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Roman CG, Chen R, Natarajan L, Conway TL, Patch C, Taylor RB, Cain KL, Roesch S, Adams MA, Saelens BE, King AC, Frank LD, Glanz K, Sallis JF. Crime-related perceptions and walking for recreation inside and outside one's home neighborhood. Health Place 2024; 89:103316. [PMID: 39089217 DOI: 10.1016/j.healthplace.2024.103316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/25/2024] [Accepted: 07/05/2024] [Indexed: 08/03/2024]
Abstract
It is widely assumed crime and related concerns, including neighborhood incivilities and fear of crime, are barriers to physical activity (PA). Past studies reveal mixed evidence. Studies of impacts for crime-protective factors are less common but have similarly mixed results. This paper evaluates a comprehensive transdisciplinary conceptual framework of cross-sectional associations between crime-related perceptions and reported minutes/week of recreational walking inside and outside one's home neighborhood. Safe and Fit Environments Study (SAFE) recruited and surveyed 2302 participants from adolescents to older adults from four U.S. metropolitan areas. A zero-inflated model estimated two components of each outcome: whether the respondent walked, and minutes/week walked. Correlates of recreational walking were location-specific, differing based on walking location. Fear of crime, risk evaluation, victimization, and incivilities were not consistently associated with walking for recreation inside one's neighborhood. People with crime concerns about their own neighborhoods, however, more commonly walked for recreation outside their neighborhoods. Protective crime-related perceptions that seldom have been studied in relation to PA, such as street efficacy (i.e., the perceived ability to avoid and manage danger), were strongly associated with recreational walking in both locations, indicating the additional heuristic value of the SAFE conceptual framework. Crime-related perceptions and walking for recreation: Evaluating a conceptual model.
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Affiliation(s)
- Caterina G Roman
- Department of Criminal Justice, Temple University, Philadelphia, PA, USA.
| | - Ruohui Chen
- Feinberg School of Medicine, Department of Preventive Medicine - Biostatistics, Northwestern University, Evanston, Illinois, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, USA
| | - Terry L Conway
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, USA
| | | | - Ralph B Taylor
- Department of Criminal Justice, Temple University, Philadelphia, PA, USA
| | - Kelli L Cain
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, USA
| | - Scott Roesch
- Department of Psychology, San Diego State University, San Diego, USA
| | - Marc A Adams
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Brian E Saelens
- Departments of Pediatrics and Psychiatry and Behavioral Sciences, University of Washington, Washington, USA
| | - Abby C King
- Stanford Prevention Research Center, Stanford University California, USA
| | - Lawrence D Frank
- Department of Urban Studies and Planning, University of California, San Diego, California, USA
| | - Karen Glanz
- Perelman School of Medicine, University of Pennsylvania, USA and School of Nursing, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, USA; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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Assari S, Najand B, Zare H. The link between residential stability and youth substance use: Role of stressful life events and behavioral problems. JOURNAL OF MEDICINE, SURGERY, AND PUBLIC HEALTH 2024; 2:100084. [PMID: 38737924 PMCID: PMC11086703 DOI: 10.1016/j.glmedi.2024.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Introduction Residential stability is increasingly recognized as a significant factor influencing youth positive development. While the existing body of research provides valuable insights, gaps remain regarding the determinants of residential stability and how its outcomes may vary by gender and race. This study aims to investigate the relationship between residential stability, substance use, and behavioral issues among children aged 9-10 years, with a focus on the mediating role of trauma exposure. Methods This research utilizes data from the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal project initiated in 2016 with a sample of 11,849 participants. It explores the links between residential stability, socioeconomic factors, stress, and emotional and behavioral outcomes using the Child Behavior Checklist (CBCL). Structural equation modeling was employed to analyze the data. Results Findings indicate that higher household income, living in a household with married parents, and residing in areas with greater household incomes correlate with residential stability. In turn, residential stability is linked to lower levels of life stress and reduced substance use in the future. Furthermore, the impact of residential stability on substance uses and CBCL scores was entirely mediated by trauma exposure. Conclusions The findings advocate for the implementation of economic, social, and public policies aimed at fostering stable living environments for children and families to mitigate the emotional and behavioral challenges future generations may face. Enhancing socioeconomic status and supporting structures that promote married family living arrangements emerge as effective strategies to improve residential stability and the well-being of young people in the United States.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States
| | - Babak Najand
- Marginalization-related Diminished Returns Center, Los Angeles, California, United States
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, 20783, USA
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3
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Gluck MA, Gills JL, Fausto BA, Malin SK, Duberstein PR, Erickson KI, Hu L. Examining the efficacy of a cardio-dance intervention on brain health and the moderating role of ABCA7 in older African Americans: a protocol for a randomized controlled trial. Front Aging Neurosci 2023; 15:1266423. [PMID: 38076534 PMCID: PMC10710152 DOI: 10.3389/fnagi.2023.1266423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/06/2023] [Indexed: 02/12/2024] Open
Abstract
Introduction African Americans are two to three times more likely to be diagnosed with Alzheimer's disease (AD) compared to White Americans. Exercise is a lifestyle behavior associated with neuroprotection and decreased AD risk, although most African Americans, especially older adults, perform less than the recommended 150 min/week of moderate-to-vigorous intensity exercise. This article describes the protocol for a Phase III randomized controlled trial that will examine the effects of cardio-dance aerobic exercise on novel AD cognitive and neural markers of hippocampal-dependent function (Aims #1 and #2) and whether exercise-induced neuroprotective benefits may be modulated by an AD genetic risk factor, ABCA7 rs3764650 (Aim #3). We will also explore the effects of exercise on blood-based biomarkers for AD. Methods and analysis This 6-month trial will include 280 African Americans (≥ 60 years), who will be randomly assigned to 3 days/week of either: (1) a moderate-to-vigorous cardio-dance fitness condition or (2) a low-intensity strength, flexibility, and balance condition for 60 min/session. Participants will complete health and behavioral surveys, neuropsychological testing, saliva and venipuncture, aerobic fitness, anthropometrics and resting-state structural and functional neuroimaging at study entry and 6 months. Discussion Results from this investigation will inform future exercise trials and the development of prescribed interventions that aim to reduce the risk of AD in African Americans.
