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Sirotiak Z, Brellenthin AG, Hariharan A, Welch AS, Meyer JD, Franke WD. Psychological correlates of physical activity among adults living in rural and urban settings. Front Psychol 2024; 15:1389078. [PMID: 38659683 PMCID: PMC11039787 DOI: 10.3389/fpsyg.2024.1389078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
Middle-aged and older adults living in rural settings have been consistently less likely to report regular physical activity (PA) than those living in urban settings. While past literature has identified sociodemographic and environmental correlates of PA that may contribute to these differences, consideration of psychological correlates has been limited. A total of 95 rural and urban adults ≥50 years old provided self-reported sociodemographic information, PA level, and psychological correlates of PA including measures assessing motivation, self-efficacy, social support, and attitudes related to PA. The average participant age was 68.6 years, and most were female (62.1%) and married (70.5%). While PA level did not differ significantly between the rural and urban groups, different psychological correlates contributed significantly to separate rural and urban linear regression models considering PA status. Among rural adults, more positive attitudes toward PA, and greater PA self-efficacy and social support were associated with greater amounts of PA while for urban adults, no psychological correlates were significantly associated with PA. Psychosocial factors may be key considerations in developing more effective PA interventions in middle-aged and older adults living in rural areas.
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Affiliation(s)
- Zoe Sirotiak
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | | | - Arjun Hariharan
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Amy S. Welch
- Department of Health and Human Performance, Norwich University, Northfield, VT, United States
| | - Jacob D. Meyer
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Warren D. Franke
- Department of Kinesiology, Iowa State University, Ames, IA, United States
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Bole A, Bernstein A, White MJ. The Built Environment and Pediatric Health. Pediatrics 2024; 153:e2023064773. [PMID: 38105697 DOI: 10.1542/peds.2023-064773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/19/2023] Open
Abstract
Buildings, parks, and roads are all elements of the "built environment," which can be described as the human-made structures that comprise the neighborhoods and communities where people live, work, learn, and recreate (https://www.epa.gov/smm/basic-information-about-built-environment). The design of communities where children and adolescents live, learn, and play has a profound impact on their health. Moreover, the policies and practices that determine community design and the built environment are a root cause of disparities in the social determinants of health that contribute to health inequity. An understanding of the links between the built environment and pediatric health will help to inform pediatricians' and other pediatric health professionals' care for patients and advocacy on their behalf. This technical report describes the range of pediatric physical and mental health conditions influenced by the built environment, as well as historical and persistent effects of the built environment on health disparities. The accompanying policy statement outlines community design solutions that can improve pediatric health and health equity, including opportunities for pediatricians and the health care sector to incorporate this knowledge in patient care, as well as to play a role in advancing a health-promoting built environment for all children and families.
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Affiliation(s)
- Aparna Bole
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aaron Bernstein
- Department of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michelle J White
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
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Wang Z, Wei G. Effects of Sports Public Goods on the Health of the Elderly: Empirical Evidence from China. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:370-380. [PMID: 35007189 DOI: 10.1080/19371918.2021.2017379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sports public service can promote the elderly to participate in sport exercises and have a positive impact on health of the elderly. The aim of this study was to identify the effect of sport public service on the health and to study the meditation effect of physical activity. We conducted a questionnaire survey on sports public service and the health of the elderly in China, and established a mediation effect model to measure the impact of five categories of sports public service on the health of the elderly. The final sample comprised 1089 older adults (548 males and 541 females). Cronbach's α was over 0.7. Sport public service have positive effect on the health of the elderly, but they have meditation effect on both frequency and duration of physical exercise of the elderly. Among which the instruction of physical activity and service of sport exercises are the most significant factors. Sports public service for the elderly in China are not well balanced both in regions and among people, with more goods in towns and cities but less in rural areas. This study clarifies the impact of sports public service on the health of the elderly, and empirically analyses its meditation effect on physical exercise of the elderly. It is emphasized that the provision of sports public service in China is not to build sports facilities, but to provide more instruction and sports public services for residents physical exercise.
