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Shilton T, Bauman A, Beger B, Chalkley A, Champagne B, Elings-Pers M, Giles-Corti B, Goenka S, Miller M, Milton K, Oyeyemi A, Ross R, Sallis JF, Armstrong-Walenczak K, Salmon J, Whitsel LP. More People, More Active, More Often for Heart Health - Taking Action on Physical Activity. Glob Heart 2024; 19:42. [PMID: 38708404 PMCID: PMC11067976 DOI: 10.5334/gh.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/12/2024] [Indexed: 05/07/2024] Open
Abstract
Physical inactivity is a leading contributor to increased cardiovascular morbidity and mortality. Almost 500 million new cases of preventable noncommunicable diseases (NCDs) will occur globally between 2020 and 2030 due to physical inactivity, costing just over US$300 billion, or around US$ 27 billion annually (WHO 2022). Active adults can achieve a reduction of up to 35% in risk of death from cardiovascular disease. Physical activity also helps in moderating cardiovascular disease risk factors such as high blood pressure, unhealthy weight and type 2 diabetes. For people with cardiovascular disease, hypertension, type 2 diabetes and many cancers, physical activity is an established and evidence-based part of treatment and management. For children and young people, physical activity affords important health benefits. Physical activity can also achieve important cross-sector goals. Increased walking and cycling can reduce journeys by vehicles, air pollution, and traffic congestion and contribute to increased safety and liveability in cities.
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Affiliation(s)
| | | | - Birgit Beger
- World Heart Federation, BE
- European Heart Network, BE
| | - Anna Chalkley
- Faculty of Life Sciences and Health Studies, University of Bradford, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, UK
| | | | | | - Billie Giles-Corti
- Centre for Urban Research, RMIT University, AU
- Telethon Kids Institute, AU
| | - Shifalika Goenka
- Public Health Foundation of India, IN
- Centre for Chronic Disease Control, IN
| | - Mark Miller
- World Heart Federation, UK
- Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Karen Milton
- Norwich Medical School, University of East Anglia, UK
| | | | - Robert Ross
- Queen’s University School of Kinesiology and Health Studies, CA
| | - James F. Sallis
- Herbert Wertheim School of Public Health, University of California, US
- Mary MacKillop Institute for Health Research, Australian Catholic University, AU
| | | | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, AU
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Chinapaw MJM, Klaufus LH, Oyeyemi AL, Draper C, Palmeira AL, Silva MN, Van Belle S, Pawlowski CS, Schipperijn J, Altenburg TM. Youth-centred participatory action approach towards co-created implementation of socially and physically activating environmental interventions in Africa and Europe: the YoPA project study protocol. BMJ Open 2024; 14:e084657. [PMID: 38387985 PMCID: PMC10882351 DOI: 10.1136/bmjopen-2024-084657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION The majority of adolescents do not meet guidelines for healthy behaviours, posing major risks for developing multiple non-communicable diseases. Unhealthy lifestyles seem more prevalent in urban than rural areas, with the neighbourhood environment as a mediating pathway. How to develop and implement sustainable and effective interventions focused on adolescent health and well-being in urban vulnerable life situations is a key challenge. This paper describes the protocol of a Youth-centred Participatory Action (YoPA) project aiming to tailor, implement, and evaluate social and physical environmental interventions. METHODS AND ANALYSIS In diverse urban environments in Denmark, the Netherlands, Nigeria and South Africa, we will engage a dynamic group of 15-20 adolescents (12-19 years) growing up in vulnerable life situations and other key stakeholders (eg, policy makers, urban planners, community leaders) in local co-creation communities. Together with academic researchers and local stakeholders, adolescents will take a leading role in mapping the local system; tailoring; implementing and evaluating interventions during participatory meetings over the course of 3 years. YoPA applies a participatory mixed methods design guided by a novel Systems, User perspectives, Participatory co-creation process, Effects, Reach, Adoption, Implementation and Maintenance framework assessing: (i) the local systems, (ii) user perspectives, (iii) the participatory co-creation process, (iv) effects, (v) reach, (vi) adoption, (vii) implementation and (viii) maintenance of interventions. Through a realist evaluation, YoPA will explore why and how specific outcomes were reached (or not) in each setting (n=800-1000 adolescents in total). ETHICS AND DISSEMINATION This study received approval from the ethics committees in Denmark, the Netherlands, Nigeria and South Africa and will be disseminated via various collaborative dissemination activities targeting multiple audiences. We will obtain informed consent from all participants. We envision that our YoPA co-creation approach will serve as a guide for participation of adolescents in vulnerable life situations in implementation of health promotion and urban planning in Europe, Africa and globally. TRIAL REGISTRATION NUMBER NCT06181162.
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Affiliation(s)
- Mai J M Chinapaw
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leonie H Klaufus
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
- Department of Physiotherapy, Redeemer's University, Ede, Nigeria
| | - Catherine Draper
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - António L Palmeira
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- CIFI2D, Universidade do Porto, Porto, Lisbon
| | - Marlene Nunes Silva
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- Programa Nacional para a Promoção da Atividade Física, Direcção-Geral da Saúde, Lisboa, Portugal
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Charlotte S Pawlowski
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Teatske M Altenburg
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Paez DC, Cortés-Corrales S, Jimenez-Mora MA, Gutiérrez A, Arango-Paternina CM, Duperly J. Health-related fitness in medical students: a curricular intervention in Bogota, Colombia. BMC Public Health 2024; 24:320. [PMID: 38287350 PMCID: PMC10826255 DOI: 10.1186/s12889-024-17748-y] [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: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE To evaluate the impact of a curricular intervention to promote health-related fitness (HRF) among medical students in Bogota, Colombia. METHOD The study was conducted between May 2014 and December 2015 as part of the medical physiology course, in which 208 medical students were enrolled.The curricular intervention included two lectures on physical activity (PA) and student-led group presentations on the physiological effects of exercise on human physiology. An academic incentive (10% of final grade) was given to students who reported and documented regular PA practice during the semester. This study assessed students' HRF variables, perceptions of the curriculum intervention, and PA practices using quantitative and qualitative approaches. RESULTS 55% of the students were female, with a mean age of 19.5 years. Body fat, estimated maximum oxygen consumption (VO2max), handgrip, and sit-up strength showed statistically significant improvements at the end of the intervention. Students reported that PA practice was positively influenced by the curriculum intervention, particularly the academic incentive and the HRF tests. Students reported a wide variety of PA practices, which were mainly done with friends, classmates, or family members. Lack of time was the main reported barrier to PA practice. CONCLUSION The curricular intervention was effective in improving HRF and promoting PA. It remains to be investigated whether these gains are sustained over time.
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Affiliation(s)
- Diana C Paez
- School of Medicine, Universidad de los Andes, Bogotá, Colombia.
| | | | | | - Agustín Gutiérrez
- Department of Social Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Carlos M Arango-Paternina
- Instituto Universitario de Educación Física y Deportes, Universidad de Antioquia, Medellín, Colombia
| | - John Duperly
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Institute of Exercise Medicine and Rehabilitation, Fundación Santa Fe de Bogotá, Bogotá, Colombia
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Karaşan A, Gündoğdu FK, Işık G, Kaya İ, İlbahar E. Assessment of governmental strategies for sustainable environment regarding greenhouse gas emission reduction under uncertainty. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 349:119577. [PMID: 37980791 DOI: 10.1016/j.jenvman.2023.119577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/12/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023]
Abstract
Since greenhouse gas emissions (GHGE) directly impact climate change that affects the environment, human health, society, and ecosystems, the reduction of GHGE is one of the essential actions for the sustainability of the environment. To reduce global GHGE, the United Nations has defined strategies at three levels: government, private, and public. Choosing between these strategies is a difficult process since there are relationships and contradictions among them. The process also includes uncertainties due to some reasons, such as lack of information, social structure, decision makers' hesitancy, and imprecision in the collected data. In this paper, a hierarchically structured methodology based on a decision-making procedure is proposed for the evaluation of the governmental strategies determined to decide the best strategies by integrating expert knowledge and a literature review. For this aim, interpretative structural modeling, cognitive mapping, and inference systems are integrated as a two-stage decision-making methodology based on fuzzy sets to address uncertainties and imprecision in the evaluation of government strategies for GHGE reduction in Türkiye. Based on the results of the first stage, "Transportation" is determined as the most influential sector for GHGE mitigation. In the second stage, strategies of the transportation sector are assessed and ranked. "Promoting the significant public health benefits of low-carbon policies, including increased public transportation and non-motorized mobility" is determined as the most appropriate transportation strategy for the governmental action plan regarding the climate change reduction objective. This paper contributes to applying knowledge and experiences from the current environmental characteristics and social fields to the strategic decision of the GHGE reduction area, to streamline its assessment process, provide human-centered solutions, and accelerate governmental actions.
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Affiliation(s)
- Ali Karaşan
- Department of Industrial Engineering, Yildiz Technical University, İstanbul, Turkey
| | - Fatma Kutlu Gündoğdu
- Department of Industrial Engineering, Turkish Air Force Academy, National Defence University, İstanbul, Turkey
| | - Gürkan Işık
- Department of Industrial Engineering, Bursa Technical University, Bursa, Turkey
| | - İhsan Kaya
- Department of Industrial Engineering, Yildiz Technical University, İstanbul, Turkey; Precidency of the Republic of Türkiye, Defence Industry Agency, Ankara, Turkiye.
| | - Esra İlbahar
- Department of Industrial Engineering, Yildiz Technical University, İstanbul, Turkey
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Hernandez ED, Guzman CA, Seron P. Interventions based on environmental determinants for nutritional and physical activity behaviours in Colombia: a scoping review. BMJ Open 2022; 12:e060085. [PMID: 36123059 PMCID: PMC9486334 DOI: 10.1136/bmjopen-2021-060085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/30/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify, systematically, the interventions based on environmental determinants to improve the nutritional and physical activity (PA) habits available in Colombia. DESIGN A scoping review was performed according to the guidelines of the Joanna Briggs Institute. STUDY SELECTION All studies about intervention programmes for PA and nutritional behaviours in Colombia were included. METHODS Searches in Medline/PubMed, Embase, Cochrane, Scielo and Lilacs, using MeSH, Decs and Emtree terms, were performed up to August 2020. Additionally, a manual search was made in specialised national journals. An internet documentary search of the official websites on policies and programmes by departmental, district and municipal secretariats was also performed.Two reviewers independently screened titles and abstracts. Then, the full texts were reviewed to select documents to be included.Data management relevant information from selected documents and articles was extracted. A descriptive analysis was considered. RESULTS Sixty-seven documents and 70 published articles were found. The programmes were identified in 13 initiatives, 7 in the area of PA and 6 with a nutrition focus. They were on physical and social environmental modifications such as the 'muévete' ('get moving') programmes in Bogota, Quindio and Cartagena; a modification of 'ciclovía'; or bicycle path programmes as well as nutrition programmes in schools, universities and companies. CONCLUSION This scoping review identified national programmes and policies in Colombia in the area of nutrition and PA from the environmental perspective in different scenarios: from schools to workplaces and communities. The need to implement such programmes from public and private institutions is also noted, promoting the practice of PA and healthy eating in every scenario in the national territory. New research to determine the impact of these programmes is essential to get a glimpse of the effects of these programmes and the implications for public health.
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Affiliation(s)
- Edgar D Hernandez
- Facultad de Medicina, Human Movement Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Cristian Arvey Guzman
- Facultad de Medicina, Universidad Nacional de Colombia, Bogota, Colombia
- Physical Therapy Department, Hospital Universitario Nacional de Colombia, Bogota, Colombia
| | - Pamela Seron
- Departamento de Ciencias de la Rehabilitación & CIGES, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Heath GW, Levine D. Physical Activity and Public Health among People with Disabilities: Research Gaps and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10436. [PMID: 36012074 PMCID: PMC9408065 DOI: 10.3390/ijerph191610436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Physical activity has become an integral component of public health systems modeling the public health core functions of assessment, policy development, and assurance. However, people with disabilities have often not been included in public health efforts to assess, develop policies, or evaluate the impact of physical activity interventions to promote health and prevent disease among people with disabilities. Addressing the core function of assessment, current physical activity epidemiology, and surveillance among people with disabilities across the globe highlights the paucity of surveillance systems that include physical activity estimates among people with disabilities. The status of valid and reliable physical activity measures among people with condition-specific disabilities is explored, including self-report measures along with wearable devices, and deficiencies in measurement of physical activity. The core functions of policy development and assurance are described in the context of community-based intervention strategies to promote physical activity among people with disabilities. The identification of research gaps in health behavior change, policy, and environmental approaches to promoting physical activity among people with disabilities is explored, along with recommendations based on the principles of inclusive and engaged research partnerships between investigators and the members of the disability community.