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Affiliation(s)
- Mark A. Gluck
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, United States
| | - Joshua L. Gills
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, United States
| | - Bernadette A. Fausto
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, United States
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | - Paul R. Duberstein
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, United States
| | | | - Liangyuan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers School of Public Health, Piscataway, NJ, United States
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Kim SJ, Blesoff JR, Tussing-Humphrys L, Fitzgibbon ML, Peterson CE. The association between neighborhood conditions and weight loss among older adults living in a large urban city. J Behav Med 2023; 46:882-889. [PMID: 37000323 PMCID: PMC10544679 DOI: 10.1007/s10865-023-00410-0] [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] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/12/2023] [Indexed: 04/01/2023]
Abstract
To elucidate the role of neighborhood walkability and crime on weight loss, we examined data from older adults residing in Chicago who participated in a randomized controlled trial lifestyle intervention. Controlling for individual demographic characteristics and the intervention assignment, the neighborhood homicide rate was significantly associated with weight change. Participants who resided in neighborhoods above the 50th percentile of homicide rate actually gained weight between pre- and post-intervention. On the other hand, there was no significant relationship between the level of walkability and weight loss. Our findings suggest that the social environment related to neighborhood crime may play a more important role in weight loss than the built environment, such as walkability. Urban characteristics related to walkability, such as sidewalks, may increase physical activity, however, interventions aiming to increase physical activity to promote weight loss will benefit by addressing the neighborhood social environment that determines how people navigate space.
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Affiliation(s)
- Sage J Kim
- School of Public Health, Division of Health Policy & Administration, University of Illinois at Chicago, 1603 W. Taylor St. #781, Chicago, IL, 60612, USA.
| | - Jamine R Blesoff
- School of Public Health, Division of Health Policy & Administration, University of Illinois at Chicago, 1603 W. Taylor St. #781, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphrys
- College of Applied Health Sciences, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, USA
| | - Marian L Fitzgibbon
- Pediatrics and Health Policy and Administration, Associate Director for Population Science, University of Illinois at Chicago, UI Cancer Center, Chicago, USA
| | - Caryn E Peterson
- School of Public Health, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, Chicago, USA
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5
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Chen T, Chen S, Honda T, Nofuji Y, Kishimoto H, Narazaki K. Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan. J Phys Act Health 2023; 20:886-893. [PMID: 37268301 DOI: 10.1123/jpah.2022-0411] [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: 07/31/2022] [Revised: 03/27/2023] [Accepted: 04/17/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. METHODS In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. RESULTS On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. CONCLUSIONS Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.
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Affiliation(s)
- Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai,China
| | - Sanmei Chen
- Global Health Nursing, Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima,Japan
| | - Takanori Honda
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka,Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo,Japan
| | - Hiro Kishimoto
- Faculty of Arts and Science, Kyushu University, Fukuoka,Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka,Japan
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Cunningham-Myrie C, Theall KP, Younger-Coleman N, Wiggan J, McFarlane S, Francis D, Bennett N, Tulloch-Reid M, Ferguson TS, Davidson T, Govia I, Guthrie-Dixon N, Aiken W, Grant A, Webster-Kerr K, Wilks R. Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III). Prev Med Rep 2022; 30:101998. [PMID: 36189127 PMCID: PMC9519374 DOI: 10.1016/j.pmedr.2022.101998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Decreased physical activity (PA) has been associated with residents living in neighborhoods perceived as being disordered or having high crime levels. What is unknown are the characteristics of individuals who engage in moderate to vigorous levels of PA (MVPA) despite living in these vulnerable neighborhoods, or who may be referred to as positive deviants (PD). We examined the factors associated with PD for PA among Jamaicans. Between 2016 and 2017 the Jamaica Health and Lifestyle Survey, a cross-sectional nationally representative survey (n = 2807), was conducted on individuals aged 15 years and older. Regression analyses were performed to identify associations with PD, defined using engagement in MVPA among persons living in vulnerable neighborhoods (N = 1710). Being female (odds ratio [OR]a = 0.64 (0.48, 0.86); p = 0.003), obese while living in an urban area (ORa = 0.39; 95 % CI = 0.26, 0.59; p < 0.0001), unemployed (ORa = 0.53; 95 % CI = 0.39, 0.73; p < 0.0001), or a student (ORa = 0.62; 95 % CI = 0.39, 0.98); p = 0.041) was associated with a significantly lower likelihood of PD, while having a personal medical history of at least one chronic disease significantly increased likelihood (ORa = 1.43; 95 % CI = 1.08, 1.90; p = 0.014). Taking a PD approach may be one angle to consider in trying to determine what is working and for whom, so that this may be harnessed in policy, prevention and intervention programming to increase PA.
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Affiliation(s)
- C Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - K P Theall
- Departments of Social, Behavioral, and Population Sciences and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - N Younger-Coleman
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - J Wiggan
- Ministry of Health & Wellness, Jamaica
| | - S McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - D Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
| | - N Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - M Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - T S Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - I Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - N Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - W Aiken
- Department of Surgery, Radiology, Anaesthesia & Intensive Care, University of the West Indies, Mona, Kingston, Jamaica
| | - A Grant
- Ministry of Health & Wellness, Jamaica
| | | | - R Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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7
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Towne SD, Xu M, Zhu X, Ory MG, Lee S, Lee C. Differential Effects of a Global Public Health Crisis on Physical Activity: Evidence From a Statewide Survey From the United States. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:63-80. [PMID: 35746822 PMCID: PMC9951772 DOI: 10.1177/19375867221107087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM We aimed to identify how the COVID-19 lockdown affected changes, including the potential for longer term sustained changes, in physical activity, as compared to immediately prior to the pandemic. BACKGROUND Physical activity's significant role in overall health is known to be influenced by the surrounding environment, such as one's neighborhood, prompting this study of physical activity and its relationship with individual-level and neighborhood-level factors within the pandemic timeline. METHODS A statewide online survey assessed adults' self-reported weekly minutes of moderate-to-vigorous physical activity (MVPA) comparing a typical week immediately prior to the pandemic and during the pandemic (prewidespread vaccination) using negative binomial models. RESULTS Overall, MVPA decreased during the pandemic, though the decrease was driven largely by the reduction in MVPA outside one's neighborhood. In contrast, MVPA done within one's neighborhood increased over time. This change in MVPA done within one's neighborhood was not uniform across several characteristics including income level favoring those with the highest income (p < .05) and race/ethnicity favoring those self-reporting as non-Hispanic White (p < .05). While several factors, including higher Walk Scores, were associated with higher levels of MVPA without evidence of change over time, evidence of a differential effect over time was seen for other key indicators of social and structural determinants of health including income and race/ethnicity. CONCLUSIONS This study can add to the existing literature surrounding not only COVID-19 but also neighborhood built environmental research seeking to identify factors associated with changes in MVPA, a known indicator of overall health and health-related outcomes.
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Affiliation(s)
- Samuel D. Towne
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA,Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA,Southwest Rural Health Research Center, Texas A&M University, College Station, TX, USA,Center for Population Health and Aging, Texas A&M University, College Station, TX, USA
| | - Minjie Xu
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Xuemei Zhu
- Department of Architecture, Texas A&M University, College Station, TX, USA
| | - Marcia G. Ory
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA,Center for Population Health and Aging, Texas A&M University, College Station, TX, USA
| | - Sungmin Lee
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
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Pontin FL, Jenneson VL, Morris MA, Clarke GP, Lomax NM. Objectively measuring the association between the built environment and physical activity: a systematic review and reporting framework. Int J Behav Nutr Phys Act 2022; 19:119. [PMID: 36104757 PMCID: PMC9476279 DOI: 10.1186/s12966-022-01352-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Objective measures of built environment and physical activity provide the opportunity to directly compare their relationship across different populations and spatial contexts. This systematic review synthesises the current body of knowledge and knowledge gaps around the impact of objectively measured built environment metrics on physical activity levels in adults (≥ 18 years). Additionally, this review aims to address the need for improved quality of methodological reporting to evaluate studies and improve inter-study comparability though the creation of a reporting framework.
