Physical activity and health: Metabolic and cardiovascular issues

Environmental barriers and enablers to physical activity participation among rural adults: a qualitative study

ISSUE ADDRESSED

Social-ecological models of health behaviour acknowledge environmental influences, but research examining how the environment shapes physical activity in rural settings is limited. This study aimed to explore the environmental factors that act as barriers or facilitators to physical activity participation among rural adults.

METHODS

Forty-nine adults from three regions of rural Tasmania, Australia, participated in semi-structured interviews that explored features of the environment that supported or hindered physical activity. Interviews were digitally recorded, transcribed verbatim and analysed thematically.

RESULTS

Four key themes emerged: functionality, diversity, spaces and places for all and realistic expectations. 'Functionality' included connectivity with other destinations, distance, safety, continuity, supporting infrastructure and surfacing. While there was limited 'diversity' of structured activities and recreational facilities, the importance of easy and convenient access to a natural environment that accommodated physical activity was highlighted. 'Spaces and places for all' highlighted the importance of shared-use areas, particularly those that were family- and dog-friendly. Despite desires for more physical activity opportunities, many participants had 'realistic expectations' of what was feasible in rural settings.

CONCLUSIONS

Functionality, diversity, spaces and places for all and realistic expectations were identified as considerations important for physical activity among rural adults. Further research using quantitative approaches in larger samples is needed to confirm these findings. SO WHAT? Urban-centric views of environmental influences on physical activity are unlikely to be entirely appropriate for rural areas. Evidence-based recommendations are provided for creating new or modifying existing infrastructure to support active living in rural settings.

Parental perceived neighborhood attributes: associations with active transport and physical activity among 10-12 year old children and the mediating role of independent mobility

BACKGROUND

During the last decades, the use of active travel modes declined in all age groups. Childhood is a critical time to establish lifelong healthy patterns. To develop effective interventions in this age group, insight in the correlates of health behaviors and the possible mediating factors is necessary. Among children, the role of parents may not be overlooked. Therefore, this study aimed to examine the associations of parental perceptions of neighborhood environmental attributes with active transport and total physical activity in 10-12 year old Belgian boys and girls. Furthermore, this study examined the potential mediating effect of independent mobility on these associations.

METHODS

In the present study, 736 10-12 year old children and their parents from 44 elementary schools in Flanders, Belgium, participated. The children were asked to wear an activity monitor and to fill in a survey questioning demographic factors and the Flemish Physical Activity Questionnaire. The parents filled in a survey concerning demographic factors, the child's level of independent mobility and environmental perceptions (Neighborhood Environmental Walkability Scale).

RESULTS

Overall, boys reported more active transport when parents perceived more land use mix diversity, shorter distances to school, good land use mix access, higher residential density and less pleasing neighborhood aesthetics. Higher total physical activity levels were reported when parents perceived shorter distances to school and availability of walking/cycling infrastructure. None of the associations was mediated by independent mobility in boys. Girls reported more active transport when parents perceived higher residential density, more land use mix diversity, shorter distances to school, good land use mix access, available walking/cycling infrastructure and convenient recreational facilities. Girls reported higher total physical activity levels when parents perceived high residential density, good land use mix access, well-maintained and high quality walking/cycling infrastructures and more traffic safety. Independent mobility was found to be an important mediator of these associations in girls.

CONCLUSIONS

Neighborhood environmental interventions to increase children's active transport and physical activity can be effective when combined with awareness raising programs for parents. Furthermore, among girls encouraging independent mobility may contribute to behavior change.

Do psychosocial factors moderate the association between neighborhood walkability and adolescents' physical activity?

Ecological models emphasize the interaction between individuals and their environment. Furthermore, they posit that environmental variables influence physical activity (PA) not only directly but also indirectly through their interaction with other factors. This study explored if the association between neighborhood walkability and adolescents' PA is moderated by psychosocial factors using data from the Belgian Environmental PA Study in Youth (BEPAS-Y). BEPAS-Y recruited adolescents from 32 neighborhoods differing in objectively determined neighborhood walkability and income. Between 2008 and 2009, 637 adolescents (13-15 years; 49.4% boys) completed a survey measuring socio-demographic and psychosocial factors and wore an accelerometer for seven days. Multilevel-regression analyses revealed that for adolescents living in low-income neighborhoods, the association between neighborhood walkability and PA is moderated by perceived barriers and perceived benefits toward PA. Neighborhood walkability was positively associated with PA among adolescents, living in low-income neighborhoods, who perceived many barriers and few benefits, while for adolescents who perceived few barriers and many benefits, the PA level was high, irrespective of neighborhood walkability. For adolescents, living in high-income neighborhoods, none of the psychosocial attributes moderated the association between neighborhood walkability and PA. These findings provide some support for the predicted interactions posited by ecological models. Improving neighborhood walkability might increase PA-levels of adolescents living in low-income neighborhoods, with less positive psychosocial profiles, or in other words; those who are most difficult to reach through PA interventions. However, in order to increase PA in large populations, interventions focusing solely on improving neighborhood walkability may not have the desired effect.

Interventions for promoting physical activity among European teenagers: a systematic review

Background

Although physical activity is considered to yield substantial health benefits, the level of physical activity among European teenagers is not sufficient. Adolescence is characterized by a decline in physical activity level. Many studies investigated the effectiveness of interventions promoting physical activity among young people, but none dealt with the available evidence specific for Europe. This review was conducted to summarize the effectiveness of interventions to promote physical activity among European teenagers.

Methods

A systematic review was conducted to identify European intervention studies published in the scientific literature since 1995. Four databases were searched, reference lists were scanned and the publication lists of the authors of the retrieved articles were checked. The ANGELO framework was used to categorise the included studies by setting and by intervention components.

Results

The literature search identified 20 relevant studies. Fifteen interventions were delivered through the school setting, of which three included a family component and another three a family and community component. One intervention was conducted within a community setting, three were delivered in primary care and one was delivered through the internet. Ten interventions included only an individual component, whereas the other ten used a multi-component approach. None of the interventions included only an environmental component.

Main findings of the review were: (1) school-based interventions generally lead to short term improvements in physical activity levels; (2) improvements in physical activity levels by school-based interventions were limited to school related physical activity with no conclusive transfer to leisure time physical activity; (3) including parents appeared to enhance school-based interventions; (4) the support of peers and the influence of direct environmental changes increased the physical activity level of secondary school children; (5) the assumption that a multi-component approach should produce synergistic results can not be confirmed; (6) when interventions aimed to affect more than one health behaviour the intervention appeared to be less effective in favour of physical activity.

Conclusion

Overall, the current European literature supports the short-term effectiveness of school-based physical activity promotion programmes. The available evidence for the effectiveness in other settings is rather limited and underscores the need for further research.