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Affiliation(s)
- Zhankun Wang
- Faculty of Physical Education, Ningbo University, Ningbo City, Zhejiang Province, China
| | - Guojiang Wei
- School of Economics, Fujian Normal University, Fuzhou City, Fujian Province, China
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Walkability indices and children's walking behavior in rural vs. urban areas. Health Place 2021; 72:102707. [PMID: 34742121 DOI: 10.1016/j.healthplace.2021.102707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE This study described associations between selected walk indices (WI) and walking and physical activity behaviors in rural and urban children. FINDINGS WI were higher in urban environments, yet children from rural areas walked for transportation more than children from urban areas. There was a negative correlation between National WI scores and walking for transportation in urban areas, and between the Frank WI scores and walking for exercise in rural areas. CONCLUSIONS Indices of walkability are not associated with objectively measured physical activity or self-reported walking behavior in children living in rural and urban settings.
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White MJ, Holliday KM, Hoover S, Robinson-Ezekwe N, Corbie-Smith G, Williams A, Bess K, Frerichs L. The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors. BMC Public Health 2021; 21:2018. [PMID: 34740336 PMCID: PMC8570769 DOI: 10.1186/s12889-021-12022-x] [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] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults' self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking. METHODS We conducted semi-structured interviews with AA adults (N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12. RESULTS The average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives' homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives' homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support. CONCLUSIONS As we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.
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Affiliation(s)
- Michelle J White
- Department of Pediatrics, Duke University School of Medicine, DUMC 102376, 2301 Erwin Rd, Durham, NC, 27705, USA.
| | - Katelyn M Holliday
- Department of Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914, Durham, NC, 27710, USA
| | - Stephanie Hoover
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA
| | - Nicole Robinson-Ezekwe
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA
| | - Giselle Corbie-Smith
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA
| | - Anissa Williams
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA
| | - Kiana Bess
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Leah Frerichs
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, 323 MacNider Hall, CB #7240, Chapel Hill, NC, 27599-7240, USA
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Roseneau Hall, CB #7400, Chapel Hill, NC, 27599-7400, USA
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Umstattd Meyer MR, Prochnow T, Pickett AC, Perry CK, Bridges Hamilton CN, Abildso CG, Pollack Porter KM. The Effects of Play Streets on Social and Community Connectedness in Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9976. [PMID: 34639278 PMCID: PMC8508026 DOI: 10.3390/ijerph18199976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Promoting physical activity (PA) is a long-standing public health initiative to improve overall health and wellbeing. Innovative strategies such as Play Streets, temporary activation of public spaces to provide safe places for active play, are being adopted in urban and rural communities to increase PA among children. As part of these strategies, aspects of social and community connectedness may be strengthened. This study analyzes focus groups and interviews from rural Play Street implementation team members (n = 14) as well as adults (n = 7) and children (n = 25) who attended Play Streets hosted in rural North Carolina, Maryland, Oklahoma, and Texas to better understand the added benefits of Play Streets in community connectedness. Overall, elements of social support and social cohesion are mentioned most frequently with instrumental and conditional support; however, concepts of social capital, collective-efficacy, and social identification are also presented. Participants expressed that Play Streets provided more than just PA; they provided opportunities to access and share resources, build perceptions of safety and trust in the community, and develop relationships with others. Fostering community connection through Play Streets may reduce health inequities in rural communities by building community resilience. Community-based PA programming that enhance and capitalize on community connectedness could be effective ways to improving the overall health and wellbeing of residents.
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Affiliation(s)
- M. Renée Umstattd Meyer
- Department of Public Health, Baylor University Robbins College of Health and Human Sciences, Waco, TX 78628, USA; (T.P.); (C.N.B.H.)
| | - Tyler Prochnow
- Department of Public Health, Baylor University Robbins College of Health and Human Sciences, Waco, TX 78628, USA; (T.P.); (C.N.B.H.)
- Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA
| | - Andrew C. Pickett
- Division of Kinesiology & Sport Management, School of Education Research Center, University of South Dakota, Vermillion, SD 57069, USA;
| | - Cynthia K. Perry
- School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Christina N. Bridges Hamilton
- Department of Public Health, Baylor University Robbins College of Health and Human Sciences, Waco, TX 78628, USA; (T.P.); (C.N.B.H.)