Methods
A systematic search of the literature was conducted following the PRISMA guidelines. After abstract and full-text screening, 94 studies were included in the final review. Results were synthesised using an association matrix to show overall association between built environment and physical activity variables. Finally, the new PERFORM (’Physical and Environmental Reporting Framework for Objectively Recorded Measures’) checklist was created and applied to the included studies rating them on their reporting quality across four key areas: study design and characteristics, built environment exposures, physical activity metrics, and the association between built environment and physical activity.
Results
Studies came from 21 countries and ranged from two days to six years in duration. Accelerometers and using geographic information system (GIS) to define the spatial extent of exposure around a pre-defined geocoded location were the most popular tools to capture physical activity and built environment respectively. Ethnicity and socio-economic status of participants were generally poorly reported. Moderate-to-vigorous physical activity (MVPA) was the most common metric of physical activity used followed by walking. Commonly investigated elements of the built environment included walkability, access to parks and green space. Areas where there was a strong body of evidence for a positive or negative association between the built environment and physical activity were identified. The new PERFORM checklist was devised and poorly reported areas identified, included poor reporting of built environment data sources and poor justification of method choice.
Conclusions
This systematic review highlights key gaps in studies objectively measuring the built environment and physical activity both in terms of the breadth and quality of reporting. Broadening the variety measures of the built environment and physical activity across different demographic groups and spatial areas will grow the body and quality of evidence around built environment effect on activity behaviour. Whilst following the PERFORM reporting guidance will ensure the high quality, reproducibility, and comparability of future research.
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Akinci ZS, Delclòs-Alió X, Vich G, Salvo D, Ibarluzea J, Miralles-Guasch C. How different are objective operationalizations of walkability for older adults compared to the general population? A systematic review. BMC Geriatr 2022; 22:673. [PMID: 35971086 PMCID: PMC9377138 DOI: 10.1186/s12877-022-03233-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/09/2022] [Indexed: 01/10/2023] Open
Abstract
Background Walking is an essential activity for everyone and for older adults in particular, given that it is the most accessible form of physical activity and one of the healthiest transportation modes. Understanding how walkability (the potential of the environment to enable and/or encourage walking) has been objectively measured and analyzed for older adults is critical to create more inclusive, healthy, and sustainable environments and to promote healthy aging. Despite the numerous reviews on physical activity among older adults and its relationship with the built environment, the literature still lacks comparison reviews focusing specifically on objective operationalizations of walkability for older adults vs. the general population. Methods We conducted a systematic review of 146 empirical studies that measured walkability objectively in relation to walking-related outcomes. We compared studies focused on older adults (n = 24) and the general population (n = 122). Content analysis included the characteristics of the study design, walkability measures, spatial extent, and associations found between walkability and walking-related outcomes. Results In both groups of publications, the majority of studies were conducted in the US, Canada, and Europe, and largely in high-income countries. They were mostly published in health-related journals and used cross-sectional designs, operationalized walkability by using indexes, employed self-reported measures for walking-related outcomes, and found positive associations between walkability and walking outcomes. However, we observed some differences among studies focusing on older adults. Compared to studies focusing on the general population, a larger proportion of studies on older adults was conducted in the Middle East and Asia, and they used longitudinal designs, mixed methods to measure walking-related outcomes, variables related with land-use characteristics, safety from traffic and crime, and greenery, and a larger proportion found positive, as well as no associations between walkability and walking-related outcomes. Conclusion Although there is a promising increase in interest in older adults-focused walkability studies in the last decade, there is still a need for more studies focusing on different settings, using wider spatial extents, longitudinal designs, objective or mixed methods to collect outcome data, and specific variables and/or specially created indexes for older adults and for settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03233-x.
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Affiliation(s)
- Zeynep S Akinci
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.
| | - Xavier Delclòs-Alió
- Grup de Recerca en Anàlisi Territorial i Estudis Turístics (GRATET), Departament de Geografia, Universitat Rovira i Virgili, Vila-seca, Spain
| | - Guillem Vich
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,ISGlobal (Barcelona Institute for Global Health), Doctor Aiguader, 88, 08003, Barcelona, Spain
| | - Deborah Salvo
- People, Health and Place Unit; Prevention Research Center in St. Louis; Brown School; Washington University in St Louis , St. Louis, Missouri, USA
| | - Jesús Ibarluzea
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain.,Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain.,Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Carme Miralles-Guasch
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona - Edifici ICTA-ICP, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain
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10
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Finucane ML, Beckman R, Ghosh-Dastidar M, Dubowitz T, Collins RL, Troxel W. Do social isolation and neighborhood walkability influence relationships between COVID-19 experiences and wellbeing in predominantly Black urban areas? LANDSCAPE AND URBAN PLANNING 2022; 217:104264. [PMID: 34690393 PMCID: PMC8519605 DOI: 10.1016/j.landurbplan.2021.104264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 05/07/2023]
Abstract
Black Americans have been disproportionately affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) pandemic. Since the pandemic's start, we have observed compounded health, social, and economic impacts for communities of color, fueled in part by profound residential segregation in the United States that, for centuries prior to the pandemic, created differences in access to opportunity and resources. Based on a longitudinal cohort of Black residents living in two racially isolated Pittsburgh neighborhoods, we sought to: 1) describe the experiences of behavioral responses to COVID-19 conditions (e.g., closures of businesses, schools, government offices) and illness experiences reported by residents within these disinvested, urban areas and 2) determine if these experiences were associated with perceptions of risk, negative mental health outcomes, and food insecurity; and 3) examine whether any of the associations were explained by social isolation or modified by neighborhood walkability. We found direct associations between residents' experience with COVID-19-related closures and with the illness, with perceived risk, and change in psychological distress, sleep quality, and food insecurity from pre-COVID-19 levels. Social isolation was a statistically significant mediator of all of these associations, most strongly mediating the pathway to psychological distress. We found neighborhood walkability to be a significant moderator of the association between closure experiences and sleep quality. The results suggest that experiences of COVID-19 closures and illness were associated with serious threats to public health in Black, disinvested, urban neighborhoods, beyond those caused directly by the virus. Outcomes of the pandemic appear very much dependent on the extent to which social and physical resources are available to meet the demands of stress.