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Affiliation(s)
- Gregory W. Heath
- Public Health Program, Department of Health and Human Performance, University of Tennessee, Chattanooga, TN 37403, USA
- University of Tennessee Health Science Center College of Medicine Chattanooga, Chattanooga, TN 37403, USA
| | - David Levine
- Department of Physical Therapy, The University of Tennessee, Chattanooga, TN 37403, USA
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Assessment of Factors Influencing Personal Exposure to Air Pollution on Main Roads in Bogota: A Mixed-Method Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081125. [PMID: 36013592 PMCID: PMC9416028 DOI: 10.3390/medicina58081125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Particulate Matter (PM), particles of variable but small diameter can penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health in users of different transport modes in four roads in Bogotá. Materials and Methods: this was a mixed-method study (including a cross sectional study and a qualitative description of the air quality perception), in 300 healthy participants, based on an exploratory sequential design. The respiratory effect was measured comparing the changes between pre- and post-spirometry. The PM2.5 and black carbon (BC) concentrations were measured using portable devices. Inhaled doses were also calculated for each participant according to the mode and route. Perception was approached through semi-structured interviews. The analysis included multivariate models and concurrent triangulation. Results: The concentration of matter and black carbon were greater in bus users (median 50.67 µg m-3; interquartile range (-IR): 306.7). We found greater inhaled dosages of air pollutants among bike users (16.41 µg m-3). We did not find changes in the spirometry parameter associated with air pollutants or transport modes. The participants reported a major sensory influence at the visual and olfactory level as perception of bad air quality. Conclusions: We observed greater inhaled doses among active transport users. Nevertheless, no pathological changes were identified in the spirometry parameters. People's perceptions are a preponderant element in the assessment of air quality.
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Rodrigues EQ, Garcia LMT, Ribeiro EHC, Barrozo LV, Bernal RTI, Andrade DR, Barbosa JPDAS, Nunes APDOB, Fermino RC, Florindo AA. Use of an Elevated Avenue for Leisure-Time Physical Activity by Adults from Downtown São Paulo, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095581. [PMID: 35564976 PMCID: PMC9106045 DOI: 10.3390/ijerph19095581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 12/10/2022]
Abstract
Leisure-time physical activity (LTPA) is associated with access and use of public open spaces. The President João Goulart Elevated Avenue, currently denominated Minhocão, is a facility for leisure activities that is open for people during the night and weekends. The aim of this study was to examine if the prevalence of LTPA among individuals living in the surroundings of Minhocão is different according to proximity to, and use of, the facility. We conducted a cross-sectional study with cluster sampling with people aged ≥18 years who lived in households up to 500 m, and between 501 m and 1500 m of Minhocão. The survey was conducted between December 2017 and March 2019 using an electronic questionnaire. We conducted a bivariate analysis and Poisson regression to examine possible differences in LTPA according to the proximity of residences and use of Minhocão. The analysis used post-stratification weights. A total of 12,030 telephone numbers of people were drawn (≤500 m = 6942; and >500 m to ≤1500 m = 5088). The final sample included 235 residents who returned the questionnaires. There was a higher prevalence of individuals engaging in at least 150 min per week of LTPA among users than non-users (Prevalence Ratio = 2.19, IC95% 1.66 to 2.90), independently of sex, age, education, the distance of houses to nearest accesses and number of barriers. The main five barriers related to the usage of the Minhocão were safety issues in and around the Minhocão, rainy weather, lack of vegetation, and lack of facilities. People who used the park had higher prevalence of all types of LTPA than non-users. The results can serve to inform government decision-making on the future of Minhocão.
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Affiliation(s)
- Eduardo Quieroti Rodrigues
- Postgraduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (J.P.d.A.S.B.); (A.A.F.)
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
- Correspondence: ; Tel.: +55-11-3091-8157
| | - Leandro Martin Totaro Garcia
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Evelyn Helena Corgosinho Ribeiro
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo 05508-080, Brazil;
| | | | - Douglas Roque Andrade
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - João Paulo dos Anjos Souza Barbosa
- Postgraduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (J.P.d.A.S.B.); (A.A.F.)
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - Ana Paula de Oliveira Barbosa Nunes
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - Rogério César Fermino
- Research Group on Environment, Physical Activity, and Health, Postgraduate Program in Physical Education, Federal University of Technology—Paraná, Curitiba 80230-901, Brazil;
- Postgraduate Program in Physical Education, Federal University of Paraná, Curitiba 80060-000, Brazil
| | - Alex Antonio Florindo
- Postgraduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (J.P.d.A.S.B.); (A.A.F.)
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
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Three Growth Spurts in Global Physical Activity Policies between 2000 and 2019: A Policy Document Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073819. [PMID: 35409498 PMCID: PMC8997640 DOI: 10.3390/ijerph19073819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022]
Abstract
Non-communicable diseases (NCDs) contribute significantly to global mortality and are of particular concern in growing urban populations of low- and-middle income countries (LMICs). Physical inactivity is a key NCD determinant and requires urgent addressing. Laudable global and regional efforts to promote physical activity are being made, but the links between physical activity (PA), NCD reduction, and integrated intersectoral approaches to reducing obesogenic environments are not consistently made. This study applied a document analysis approach to global PA and NCD policies to better understand the current global policy environment and how this may facilitate integrated PA promotion. A total of 34 global policies related to PA, from different sectors, were analyzed. PA policy in mitigation of NCDs has evolved exponentially, with a progression towards addressing structural determinants alongside individual behavior change. The global PA agenda is primarily driven by the World Health Organization. Intersectoral collaboration is importantly regarded, but the contributions of other sectors, outside of health, education, transport, and urban planning, are less clear. Improving PA among key sub-populations-women, girls, and adolescents-requires greater policy consideration. It is imperative for PA-relevant sectors at all levels to recognize the links with NCDs and work towards integrated policy and practice in mitigation of the rising NCD pandemic.
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Glazener A, Wylie J, van Waas W, Khreis H. The Impacts of Car-Free Days and Events on the Environment and Human Health. Curr Environ Health Rep 2022; 9:165-182. [PMID: 35146704 PMCID: PMC8831014 DOI: 10.1007/s40572-022-00342-y] [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] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
Purpose of review In this paper, we seek to elucidate the impact of car-free days and events on human health. Car-free days and events are often designed to alleviate the impact of transportation-related air pollution, noise, physical inactivity, traffic congestion, or other detrimental externalities of private motor vehicle travel. We reviewed existing peer-reviewed and gray literature to understand the variety of potential public health impacts that have been measured as a result of car-free days or events and associated changes in environmental exposures and lifestyles. Recent findings The impacts of car-free days and events are highly variable and seem to depend on the scope (frequency, duration, and geographic size) and goals of each car-free day and event. Most of the existing literature measures impacts in terms of air and noise pollution and some studies focus on physical activity metrics. In some cases, car-free days and events were successful in reducing the concentration of certain air pollutants but had little or adverse impacts on the concentration of others. Often, traffic is diverted from cordoned areas to surrounding streets, displacing traffic congestion and adverse environmental exposures to other areas of a city, with potential understudied implications to environmental justice. Summary Car-free days and events are often an attractive policy option; however, they require intensive planning to be successful. The organization and execution of car-free days and events, as well as public support and stakeholder engagement, greatly influence the level of success and the sustainability of such initiatives. Health benefits may be a palatable and convincing argument to the general public. However, very few studies focus on actual health impacts associated with car-free days and events. Future research could be most useful if it focused on measuring health outcomes associated with car-free days and events through longitudinal studies.
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Affiliation(s)
- Andrew Glazener
- Community and Regional Planning Program, School of Architecture, University of Texas at Austin, Austin, TX, USA
| | - James Wylie
- Solar Impulse Foundation, Lausanne, Switzerland
| | - Willem van Waas
- Department of Traffic and Public Space, Municipality of Amsterdam, Amsterdam, The Netherlands
| | - Haneen Khreis
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 0SL, UK. .,Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A&M Transportation Institute (TTI), College Station, TX, 77843-3135, USA.
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Büchel B, Marra AD, Corman F. COVID-19 as a window of opportunity for cycling: Evidence from the first wave. TRANSPORT POLICY 2022; 116:144-156. [PMID: 36570515 PMCID: PMC9759314 DOI: 10.1016/j.tranpol.2021.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/01/2021] [Indexed: 05/28/2023]
Abstract
Across the world, the COVID-19 pandemic has forced people to reconsider their habits in terms of how they work, how they interact with each other, and of their mobility. During lockdowns, mobility was in general significantly reduced. Means of collective transportation were used much less, and people preferred means of individual transport. Evidence from some cities suggests that people turned to cycling as a resilient and reliable option with a small risk of contagiousness. This spike in demand led some governments to respond by opening additional bike lanes, reducing the fees of bike-sharing systems, banning cars on selected streets, or giving monetary incentives for the purchase of new bikes. We analyze the bike traffic in Basel and Zurich, two major Swiss cities. Throughout the pandemic, no specific measure to promote cycling was implemented in any of the two cities; we can thus see latent demand patterns exposed when conditions change. As cycling depends on the season and weather, we incorporate these data and correct the traffic counts hereby. We can identify a distinct change in cycling traffic over the course of the day. During the lockdown period, relatively more traffic is observed in the afternoon, possibly associated with leisure activities. Furthermore, there is a short-term drop in the corrected cycling traffic and a fast recovery, demonstrating cycling as a resilient transport mode. Soon bike traffic reached pre-lockdown levels, but no significant increase could be identified, possibly attributed to the absence of explicit policy measures. We furthermore survey a panel of bike policy experts to identify policy actions that could be taken in Basel and Zurich to increase bike usage. The COVID-19 pandemic disrupts life as we know it, leading people to reconsider their travel choices. Given authorities' desire to increase bike usage, it represents a window of opportunity to test new policy measures, increase bike trips of active cyclists, and attract new cyclists. As long as this window is open, people are susceptible to policy measures to reconsidering past choices. However, if no policy measures are conducted during the pandemic, as in the case study, it is likely that bike usage is not increased in the long run. Authorities are well-advised to take this opportunity to strengthen cycling and to lead to a more resilient, accessible, safe, and sustainable urban transport system.
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Affiliation(s)
- Beda Büchel
- Institute of Transport Systems, ETH Zurich, Switzerland
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Fitriahadi E, Priskila Y, Suryaningsih EK, Satriyandari Y, Intarti WD. Social Demographic Analysis with the Growth and Development of Children in the Era of the COVID-19 Pandemic in Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The golden period is a phase of 0–2 years. The parents must get a thorough stimulation of health, nutrition, parenting, and education. During a pandemic like now, the growth and development of toddlers must still be considered, especially by parents.
AIM: Exploring the sociodemographic analysis in term of growth and development of toddler during Covid-19 pandemic.
METHODS: Pregnant women and their parents visited at a primary health center in Yogyakarta, Indonesia, with inclusion criteria: (1) Toddlers aged 18–40 months, (2) mothers of all age ranges, (3) not having current disease complications, (4) mothers at all levels of education, and (5) parents at all income types. The sampling technique is total sampling using a questionnaire instrument and the KPSP format. Data processing using Chi-square statistical test.
RESULTS: The results of the bivariate analysis found that sociodemographics related to the growth and development of children under 5 were maternal education with p = 0.001 and family income with p = 0.000. The unrelated is the age of the toddler p = 0.156, the mother’s age with p = 0.888, and the mother’s occupation with p = 0.113.
CONCLUSION: This study provides essential information as a new approach to improving and determining toddlers’ growth and development during the COVID-19 pandemic.