- Department of Public Health & Health Education, SUNY Brockport, Brockport, NY 14420, USA
| | - Christiaan G. Abildso
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV 25606, USA;
| | - Keshia M. Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
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Schwartz J, Oh P, Perotto MB, Rhodes RE, Firth W, Bredin SSD, Gaytán-González A, Warburton DER. A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security. Front Cardiovasc Med 2021; 8:730373. [PMID: 34527714 PMCID: PMC8435680 DOI: 10.3389/fcvm.2021.730373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/10/2021] [Indexed: 01/12/2023] Open
Abstract
In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.
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Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Maira B. Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Wanda Firth
- Hearts & Health in Motion Program, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS, Canada
| | - Shannon S. D. Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Alejandro Gaytán-González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E. R. Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
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Pelletier CA, White N, Duchesne A, Sluggett L. Likelihood of meeting physical activity guidelines in rural and urban adults: cross-sectional analysis of the Canadian Community Health Survey. Canadian Journal of Public Health 2021; 112:748-757. [PMID: 33977500 DOI: 10.17269/s41997-021-00507-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The goal of this study was to compare the odds of meeting physical activity (PA) guidelines among adults living in rural and urban areas of Canada. METHODS Data from the 2017 cycle of the Canadian Community Health Survey were analyzed using binomial logistic regression with a sample of 47,266 adults representing a survey-weighted total of 25,669,018. The odds of meeting PA guidelines were determined based on self-reported moderate-to-vigorous PA (<150 min per week or ≥150 min per week). Communities were categorized as urban or rural based on population size and density. Individual-level correlates included in the model were self-identified sex, age, body mass index, highest level of education, household income, perceived health, and sense of belonging to community. RESULTS Approximately 56.6% of rural and 59.3% of urban adults reported meeting recommended PA levels when location was examined as a sole predictor. The best-fit model adjusted for all individual-level factors showed a significant sex × location interaction. Males in rural communities were more likely to report meeting PA guidelines (odds = 0.90 or 47.4%) than males in urban areas (odds = 0.78 or 43.8%), whereas females living in rural communities (odds = 0.58 or 36.7%) were less likely to report meeting PA guidelines than females in urban areas (odds = 0.65 or 39.4%). CONCLUSION The association between rural-urban residence and meeting PA guidelines appears to be contingent on self-identified sex differences. Future work should explore how gender- and location-related variables interact to influence self-reported PA engagement.
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Affiliation(s)
- Chelsea A Pelletier
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada.
| | - Nicole White
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada
| | - Annie Duchesne
- Department of Psychology, University of Northern British Columbia, Prince George, Canada
| | - Larine Sluggett
- University of Northern British Columbia, Prince George, Canada
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White MJ, McClure E, Killeen J, Howard J, Skinner AC, Spears T, Perrin EM. Changes in the Recreational Built Environment and Youth Body Mass Index. Acad Pediatr 2021; 21:76-83. [PMID: 32916342 PMCID: PMC10015613 DOI: 10.1016/j.acap.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Many cities have implemented programs to improve the recreational built environment. We evaluated whether neighborhood recreational built environmental changes are associated with change in body mass index (BMI). METHODS We performed a longitudinal assessment of association between the recreational built environment and BMI percent of 95th percentile (BMIp95). Patient data from 2012 to 2017 were collected from electronic medical records including height, weight, sex, race/ethnicity, insurance type, and address. BMIp95 was calculated. Environmental data including sidewalks, trails, Healthy Mile Trails, and parks were collected. Patients' neighborhood environments were characterized using proximity of features from home address. Multilevel linear regressions with multiple encounters per patient estimated effects of recreational features on BMIp95 and stratified models estimated effect differences. RESULTS Of 8282 total patients, 27.7% were non-Hispanic White, half were insured by Medicaid, and 29.5% changed residence. Median BMIp95 was 86.3%. A decrease in BMIp95 was associated with park proximity in the full cohort (-2.85; 95% CI [confidence interval]: -5.47, -0.24; P = .032), children with obesity at baseline (-6.50; 95% CI: -12.36, -0.64; P = .030) and privately insured children (-4.77; 95% CI: -9.14, -0.40; P = .032). Healthy Mile Trails were associated with an increase in BMIp95 among children without obesity (1.00; 95% CI 0.11, 1.89; P = .027) and children living in higher income areas (6.43; 95% CI: 0.23, 12.64; P = .042). CONCLUSIONS Differences in effect indicate that built environment changes may improve or exacerbate disparities. Improving obesity disparities may require addressing family-level barriers to the use of recreational features in addition to proximity.