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Scerpella DL, Bouranis NG, Webster MJ, Dellapina M, Koeuth S, Parker LJ, Kales HC, Gitlin LN. Using Geographic Information Systems (GIS) for Targeted National Recruitment of Community-Dwelling Caregivers Managing Dementia-Related Behavioral and Psychological Symptoms: A Recruitment Approach for a Randomized Clinical Trial. JOURNAL OF GEOGRAPHIC INFORMATION SYSTEM 2021; 13:302-317. [PMID: 34484851 PMCID: PMC8415725 DOI: 10.4236/jgis.2021.133017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Over 16 million caregivers of people living with dementia require support in a range of issues, including self-care, disease education, and guidance for how to manage behavioral and psychological symptoms of dementia (BPSD). Non-pharmacological interventions are needed to address these areas, and online applications have been shown to be safe and effective. To ensure the efficacy of such interventions, racially, ethnically, geographically, and socioeconomically diverse participants must be recruited to increase the generalizability of study outcomes. This protocol paper describes a recruitment plan using Geographic Information Systems (GIS) to reach a representative sample of caregivers across the United States for a national Phase III clinical study. Using publicly available census data from the American Community Survey (ACS), combined with location data for local aging resources such as Area Agencies on Aging (AAA), recruitment will be derived from data analysis conducted in ESRI ArcGIS v10.7.1. Datasets including age, gender, income, and education will be assessed nationally at the county and census tract spatial scale in a nine-step process to develop recruitment priority areas containing high concentrations of eligible participants living in the community. Overall, the current protocol will demonstrate the value of GIS in tailoring targeted outreach strategies to recruit community-dwelling populations through local resource institutions. This novel approach may have far-reaching implications in future recruitment initiatives and help to secure racially/ethnically diverse samples.
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Affiliation(s)
| | - Nicole G Bouranis
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Melinda J Webster
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Maria Dellapina
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Sokha Koeuth
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Lauren J Parker
- School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Helen C Kales
- Department of Psychiatry, University of California-Davis, Sacramento, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
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12
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Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review. ACTA ACUST UNITED AC 2021; 6:464-485. [PMID: 33688575 PMCID: PMC7934124 DOI: 10.1007/s41347-021-00195-6] [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: 07/15/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022]
Abstract
Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.
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13
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Nagata S, Nakaya T, Hanibuchi T, Amagasa S, Kikuchi H, Inoue S. Objective scoring of streetscape walkability related to leisure walking: Statistical modeling approach with semantic segmentation of Google Street View images. Health Place 2020; 66:102428. [PMID: 32977303 DOI: 10.1016/j.healthplace.2020.102428] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/19/2020] [Accepted: 08/18/2020] [Indexed: 12/19/2022]
Abstract
Although the pedestrian-friendly qualities of streetscapes promote walking, quantitative understanding of streetscape functionality remains insufficient. This study proposed a novel automated method to assess streetscape walkability (SW) using semantic segmentation and statistical modeling on Google Street View images. Using compositions of segmented streetscape elements, such as buildings and street trees, a regression-style model was built to predict SW, scored using a human-based auditing method. Older female active leisure walkers living in Bunkyo Ward, Tokyo, are associated with SW scores estimated by the model (OR = 3.783; 95% CI = 1.459 to 10.409), but male walkers are not.
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Affiliation(s)
- Shohei Nagata
- Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-0845, Japan.
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-0845, Japan.
| | - Tomoya Hanibuchi
- Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-0845, Japan.
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
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14
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Abstract
Nowadays, the elderly tend to make more trips: Health benefits resulting from their daily walking routines are an important topic in the context of urban renewal processes. Many health organizations and researchers have demonstrated the influence of the urban environment on walkability levels. This article aims to design a multifactor Walkability Index for Elderly Health (WIEH), capable of associating both the adequacy level of public spaces to elderly walkability, and physical exercise benefits while walking. The methodological approach comprised two main parts: Firstly, a literature review of main reports, legislation, and scientific articles was conducted at the intersection of ‘gerontology and physical exercise’ with ‘urban design and mobility’, leading to the selection of four aging-related studies as main contributors to the design of the WIEH; and, secondly, the development of the WIEH was undertaken, based on two premises and designed according to four steps. The first premise defined three systematic areas (urban tissue, urban scene, and safety), variables, and criteria to classify the pedestrian network; and the second premise focused on slopes and stairs in public spaces. The WIEH is divided in four steps: (1) Analyzing public spaces and characterizing their quality for walking, (2) considering the existence of slopes and stairs, (3) calculating different routes for the elderly in their daily routines, or when going to points of interest, and (4) selecting the “heart-friendly route” for elderly people. Adequate walking paths for the elderly can be identified through this innovative approach, with the aim of achieving direct health benefits during their daily routines. Ultimately, the WIEH is capable of supporting decision makers and designers in creating inclusive and age-friendly spaces.
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15
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Kamimura A, Higham R, Panahi S, Lee E, Ashby J. Social Norms and Self-Management Ability among Uninsured Primary Care Patients. South Med J 2020; 113:407-412. [DOI: 10.14423/smj.0000000000001128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Antonakos C, Baiers R, Dubowitz T, Clarke P, Colabianchi N. Associations between body mass index, physical activity and the built environment in disadvantaged, minority neighborhoods: Predictive validity of GigaPan® imagery. JOURNAL OF TRANSPORT & HEALTH 2020; 17:100867. [PMID: 32368490 PMCID: PMC7196415 DOI: 10.1016/j.jth.2020.100867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 04/12/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The built environment has been shown to influence health in studies of disadvantaged populations using different measurement methods. This study determined whether environmental exposures derived from GigaPan® images could serve as valid predictors of body mass index (BMI), walking and moderate to vigorous physical activity (MVPA) in a longitudinal study of low-income adults living in two primarily African American neighborhoods in Pittsburgh, Pennsylvania, USA. GigaPan® is a robotic system used to obtain high-resolution, panoramic images of environments. METHODS Microscale environmental features along 481 streets were audited in 2015-2016 using an audit form. Environmental exposures were estimated for 731 adult participants, using a sample of street segments within a 0.4 km (0.25 mile) network distance from each participant's residential address. Summary environmental exposures were constructed using factor analysis. We tested associations between participant-level environmental exposures and objectively measured BMI, self-reported walking and objectively measured MVPA in regression models controlling for baseline health and demographic variables. RESULTS Three factors representing participants' environmental exposures were constructed: pedestrian bicycle-amenities; hilly-vacant-boarded; physical activity-recreation/low housing density. Environments with infrastructure and amenities supportive of walking and bicycling were associated with lower BMI (Coef. = ‒0.47, p = 0.02). Frequent walking was less likely in environments with more physical activity and recreation venues/low housing density (OR = 0.81, 95% CI [0.67, 0.96]). MVPA was not associated with any of the environmental measures and the hilly-vacant-boarded factor was not associated with any of the outcomes. CONCLUSIONS Predictive validity was demonstrated for an environmental exposure factor that captured features supportive of walking and cycling in a model predicting BMI, using built environment audit data from GigaPan® imagery. A complementary analysis found lower odds of frequent walking in the neighborhood among participants with exposure to more physical activity and recreational features, but fewer types and lower density of housing.
