful discharge for patients with ADRD varies by the severity of ADRD.

DESIGN

This is a retrospective cohort study.

SETTING AND PARTICIPANTS

Medicare Fee-for-service beneficiaries, aged 65 or older, who received home health care in 2019.

METHODS

We used linear probability regression models with successful discharge to the community as the main outcome, and neighborhood SES and ADRD as independent variables. Also, we modified the Functional Assessment Staging Tool (FAST) to measure ADRD severity.

RESULTS

Our study results show ADRD and residing in neighborhoods with lower socioeconomic conditions were independently associated with lower probabilities of successful discharge to the community. We also found that the differences in probabilities of remaining at home between patients with and without ADRD were larger among those in neighborhoods with lower SES (ADRD∗less disadvantaged neighborhood, coeff: -0.01, P < .001; ADRD∗more disadvantaged neighborhood, coeff: -0.02, P < .001; ADRD∗most disadvantaged neighborhood, coeff: 0.032, P < .001). Among patients with ADRD, patients with the most advanced ADRD were less likely to remain in their homes and community when living in neighborhoods with lower SES.

CONCLUSIONS AND IMPLICATIONS

Our study results show that when patients with ADRD receiving home health care live in neighborhoods with lower SES, they face further challenges to remaining in their homes and community. Public health officials and community planners should consider using area-level interventions to improve care and health outcomes for patients with ADRD. Also, further research aimed at identifying the specific factors and resources influencing lower care quality and poorer health outcomes in socioeconomically disadvantaged neighborhoods, particularly for patients with ADRD, can provide valuable insights for the development and implementation of targeted interventions.

Where Patients Live Matter in Emergency Department Visits in Home Health Care: Rural/Urban Status and Neighborhood Socioeconomic Status

An increasing body of evidence highlights the importance of an individual's place of residence on their health and functional outcomes. This study is based on Outcome and Assessment Information Set data to assess the differences in emergency department visits among Medicare home health care patients by patients' residence location (rural/urban status and neighborhood socioeconomic status). Compared to urban patients, a disproportionately higher proportion of rural patients lived in more or most disadvantaged neighborhoods (83.9% vs. 41.3%). Using linear probability regression models, patients in rural areas (coefficient = .02, p < .001) and disadvantaged neighborhoods (less disadvantaged: coefficient = .02, p < .001; more disadvantaged: coefficient = .034, p < .001; most disadvantaged: coefficient = .042, p < .001) were more likely to experience emergency department visits. Policymakers should consider utilizing area-based target interventions to mitigate gaps in home health care. Also, given that the majority of rural patients reside in disadvantaged neighborhoods, neighborhood characteristics should be considered in addressing rural-urban disparities and improving home health care.

Social support and trauma experiences of imprisoned men in Northern Ireland

BACKGROUND

Social Support has multiple benefits for health and mental wellbeing. Its existence, and the extent to which it can be beneficial, is dependent upon the context in which it is provided, and the recipients' view of it. Social support has long been established as a 'buffer' to the negative impact of stressful life experiences. Trauma can negatively impact upon social support, reducing the extent of social networks and ability of some trauma experienced individuals to sustain extensive social support networks. However, some trauma experiences can also strengthen social relationships. Imprisoned men are disproportionately likely to have experienced a traumatic event when compared with the general population. Past research has found that traumatic events can lead to a decrease in social support among imprisoned men but more research is needed to understand the variations in perceived social support experienced by imprisoned men and to determine how different types of trauma may be related to perceived social support.

METHOD

A cross-sectional survey of 384 adult men detained in the Northern Ireland Prison Service was conducted between November 2022 and January 2023. The survey collected data on the men's demographics, mental health, substance use, and criminal history. Respondents were also asked to complete a Trauma History Questionnaire (THQ) and the Multi-dimensional Scale of Perceived Social Support (MSPSS). Regression analysis was then used to investigate the possible associations between individual characteristics, different types of trauma experiences and perceived social support.

RESULTS

Most types of trauma experiences were not associated with lower levels of perceived social support. Only those who had experienced crime related trauma were more likely to report lower levels of social support. Older imprisoned men and those using substances were more likely to report lower levels of perceived social support, while those who had served a sentence of less than one year reported higher levels of perceived social support.