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Affiliation(s)
- Michelle J White
- Duke Center for Childhood Obesity Research (MJ White, J Howard, AC Skinner, and EM Perrin), Duke University School of Medicine, Durham, NC; Department of Pediatrics (MJ White, J Howard, and EM Perrin), Duke University School of Medicine, Durham, NC.
| | - Elizabeth McClure
- Department of Epidemiology (E McClure), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Janna Howard
- Duke Center for Childhood Obesity Research (MJ White, J Howard, AC Skinner, and EM Perrin), Duke University School of Medicine, Durham, NC; Department of Pediatrics (MJ White, J Howard, and EM Perrin), Duke University School of Medicine, Durham, NC
| | - Asheley C Skinner
- Duke Center for Childhood Obesity Research (MJ White, J Howard, AC Skinner, and EM Perrin), Duke University School of Medicine, Durham, NC; Department of Population Health Sciences (AC Skinner), Duke University, Durham, NC
| | - Tracy Spears
- Center for Predictive Medicine (T Spears), Duke Clinical Research Institute, Durham, NC
| | - Eliana M Perrin
- Duke Center for Childhood Obesity Research (MJ White, J Howard, AC Skinner, and EM Perrin), Duke University School of Medicine, Durham, NC; Department of Pediatrics (MJ White, J Howard, and EM Perrin), Duke University School of Medicine, Durham, NC
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Prochnow T, Umstattd Meyer MR, Bridges Hamilton CN, Pollack Porter KM. Differences in Child Physical Activity Levels at Rural Play Streets Due to Activity Type and Sex. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2020; 1:16-26. [PMID: 37790134 PMCID: PMC10544929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Children are significantly less active during summer months, and rural children may face unique barriers to engaging in physical activity. Play Streets is a low-cost way communities can provide safe play opportunities by activating public spaces. Four low-income rural communities received mini-grants to implement four three-hour Play Streets throughout summer 2017 for a total of 16 Play Streets. System for Observing Play and Recreation in Communities (SOPARC) and iSOPARC were used to assess physical activity. Chi-square tests of homogeneity determined significant differences in the proportion of children observed as active based on sex and target area type. Binomial logistic regression was used to determine if target area characteristics (i.e., type, equipped, supervised, organized) and presence of other active children or adults increased the odds of observing a child as active. In total, 1,750 children were observed across all 16 Play Streets; roughly half of all children (48.6% of boys, 48.7% of girls) were observed as active. There was no significant difference in proportion of children observed as active based on sex of the child (OR = 0.99, 95% CI:0.82-1.20). Significant differences in the proportion of active children were found between target area categories. Boys were significantly more likely to be observed as active in areas which were equipped or organized. All children were significantly more likely to be active if there was another active child present in the same area. These results add to the growing literature surrounding successful implementation of Play Streets in rural settings, social influence, and active play.
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White MJ, Perrin AJ, Caren N, Perrin EM. Back in the Day: Nostalgia Frames Rural Residents' Perspectives on Diet and Physical Activity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:126-133. [PMID: 31611049 DOI: 10.1016/j.jneb.2019.05.601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To observe and interpret cultural influences on health behaviors in a rural area with a high prevalence of obesity. DESIGN Descriptive, qualitative study. SETTING Lenoir County, NC, US. PARTICIPANTS Four focus groups (n = 33) were conducted. Participants were 76% African American and with an average of 25 years of county residence. PHENOMENON OF INTEREST Diet, physical activity, environment ANALYSIS: Content analysis and thematic data analysis to identify key themes using qualitative analysis software. RESULTS Participants frequently evoked nostalgia to frame recurrent themes including decreased opportunities for physical activity and changing food access and preparation in the community, contrasting with memories of enjoying local produce and safe outdoor recreation. They interpreted present health behaviors in the context of these past losses. CONCLUSIONS AND IMPLICATIONS Nostalgia is an important element in our participants' cultural repertoires, revealing elements of place-based culture. Nostalgic narratives may foster a sense of reduced options for healthy eating and exercise by over-emphasizing loss. The incorporation of place-specific obesogenic cultural factors, including the way residents juxtapose past and present, may improve obesity interventions in rural settings.