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Affiliation(s)
- Cathy Antonakos
- Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Ross Baiers
- Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Philippa Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Natalie Colabianchi
- Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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17
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Gary-Webb TL, Egnot NS, Nugroho A, Dubowitz T, Troxel WM. Changes in perceptions of neighborhood environment and Cardiometabolic outcomes in two predominantly African American neighborhoods. BMC Public Health 2020; 20:52. [PMID: 31937271 PMCID: PMC6961335 DOI: 10.1186/s12889-019-8119-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/22/2019] [Indexed: 01/24/2023] Open
Abstract
Background Perceived neighborhood characteristics, including satisfaction with one’s neighborhood as a place to live, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. Yet, few studies have evaluated whether changes in perceived neighborhood characteristics over time may be associated with cardiometabolic health indicators. Methods Changes in perception of one’s neighborhood (2013–2016) were determined from a cohort of residents who lived in one of two low-income urban neighborhoods. Changes were categorized into the following: improvement vs. no change or worsening over the three-year time-period. Multivariable linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, DBP, HbA1c, HDL-c) that were assessed in 2016, and compared with those who perceived no change or worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, and years spent in neighborhood. To examine potential sex differences, follow-up models were conducted and stratified by sex. Results Among the 622 individuals who remained in the same neighborhood during the time period, 93% were African American, 80% were female, and the mean age was 58 years. In covariate-adjusted models, those who perceived improvement in their neighborhood safety over the time period had a significantly higher BMI (kg/m2) than those who perceived no improvement or worsening (β = 1.5, p = 0.0162); however, perceived improvement in safety was also significantly associated with lower SBP (mmHg) (β = − 3.8, p = 0.0361). When results were stratified by sex, the relationship between improved perceived neighborhood safety and BMI was only evident in females. Conclusions These findings suggest that perceived neighborhood characteristics may impact cardiometabolic outcomes (BMI, SBP), but through differing pathways. This highlights the complexity of the associations between neighborhood characteristics and underscores the need for more longitudinal studies to confirm the associations with cardiometabolic health in African American populations.
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Affiliation(s)
- Tiffany L Gary-Webb
- Departments of Behavioral and Community Health Sciences and Epidemiology, University of Pittsburgh Graduate School of Public Health 130 DeSoto St, Rm 6135 Public Health Building, Pittsburgh, PA, 15261, USA.
| | - Natalie Suder Egnot
- Departments of Behavioral and Community Health Sciences and Epidemiology, University of Pittsburgh Graduate School of Public Health 130 DeSoto St, Rm 6135 Public Health Building, Pittsburgh, PA, 15261, USA
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18
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Derose KP, Han B, Park S, Williamson S, Cohen DA. The mediating role of perceived crime in gender and built environment associations with park use and park-based physical activity among park users in high poverty neighborhoods. Prev Med 2019; 129:105846. [PMID: 31518627 PMCID: PMC6886686 DOI: 10.1016/j.ypmed.2019.105846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/19/2019] [Accepted: 09/09/2019] [Indexed: 11/18/2022]
Abstract
Women use parks less for physical activity than men, and explanations include gendered concerns regarding personal safety and access to walking paths. This study conducted mediation analyses to examine the effects of gender and presence of park walking path on park use, participation in park programs, and park-based physical activity through the hypothesized mediator (perception of crime). The sample included 3213 park users from 48 parks in high poverty neighborhoods in Los Angeles surveyed between 2013 and 2015; park-level factors were assessed through systematic observations of study parks. Women reported fewer park visits than men in the last 7 days (β = -0.17, p = 0.02) and had significantly higher perceived crime (β = 0.12, p < 0.0001) and perceived crime partially mediated the gender association with park visits (βgender, direct = -0.09, p = 0.19; βgender, indirect = -0.07, p < 0.0001). Similarly, the existence of a walking path in the park was significantly related to increased park use (β = 0.27, p = 0.006) and a lower level of perceived crime (β = -0.25, p = 0.0034) and perceived crime partially mediated the association of walking path with park visits (βwalking path, direct = 0.18, p = 0.10; βwalking path, indirect = 0.15, p = 0.005). The associations between gender, walking path, and park-based exercise and program participation were not meaningfully mediated by perceived crime. Among park users in majority Latino, high poverty neighborhoods, addressing crime concerns are likely necessary to increase park use among women and adults whose parks do not have a walking path. For park-based exercise and participation in park programs, gendered preferences regarding park-based physical activity should be explored.
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Affiliation(s)
- Kathryn P Derose
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America.
| | - Bing Han
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America.
| | - Sujeong Park
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America.
| | - Stephanie Williamson
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America.
| | - Deborah A Cohen
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States of America.
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19
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Craike M, Bourke M, Hilland TA, Wiesner G, Pascoe MC, Bengoechea EG, Parker AG. Correlates of Physical Activity Among Disadvantaged Groups: A Systematic Review. Am J Prev Med 2019; 57:700-715. [PMID: 31630762 DOI: 10.1016/j.amepre.2019.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Socioeconomically disadvantaged adults have lower engagement in leisure-time physical activity than those who are more affluent. Identification of correlates of physical activity can inform the design of effective interventions. The aim of this systematic review was to identify consistent correlates of unspecified physical activity and leisure-time physical activity among socioeconomically disadvantaged adults. EVIDENCE ACQUISITION PubMed and Scopus were searched up to May 2018, and titles/abstracts and full texts were screened against eligibility criteria. Methodologic quality was assessed, and correlates were synthesized from July to September 2018. EVIDENCE SYNTHESIS Seventy-three studies were selected for synthesis; 48 examined unspecified physical activity and 31 examined leisure-time physical activity (6 examined both). Self-rated health, functional capacity, and physical activity self-efficacy were consistently, positively associated with unspecified physical activity. Mental health status and perceived benefits and enjoyment of physical activity were consistently, positively associated with leisure-time physical activity. Most studies were cross-sectional and used validated self-report measures of physical activity; few reported response rates >50%. CONCLUSIONS Few factors were consistently associated with either unspecified physical activity or leisure-time physical activity. Based on available evidence, strategies to increase physical activity should consider the needs of, and focus on, those with poor self-rated health and functional capacity and should use strategies to improve physical activity self-efficacy. Strategies to increase leisure-time physical activity should focus on simultaneously addressing leisure-time physical activity and mental health concerns and improving perceptions of physical activity benefits and enjoyment. It is recommended that future studies focus on leisure-time physical activity, focus on men, use longitudinal design, examine variables related to behavioral attributes and skills, and carefully consider and plan recruitment strategies.