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Palacios C, Magnus M, Arrieta A, Gallardo H, Tapia R, Espinal C. Obesity in Latin America, a scoping review of public health prevention strategies and an overview of their impact on obesity prevention. Public Health Nutr 2021; 24:5142-5155. [PMID: 33843569 PMCID: PMC11082825 DOI: 10.1017/s1368980021001403] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/05/2021] [Accepted: 03/25/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe the strategies implemented in seventeen Latin American countries for obesity prevention and to provide an overview of their impact. DESIGN A thorough search of strategies and their impact was done through an Internet search, governmental webpages, reports and research articles in English, Spanish and Portuguese. SETTING Latin America (not including the Caribbean countries). PARTICIPANTS Any. RESULTS The Ministry of Health is the main oversight for obesity prevention, with six countries having a specific structure for this. Regular obesity monitoring occurs in a few countries, and thirteen countries have a national obesity prevention plan. The main regulations being implemented/designed are front-of-package labelling (sixteen countries), school environment (fifteen countries), school nutrition education (nine countries), promotion of physical activity level (nine countries) and sugar-sweetened beverage tax (eight countries). All countries have dietary guidelines. The main community-based programmes being implemented are school meals (seventeen countries), complementary nutrition (eleven countries), nutrition education (fourteen countries), promotion of physical activity (nine countries) and healthy environments (nine countries). Most of these strategies have not been evaluated. The few with positive results have used a coordinated, multi-disciplinary and multi-sector approach, with legislation and executive-level support. CONCLUSIONS Important obesity prevention strategies are being implemented in the seventeen Latin American countries included in the present review. However, few have been evaluated to assess their impact on preventing obesity. This information can help assess that actions can be generalised to other countries within the region and can help inform how to prevent obesity in different settings.
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Affiliation(s)
- Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL33199, USA
| | - Marcia Magnus
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL33199, USA
| | - Alejandro Arrieta
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | | | | | - Carlos Espinal
- Global Health Consortium, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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Participation and Physical Activity in Recreovia of Bucaramanga, Colombia. J Phys Act Health 2021; 18:1277-1285. [PMID: 34489368 DOI: 10.1123/jpah.2021-0047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/13/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Open Streets initiatives have allowed for physical activity (PA) in cities worldwide. However, few studies have evaluated the use of small Open Streets in low- and middle-income countries, such as those in Latin America. Thus, this study aimed to describe participation and PA level of users in the Recreovia program in Bucaramanga, Colombia. METHODS A cross-sectional study was conducted during 5 Sundays from September to November 2017. Recreovia use was evaluated at 4 strategic points according to street accessibility (2 points) and aerobics class areas (2 points), using the System for Observing Play and Recreation in Communities. RESULTS A total of 38,577 observations were made (34,969 on streets and 3608 in aerobics class areas). Men (63%) and adults (62%), with moderate to vigorous PA (MVPA) (98%) were observed on streets. The most common PAs were biking (50%), walking/dog walking (36%), and jogging (9%). In aerobics class areas, the most common groups were female (65%) and adults (89%). Participants were engaged in moderate to vigorous PA (91%). CONCLUSION Measurement of number of participants at moderate to vigorous levels of PA was high. A difference between sexes and age in these street and aerobic class area groups was also observed.
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Gauna D, Brown J, Lu K, Martinez M, Ablah E. An Evaluation of a Kansas Open Streets Event's Impact on Businesses. Kans J Med 2021; 14:187-191. [PMID: 34367487 PMCID: PMC8343606 DOI: 10.17161/kjm.vol1414662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Open Streets is an event that promotes physical activity among populations by encouraging city residents to walk and bicycle in streets blocked from motor vehicles. Engagement of businesses is a critical component of Open Streets. This study sought to evaluate the Open Streets ICT 2019 event's impact on adjacent businesses. Methods A 12-item novel survey was developed for this study. Businesses eligible for study participation included retail and non-retail (e.g., non-profits, churches) sites along the Open Streets ICT route in Wichita, Kansas. To understand how Open Streets ICT impacted businesses, the survey used Likert scale questions to prompt respondents to report sales and visitors experiences during the event. Additionally, respondents reported a percent difference in sales compared to a typical Sunday. A phenomenological approach was used to convey the experiences among study participants during Open Streets ICT. Results A total of 102 surveys were completed, a 42% response rate. Most businesses (56%, n = 56) reported being open during Open Streets ICT. Many businesses (72%) reported having "more" visitors compared to a typical Sunday. More than half reported they experienced new and regular visitors (54%, n = 30) from the event. Most businesses (64%, n = 36) reported a positive financial impact, and (52%, n = 29) having more sales than a typical Sunday. Conclusions Open Streets ICT increased sales and the number of visitors among businesses. Respondents reported they plan to participate in the 2020 Open Streets ICT, and if Open Streets ICT was offered twice a year. Finally, most participating businesses reported they recommend that other businesses participate in Open Streets ICT.
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Affiliation(s)
- Danielle Gauna
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Jack Brown
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Kelsey Lu
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | | | - Elizabeth Ablah
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
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Rubio MA, Triana C, King AC, Rosas LG, Banchoff AW, Rubiano O, Chrisinger BW, Sarmiento OL. Engaging citizen scientists to build healthy park environments in Colombia. Health Promot Int 2021; 36:223-234. [PMID: 32361761 DOI: 10.1093/heapro/daaa031] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Colombia's Recreovía program offers community-based free physical activity (PA) classes in parks. We evaluated built and social environmental factors influencing Recreovía local park environments, and facilitated a consensus-building and advocacy process among community members, policymakers and academic researchers aimed at improving uptake and impact of the Recreovía program. We used a mixed-methods approach, with individual and contextual PA measurements and a resident-enabled participatory approach (the Our Voice citizen science engagement model). Recreovía participants were likely to be women meeting PA recommendations, and highly satisfied with the Recreovía classes. Reported facilitators of the Recreovía included its role in enhancing social and individual well-being through PA classes. Reported barriers to usage were related to park maintenance, cleanliness and safety. The Our Voice process elicited community reflection, empowerment, advocacy and action. Our Voice facilitated the interplay among stakeholders and community members to optimize the Recreovía program as a facilitator of active living, and to make park environments more welcoming.
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Affiliation(s)
| | - Camilo Triana
- School of Medicine, Universidad de los Andes, Carrera 1 n°18ª-12 Bogotá, Colombia
| | - Abby C King
- Department of Epidemiology and Population Health, Stanford University School Medicine, Stanford, CA 94305, USA.,Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Stanford University School Medicine, Stanford, CA 94305, USA.,Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ann W Banchoff
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Oscar Rubiano
- Recreovía Program Coordination, Institute of Recreation and Sports, Calle 63 n°59A-0, Bogotá, Colombia
| | - Benjamin W Chrisinger
- Department of Social Policy and Intervention, University of Oxford, Oxford, OX1 2ER, UK
| | - Olga L Sarmiento
- School of Medicine, Universidad de los Andes, Carrera 1 n°18ª-12 Bogotá, Colombia
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Sivaram S, Perkins S, He M, Ginsburg E, Dominguez G, Vedham V, Katz F, Parascandola M, Bogler O, Gopal S. Building Capacity for Global Cancer Research: Existing Opportunities and Future Directions. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:5-24. [PMID: 34273100 PMCID: PMC8285681 DOI: 10.1007/s13187-021-02043-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 05/21/2023]
Abstract
Cancer incidence and mortality are increasing in low- and middle-income countries (LMICs), where more than 75% of global cancer burden will occur by the year 2040. The primary drivers of cancer morbidity and mortality in LMICs are environmental and behavioral risk factors, inadequate prevention and early detection services, presence of comorbidities, and poor access to treatment and palliation. These same drivers also contribute to marked cancer health disparities in high-income countries. Studying cancer in LMICs provides opportunities to better understand and address these drivers to benefit populations worldwide, and reflecting this, global oncology as an academic discipline has grown substantially in recent years. However, sustaining this growth requires a uniquely trained workforce with the skills to pursue relevant, rigorous, and equitable global oncology research. Despite this need, dedicated global cancer research training programs remain somewhat nascent and uncoordinated. In this paper, we discuss efforts to address these gaps in global cancer research training at the US National Institutes of Health.
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Affiliation(s)
- Sudha Sivaram
- Center for Global Health, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Susan Perkins
- Center for Cancer Training, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Min He
- Office of Cancer Centers, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Erika Ginsburg
- Center for Cancer Training, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Geraldina Dominguez
- Office of HIV/AIDS Malignancy, National Cancer Institute, National Institutes of Health, 31 Center Dr, Room 3A33, Bethesda, MD 20892‑2440 USA
| | - Vidya Vedham
- Center for Global Health, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Flora Katz
- Fogarty International Center, National Institutes of Health, 31 Center Drive, Building 31, Bethesda, MD 20892-2220 USA
| | - Mark Parascandola
- Center for Global Health, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Oliver Bogler
- Center for Cancer Training, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
| | - Satish Gopal
- Center for Global Health, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9760 USA
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Backholer K, Baum F, Finlay SM, Friel S, Giles-Corti B, Jones A, Patrick R, Shill J, Townsend B, Armstrong F, Baker P, Bowen K, Browne J, Büsst C, Butt A, Canuto K, Canuto K, Capon A, Corben K, Daube M, Goldfeld S, Grenfell R, Gunn L, Harris P, Horton K, Keane L, Lacy-Nichols J, Lo SN, Lovett RW, Lowe M, Martin JE, Neal N, Peeters A, Pettman T, Thoms A, Thow AMT, Timperio A, Williams C, Wright A, Zapata-Diomedi B, Demaio S. Australia in 2030: what is our path to health for all? Med J Aust 2021; 214 Suppl 8:S5-S40. [PMID: 33934362 DOI: 10.5694/mja2.51020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/11/2022]
Abstract
CHAPTER 1: HOW AUSTRALIA IMPROVED HEALTH EQUITY THROUGH ACTION ON THE SOCIAL DETERMINANTS OF HEALTH: Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non-existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID-19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality. CHAPTER 2: ABORIGINAL AND TORRES STRAIT ISLANDER CONNECTION TO CULTURE: BUILDING STRONGER INDIVIDUAL AND COLLECTIVE WELLBEING: Aboriginal and Torres Strait Islander peoples have long maintained that culture (ie, practising, maintaining and reclaiming it) is vital to good health and wellbeing. However, this knowledge and understanding has been dismissed or described as anecdotal or intangible by Western research methods and science. As a result, Aboriginal and Torres Strait Islander culture is a poorly acknowledged determinant of health and wellbeing, despite its significant role in shaping individuals, communities and societies. By extension, the cultural determinants of health have been poorly defined until recently. However, an increasing amount of scientific evidence supports what Aboriginal and Torres Strait Islander people have always said - that strong culture plays a significant and positive role in improved health and wellbeing. Owing to known gaps in knowledge, we aim to define the cultural determinants of health and describe their relationship with the social determinants of health, to provide a full understanding of Aboriginal and Torres Strait Islander wellbeing. We provide examples of evidence on cultural determinants of health and links to improved Aboriginal and Torres Strait Islander health and wellbeing. We also discuss future research directions that will enable a deeper understanding of the cultural determinants of health for Aboriginal and Torres Strait Islander people. CHAPTER 3: PHYSICAL DETERMINANTS OF HEALTH: HEALTHY, LIVEABLE AND SUSTAINABLE COMMUNITIES: Good city planning is essential for protecting and improving human and planetary health. Until recently, however, collaboration between city planners and the public health sector has languished. We review the evidence on the health benefits of good city planning and propose an agenda for public health advocacy relating to health-promoting city planning for all by 2030. Over the next 10 years, there is an urgent need for public health leaders to collaborate with city planners - to advocate for evidence-informed policy, and to evaluate the health effects of city planning efforts. Importantly, we need integrated planning across and between all levels of government and sectors, to create healthy, liveable and sustainable cities for all. CHAPTER 4: HEALTH PROMOTION IN THE ANTHROPOCENE: THE ECOLOGICAL DETERMINANTS OF HEALTH: Human health is inextricably linked to the health of the natural environment. In this chapter, we focus on ecological determinants of health, including the urgent and critical threats to the natural environment, and opportunities for health promotion arising from the human health co-benefits of actions to protect the health of the planet. We characterise ecological determinants in the Anthropocene and provide a sobering snapshot of planetary health science, particularly the momentous climate change health impacts in Australia. We highlight Australia's position as a major fossil fuel producer and exporter, and a country lacking cohesive and timely emissions reduction policy. We offer a roadmap for action, with four priority directions, and point to a scaffold of guiding approaches - planetary health, Indigenous people's knowledge systems, ecological economics, health co-benefits and climate-resilient development. Our situation requires a paradigm shift, and this demands a recalibration of health promotion education, research and practice in Australia over the coming decade. CHAPTER 5: DISRUPTING THE COMMERCIAL DETERMINANTS OF HEALTH: Our vision for 2030 is an Australian economy that promotes optimal human and planetary health for current and future generations. To achieve this, current patterns of corporate practice and consumption of harmful commodities and services need to change. In this chapter, we suggest ways forward for Australia, focusing on pragmatic actions that can be taken now to redress the power imbalances between corporations and Australian governments and citizens. We begin by exploring how the terms of health policy making must change to protect it from conflicted commercial interests. We also examine how marketing unhealthy products and services can be more effectively regulated, and how healthier business practices can be incentivised. Finally, we make recommendations on how various public health stakeholders can hold corporations to account, to ensure that people come before profits in a healthy and prosperous future Australia. CHAPTER 6: DIGITAL DETERMINANTS OF HEALTH: THE DIGITAL TRANSFORMATION: We live in an age of rapid and exponential technological change. Extraordinary digital advancements and the fusion of technologies, such as artificial intelligence, robotics, the Internet of Things and quantum computing constitute what is often referred to as the digital revolution or the Fourth Industrial Revolution (Industry 4.0). Reflections on the future of public health and health promotion require thorough consideration of the role of digital technologies and the systems they influence. Just how the digital revolution will unfold is unknown, but it is clear that advancements and integrations of technologies will fundamentally influence our health and wellbeing in the future. The public health response must be proactive, involving many stakeholders, and thoughtfully considered to ensure equitable and ethical applications and use. CHAPTER 7: GOVERNANCE FOR HEALTH AND EQUITY: A VISION FOR OUR FUTURE: Coronavirus disease 2019 has caused many people and communities to take stock on Australia's direction in relation to health, community, jobs, environmental sustainability, income and wealth. A desire for change is in the air. This chapter imagines how changes in the way we govern our lives and what we value as a society could solve many of the issues Australia is facing - most pressingly, the climate crisis and growing economic and health inequities. We present an imagined future for 2030 where governance structures are designed to ensure transparent and fair behaviour from those in power and to increase the involvement of citizens in these decisions, including a constitutional voice for Indigenous peoples. We imagine that these changes were made by measuring social progress in new ways, ensuring taxation for public good, enshrining human rights (including to health) in legislation, and protecting and encouraging an independent media. Measures to overcome the climate crisis were adopted and democratic processes introduced in the provision of housing, education and community development.