DISCUSSION

Crime related trauma experiences were found to be associated with lower levels of perceived social support. There were no significant findings around perceived social support and any of the other trauma types i.e. physical, sexual and general disaster experiences. Trauma informed policy responses should be cognisant of this, as those with experiences of crime related victimisation are less likely to have the social support needed to buffer against future trauma experiences. The findings demonstrate that some individuals experience lower levels of perceived social support and several factors are associated with this including age, time served and substance use history. This will potentially impact upon them during release and affect their reintegration into society. Specific policies aimed at these groups should be considered to prevent them from experiencing a lack of support and any accompanying adversity upon release.

Environment matters: How are neighborhood structural indexes associated with parenting stress among Asian immigrant families?

The Asian immigrant population is the fourth largest immigrant population in the United States, and its parenting stress issues have been consistently recognized in previous studies. However, little attention has been paid to neighborhood-level factors and their parenting stress. Using the Study of Asian American Families and 2016 American Community Survey 5-year estimates, this study examined the association between neighborhood structural indexes and Asian immigrant parents' parenting stress, along with the mechanism driving the relationship. We found that cultural orientation and social support fully mediated the effects of economic disadvantages on parenting stress among Asian immigrant parents. Only cultural orientation mediated the direct effects of ethnic heterogeneity on Asian parents' parenting stress. Improving Asian immigrants' living environment, including economic status and ethnic diversity, would be critical to relieve the parenting stress of Asian immigrant families. Interventions and preventions to increase social support, and inform cultural orientation and acculturation are emphasized.

Disparities in Successful Discharge to the Community Following Use of Medicare Home Health by Level of Neighborhood Socioeconomic Disadvantage

Considering the importance of social and structural support and resources in recovering health, where people reside could lead to differences in health outcome in Medicare home health care. We used the 2019 Outcome and Assessment Information Set and Area Deprivation Index to examine the association between neighborhood context and successful discharge to community among older Medicare home health care users. Based on the multivariable logistic regression (OR: 0.84; 95% CI, 0.83-0.85) and conditional logistic regression models stratified by home health agency (OR: 0.95; 95% CI, 0.94-0.95), patients living in the most disadvantaged neighborhoods were less likely to experience successful discharge to community than others. Furthermore, the predicted probability of successful discharge to community decreased as the percentage of patients from the most disadvantaged neighborhoods within a home health agency increased. Policymakers should consider using area-level interventions and supports to reduce disparities in Medicare home health care.

Perceptions of neighborhood environment and loneliness among older Chinese adults: the mediator role of cognitive and structural social capital

OBJECTIVE

This study aimed to examine the mediating role of social capital in the association between perceived physical neighborhood environment and loneliness among older adults in urban China.

METHOD

Data were derived from face-to-face interviews with people (n = 472) aged 60 or older in urban communities of Shanghai, China, in 2020. Loneliness was measured by the 6-item De Jong Gierveld Scale. A multiple mediator model was adopted to examine the research hypotheses.

RESULTS

Cognitive social capital played a full mediation role in the association between perceived community health care (β = -.061, p < .05), safety (β = -.168, p < .001), recreational services (β = -.058, p < .05), and loneliness. Structural social capital was associated with loneliness (β = -.102, p < .05), whereas its mediator effect was not significant. Perceived transportation convenience had neither a direct nor an indirect effect on loneliness among older adults.

CONCLUSION

Findings indicate that older adults' perceptions of healthcare services, safety, and recreational resources could help alleviate their loneliness via fostering cognitive social capital. Interventions improving older adults' perceptions of community health care, safety, and recreation, and their social capital level could help reduce the prevalence of loneliness.

Neighborhood Disadvantage and Mental Health: Test of a Parallel Mediation Model through Social Support and Negative Emotionality

According to the life stress model, stressful circumstances occur in the context of social, psychological, and environmental features that can function as either resources or aggravating factors, each of which are associated with well-being. This research was designed to test indirect effects of living in disadvantaged neighborhoods on mental health, through reduced social support and increased negative emotionality. This model was tested with data from a national sample of 1050 adults residing in the United States. Participants completed measures of social support, negative emotionality, depression, loneliness, stress, and alcohol consumption. These scores were merged with data from the 2015 American Community Survey to assess indicators of neighborhood disadvantage at the zip code level. The test of a parallel mediation model with structural equation modeling indicated that neighborhood disadvantage did not have direct effects on either psychological distress or alcohol consumption. However, neighborhood disadvantage was associated with greater negative emotionality, and through negative emotionality, exhibited indirect effects on psychological distress and alcohol consumption. These results are consistent with elements of the life stress model that specify various psychosocial traits as maladaptive in the context of stressful environments.