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Affiliation(s)
- Melinda Craike
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; Mitchell Institute, Victoria University, Melbourne, Victoria, Australia.
| | - Matthew Bourke
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Toni A Hilland
- School of Education, College of Design and Social Context, Bundoora, Victoria, Australia
| | - Glen Wiesner
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Enrique Garcia Bengoechea
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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20
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Azmeh R, Greydanus DE, Agana MG, Dickson CA, Patel DR, Ischander MM, Lloyd RD. Update in Pediatric Asthma: Selected Issues. Dis Mon 2019; 66:100886. [PMID: 31570159 DOI: 10.1016/j.disamonth.2019.100886] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities. Also reviewed are links of asthma with mental health disorders, sleep disturbances and other comorbidities. A stepwise approach to asthma management is discussed that includes pharmacologic and non-pharmacologic strategies in the pediatric population. The role of immunotherapy and use of various immunomodulators are considered as well.
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Affiliation(s)
- Roua Azmeh
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Marisha G Agana
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Cheryl A Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States; Health Equity and Community Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Mariam M Ischander
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Robert D Lloyd
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, United States
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21
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Claudel SE, Shiroma EJ, Harris TB, Mode NA, Ahuja C, Zonderman AB, Evans MK, Powell-Wiley TM. Cross-Sectional Associations of Neighborhood Perception, Physical Activity, and Sedentary Time in Community-Dwelling, Socioeconomically Diverse Adults. Front Public Health 2019; 7:256. [PMID: 31572702 PMCID: PMC6753201 DOI: 10.3389/fpubh.2019.00256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/22/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Little is known about the role of perceived neighborhood environment as a determinant of physical activity (PA) and sedentary time (ST) in understanding obesity-related health behaviors. We focus on a biracial, socioeconomically diverse population using objectively measured ST, which is under-represented in the literature. Methods: We examined the association between self-reported neighborhood perception (Likert-scale questions), PA using the Baecke questionnaire, and both non-sedentary time and ST using accelerometry from wave 4 of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 2,167). After applying exclusion criteria, the sample size was n = 1,359 for analyses of self-reported PA and n = 404 for analyses of accelerometry data. Factor analysis identified key neighborhood characteristics to develop a total neighborhood perception score (NPS). Higher NPS indicated less favorable neighborhood perception. Linear regression was used to determine the relationship between NPS, PA, non-sedentary time, and ST. Results: Complete data were available for n = 1,359 [age 56.6(9.0) years, 59.5% female, 62.2% African American] for whom we identified four neighborhood perception factors: (1) concern about crime, (2) physical environment, (3) location of violent crime, and (4) social environment. Worsening perception of the overall neighborhood [β = −0.13 (SE = 0.03); p = 0.001], the physical environment [−0.11 (0.05); p = 0.03], and the social environment [−0.46 (0.07); p < 0.0001] were associated with decreased PA. Worsening perception of the overall neighborhood [1.14 (0.49); p = 0.02] and neighborhood social environment [3.59 (1.18); p = 0.003] were associated with increased ST over the day. There were no interactions for race, sex, poverty status, or economic index. Conclusion: Poor overall neighborhood perception, perceived social environment, and perceived neighborhood physical environment are associated with PA and ST in a multi-racial, socioeconomically diverse cohort of urban adults. Clinical Trial Registration: The HANDLS study is registered at ClinicalTrials.gov as NCT01323322.
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Affiliation(s)
- Sophie E Claudel
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Blood, Lung Institute, National Institutes of Health, Bethesda, MD, United States
| | - Eric J Shiroma
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Nicolle A Mode
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Chaarushi Ahuja
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Blood, Lung Institute, National Institutes of Health, Bethesda, MD, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Blood, Lung Institute, National Institutes of Health, Bethesda, MD, United States
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22
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Abshire DA, Wilson DK, Sweeney AM, Pinto BM. Correlates of Moderate-to-Vigorous Physical Activity and Exercise Motivation in Underserved African American Men. Am J Mens Health 2019; 13:1557988319855155. [PMID: 31148501 PMCID: PMC6545657 DOI: 10.1177/1557988319855155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Effective interventions are needed to increase physical activity (PA) in African American men, but little is known about correlates of PA and exercise motivation in this population. Using an ecological approach that considers cognitive, social, and environmental factors, correlates of moderate-to-vigorous physical activity (MVPA) and exercise motivation in underserved African American men were examined. Greater exercise motivation, greater social support for exercise, and more favorable environmental perceptions were hypothesized to be associated with higher MVPA, and greater social support and environmental perceptions were hypothesized to be associated with higher exercise motivation. This secondary analysis used baseline data from the Positive Action for Today’s Health (PATH) trial. African American men (n = 166, aged 48 ± 15 years) completed surveys that assessed cognitive, social, and environmental factors theoretically relevant to MVPA. Accelerometers were used to obtain a 7-day estimate of MVPA. Hierarchical linear regression analyses showed that exercise motivation was positively associated with MVPA (B = 1.15, SE = .41, p = .006). Exercise attitudes (B = .16, SE = .07, p = .037), exercise self-concept (B = .28, SE = .06, p < .001), exercise support from friends (B = .12, SE = .06, p = .048), and places for walking and cycling (B = .13, SE = .06, p = .032) were positively associated with exercise motivation. Interventions that improve exercise motivation and associated variables may be warranted to increase MVPA in underserved African American men. ClinicalTrials.gov # NCT01025726
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Affiliation(s)
| | - Dawn K Wilson
- 2 Department of Psychology, University of South Carolina, College of Arts and Sciences, Columbia, SC, USA
| | - Allison M Sweeney
- 2 Department of Psychology, University of South Carolina, College of Arts and Sciences, Columbia, SC, USA
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23
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Scerpella DL, Adam A, Marx K, Gitlin LN. Implications of Geographic Information Systems (GIS) for targeted recruitment of older adults with dementia and their caregivers in the community: A retrospective analysis. Contemp Clin Trials Commun 2019; 14:100338. [PMID: 30899836 PMCID: PMC6412022 DOI: 10.1016/j.conctc.2019.100338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
5.5 million Americans are living with Alzheimer's dementia (AD) or related dementias. Developing evidence-based interventions for these people and their caregivers (dyads) is a public health priority, and is highly dependent on recruiting representatives from the community. Precision recruitment methodologies are needed to improve the efficiency of this process. Geographic Information Systems (GIS) offer the potential to determine location trends of an older adult population of people living with dementia in the community and their caregivers. American Community Survey (ACS) 2015 5-year estimates were analyzed at the census tract level in ESRI ArcMap v. 10.5.1. Datasets included summarized estimates of age, gender, income, and education in Maryland. Using a two-step process, geographic regions were identified in ArcMap that contained various combinations of available data variables. These areas were compared to participant locations from a previously completed traditional recruitment effort to determine overlap (Dementia Behavior Study - R01AGO41781). The largest number of existing participants were identified in derived regions defined by combining age, education, gender, and income variables; predicting 184 (79%) of 234 participants regardless of the population density within census tracts. 208 (89%) were identified when matching this variable combination to the highest density census tracts (city/urban), and 66 (28%) in regions with the lowest population density (rural). This study successfully defined specific geographic regions in the state of Maryland that overlapped with a large number of known dementia dyad locations obtained via traditional recruitment efforts. Implications for these findings allow for more targeted recruitment efforts of difficult to recruit populations, and less utilization of resources for doing so.