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Marqués-Sánchez P, Benítez-Andrades JA, Calvo Sánchez MD, Arias N. The socialisation of the adolescent who carries out team sports: a transversal study of centrality with a social network analysis. BMJ Open 2021; 11:e042773. [PMID: 33692178 PMCID: PMC7949419 DOI: 10.1136/bmjopen-2020-042773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To analyse the physical activity carried out by the adolescents in the study, its relationship to being overweight (overweight+obese) and to analyse the structure of the social network of friendship established in adolescents doing group sports, using different parameters indicative of centrality. SETTING It was carried out in an educational environment, in 11 classrooms belonging to 5 Schools in Ponferrada (Spain). PARTICIPANTS 235 adolescents were included in the study (49.4% female), who were classified as normal weight or overweight. PRIMARY AND SECONDARY OUTCOME MEASURES Physical Activity Questionnaire for Adolescents (PAQ-A) was used to study the level of physical activity. A social network analysis was carried out to analyse structural variables of centrality in different degrees of contact. RESULTS 30.2% of the participants in our study were overweight. Relative to female participants in this study, males obtained significantly higher scores in the PAQ-A (OR: 2.11; 95% CI: 1.04 to 4.25; p value: 0.036) and were more likely to participate in group sport (OR: 4.59; 95% CI: 2.28 to 9.22; p value: 0.000). We found no significant relationship between physical activity and the weight status in the total sample, but among female participants, those with overweight status had higher odds of reporting high levels of physical exercise (OR: 4.50; 95% CI: 1.21 to 16.74; p value: 0.025). In terms of centrality, differentiating by gender, women who participated in group sports were more likely to be classified as having low values of centrality, while the opposite effect occurred for men, more likely to be classified as having high values of centrality. CONCLUSIONS Our findings, with limitations, underline the importance of two fundamental aspects to be taken into account in the design of future strategies: gender and the centrality within the social network depending on the intensity of contact they have with their peers.
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Affiliation(s)
- Pilar Marqués-Sánchez
- Nursing and Physiotherapy, Universidad de León-Campus de Ponferrada, Ponferrada, Castilla y León, Spain
| | | | | | - Natalia Arias
- Nursing and Physiotherapy, Universidad de León-Campus de Ponferrada, Ponferrada, Castilla y León, Spain
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Jaramillo AM, Montes F, Sarmiento OL, Ríos AP, Rosas LG, Hunter R, Rodríguez AL, King AC. Social cohesion emerging from a community-based physical activity program: A temporal network analysis. NETWORK SCIENCE (CAMBRIDGE UNIVERSITY PRESS) 2021; 9:35-48. [PMID: 34322275 PMCID: PMC8315584 DOI: 10.1017/nws.2020.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Community-based physical activity programs, such as the Recreovía, are effective in promoting healthy behaviors in Latin America. To understand Recreovías' challenges and scalability, we characterized its social network longitudinally while studying its participants' social cohesion and interactions. First, we constructed the Main network of the program's Facebook profile in 2013 to determine the main stakeholders and communities of participants. Second, we studied the Temporal network growth of the Facebook profiles of three Recreovía locations from 2008 to 2016. We implemented a Time Windows in Networks algorithm to determine observation periods and a scaling model of cities' growth to measure social cohesion over time. Our results show physical activity instructors as the main stakeholders (20.84% nodes of the network). As emerging cohesion, we found: (1) incremental growth of Facebook users (43-272 nodes), friendships (55-2565 edges), clustering coefficient (0.19-0.21), and density (0.04-0.07); (2) no preferential attachment behavior; and (3) a social cohesion super-linear growth with 1.73 new friendships per joined user. Our results underscore the physical activity instructors' influence and the emergent cohesion in innovation periods as a co-benefit of the program. This analysis associates the social and healthy behavior dimensions of a program occurring in natural environments under a systemic approach.
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Affiliation(s)
- Ana María Jaramillo
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
- Department of Computer Science, University of Exeter, Exeter, UK
| | - Felipe Montes
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | | | - Ana Paola Ríos
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Grupo de Cuidado Cardiorrespiratorio, Universidad Manuela Beltrán, Bogotá
| | - Lisa G. Rosas
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA and Stanford University, Palo Alto, CA, USA
| | - Ruth Hunter
- United Kingdom Clinical Research Collaboration Centre of Excellence for Public Health/Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Ana Lucía Rodríguez
- Department of Psychology, Health Disparities and Cultural Identities Research Lab, Florida International University, Miami, FL, USA
| | - Abby C. King
- Stanford Prevention Research Center, Department of Medicine, School of Medicine at Stanford University, 1070 Arrastradero Road, Suite 100, Palo Alto, CA, USA and Department of Health Research and Policy, School of Medicine at Stanford University, Palo Alto, CA, USA
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Useche SA, Esteban C, Alonso F, Montoro L. Are Latin American cycling commuters "at risk"? A comparative study on cycling patterns, behaviors, and crashes with non-commuter cyclists. ACCIDENT; ANALYSIS AND PREVENTION 2021; 150:105915. [PMID: 33276186 DOI: 10.1016/j.aap.2020.105915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 07/21/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION As part of the transformation of urban transportation dynamics, commuter cycling has acquired a high relevance as an alternative mode of transport in different countries, and Latin America seems to be one of the main focus of this worldwide "revolution". However, the high rates of crashes and injuries suffered by commuters have become a relevant issue in the field of road safety, especially in emerging regions with low cycling tradition, where social and infrastructural gaps may endanger the cyclists' safety. OBJECTIVES This study had two objectives. First, to compare key safe cycling-related variables between cycling commuters and non-commuters; and second, to differentially asses the effect of individual and cycling-related variables on their self-reported crash rates. METHOD For this cross-sectional research, the data provided by 577 Latin American urban cyclists from three countries (Argentina, Colombia and Mexico) with a mean age of 32.7 years was used. They answered a questionnaire on cycling habits, risk perception, rule knowledge, cycling behaviors and riding crashes. RESULTS The outcomes of this study showed that, despite having a higher risk perception, cycling commuters perform deliberate risky cycling behaviors (traffic violations) more frequently, and they suffer more crashes; cycling commuters report higher rates of psychological distress, and a lower degree of rule knowledge and protective behaviors than non-commuters. Furthermore, structural similarities and differences in the explanation of cycling crashes were found across commuters and non-commuters. CONCLUSION The results of this study suggest that non-commuters, whose purposes for cycling are more aimed at leisure and occasional trips, perform less risky behaviors but suffer more cycling distractions, whereas commuters are comparatively more exposed to behavioral-based safety risks, and suffer more frequent crashes. Since recent evidence forecasts that urban cycling will keep growing in Latin American cities, it is necessary to implement policies and educational/training improvements that may enhance the safety and health of cyclists in these countries.
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Affiliation(s)
- Sergio A Useche
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, Carrer del Serpis 29, 3rd Floor, DATS. 46022, Valencia, Spain; FACTHUM.Lab (Human Factor and Road Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, Spain.
| | - Cristina Esteban
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, Carrer del Serpis 29, 3rd Floor, DATS. 46022, Valencia, Spain.
| | - Francisco Alonso
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, Carrer del Serpis 29, 3rd Floor, DATS. 46022, Valencia, Spain.
| | - Luis Montoro
- FACTHUM.Lab (Human Factor and Road Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, Spain.
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Geographic Distribution of the Ciclovia and Recreovia Programs by Neighborhood SES in Bogotá: How Unequal is the Geographic Access Assessed Via Distance-based Measures? J Urban Health 2021; 98:101-110. [PMID: 33236318 PMCID: PMC7873177 DOI: 10.1007/s11524-020-00496-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 10/22/2022]
Abstract
Ciclovia, also known as Open Streets initiatives in other countries, are city streets that are closed to motorized traffic and opened during certain times to residents for engaging in physical activity (PA). These initiatives are viewed by policy makers and health and community advocates as being beneficial to social, environmental, and community health. This study explores the geographic distribution of Ciclovia and Recreovia and the differences in geographic access assessed via distance-based measures, based on the socioeconomic status (SES) of the area. Results from this study show that the median distance to the Ciclovia according to SES ranges from 2930 m for SES 1 (most disadvantaged) to 482 m for SES 6 (wealthiest). The median distance to the Recreovia sites ranges from 5173 m for SES 1 to 3869 m for SES 6. This study found revealing urban inequities in the distribution of Ciclovia, whereas there was less inequalities within the Recreovia sites. This study shows that urban interventions are needed to promote recreational activity and reduce health disparities in under resourced, low SES areas.
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Galindo-Perdomo F, Peiró-Velert C, Valencia-Peris A. Do Adolescents Who Meet Physical Activity Recommendations on Weekdays Also Meet Them on Weekends? A Cross-Sectional Study in Colombia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:897. [PMID: 33494203 PMCID: PMC7908133 DOI: 10.3390/ijerph18030897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine whether Colombian adolescents fulfill physical activity (PA) recommendations by type of day depending on several variables. A cross-sectional study was carried out on a sample of 2624 adolescents from Neiva (Colombia) using the Seven Day PA Recall and the Family Affluence Scale II self-reported questionnaires. Statistical analyses were performed to find any differences by gender, socioeconomic status, PA recommendations accomplishment, participation in organized and non-organized PA, parents' involvement in sport, and adolescents' academic achievement, and to determine the probability of complying with the PA guidelines. Only 12.3% of the participants met the PA recommendations on weekdays and weekends. Girls maintained their (in)active patterns during the week more than boys (84.4% vs. 70.7%, respectively), while more boys than girls changed them according to the type of day (25.3% vs. 19.6%). Participation in organized sports was the predictor variable with the highest probability of both boys and girls complying with the PA recommendations on weekdays. Non-organized activities were more likely to make girls more active on weekends. In conclusion, a wider offer of organized and non-competitive PA over the weekend and broader sports schedules should be provided to youth in Neiva.