How Neighborhood Characteristics Influence Neighborhood Crimes: A Bayesian Hierarchical Spatial Analysis

Urban crimes are a severe threat to livable and sustainable urban environments. Many studies have investigated the patterns, causes, and strategies for curbing the occurrence of urban crimes. It is found that neighborhood socioeconomic status, physical environment, and ethnic composition all might play a role in the occurrence of urban crimes. Inspired by the recent interest in exploring urban crime patterns with spatial data analysis techniques and the development of Bayesian hierarchical analytical approaches, we attempt to explore the inherently intricate relationships between urban assaultive violent crimes and the neighborhood socioeconomic status, physical environment, and ethnic composition in Paterson, NJ, using census data of the American Community Survey, alcohol and tobacco sales outlet data, and abandoned property listing data from 2013. Analyses are set at the census block group level. Urban crime data are obtained from the Paterson Police Department. Instead of examining relationships at a global level with both non-spatial and spatial analyses, we examine in depth the potential locally varying relationships at the local level through a Bayesian hierarchical spatially varying coefficient model. At both the global and local analysis levels, it is found that median household income is decisively negatively related to urban crime occurrence. Percentage of African Americans and Hispanics, number of tobacco sales outlets, and number of abandoned properties are all positively related with urban crimes. At the local level of analysis, however, the different factors have varying influence on crime occurrence throughout the city of Paterson, with median household income having the broadest influence across the city. The practice of applying a Bayesian hierarchical spatial analysis framework to understand urban crime occurrence and urban neighborhood characteristics enables urban planners, stakeholders, and public safety officials to engage in more active and targeted crime-reduction strategies.

Perceived neighborhood environment and depressive symptoms among older adults living in Urban China: The mediator role of social capital

An increasing number of studies have focused on the relationship between neighbourhood environment and depressive symptoms among older people. However, the underlying mechanisms are still unclear. This study examined the association between neighbourhood environment and depressive symptoms among older urban Chinese adults and the mediator role of social capital in this association. Using a quota sampling approach, 472 respondents aged 60 years or older were recruited from 23 urban communities of Shanghai, China, in 2020. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. Social capital was measured by two latent constructs: cognitive social capital (e.g., trust, reciprocity, belongingness) and structural social capital (e.g., memberships, social participation). Perceived physical neighbourhood environment was assessed in terms of health care, security, and public transportation status. Structural equation modelling was conducted to test the study hypotheses. Health care services in the community had a direct effect on depressive symptoms (β = -0.097, p < .05). Cognitive social capital played a mediator role in the relationship between physical neighbourhood environment and depressive symptoms (community health care: β = -0.124, p < .01; community security: β = -0.284, p < .01). The mediator effect of structural social capital in the relationship between physical neighbourhood environment and depressive symptoms was not significant. The findings highlight the role of physical neighbourhood environment in fostering community-based social capital and promoting mental health among older adults in urban China. Policy strategies could focus on improving community health care and security to promote mental health.

Perceived neighborhood environment, social capital and life satisfaction among older adults in Shanghai, China

This study examined the mediator role of social capital on the association between perceived neighborhood environment and life satisfaction among older adults in urban China, and further tested the moderating effect of gender in the above paths (i.e., from neighborhood environment to life satisfaction; from neighborhood environment to social capital; from social capital to life satisfaction). We used quota sampling approach to recruit 472 respondents aged 60 years old or older in Shanghai in 2020. From the perspective of structural equation modeling, multiple group analysis was conducted to examine the proposed hypotheses. The measurement model of social capital was well established in urban Chinese community contexts. Based on the whole sample, the results of the mediation model showed that social capital played a mediation role in the association between neighborhood environment and life satisfaction. Furthermore, the results of multiple group analysis showed that the association between neighborhood environment and cognitive social capital was only significant among older women. The findings highlight the role of neighborhood environment and social capital in building age-friendly communities.