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Affiliation(s)
- Danny L. Scerpella
- Johns Hopkins School of Nursing, Center for Innovative Care in Aging, 901 N. Broadway, Baltimore, MD, 21205, USA
- Corresponding author.
| | - Atif Adam
- Johns Hopkins Bloomberg School of Public Health, Center on Aging and Health, 624 N. Broadway, Room 390, Baltimore, MD, 21205, USA
| | - Katherine Marx
- Johns Hopkins School of Nursing, Center for Innovative Care in Aging, 901 N. Broadway, Baltimore, MD, 21205, USA
| | - Laura N. Gitlin
- Drexel University, 1601 Cherry Street, 10th Floor, Room 1092, Philadelphia, PA, 19102, USA
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Colabianchi N, Clennin MN, Dowda M, McIver KL, Dishman RK, Porter DE, Pate RR. Moderating effect of the neighbourhood physical activity environment on the relation between psychosocial factors and physical activity in children: a longitudinal study. J Epidemiol Community Health 2019; 73:598-604. [PMID: 30967488 PMCID: PMC6559835 DOI: 10.1136/jech-2018-211456] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 12/22/2022]
Abstract
Background Few studies have examined the moderating role of neighbourhood environments on the relation between psychosocial factors and physical activity, and results of these studies are mixed. This study examined this relationship in 636 fifth to seventh graders from South Carolina, USA. Methods From 2010 to 2013, children and their parent/guardian completed annual self-reported surveys assessing psychosocial factors, and children wore accelerometers for 1 week each year. Neighbourhood environments were classified as supportive or non-supportive for physical activity (PA) based on in-person audits of facilities near children’s homes and windshield surveys of children’s streets. Growth curve analyses were completed to assess the moderating effect of the neighbourhood physical activity environment (NPAE) on the relation between psychosocial factors and total physical activity (TPA) over time. Results Significant interactions on TPA were found for (1) time, NPAE and parent-reported parent support for PA; (2) time, NPAE and child-reported equipment in the home; (3) child-reported parental support for PA and time; (4) child-reported parental support for PA and NPAE; (5) PA self-schema and time and (6) child-reported parental encouragement and time. Parental support and a supportive NPAE were important for TPA, especially as children transitioned to middle school, whereas home equipment and a supportive NPAE were important for fifth graders’ TPA. Conclusion Consistent with the socioecological model, PA behaviour was dependent on interacting effects across levels of influence. Generally, both a supportive NPAE and positive psychosocial factors were needed to support TPA. Factors influencing PA across multiple levels should be addressed in PA interventions.
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Affiliation(s)
- Natalie Colabianchi
- Applied Exercise Science, School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Morgan N Clennin
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Marsha Dowda
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Kerry L McIver
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Rod K Dishman
- Department of Kinesiology, College of Education, University of Georgia, Athens, Georgia, USA
| | - Dwayne E Porter
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Russell R Pate
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Benjamin-Neelon SE, Platt A, Bacardi-Gascon M, Armstrong S, Neelon B, Jimenez-Cruz A. Greenspace, physical activity, and BMI in children from two cities in northern Mexico. Prev Med Rep 2019; 14:100870. [PMID: 31016122 PMCID: PMC6468144 DOI: 10.1016/j.pmedr.2019.100870] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/31/2019] [Accepted: 04/03/2019] [Indexed: 12/26/2022] Open
Abstract
Numerous previous studies have reported positive associations between exposure to greenspace and children's physical activity, but in high-income countries only. Prior studies have also examined greenspace and obesity in children, but these have yielded inconsistent results and focused mostly on older children. The purpose of this study was to assess associations between time children spent in greenspace as the primary exposure and our outcomes of interest, including 1) minutes of physical activity, and 2) body mass index (BMI) z-score. Our sample was 102 children ages 3 to 5 years living in Ensenada and Tijuana, Mexico. We fit linear mixed models to estimate associations between greenspace and children's physical activity and BMI z-score. After adjustment for potential confounders, greater time in greenspace was associated with decreased sedentary time (−0.08 min per hour for each additional 30 min in greenspace; 95% CI −0.13, −0.04; p = 0.002) and increased moderate-to-vigorous physical activity (MVPA) (0.06; 95% CI 0.03, 0.10; p < 0.001). Results were driven primarily by children in Tijuana (−0.22; 95% CI −0.38, −0.06; p = 0.008 for sedentary time and 0.15; 95% CI 0.06, 0.38; p = 0.007 for MVPA). Time in greenspace was not associated with BMI z-score in children in Ensenada (0.001; 95% CI −0.008, 0.01; p = 0.83) or Tijuana (−0.009; 95% CI −0.02, 0.004; p = 0.17). Greater time in greenspace was associated with physical activity but not BMI in our sample of children—more so in Tijuana compared to Ensenada. Given high rates of obesity, interventions should aim to increase physical activity in young children in Northern Mexico. Greater time in greenspace was associated with decreased sedentary time. Greater time in greenspace was associated with increased physical activity. Associations were mainly driven by children in Tijuana compared to Ensenada. Time spent in greenspace was not associated with body mass index z-score.
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Affiliation(s)
- Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, 615 North Wolfe Street, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alyssa Platt
- Duke Global Health Institute, Department of Biostatistics and Bioinformatics, 310 Trent Drive, Durham, NC 27710, USA
| | - Montserrat Bacardi-Gascon
- Schools of Medicine and Psychology, Universidad Autónoma de Baja California, Calzada Universidad 14418, Mesa de Otay, CP 22390 Tijuana, Mexico
| | - Sarah Armstrong
- Department of Pediatrics, 4020 Roxboro Road, Duke University Medical Center, Durham, NC 27704, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29415, USA
| | - Arturo Jimenez-Cruz
- Schools of Medicine and Psychology, Universidad Autónoma de Baja California, Calzada Universidad 14418, Mesa de Otay, CP 22390 Tijuana, Mexico
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Twardzik E, Judd S, Bennett A, Hooker S, Howard V, Hutto B, Clarke P, Colabianchi N. Walk Score and objectively measured physical activity within a national cohort. J Epidemiol Community Health 2019; 73:549-556. [PMID: 30944171 PMCID: PMC6581093 DOI: 10.1136/jech-2017-210245] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/26/2018] [Accepted: 01/25/2019] [Indexed: 01/18/2023]
Abstract
Background There have been mixed findings regarding the relationship between walkability and level of physical activity in adults. Methods Participants from The REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort (N=7561) were used to examine the association between Walk Score and physical activity measured via accelerometry. The subsample included geographically diverse adults, who identified as black or white, and were over the age of 45. Linear regression was used to examine the direct effects, as well as the interaction, of Walk Score by sex, age and race. Results The majority of participants lived in a ‘Very Car-Dependent’ location (N=4115). Only 527 lived in a location that was ‘Very Walkable/Walker’s Paradise’. Living in a location with a Walk Score of ‘Very Car-Dependent’ compared with ‘Very Walkable/Walker’s Paradise’ was associated with 19% (0.81; 95% CI 0.73 to 0.90) lower predicted minutes of moderate to vigorous physical activity per day, after adjustment for covariates. There was no evidence of statistically significant interactions between Walk Score and sex, age or race (p>0.05). Conclusion Accumulated daily time in moderate to vigorous physical activity was higher for participants living in neighbourhoods designated as ‘Very Walkable/Walker’s Paradise’. This effect was not moderated by sex, age or race of participants.