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Affiliation(s)
| | - Carmen Peiró-Velert
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
| | - Alexandra Valencia-Peris
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, 46022 Valencia, Spain;
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Social Inclusion and Physical Activity in Ciclovía Recreativa Programs in Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020655. [PMID: 33466637 PMCID: PMC7828741 DOI: 10.3390/ijerph18020655] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/22/2020] [Accepted: 12/31/2020] [Indexed: 11/25/2022]
Abstract
Ciclovía Recreativa is a program in which streets are closed off to automobiles so that people have a safe and inclusive space for recreation and for being physically active. The study aims were: (1) to compare participant’s spatial trajectories in four Ciclovía Recreativa programs in Latin America (Bogotá, Mexico City, Santiago de Cali, and Santiago de Chile) according to socioeconomic characteristics and urban segregation of these cities; and (2) to assess the relationship between participants’ physical activity (PA) levels and sociodemographic characteristics. We harmonized data of cross-sectional studies including 3282 adults collected between 2015 and 2019. We found the highest mobility for recreation in Bogotá, followed closely by Santiago de Cali. In these two cities, the maximum SES (socioeconomic status) percentile differences between the neighborhood of origin and the neighborhoods visited as part of the Ciclovía use were 33.58 (p-value < 0.001) and 30.38 (p-value < 0.001), respectively, indicating that in these two cities, participants were more likely to visit higher or lower SES neighborhoods than their average SES-of-neighborhood origin. By contrast, participants from Mexico City and Santiago de Chile were more likely to stay in geographic units similar to their average SES-of-origin, having lower overall mobility during leisure time: maximum SES percentile difference 1.55 (p-value < 0.001) and −0.91 (p-value 0.001), respectively. PA levels of participants did not differ by sex or SES. Our results suggest that Ciclovía can be a socially inclusive program in highly unequal and segregated urban environments, which provides a space for PA whilefacilitat physical proximity, exposure to new communities and environments, and interactions between different socioeconomic groups.
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Aguilar-Farias N, Toledo-Vargas M, Miranda-Marquez S, Cortinez-O’Ryan A, Cristi-Montero C, Rodriguez-Rodriguez F, Martino-Fuentealba P, Okely AD, del Pozo Cruz B. Sociodemographic Predictors of Changes in Physical Activity, Screen Time, and Sleep among Toddlers and Preschoolers in Chile during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E176. [PMID: 33383721 PMCID: PMC7796176 DOI: 10.3390/ijerph18010176] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/17/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022]
Abstract
The aim was to examine the sociodemographic predictors associated with changes in movement behaviors (physical activity, screen time, and sleep) among toddlers and preschoolers during the early stages of the coronavirus disease 2019 pandemic in Chile. Caregivers of 1- to 5-year-old children completed an online survey between 30 March and 27 April 2020. Information about the child's movement behaviors before (retrospectively) and during the pandemic, as well as family characteristics were reported. In total, 3157 participants provided complete data (mean children age: 3.1 ± 1.38 years). During early stages of the pandemic, time spent in physical activity decreased, recreational screen time and sleep duration increased, and sleep quality declined. Toddlers and preschoolers with space to play at home and living in rural areas experienced an attenuated impact of the pandemic restrictions on their physical activity levels, screen time, and sleep quality. Older children, those whose caregivers were aged ≥35-<45 years and had a higher educational level, and those living in apartments had greater changes, mainly a decrease in total physical activity and increase in screen time. This study has shown the significant impact of the pandemic restrictions on movement behaviors in toddlers and preschoolers in Chile.
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Affiliation(s)
- Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4780000, Chile; (M.T.-V.); (S.M.-M.); (A.C.-O.); (P.M.-F.)
- UFRO Activate Research Group, Universidad de La Frontera, Temuco 4780000, Chile
| | - Marcelo Toledo-Vargas
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4780000, Chile; (M.T.-V.); (S.M.-M.); (A.C.-O.); (P.M.-F.)
- UFRO Activate Research Group, Universidad de La Frontera, Temuco 4780000, Chile
| | - Sebastian Miranda-Marquez
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4780000, Chile; (M.T.-V.); (S.M.-M.); (A.C.-O.); (P.M.-F.)
- UFRO Activate Research Group, Universidad de La Frontera, Temuco 4780000, Chile
| | - Andrea Cortinez-O’Ryan
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4780000, Chile; (M.T.-V.); (S.M.-M.); (A.C.-O.); (P.M.-F.)
- UFRO Activate Research Group, Universidad de La Frontera, Temuco 4780000, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile; (C.C.-M.); (F.R.-R.)
| | - Fernando Rodriguez-Rodriguez
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile; (C.C.-M.); (F.R.-R.)
| | - Pia Martino-Fuentealba
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco 4780000, Chile; (M.T.-V.); (S.M.-M.); (A.C.-O.); (P.M.-F.)
- UFRO Activate Research Group, Universidad de La Frontera, Temuco 4780000, Chile
| | - Anthony D. Okely
- Early Start, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW 2522, Australia;
- Illawarra Health & Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Borja del Pozo Cruz
- Faculty of Health Sciences, Institute for Positive Psychology and Education, Australian Catholic University, Sydney, NSW 2060, Australia;
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Malagon-Rojas JN, Pinzón-Silva DC, Parra EL, Lagos M LF, Toloza-Perez YG, Hernández Florez LJ, Morales Betancourt R, Romero SA, Ríos Cabra AP, Sarmiento OL. Assessment of personal exposure to particulate air pollution in different microenvironments and traveling by several modes of transportation in Bogotá, Colombia: protocol for a mixed-methods study. (Preprint). JMIR Res Protoc 2020; 11:e25690. [PMID: 35099404 PMCID: PMC8845014 DOI: 10.2196/25690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/12/2021] [Accepted: 05/04/2021] [Indexed: 12/27/2022] Open
Abstract
Background Air pollution in most countries exceeds the levels recommended by the World Health Organization, causing up to one-third of deaths due to noncommunicable diseases. Fine particulate matter (PM2.5) and black carbon (BC) from mobile sources are the main contaminants. Objective The aim of this study is to assess the relationship of exposure to air pollutants (PM2.5 and BC) in microenvironments according to respiratory health and physical activity in users traveling by different types of transportation in Bogotá, Colombia. Methods A mixed methods study based on a convergent parallel design will be performed with workers and students. The sample will include 350 healthy transport users traveling by different urban transportation modes in three main routes in Bogotá. The study is broken down into two components: (1) a descriptive qualitative component focused on assessing the individual perception of air pollution using semistructured interviews; and (2) a cross-sectional study measuring the individual exposure to PM2.5 and BC using portable instruments (DustTrak and microAeth, respectively), pulmonary function by spirometry, and physical activity with accelerometry. The analysis will include concurrent triangulation and logistic regression. Results The findings will be useful for the conception, design, and decision-making process in the sectors of health and mobility from public, academy, and private perspectives. This study includes personal measurements of PM2.5 and BC during typical trips in the city to assess the exposure to these contaminants in the major roadways in real time. The study further compares the performance of two different lung tests to identify possible short-term respiratory effects. As a limitation, the protocol will include participants from different institutions in the city, which are not necessarily representative of all healthy populations in Bogotá. In this sense, it is not possible to draw causation conclusions. Moreover, a convergent parallel design could be especially problematic concerning integration because such a design often lacks a clear plan for making a connection between the two sets of results, which may not be well connected. Nevertheless, this study adopts a procedure for how to integrate qualitative and quantitative data in the interpretation of the results and a multilevel regression. The time that participants must live in the city will be considered; this will be controlled in the stratified analysis. Another limitation is the wide age range and working status of the participants. Regional pollution levels and episodes (PM2.5) will be handled as confounding variables. The study is currently in the enrollment phase of the participants. Measurements have been made on 300 participants. Pandemic conditions affected the study schedule; however, the results are likely to be obtained by late 2022. Conclusions This study investigates the exposure to air pollutants in microenvironments in Bogotá, Colombia. To our knowledge, this is the first mixed methods study focusing on PM2.5, BC, and respiratory health effects in a city over 2 meters above sea level. This study will provide an integration of air pollution exposure variables and respiratory health effects in different microenvironments. International Registered Report Identifier (IRRID) PRR1-10.2196/25690
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Affiliation(s)
- Jeadran N Malagon-Rojas
- Grupo de Salud Ambiental y Laboral, Instituto Nacional de Salud, Bogotá, Colombia
- Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
| | | | - Eliana L Parra
- Grupo de Salud Ambiental y Laboral, Instituto Nacional de Salud, Bogotá, Colombia
| | - Luisa F Lagos M
- Grupo de Salud Ambiental y Laboral, Instituto Nacional de Salud, Bogotá, Colombia
| | - Yesith Guillermo Toloza-Perez
- Grupo de Salud Ambiental y Laboral, Instituto Nacional de Salud, Bogotá, Colombia
- Maestría en Epidemiologia, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
| | - Luis Jorge Hernández Florez
- Grupo de Investigación Salud Pública, Educación y Profesionalismo, Universidad de los Andes, Bogotá, Colombia
| | | | - Sol Angie Romero
- Grupo de Cuidado Cardiorrespiratorio, Universidad Manuela Beltrán, Bogotá, Colombia
| | - Ana Paola Ríos Cabra
- Grupo de Cuidado Cardiorrespiratorio, Universidad Manuela Beltrán, Bogotá, Colombia
| | - Olga L Sarmiento
- Grupo de Epidemiología EPIANDES, Universidad de los Andes, Bogotá, Colombia
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Chen P, Wang D, Shen H, Yu L, Gao Q, Mao L, Jiang F, Luo Y, Xie M, Zhang Y, Feng L, Gao F, Wang Y, Liu Y, Luo C, Nassis GP, Krustrup P, Ainsworth BE, Harmer PA, Li F. Physical activity and health in Chinese children and adolescents: expert consensus statement (2020). Br J Sports Med 2020; 54:1321-1331. [PMID: 32471813 PMCID: PMC7606574 DOI: 10.1136/bjsports-2020-102261] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2020] [Indexed: 12/28/2022]
Abstract
China is experiencing significant public health challenges related to social and demographic transitions and lifestyle transformations following unprecedented economic reforms four decades ago. Of particular public health concern is the fourfold increase in overweight and obesity rates in the nation's youth population, coupled with the low prevalence of adolescents meeting recommended levels of physical activity. Improving the overall health of China's more than 170 million children and adolescents has become a national priority. However, advancing nationwide health initiatives and physical activity promotion in this population has been hampered by the lack of a population-specific and culturally relevant consensus on recommendations for achieving these ends. To address this deficiency and inform policies to achieve Healthy China 2030 goals, a panel of Chinese experts, complemented by international professionals, developed this consensus statement. The consensus was achieved through an iterative process that began with a literature search from electronic databases; in-depth reviews, conducted by a steering committee, of the resulting articles; and panel group evaluations and discussions in the form of email correspondence, conference calls and written communications. Ultimately, the panel agreed on 10 major themes with strong scientific evidence that, in children and adolescents aged 6-17, participating in moderate to vigorous physical activities led to multiple positive health outcomes. Our consensus statement also (1) highlights major challenges in promoting physical activity, (2) identifies future research that addresses current knowledge gaps, and (3) provides recommendations for teachers, education experts, parents and policymakers for promoting physical activity among Chinese school-aged children and adolescents. This consensus statement aligns with international efforts to develop global physical activity guidelines to promote physical activity and health and prevent lifestyle-related diseases in children and adolescents. More importantly, it provides a foundation for developing culturally appropriate and effective physical activity interventions, health promotion strategies and policy initiatives to improve the health of Chinese children and adolescents.