Measuring perceptions of social environments for walking: A scoping review of walkability surveys

The neighborhood pedestrian environment is an important determinant of physical activity and health. Despite widespread acknowledgment that neighborhoods' social and physical characteristics contribute to a walkable place, constructs and metrics remain focused primarily on the built environment. This scoping review documents the current state of the practice to measure perceived social elements of pedestrian environments in order to identify measurement strategies to understand and support walking, particularly in socially diverse neighborhoods. We identified 20 survey instruments focused on pedestrian environments, walkability, or physical activity at the local (neighborhood) scale and designed to capture residents' perceptions of outdoor walking environments. Across the 20 instruments, we identified and categorized 182 distinct items that measured social environments into four domains (social capital, personal safety, physical signifiers, and general neighborhood descriptors) and thirteen subdomains. Many items emphasized negative social elements, such as crime and disorder. Only a few items focused on community identity. Most instruments cover some aspects of the social environment well, but few provide a holistic inventory of the social environment across domains and subdomains. We also observe that the state of the practice seems frozen, with most instruments in use having originated in 2010 or earlier.

Direct and Indirect Relationships Between the Built Environment and Individual-Level Perceptions of Physical Activity: A Systematic Review

Background

Socioecological models highlight the potential direct and indirect effects of multiple levels of influence in explaining physical activity (PA). Social cognitive theories, however, position individual cognitions as the mediator of external factors such as the built environment when explaining PA.

Purpose

To appraise the evidence for direct and indirect associations between the built environment and social cognition to predict PA.

Methods

Literature searches were concluded in February 2019 using five common databases. Eligible studies were in the English language that included any direct and indirect tests of individual perceptions and the built environment with PA.

Results

The initial search yielded 18,521 hits, which was reduced to 46 independent studies of primarily medium quality after screening for eligibility criteria. Findings were grouped by type of PA then grouped by the type of individual and built environment constructs within the model, and subdivided by adult and youth samples. There was evidence that self-efficacy/perceived control accounted for the covariance between environmental accessibility/convenience and total PA, while habit accounted for the covariance in this relationship for transport PA, particularly in adult samples. There was no evidence that the built environment had a direct association with PA after controlling for individual-level factors.

Conclusions

The results provide initial support for the mediation tenet in social cognition models for the relationship between individual, built environment, and PA. In practice, these findings highlight the need for coordinated interventions of individual and environmental change.

The neighborhood social environment and physical activity: a systematic scoping review

BACKGROUND

Investigating the association of the neighborhood social environment on physical activity is complex. A systematic scoping review was performed to (1) provide an inventory of studies assessing the influence of the neighborhood social environment on physical activity since 2006; (2) describe methodologies employed; and (3) formulate recommendations for the field.

METHODS

Two databases were searched using terms related to 'physical activity,' 'neighborhood,' and 'social environment' in January 2017. Eligibility criteria included: 1) physical activity as an outcome; 2) neighborhood social environment as a predictor; 3) healthy population (without diagnosed clinical condition or special population); 4) observational or experimental design. Of 1352 studies identified, 181 were included. Textual data relevant to the social environment measurement and analysis were extracted from each article into qualitative software (MAXQDA) and coded to identify social environmental constructs, measurement methods, level of measurement (individual vs. aggregated to neighborhood), and whether authors explicitly recognized the construct as the social environment. The following measures were generated for each construct: number of unique measurements; % of times measured at an aggregate level; % of times authors referred to the construct as the social environment. Social environmental constructs were then grouped into larger descriptive dimensions.

RESULTS/FINDINGS

Fifty-nine social environmental constructs were identified and grouped into 9 dimensions: Crime & Safety (n = 133 studies; included in 73% of studies); Economic & Social Disadvantage (n = 55, 33%); Social Cohesion & Capital (n = 47, 26%); Social Relationships (n = 22, 12%); Social Environment (n = 16, 9%); Disorder & Incivilities (n = 15, 8%); Sense of Place/Belonging (n = 8, 4%); Discrimination/Segregation (n = 3, 2%); Civic Participation & Engagement (n = 2, 1%). Across all articles, the social environment was measured using 176 different methods, was measured at an aggregate-level 38% of the time, and referred to as the social environment 23% of the time.