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Affiliation(s)
- Michelle J White
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC; Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Andrew J Perrin
- Department of Sociology, College of Arts & Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Neal Caren
- Department of Sociology, College of Arts & Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Eliana M Perrin
- Division of Primary Care Pediatrics, Department of Pediatrics, Duke University School of Medicine, Durham, NC
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Umstattd Meyer MR, Bridges Hamilton CN, Prochnow T, McClendon ME, Arnold KT, Wilkins E, Benavidez G, Williams TD, Abildso CG, Pollack Porter KM. Come together, play, be active: Physical activity engagement of school-age children at Play Streets in four diverse rural communities in the U.S. Prev Med 2019; 129:105869. [PMID: 31654727 DOI: 10.1016/j.ypmed.2019.105869] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/24/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
Across the U.S., Play Streets - temporary street closures creating safe places for play for a few hours- are being implemented in urban areas during summer. Play Streets have never been implemented or evaluated in rural communities but have the potential to address challenges residents face accessing safe physical activity opportunities in these areas. Community organizations in four diverse low-income rural communities (selected to represent African American, American Indian, Latino, or White, non-Hispanic populations) received mini-grants in 2017 to implement four, three-hour Play Streets during the summer focusing on school-aged children in elementary-to-middle school. Physical activity was measured using Digi-walker (Yamax-SW200) pedometers and the System for Observing Play and Recreation in Communities (SOPARC/iSOPARC). Sixteen Play Streets were implemented in rural Maryland, North Carolina, Oklahoma, and Texas communities during June-September 2017. A total of 370 children (mean age = 8.81 years [SD = 2.75]; 55.0% female) wore pedometers across all 16 Play Streets (μ = 23.13 [SD = 8.59] children/Play Street). School-aged children with complete data (n = 353) wore pedometers for an average of 92.97 min (SD = 60.12) and accrued a mean of 42.08 steps/min (SD = 17.27), with no significant differences between boys (μ = 43.82, SD = 15.76) and girls (μ = 40.66, SD = 18.34). iSOPARC observations revealed no significant differences in child activity by sex; however, male teens were more active than female teens. Most adults were sedentary during Play Streets according to pedometer and iSOPARC data. Children in diverse rural communities are physically active at Play Streets. Play Streets are a promising intervention for promoting active play among children that lack safe opportunities to be active.
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Affiliation(s)
- M Renée Umstattd Meyer
- Baylor University, Department of Public Health, One Bear Place #97343, Waco, TX 76798, USA.