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Affiliation(s)
- Peijie Chen
- Shanghai University of Sport, Shanghai, China
| | - Dengfeng Wang
- Department of Physical, Health and Arts Education, Ministry of Education of People's Republic of China, Beijing, China
| | | | - Lijuan Yu
- Shanghai Municipal People's Government, Shanghai, China
| | - Qian Gao
- School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Lijuan Mao
- Shanghai Municipal Education Commission, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yaojia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, Guangdong, China
| | - Minhao Xie
- Institute of Sports Medicine, General Administration of Sport of China, Beijing, China
| | - Yong Zhang
- Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Tianjin University of Sport, Tianjin, China
| | - Lianshi Feng
- China Institute of Sport Science, Beijing, China
| | - Feng Gao
- School of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Liu
- Shanghai University of Sport, Shanghai, China
| | - Chunyan Luo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - George P Nassis
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Faculty of Health Sciences, Odense, Denmark
- School of Physical Education and Sports Training, Shanghai University of Sport, Shanghai, China
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Faculty of Health Sciences, Odense, Denmark
- School of Physical Education and Sports Training, Shanghai University of Sport, Shanghai, China
| | - Barbara E Ainsworth
- Shanghai University of Sport, Shanghai, China
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Peter A Harmer
- Department of Exercise and Health Science, Willamette University, Salem, Oregon, USA
| | - Fuzhong Li
- Oregon Research Institute, Eugene, Oregon, USA
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de Vries E, Torres MZ, Rojas MP, Díaz G, Herrán OF. Theoretical reduction of the incidence of colorectal cancer in Colombia from reduction in the population exposure to tobacco, alcohol, excess weight and sedentary lifestyle: a modelling study. BMJ Open 2020; 10:e037388. [PMID: 33115892 PMCID: PMC7594367 DOI: 10.1136/bmjopen-2020-037388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/04/2020] [Accepted: 09/11/2020] [Indexed: 11/24/2022] Open
Abstract
AIMS To determine the potential impact fraction of alcohol and tobacco consumption, high body mass index and low physical activity on colorectal cancer burden in Colombia for the period 2016-2050. METHODS Based on age-specific and sex-specific data on colorectal cancer incidence, data from population-based surveys for the exposure data and population projections, the macrosimulation model Prevent V.3.01 was used to model expected colorectal cancer incidence for the period 2016-2050. Baseline models were those where exposure levels were not subject to change because of interventions. Two intervention scenarios were specified: one with elimination of exposure to the risk factor as of 2017 and a second one where over a 10-year period the current prevalence data gradually declined until they reach 90% of the 2016 levels. RESULTS Under the reference scenarios, a total number of 274 637 colorectal cancers would be expected to occur in the period 2016-2050. Under the scenario of 10% gradual decline in the prevalence of alcohol and tobacco consumption, physical inactivity and high body mass index, a total of 618, 488, 2954 and 2086 new cases, respectively, would be avoided. Under scenarios of elimination, these numbers of avoided cases would be 6908 (elimination alcohol), 6104 (elimination tobacco), 16 637 (optimizing physical inactivity) and 25 089 (all on ideal weight). CONCLUSIONS In order to reduce the burden of colorectal cancer, it is important to take measures to halt the current trends of increasing sedentary behaviour and overweight in the Colombian population. Proportionally, alcohol and tobacco consumption are less important population risk factors for colorectal cancer.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Miguel Zamir Torres
- Grupo de Apoyo y Seguimiento para la Investigación, Instituto Nacional de Cancerología, Bogota, Colombia
| | - Martha Patricia Rojas
- Grupo de Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogota, Colombia
| | - Gustavo Díaz
- School of Medicine, Universidad El Bosque, Bogota, Colombia
| | - Oscar Fernando Herrán
- School of Nutrition and Dietetics, Industrial University of Santander, Bucaramanga, Colombia
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Carvajal GA, Sarmiento OL, Medaglia AL, Cabrales S, Rodríguez DA, Quistberg DA, López S. Bicycle safety in Bogotá: A seven-year analysis of bicyclists' collisions and fatalities. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105596. [PMID: 32603927 PMCID: PMC7447975 DOI: 10.1016/j.aap.2020.105596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/21/2020] [Accepted: 05/13/2020] [Indexed: 05/07/2023]
Abstract
Road safety research in low- and middle-income countries is limited, even though ninety percent of global road traffic fatalities are concentrated in these locations. In Colombia, road traffic injuries are the second leading source of mortality by external causes and constitute a significant public health concern in the city of Bogotá. Bogotá is among the top 10 most bike-friendly cities in the world. However, bicyclists are one of the most vulnerable road-users in the city. Therefore, assessing the pattern of mortality and understanding the variables affecting the outcome of bicyclists' collisions in Bogotá is crucial to guide policies aimed at improving safety conditions. This study aims to determine the spatiotemporal trends in fatal and nonfatal collision rates and to identify the individual and contextual factors associated with fatal outcomes. We use confidence intervals, geo-statistics, and generalized additive mixed models (GAMM) corrected for spatial correlation. The collisions' records were taken from Bogotá's Secretariat of Mobility, complemented with records provided by non-governmental organizations (NGO). Our findings indicate that from 2011 to 2017, the fatal bicycling collision rates per bicyclists' population have remained constant for females while decreasing 53 % for males. Additionally, we identified high-risk areas located in the west, southwest, and southeast of the city, where the rate of occurrence of fatal events is higher than what occurs in other parts of the city. Finally, our results show associated risk factors that differ by sex. Overall, we find that fatal collisions are positively associated with factors including collisions with large vehicles, the absence of dedicated infrastructure, steep terrain, and nighttime occurrence. Our findings support policy-making and planning efforts to monitor, prioritize, and implement targeted interventions aimed at improving bicycling safety conditions while accounting for gender differences.
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Affiliation(s)
- Germán A Carvajal
- School of Economics, Universidad de los Andes, Bogotá, Colombia; Department of Industrial Engineering, Center for Optimization and Applied Probability, Universidad de los Andes, Bogotá, Colombia
| | | | - Andrés L Medaglia
- Department of Industrial Engineering, Center for Optimization and Applied Probability, Universidad de los Andes, Bogotá, Colombia.
| | - Sergio Cabrales
- Department of Industrial Engineering, Center for Optimization and Applied Probability, Universidad de los Andes, Bogotá, Colombia
| | - Daniel A Rodríguez
- Department of City and Regional Planning, Institute for Transportation Studies, University of California, Berkeley, USA
| | - D Alex Quistberg
- Urban Health Collaborative at the Dornsife School of Public Health, Drexel University, Philadelphia, USA; Department of Environmental & Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Segundo López
- Health and Road Safety Department, World Resources Institute Ross Center for Sustainable Cities, Bogotá, Colombia
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González SA, Aubert S, Barnes JD, Larouche R, Tremblay MS. Profiles of Active Transportation among Children and Adolescents in the Global Matrix 3.0 Initiative: A 49-Country Comparison. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5997. [PMID: 32824793 PMCID: PMC7460170 DOI: 10.3390/ijerph17165997] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/02/2020] [Accepted: 08/14/2020] [Indexed: 01/10/2023]
Abstract
This article aims to compare the prevalence of active transportation among children and adolescents from 49 countries at different levels of development. The data was extracted from the Report Cards on Physical Activity for Children and Youth from the 49 countries that participated in the Global Matrix 3.0 initiative. Descriptive statistics and a latent profile analysis with active transportation, Human Development Index and Gini index as latent variables were conducted. The global average grade was a "C", indicating that countries are succeeding with about half of children and youth (47-53%). There is wide variability in the prevalence and in the definition of active transportation globally. Three different profiles of countries were identified based on active transportation grades, Human Development Index (HDI) and income inequalities. The first profile grouped very high HDI countries with low prevalence of active transport and low inequalities. The second profile grouped low and middle HDI countries with high prevalence of active transportation and higher inequalities. And the third profile was characterized by the relatively high prevalence of active transportation and more variability in the socioeconomic variables. Promising policies from countries under each profile were identified. A unified definition of active transportation and contextualized methods for its assessment are needed to advance in surveillance and practice.
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Affiliation(s)
- Silvia A. González
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (S.A.); (J.D.B.); (R.L.); (M.S.T.)
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Salomé Aubert
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (S.A.); (J.D.B.); (R.L.); (M.S.T.)
| | - Joel D. Barnes
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (S.A.); (J.D.B.); (R.L.); (M.S.T.)
| | - Richard Larouche
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (S.A.); (J.D.B.); (R.L.); (M.S.T.)
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB T1K 3M4, Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; (S.A.); (J.D.B.); (R.L.); (M.S.T.)
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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Guerra PH, Garcia LMT, Ribeiro EHC, Maretti ALR, Andrade DR, Florindo AA. [Identification and analysis of national physical activity guidelines in the Americas]. CIENCIA & SAUDE COLETIVA 2020; 26:2961-2968. [PMID: 34378689 DOI: 10.1590/1413-81232021268.15922020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/09/2020] [Indexed: 11/21/2022] Open
Abstract
Given the potential of institutional approaches to health promotion, this study sought to identify the countries on the American continent which have national physical activity (PA) guidelines approved by their national health agencies. A scoping review was conducted in May 2019, with a search conducted in five electronic databases, national health agency websites and contacts with members of the Physical Activity Network of the Americas. In all, national PA guidelines were found in ten of the 36 countries surveyed (27.8%), published between 2011 and 2018, the majority being in South American countries (n = 6). All guidelines presented "approaches and strategies for primary health care," "PA recommendations for health," and the "involvement of different PA domains," however, few guidelines addressed "constructed environment and infrastructure" (n = 3), as well as "monitoring and surveillance actions" (n = 5). The conclusion can be drawn that, although few countries on the American continent have guidelines for PA and that the majority of those available address PA in a limited way, new national guidelines, based on the complexity of the determinants, monitoring and consequences of PA are needed to guide and foster policies to promote PA within the population.
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Affiliation(s)
- Paulo Henrique Guerra
- Universidade Federal da Fronteira Sul. Bairro Fronteira Sul s/n Km 02 Bloco dos professores sala 110, Fronteira Sul. 89802-112 Chapecó SC Brasil. .,Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | - Leandro Martin Totaro Garcia
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | | | - Ana Lúcia Rodrigues Maretti
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | - Douglas Roque Andrade
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | - Alex Antonio Florindo
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
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Chaparro R, Melendi S, Santero M, Seijo M, Elorriaga N, Belizan M, Rubinstein A, Irazola V. A review of assessment indicators used by Healthy Municipalities and Communities Program in Latin America and the Caribbean region. Health Promot Int 2019; 35:714-729. [DOI: 10.1093/heapro/daz059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Abstract
The Healthy Municipalities and Communities Strategy (HMCS) was developed by the Pan American Health Organization in 1990. Evaluation and monitoring are fundamental components of health promotion policies. The aim of this study is to explore the indicators used in Latin America and the Caribbean (LAC) countries to assess the performance of HMCS. We searched MEDLINE, EMBASE, LILACS, BVSDE and Google Advanced Search for documents published between January 2000 and April 2016. We included only documents with assessment indicators of the strategy. All articles were independently assessed for eligibility by pairs of reviewers. We classified the indicators with a supporting framework proposed by O’Neill and Simard (Choosing indicators to evaluate Healthy Cities projects: a political task? Health Promot Int 2006, 21, 145–152.). Local level indicators figured far more prominently among countries and were distributed both in projects and specific activities. Regarding the evolution of the HMCS, indicators were reported in the five levels of analysis (local projects and activities, provincial, national and international networks). Empowerment was represented through the presence of active community organizations and different methods of community participation (forums, open hearing and participation maps). Public policies (such as for tobacco cessation) and bylaws adherence and changes in school’s curricula regarding healthy eating were frequently mentioned. However, this review demonstrated that impact indicators related to lifestyle changes or built environment are not clearly defined and there is a lack of indicators to measure progress in achieving change in long-term outcomes in LAC. We highlight the importance of designing validated indicators for measuring the impact of health promotion policies in partnership with each country involved.