CONCLUSIONS

Inconsistent terminology, definitions, and measurement of the social environment and the lack of explicit language identifying constructs as the social environment make it challenging to compare results across studies and draw conclusions. Improvements are needed to increase our understanding of social environmental correlates and/or determinants of physical activity and facilitate cross-disciplinary conversations necessary to effectively intervene to promote physical activity.

TRIAL REGISTRATION

PROSPERO CRD42017059580.

The Relationships between Park Quality, Park Usage, and Levels of Physical Activity in Low-Income, African American Neighborhoods

Parks can be an important, low-cost neighborhood resource to increase physical activity and reduce overweight and obesity. The quality of parks, however, may impact use. This study used observational data to examine the relationships between park quality, park usage and levels of physical activity among users in 31 parks within low-income, African American neighborhoods. Relationships between park use and park characteristics (signs of disorder, attractiveness, and number of activity settings) varied by gender and user activity level. No variables of interest were significant for overall number of male users; whereas, disorder and attractiveness were significant for overall number of female users. Parks with signs of disorder were associated with 49% fewer female users (IRR = 0.51, 95% CI = (0.34–0.77)) and attractive parks with 146% more female users (IRR = 2.46, 95% CI = (1.39–4.33)). Similar significant relationships were found among active but not sedentary female users. Communities may consider increasing park maintenance and addressing attractiveness in existing parks as a relatively low-cost environmental strategy to encourage park use, increase physical activity, and reduce the burden of obesity, especially among women in low-income, African-American communities.

Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors

The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.

Linking Neighborhood Context and Health in Community-Dwelling Older Adults in the Medicare Advantage Program

OBJECTIVES

To examine whether neighborhood context moderates the relationship between multiple chronic conditions (MCCs) and function in Medicare Advantage (MA) beneficiaries.

DESIGN

Cross-sectional study.

SETTING

Medicare Health Outcome Survey Cohort 16 baseline data from 2013.

PARTICIPANTS

MA beneficiaries aged 65 and older (N=187,434).

MEASUREMENTS

We defined disadvantaged neighborhoods as those with an Area Deprivation Index greater than the 85^th percentile. MCCs was defined as having 2 or more chronic conditions. The primary outcome was any self-reported functional limitations with a basic or instrumental activity of daily living. We used survey-weighted multivariate linear probability regression to examine whether the neighborhood disadvantage moderates the relationship between MCCs and report of a functional limitation.

RESULTS

More than one third (35.6%) of the sample reported a functional limitation. Beneficiaries with MCCs were more likely to report a functional limitation those with 0 or 1 chronic condition (odds ratio (OR)=2.63, 95% confidence interval (CI)=2.50-2.77). Beneficiaries in more-disadvantaged neighborhoods were more likely to report a functional limitation than those in less-disadvantaged neighborhoods (OR=1.14, 95% CI=1.08-1.21). In older adults with MCCs, the probability of reporting a functional limitation was 12 percentage points greater in those living in more-disadvantaged neighborhoods than in those living in less-disadvantaged neighborhoods.

CONCLUSION

Neighborhood context is a significant predictor of functional limitation and moderates the association between chronic conditions and functional limitations. Health plans and public health officials could use publicly available indicators such as the ADI to target interventions to reduce functional impairment.

Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland

Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%), lack of time (28.1%), no willingness to exercise (25.4%). Close to 82% of the surveyed population did not practice commuting physical activity (CPA). The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11–1.65; p ≤ 0.05). Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

The observed and perceived neighborhood environment and physical activity among urban-dwelling adults: The moderating role of depressive symptoms

RATIONALE

Physical environmental features of neighborhoods are associated with physical activity, but the influence of mental health factors, such as depression, on these associations is poorly understood.

OBJECTIVE

We examined whether the perceived neighborhood environment mediated associations between the observed neighborhood environment and physical activity, and whether these associations were moderated by depressive symptoms.

METHODS

Data consisted of systematic social observations of 343 neighborhoods and resident surveys. Participants' (N = 2969) mean age was 41.9 ± 16.2 years, 60.2% were female, and 67.9% were non-White. We conducted multiple linear regression and tests for mediation and moderated mediation.