| | | | - T Prochnow
- Baylor University, College of Health and Human Sciences, One Bear Place #97311, Waco, TX 76798, USA
| | - Megan E McClendon
- Baylor University, College of Health and Human Sciences, One Bear Place #97311, Waco, TX 76798, USA; Texas State University, USA
| | - Kimberly T Arnold
- Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, 624 N. Broadway, Hampton House 380A, Baltimore, MD 21205, USA; University of Pennsylvania, USA
| | - Emily Wilkins
- Baylor University, Department of Public Health, One Bear Place #97343, Waco, TX 76798, USA
| | - Gabriel Benavidez
- Baylor University, Department of Public Health, One Bear Place #97343, Waco, TX 76798, USA
| | - Tiffany D Williams
- Gramercy Research Group, 7990 North Point Boulevard, Suite 108, Winston-Salem, NC 27106, USA
| | - Christiaan G Abildso
- West Virginia University School of Public Health, PO Box 9190, Morgantown, WV 26506-9190, USA
| | - Keshia M Pollack Porter
- Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, 624 N. Broadway, Hampton House 380A, Baltimore, MD 21205, USA
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13
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Forbes CC, Yu ZM, Cui Y, DeClercq V, Grandy SA, Parker L, Sweeney E, Dummer TJB, Keats MR. Rural-Urban Disparities in Total Physical Activity, Body Composition, and Related Health Indicators: An Atlantic PATH Study. J Rural Health 2019; 36:111-119. [PMID: 30865321 DOI: 10.1111/jrh.12363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To describe and compare the sociodemographic and lifestyle characteristics of urban and rural residents in Atlantic Canada. METHODS Cross-sectional analyses of baseline data from the Atlantic Partnership for Tomorrow's Health cohort were conducted. Specifically, 17,054 adults (35-69 years) who provided sociodemographic characteristics, measures of obesity, and a record of chronic disease and health behaviors were included in the analyses. Multiple linear regression and logistic regression models were used to calculate the multivariable-adjusted beta coefficients (β), odds ratios (OR), and related 95% confidence intervals (CI). FINDINGS After adjusting for age, sex, and province, when compared to urban participants, rural residents were significantly more likely to: be classified as very active (OR: 1.19, CI: 1.11-1.27), be obese (OR: 1.13, 1.05-1.21), to present with abdominal obesity (OR: 1.08, CI: 1.01-1.15), and have a higher body fat percentage (β: 0.40, CI: 0.12-0.68) and fat mass index (β: 0.32, CI: 0.19-0.46). Rural residents were significantly less likely to be regular or habitual drinkers (OR: 0.83, CI: 0.78-0.89). Significant differences remained after further adjustment for confounding sociodemographic, lifestyle, and health characteristics. No significant differences in smoking behavior, fruit and vegetable intake, multimorbidity, or waist circumference were found. CONCLUSIONS As expected, obesity prevalence was higher in rural Atlantic Canadians. In contrast to much of the existing literature, we found that rural participants were more likely to report higher levels of total physical activity and lower alcohol consumption. Findings suggest that novel obesity prevention strategies may be needed for rural populations.
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Affiliation(s)
- Cynthia C Forbes
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Zhijie Michael Yu
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yunsong Cui
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vanessa DeClercq
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Louise Parker
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ellen Sweeney
- Population Cancer Research Program, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Trevor J B Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie R Keats
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
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14
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Mattli R, Wieser S, Probst-Hensch N, Schmidt-Trucksäss A, Schwenkglenks M. Physical inactivity caused economic burden depends on regional cultural differences. Scand J Med Sci Sports 2018; 29:95-104. [PMID: 30260508 DOI: 10.1111/sms.13311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/19/2018] [Indexed: 12/16/2022]
Abstract
Physical inactivity is a major risk factor for numerous non-communicable diseases which dominate the overall burden of disease in Switzerland. We aimed to estimate the burden attributable to adult physical inactivity in Switzerland and its three culturally different language regions from a societal perspective in terms of disability-adjusted life years (DALYs), medical costs, and productivity losses. The burden of physical inactivity was estimated with a population attributable fractions (PAFs) approach. PAFs were calculated based on the prevalence of physical inactivity in the Swiss Health Survey and literature-based adjusted risk ratios of disease incidence. These PAFs were then applied to the total burden of the diseases related to physical inactivity. Physical inactivity was responsible for 2.0% (95%CI 1.7%-2.2%) of total DALYs lost and 1.2% (95%CI 1.0%-1.3%) of total medical costs in 2013. This is equivalent to 116 (95%CI 99-135) Swiss francs per capita per year. Productivity losses were valued at 117 (95%CI 94-142) Swiss francs per capita per year. The two diseases which caused the highest economic burden were low back pain and depression. The analysis of regional differences revealed that the per capita burden of physical inactivity is about twice as high in the French- and Italian-speaking regions compared to the German-speaking region. Reasons include a higher prevalence of physical inactivity, higher per capita health care spending, and higher disease prevalence. Cost-effectiveness analysis of related interventions should consider regional differences for optimal resource allocation in physical activity promotion policies.
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Affiliation(s)
- Renato Mattli
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.,Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Simon Wieser
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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