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Affiliation(s)
- Raul Chaparro
- School of Public Health, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Santiago Melendi
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Marilina Santero
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Mariana Seijo
- Laboratory of Metabolic Osteopathies (INIGEM), Clinical Hospital (UBA), Buenos Aires, Argentina
| | - Natalia Elorriaga
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Maria Belizan
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | | | - Vilma Irazola
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
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Abstract
PURPOSE OF REVIEW By 2050, 70% of the global population will live in urban areas, exposing a greater number of people to specific city-related health risks that will only be exacerbated by climate change. Two prominent health risks are poor air quality and physical inactivity. We aim to review the literature and state the best practices for clean air and active transportation in urban areas. RECENT FINDINGS Cities have been targeting reductions in air pollution and physical inactivity to improve population health. Oslo, Paris, and Madrid plan on banning cars from their city centers to mitigate climate change, reduce vehicle emissions, and increase walking and cycling. Urban streets are being redesigned to accommodate and integrate various modes of transportation to ensure individuals can become actively mobile and healthy. Investments in pedestrian, cycling, and public transport infrastructure and services can both improve air quality and support active transportation. Emerging technologies like electric and autonomous vehicles are being developed and may reduce air pollution but have limited impact on physical activity. Green spaces too can mitigate air pollution and encourage physical activity. Clean air and active transportation overlap considerably as they are both functions of mobility. The best practices of clean air and active transportation have produced impressive results, which are improved when enacted simultaneously in integrated policy packages. Further research is needed in middle- and low-income countries, using measurements from real-world interventions, tracing air pollution back to the sources responsible, and holistically addressing the entire spectrum of exposures and health outcomes related to transportation.
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Triana CA, Sarmiento OL, Bravo-Balado A, González SA, Bolívar MA, Lemoine P, Meisel JD, Grijalba C, Katzmarzyk PT. Active streets for children: The case of the Bogotá Ciclovía. PLoS One 2019; 14:e0207791. [PMID: 31091227 PMCID: PMC6519789 DOI: 10.1371/journal.pone.0207791] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 02/26/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The Ciclovía is a worldwide program in which streets are temporarily closed to motorized transport to create a space for recreation and outdoor play among children and adults. The aim of this study was to assess the associations between physical activity (PA), sedentary time (SED), body mass index and Ciclovía participation among children aged 9 to 13 years. METHODS All students in the 4th and 5th grades from the selected schools were invited to participate in the study. The study included 923 children. PA and SED were measured using waist-worn accelerometers, and height and weight were measured using standardized procedures. Ciclovía participation was self-reported. The analyses included multilevel linear, generalized mixed and generalized additive models. RESULTS The mean age of the sample was 10.1±0.7 years, and 49.5% were boys. In the last year, 46% of the children participated in the Ciclovía, and 34% reported participating frequently (at least once per month). No differences were found in the mean minutes of moderate-to-vigorous PA on weekdays between frequent Ciclovía users and sporadic and non-Ciclovía users (72 vs 69; p = 0.09). In contrast, frequent Ciclovía users had higher moderate-to-vigorous PA on Sundays than sporadic and non-Ciclovía users (65.6 vs 59.2; p = 0.01), specifically between the hours of 12:00 and 16:00. In addition, frequent Ciclovía users did not differ from the sporadic and non-Ciclovía users in SED (515.3 vs 521.3; p = 0.19). Frequent Ciclovía users had lower SED on Sundays than the sporadic and non-Ciclovía users (437.7 vs 456.5; p = 0.005). Additionally, frequent Ciclovía users were more likely to be overweight (28.3% vs 20.4% p = 0.01). We did not find differences in participation by sex, and low-to-middle income children were more likely to participate. CONCLUSIONS The Ciclovías offer an innovative, inclusive recreational space and consequently provide opportunities to increase moderate-to-vigorous PA and reduce SED among children.
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Affiliation(s)
- Camilo A. Triana
- Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Olga L. Sarmiento
- Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Alejandra Bravo-Balado
- Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Silvia A. González
- Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Manuel A. Bolívar
- Department of Industrial Engineering, Faculty of Engineering, Universidad de los Andes, Bogotá, Colombia
| | - Pablo Lemoine
- Department of Industrial Engineering, Faculty of Engineering, Universidad de los Andes, Bogotá, Colombia
| | - Jose D. Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Ibagué, Colombia
| | - Carlos Grijalba
- Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
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Move on Bikes Program: A Community-Based Physical Activity Strategy in Mexico City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101685. [PMID: 31091737 PMCID: PMC6572080 DOI: 10.3390/ijerph16101685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/30/2019] [Accepted: 05/05/2019] [Indexed: 11/16/2022]
Abstract
Open streets programs are free and multisectoral programs in which streets are temporally closed allowing access to walkers, runners, rollerbladers, and cyclists. The Move on Bikes program (by its name in Spanish Muévete en Bici) (MEB) consists of 55 km of interconnected streets in middle-high income areas of Mexico City. There is scarce evidence on the evaluation of this program in Mexico. The purposes of this study were to estimate the participation, physical activity levels among the MEB participants, and the association of the frequency of participation with sociodemographic, physical, and program characteristics. Methods: From October 2017 to July 2018, six hundred seventy-nine MEB participants were surveyed using a questionnaire that contains sociodemographic, physical, and program characteristics. A wide-angle video camera was used to estimate the average speed of each activity per event per participant. Based on the information collected by the program authorities and survey interviews, we estimated the number of participants per event. Results: On a typical MEB program day, 21,812 people participated. MEB program users accumulated an average of 221 min of moderate-to-vigorous physical activity (MVPA) per typical Sunday and 88.4% accumulated at least 150 min of MVPA. In total, 29.6% of users attended the program every Sunday. Those who were more likely to attend the program frequently included: men, those aged 41 to 64 years old, users classified as very and sufficiently active, those that used active transportation to travel to the program, and participants that came alone. Conclusions: This study provides evidence that the MEB program adds an extra 71 min/week of MVPA to more than 20,000 users.
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Zieff SG, Musselman EA, Sarmiento OL, Gonzalez SA, Aguilar-Farias N, Winter SJ, Hipp JA, Quijano K, King AC. Talking the Walk: Perceptions of Neighborhood Characteristics from Users of Open Streets Programs in Latin America and the USA. J Urban Health 2018; 95:899-912. [PMID: 29948785 PMCID: PMC6286281 DOI: 10.1007/s11524-018-0262-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Physical inactivity is estimated to be the fourth leading cause of global mortality. Strategies to increase physical activity (PA) increasingly emphasize environmental and policy changes including the modification of neighborhood environments to promote walking and other forms of healthy activity. Open Streets (OS) initiatives, an important and growing strategy to modify neighborhood environments for PA, create temporary parks for recreational activity by closing streets to motor vehicle traffic, thereby offering health and community building benefits. We used the Stanford Neighborhood Discovery Tool (DT)-photo/voice software on a tablet-to train neighborhood residents to act as "citizen scientist" observers of the local built environment on a non-event day and during an OS initiative. The purposes of this project were as follows: (1) to assess adult residents' perceptions of neighborhood characteristics of the OS initiative in three socioeconomically diverse sites and (2) to test the DT for use in three international urban settings with OS initiatives; Bogota, Colombia; San Francisco, USA; and Temuco, Chile, among a multigenerational, multiethnic sample of adults including, for the first time, a vulnerable population of homeless adults (Bogota). Using the DT, participants walked an OS route taking photos and recording reasons for the photos, then completed a 25-item demographic/environmental observation survey and a 16-item Reflection Survey on perceived environmental changes. A total of 18 themes were reported by participants with areas of overlapping themes (e.g., Community and Social Connectedness) and areas where a single site reported a theme (e.g., Social Isolation in Older Adults). Ten of the 18 themes were identified by at least two sites including "Bike Resources" and "Services", indicating the value of programming at OS initiatives. The themes of "Festive Environment" and "Family Friendly Environment" reflect the quality of the overall environment for participants. Four themes (Community and Social Connectedness, Family Friendly Environment, PA, and Safety) were reported by all sites. Three of the four unifying themes were also ranked among the highest reported categories of "seemed better" on the Reflection Survey (Ease of Walking, Overall Safety of Neighborhood, and Friendliness of Environment), providing additional confirmation of the shared experience of social, health, and psychological benefits from OS initiatives. OS initiatives offer a global strategy for increasing neighborhood opportunities for PA and a potential site for training citizen scientists to document environmental influences on PA.
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Affiliation(s)
- Susan G Zieff
- San Francisco State University, San Francisco, CA, USA.
| | | | | | - Silvia A Gonzalez
- Universidad de los Andes, Bogota, Colombia.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | | | - J Aaron Hipp
- North Carolina State University, Raleigh, NC, USA
| | | | - Abby C King
- Stanford University School of Medicine, Palo Alto, CA, USA
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Rodrigues DE, César CC, Kawachi I, Xavier CC, Caiaffa WT, Proietti FA. The Influence of Neighborhood Social Capital on Leisure-Time Physical Activity: a Population-Based Study in Brazil. J Urban Health 2018; 95:727-738. [PMID: 30062644 PMCID: PMC6181814 DOI: 10.1007/s11524-018-0293-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Environmentally targeted approaches to promote physical activity are emerging in recent years as a complementary strategy to the traditional individual approaches. This study explored the relation between community social capital and leisure-time physical activity in an adult population-based sample in Brazil. We applied a generalized estimating equation approach to analyze a cross-sectional survey of 3667 adults living in 149 neighborhoods. Social capital was assessed by scales that measured collective efficacy and social cohesion in the neighborhood. We find that individuals living in areas with higher level of social cohesion were more likely to be physically active even after controlling for potentially confounding individual and area-level covariates (PR = 1.56; 95% CI = 1.13, 2.16). Collective efficacy was not significantly associated with leisure-time physical activity. Interventions to strengthen social cohesion in the community may be an avenue for promoting physical activity.
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Exploring Neighborhood Environments and Active Commuting in Chennai, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091840. [PMID: 30149686 PMCID: PMC6163753 DOI: 10.3390/ijerph15091840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/13/2018] [Accepted: 08/13/2018] [Indexed: 11/23/2022]
Abstract
Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, poor enforcement of traffic rules and regulations, air pollution, and overcrowding. This cross-sectional study investigated associations between home neighborhood environment characteristics and active commuting in Chennai, India. Adults (N = 370, 47.2% female, mean age = 37.9 years) were recruited from 155 wards in the metropolitan area of Chennai in southern India between January and June 2015. Participants self-reported their usual mode of commute to work, with responses recoded into three categories: (1) multi-modal or active commuting (walking and bicycling; n = 56); (2) public transit (n = 52); and (3) private transport (n = 111). Environmental attributes around participants’ homes were assessed using the Neighborhood Environment Walkability Scale for India (NEWS-India). Associations between environmental characteristics and likelihood of active commuting and public transit use were modeled using logistic regression with private transport (driving alone or carpool) as the reference category, adjusting for age, gender, and household car ownership. Consistent with other international studies, participants living in neighborhoods with a mix of land uses and a transit stop within a 10-minute walk from home were more likely to use active commuting (both p < 0.01). Land-use mix was significantly associated with the use of public transit compared to private transport (adjusted odds ratio (aOR) = 5.2, p = 0.002). Contrary to findings in high-income countries, the odds of active commuting were reduced with improved safety from crime (aOR = 0.2, p = 0.003), aesthetics (aOR = 0.2, p = 0.05), and street connectivity (aOR = 0.2, p = 0.003). Different environmental attributes were associated with active commuting, suggesting that these relationships are complex and may distinctly differ from those in high-income countries. Unexpected inverse associations of perceived safety from crime and aesthetics with active commuting emphasize the need for high-quality epidemiologic studies with greater context specificity in the study of physical activity in LMICs. Findings have public health implications for India and suggest that caution should be taken when translating evidence across countries.