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Affiliation(s)
- Erica Twardzik
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Suzanne Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Aleena Bennett
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Steven Hooker
- College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Virginia Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Brent Hutto
- School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Philippa Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA .,Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Dubowitz T, Ghosh Dastidar M, Richardson AS, Colabianchi N, Beckman R, Hunter GP, Sloan JC, Nugroho AK, Collins RL. Results from a natural experiment: initial neighbourhood investments do not change objectively-assessed physical activity, psychological distress or perceptions of the neighbourhood. Int J Behav Nutr Phys Act 2019; 16:29. [PMID: 30917831 PMCID: PMC6438005 DOI: 10.1186/s12966-019-0793-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have assessed objectively measured physical activity (PA), active transportation, psychological distress and neighborhood perceptions among residents of a neighborhood before and after substantial improvements in its physical environment. Also, most research-to-date has employed study designs subject to neighborhood selection, which may introduce bias in reported findings. We built upon a previously enrolled cohort of households from two low-income predominantly African American Pittsburgh neighborhoods, matched on socio-demographic composition including race/ethnicity, income and education. One of the two neighborhoods received substantial neighborhood investments over the course of this study including, but not limited to public housing development and greenspace/landscaping. We implemented a natural experiment using matched intervention and control neighborhoods and conducted pre-post assessments among the cohort. Our comprehensive assessments included accelerometry-based PA, active transportation, psychological distress and perceptions of the neighborhood, with assessments conducted both prior to and following the neighborhood changes. In 2013, we collected data from 1003 neighborhood participants and in 2016, we re-interviewed 676 of those participants. We conducted an intent to treat analysis, with a difference-in-difference estimator using attrition weighting to account for nonresponse between 2013 and 2016. In addition, we derived an individual-level indicator of exposure to neighbourhood investment and estimated effect of exposure to investment on the same set of outcomes using covariate-adjusted models. RESULTS We observed no statistically significant differences in activity, psychological distress, satisfaction with one's neighborhood as a place to live or any of the other measures we observed prior to and after the neighborhood investments between the intervention and control neighborhoods or those exposed vs not exposed to investments. CONCLUSIONS Using this rigorous study design, we observed no significant changes in the intervention neighborhood above and beyond secular trends present in the control neighborhood. Although neighborhood investment may have other benefits, we failed to see improvement in PA, psychological distress or related outcomes in the low-income African American neighborhoods in our study. This may be an indication that improvements in the physical environment may not directly translate into improvements in residents' physical activity or health outcomes without additional individual-level interventions. It is also possible that these investments were not dramatic enough to spur change within the three year period. Additional studies employing similar design with other cohorts in other settings are needed to confirm these results. TRIAL REGISTRATION Trial Registration is not applicable since we did not prospectively assign individuals to a health-related intervention.
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Affiliation(s)
- Tamara Dubowitz
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA USA
| | | | | | | | - Robin Beckman
- RAND Corporation, 1776 Main Street, Santa Monica, CA USA
| | - Gerald P. Hunter
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA USA
| | | | - Alvin K. Nugroho
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA USA
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Abstract
Purpose of review Limited physical activity (PA) and obesity are two primary risk factors for cardiovascular disease (CVD). Within a socio-ecological framework, neighborhood social environment may play a key role in influencing PA and obesity. However, the mechanisms underlying this relationship remain ambiguous. Our goals in this review are: (1) to summarize findings from the recent studies on neighborhood social environment in relation to PA and obesity as CVD risk factors, and (2) to briefly describe several innovative approaches to assessing neighborhood social environment. Recent findings Almost all recent studies assessed neighborhood social environment around residential areas. There were consistent associations between neighborhood social environment and PA and obesity, with some exceptions (indicating null associations or paradoxical associations). However, a focus on residential social environment may limit results because these studies did not account for any exposures occurring away from individuals' homes. Additionally, the majority of studies utilized a cross-sectional design, which limits our ability to make inferences regarding the causality of the association between social environment and PA or obesity as CV risk factors. Summary The majority of the studies on neighborhood social environment characterized factors around residential areas and assessed participant activity via self-reported surveys. Future research should leverage tools to account for the spatial mismatch between environmental exposures and outcomes by using global positioning systems, ecological momentary assessments, virtual neighborhood audits, and simulation modeling. These approaches can overcome major limitations by tracking individuals' daily activity and real-time perceptions of neighborhood social environments linked to CVD events.
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Gray CL, Messer LC, Rappazzo KM, Jagai JS, Grabich SC, Lobdell DT. The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study. PLoS One 2018; 13:e0203301. [PMID: 30161196 PMCID: PMC6117021 DOI: 10.1371/journal.pone.0203301] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/18/2018] [Indexed: 01/29/2023] Open
Abstract
Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for state, adjusted for percent minority and rural-urban status. We modelled overall and sex-specific estimates, reporting prevalence differences (PD) and 95% confidence intervals (CI). In the overall population, the PD increased from best (PD = 0.341 (95% CI: 0.287, 0.396)) to worst (PD = 0.645 (95% CI: 0.599, 0.690)) EQI tertile. We observed similar trends in males from best (PD = 0.244 (95% CI: 0.194, 0.294)) to worst (PD = 0.601 (95% CI: 0.556, 0.647)) quality environments, and in females from best (PD = 0.446 (95% CI: 0.385, 0.507)) to worst (PD = 0.655 (95% CI: 0.607, 0.703)). We found that poor environmental quality exacerbates the LTPIA-obesity relationship. Efforts to improve obesity through LTPIA may benefit from considering this relationship.
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Affiliation(s)
- Christine L. Gray
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
| | - Lynne C. Messer
- School of Public Health, Oregon Health & Sciences University-Portland State University, Portland, Oregon, United States of America
| | - Kristen M. Rappazzo
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
| | - Jyotsna S. Jagai
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Shannon C. Grabich
- Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
| | - Danelle T. Lobdell
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
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