RESULTS

Observed recreation facilities, commercial destinations, physical disorder, and physical deterioration were indirectly associated with walking via perceived neighborhood environment variables. Observed recreation facilities was indirectly and positively associated with leisure-time physical activity via perceived park access, and indirectly and inversely associated with walking and leisure-time physical activity via perceived traffic danger, but only among participants with low depressive symptom scores. Observed recreation facilities was indirectly and inversely associated, and observed physical disorder and physical deterioration were indirectly and positively associated with walking via perceived disorder, but only among participants with high depressive symptom scores.

CONCLUSION

Depressive symptoms affected the strength and direction of associations between the observed neighborhood environment and physical activity via residents' perceptions.

Serum lipid changes following the onset of depressive symptoms in postmenopausal women

A cross-sectional association between depression and serum low-density lipoprotein cholesterol (LDL-c) has been noted in psychiatric literature, raising the question of temporality: does low LDL-c predict depression, does depression lead to changes in LDL-c levels, or is this relationship bidirectional? In a previous longitudinal analysis of postmenopausal women ages 50-79 who participated in the Women's Health Initiative (WHI), we detected an association between low LDL-c and the subsequent onset of depressive symptoms (HR=1.25, 95% CI 1.05-1.49, p=0.01). This current study uses the WHI cohort to explore the question of temporality in the opposite direction, examining the influence of depressive symptoms on subsequent changes in LDL-c levels. This study provides no evidence to suggest an association between depression and subsequent changes in LDL-c level (-2.78mg/dL, 95% CI=-7.49 to 1.92, p=0.25), nor was any association detected for total cholesterol, HDL, or triglyceride changes over time. Further, this study demonstrates that the relationship between depression and serum LDL changes is not mediated by changes in weight, exercise, or energy intake.

Associations between physical activity and the neighbourhood social environment: baseline results from the HABITAT multilevel study

Limitations have arisen when measuring associations between the neighbourhood social environment and physical activity, including same-source bias, and the reliability of aggregated neighbourhood-level social environment measures. This study examines cross-sectional associations between the neighbourhood social environment (perceptions of incivilities, crime, and social cohesion) and self-reported physical activity, while accounting for same-source bias and reliability of neighbourhood-level exposure measures, using data from a large population-based clustered sample. This investigation included 11,035 residents aged 40-65years from 200 neighbourhoods in Brisbane, Australia, in 2007. Respondents self-reported their physical activity and perceptions of the social environment (neighbourhood incivilities, crime and safety, and social cohesion). Models were adjusted for individual-level education, occupation, and household income, and neighbourhood disadvantage. Exposure measures were generated via split clusters and an empirical Bayes estimation procedure. Data were analysed in 2016 using multilevel multinomial logistic regression. Residents of neighbourhoods with the highest incivilities and crime, and lowest social cohesion were reference categories. Individuals were more likely to be in the higher physical activity categories if they were in neighbourhoods with the lowest incivilities and the lowest crime. No associations were found between social cohesion and physical activity. This study provides a basis from which to gain a clearer understanding of the relationship between the neighbourhood social environment and individual physical activity. Further work is required to explore the pathways between perceptions of the neighbourhood social environment and physical activity.

Environmental and personal correlates of physical activity and sedentary behavior in African American women: An ecological momentary assessment study

The authors of this study examined within-person associations of environmental factors (weather, built and social environmental barriers) and personal factors (daily hassles, affect) with moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) in African American women aged 25-64 years living in metropolitan Chicago (n = 97). In 2012-13, for seven days, women wore an accelerometer and were signaled five times per day to complete a survey covering environmental and personal factors on a study-provided smartphone. Day-level measures of each were derived, and mixed regression models were used to test associations. Poor weather was associated with a 27.3% reduction in daily MVPA. Associations between built and social environmental barriers and daily MVPA or SB were generally not statistically significant. Negative affect at the first daily signal was associated with a 38.6% decrease in subsequent daily MVPA and a 33.2-minute increase in subsequent daily SB. Each one-minute increase in MVPA during the day was associated with a 2.2% higher likelihood of positive affect at the end of the day. SB during the day was associated with lower subsequent positive affect. Real-time interventions that address overcoming poor weather and negative affect may help African American women increase MVPA and/or decrease SB.