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Gutiérrez-Martínez L, Martínez RG, González SA, Bolívar MA, Estupiñan OV, Sarmiento OL. Effects of a strategy for the promotion of physical activity in students from Bogotá. Rev Saude Publica 2018; 52:79. [PMID: 30066815 PMCID: PMC6063693 DOI: 10.11606/s1518-8787.2018052017173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/07/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the effect of the promotion of physical activity during recess on the levels of physical activity, sedentary behaviors, and adiposity of Colombian students. METHODS Three schools were randomly selected by an intervention group in Bogotá, Colombia, in 2013: Intervention (Active Module of Active Recess – MARA) + Text Messages (SMS) (MARA+SMS group), intervention (MARA group), control (control group). Intervention was implemented for ten weeks. The duration and intensity of physical activity and sedentary behaviors were measured objectively using accelerometers Actigraph-GT3X+. Adiposity was measured by body mass index and fat percentage. We measured at baseline (T0) and during the tenth week of intervention (T1). We evaluated the effect of the intervention using a difference-in-difference analysis (DID). RESULTS We included 120 students (57.5% girls; mean age = 10.5 years; standard deviation [SD] = 0.64). There was a significant increase in the mean daily minutes of moderate to vigorous physical activity in the MARA group (Difference T1-T0 = 6.1 minutes, standard error [SE] = 3.49, p = 0.005) in relation to the control group. There were no significant changes in the minutes of moderate to vigorous physical activity in the MARA+SMS group (Difference T1-T0 = -1.0 minute; SE = 3.06; p = 0.363). The minutes decreased in the control group (Difference T1-T0 = -7.7 minutes; SE = 3.15; p = 0.011). The minutes of sedentary behaviors decreased in the MARA and MARA+SMS groups and increased in the control group (MARA Difference T1-T0 = -15.8 minutes; SE = 10.05; p= 0.279; MARA+SMS Difference T1-T0 = -11.5 minutes; SE = 8.80; p= 0.869; Control Difference T1-T0 = 10.9 minutes; SE = 9.07; p = 0.407). There was a higher participation in the MARA group in relation to the MARA+SMS group (MARA group = 34.4%; MARA+SMS group = 12.1%). There were no significant changes in adiposity at 10 weeks according to difference-in-differences analysis (body mass index p: ΔMARA+SMS group versus Δcontrol group = 0.945, ΔMARA group versus Δcontrol group = 0.847, ΔMARA+SMS group versus ΔMARA group = 0.990; FP p ΔMARA+SMS group versus Δcontrol group = 0.788, ΔMARA group versus Δcontrol group = 0.915, ΔMARA+SMS group versus ΔMARA group = 0.975). CONCLUSIONS The Active Module of Active Recess is a promising strategy to increase physical activity levels and decrease sedentary behavior in students. The addition of Text Messages was not associated with increased moderate to vigorous physical activity or changes in adiposity.
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Affiliation(s)
- Leidys Gutiérrez-Martínez
- Universidad de los Andes. Facultad de Medicina. Grupo de Epidemiología. Bogotá, Colombia.,Fundación Valle del Lili. Centro de Investigaciones Clínicas. Cali, Colombia
| | | | - Silvia A González
- Universidad de los Andes. Facultad de Medicina. Grupo de Epidemiología. Bogotá, Colombia.,Children's Hospital of Eastern Ontario Research Institute. Healthy Active Living and Obesity Research Group. Ontario, Canada
| | - Manuel A Bolívar
- Universidad de los Andes. Facultad de Ingeniería. Centro para la Optimización y la Probabilidad Aplicada. Bogotá, Colombia
| | | | - Olga L Sarmiento
- Universidad de los Andes. Facultad de Medicina. Grupo de Epidemiología. Bogotá, Colombia
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Evaluation of Event Physical Activity Engagement at an Open Streets Initiative Within a Texas-Mexico Border Town. J Phys Act Health 2018; 15:605-612. [PMID: 29741429 DOI: 10.1123/jpah.2017-0112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Open streets initiatives provide an opportunity to engage in physical activity (PA) freely by temporarily closing streets to motorized traffic. METHODS Route counting estimation and event intercept surveys (n = 682) were conducted across 4 CycloBia events in Brownsville, TX, in 2015 to determine sociodemographics, PA engagement at the event, event awareness, and past CycloBia attendance. RESULTS Cycling was the most commonly observed activity along the route (73.6%) followed by walking (22.9%). Attendees self-reported a median of 120 minutes in PA with 17.3% of attendees meeting recommended weekly PA guidelines at the event. Significant predictors of meeting PA guidelines via event PA engagement were past event attendance, sex, age, and Hispanic ethnicity. CONCLUSIONS Findings suggest that CycloBia reached a large, low-income, predominantly Hispanic population and may be effective in promoting PA. Results help understand the effect of an open streets initiative on attendees living in a midsize, border city.
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Cycling for Transportation in Sao Paulo City: Associations with Bike Paths, Train and Subway Stations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040562. [PMID: 29561755 PMCID: PMC5923604 DOI: 10.3390/ijerph15040562] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 11/17/2022]
Abstract
Cities that support cycling for transportation reap many public health benefits. However, the prevalence of this mode of transportation is low in Latin American countries and the association with facilities such as bike paths and train/subway stations have not been clarified. We conducted a cross-sectional analysis of the relationship between bike paths, train/subway stations and cycling for transportation in adults from the city of Sao Paulo. We used data from the Sao Paulo Health Survey (n = 3145). Cycling for transportation was evaluated by a questionnaire and bike paths and train/subway stations were geocoded using the geographic coordinates of the adults' residential addresses in 1500-m buffers. We used multilevel logistic regression, taking account of clustering by census tract and households. The prevalence of cycling for transportation was low (5.1%), and was more prevalent in males, singles, those active in leisure time, and in people with bicycle ownership in their family. Cycling for transportation was associated with bike paths up to a distance of 500 m from residences (OR (Odds Ratio) = 2.54, 95% CI (Confidence interval) 1.16-5.54) and with the presence of train/subway stations for distances >500 m from residences (OR = 2.07, 95% CI 1.10-3.86). These results are important to support policies to improve cycling for transportation in megacities such as Sao Paulo.
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Torres A, Díaz MP, Hayat MJ, Lyn R, Pratt M, Salvo D, Sarmiento OL. Assessing the effect of physical activity classes in public spaces on leisure-time physical activity: "Al Ritmo de las Comunidades" A natural experiment in Bogota, Colombia. Prev Med 2017; 103S:S51-S58. [PMID: 27847217 DOI: 10.1016/j.ypmed.2016.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 11/10/2016] [Accepted: 11/11/2016] [Indexed: 10/20/2022]
Abstract
The Recreovia program provides free physical activity (PA) classes in public spaces in Bogota, Colombia. The purpose of this study was to assess the effectiveness of the Recreovia program in increasing PA among users of nine parks in Bogota. This study was a natural experiment conducted between 2013 and 2015 in Bogota. Community members and park users living nearby three groups of parks were compared: Group 1 were parks implementing new Recreovias (n=3), Group 2 were control parks (n=3) without Recreovias, and Group 3 were parks with existing Recreovías. Individuals in the "intervention" group were exposed to newly implemented Recreovia programs in parks near their homes. Measurements were collected at baseline and 6-8months after the intervention started. A total of 1533 participants were enrolled in the study: 501 for the existing Recreovias (included in a cross-sectional assessment) and 1032 participants (from the new Recreovias and control parks) included in the cross-sectional and pre-post study. Most participants were low income females. Twenty-three percent of the intervention group started participating in the program. Users of existing Recreovias were significantly more active and less likely to be overweight/obese compared to new Recreovia users at baseline. No changes on PA were found when comparing the intervention and control groups. Recreovias may have potential for increasing PA at the population level in urban areas given their rapid scalability, the higher levels of PA observed among program users, and its potential to reach women, low-income, less educated populations, and the overweight and obese.
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Affiliation(s)
| | | | - Matthew J Hayat
- School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Rodney Lyn
- School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Michael Pratt
- Institute for Public Health, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, United States
| | - Deborah Salvo
- School of Public Health, University of Texas, Austin, TX, United States
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Sarmiento OL, Díaz Del Castillo A, Triana CA, Acevedo MJ, Gonzalez SA, Pratt M. Reclaiming the streets for people: Insights from Ciclovías Recreativas in Latin America. Prev Med 2017; 103S:S34-S40. [PMID: 27497659 DOI: 10.1016/j.ypmed.2016.07.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/25/2016] [Accepted: 07/31/2016] [Indexed: 12/01/2022]
Abstract
The Ciclovías comprise worldwide programs in which streets are closed to motor-vehicles and open to individuals for leisure activities. Currently, 93% of the regular programs are in Latin American countries (LAC). The aims of this study were to describe the characteristics of regular Ciclovías in 7 LAC and to analyze the factors that influence the sustainability and scaling-up of five case studies. We conducted a survey of 67 Ciclovías in 2014-2015. In addition, we conducted semi-structured interviews with current and former program coordinators and reviewed policy documents from Ciclovías in 5 LAC. The greatest expansion of Ciclovías has occurred since 2000. The number of participants per event ranged from 40 to 1,500,000 (mean 41,399±193,330; median 1600), and the length ranged from 1 to 113.6km (mean 9.1±16.4; median 3). Ciclovía routes connect low-middle and high income neighborhoods (89.3%), and include the participation of minority populations (61.2%). The main complementary activity offered was physical activity (PA) classes (94.0%), and 80.0% of the programs included strategies to promote biking. All five case studies met definitions for sustainability and scaling-up. All programs shared some level of government support, alliances, community appropriation, champions, compatibility with the mission of the host organization, organizational capacity, flexibility, perceived benefits, and funding stability. However, they differed in operational conditions, political favorability, sources of funding, and number of alliances. The Ciclovías of LAC showed heterogeneity within their design and sustainability factors. Both their heterogeneity and flexibility to adjust to changes make them promising examples of socially inclusive programs to promote PA.
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Affiliation(s)
- Olga L Sarmiento
- School of Medicine, Universidad de los Andes, Cra 7 N° 116-05, Bogotá, Colombia.
| | - Adriana Díaz Del Castillo
- School of Medicine, Universidad de los Andes, Cra 7 N° 116-05, Bogotá, Colombia; Salud Transversal-Consulting, Carrera 21 #102-69, Bogotá, Colombia.
| | - Camilo A Triana
- School of Medicine, Universidad de los Andes, Cra 7 N° 116-05, Bogotá, Colombia.
| | | | - Silvia A Gonzalez
- School of Medicine, Universidad de los Andes, Cra 7 N° 116-05, Bogotá, Colombia.
| | - Michael Pratt
- School of Medicine, Universidad de los Andes, Cra 7 N° 116-05, Bogotá, Colombia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; School of Government, Universidad de los Andes, Cra 1 N° 18a-10, Bogotá, Colombia.
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Díaz Del Castillo A, González SA, Ríos AP, Páez DC, Torres A, Díaz MP, Pratt M, Sarmiento OL. Start small, dream big: Experiences of physical activity in public spaces in Colombia. Prev Med 2017; 103S:S41-S50. [PMID: 27575321 DOI: 10.1016/j.ypmed.2016.08.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 08/18/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
Multi-sectoral strategies to promote active recreation and physical activity in public spaces are crucial to building a "culture of health". However, studies on the sustainability and scalability of these strategies are limited. This paper identifies the factors related to the sustainability and scaling up of two community-based programs offering physical activity classes in public spaces in Colombia: Bogotá's Recreovía and Colombia's "Healthy Habits and Lifestyles Program-HEVS". Both programs have been sustained for more than 10years, and have benefited 1455 communities. We used a mixed-methods approach including semi-structured interviews, document review and an analysis of data regarding the programs' history, characteristics, funding, capacity building and challenges. Interviews were conducted between May-October 2015. Based on the sustainability frameworks of Shediac-Rizkallah and Bone and Scheirer, we developed categories to independently code each interview. All information was independently analyzed by four of the authors and cross-compared between programs. Findings showed that these programs underwent adaptation processes to address the challenges that threatened their continuation and growth. The primary strategies included flexibility/adaptability, investing in the working conditions and training of instructors, allocating public funds and requesting accountability, diversifying resources, having community support and champions at different levels and positions, and carrying out continuous advocacy to include physical activity in public policies. Recreovía and HEVS illustrate sustainability as an incremental, multi-level process at different levels. Lessons learned for similar initiatives include the importance of individual actions and small events, a willingness to start small while dreaming big, being flexible, and prioritizing the human factor.
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Affiliation(s)
- Adriana Díaz Del Castillo
- Salud Transversal-Consulting, Bogotá, Colombia; School of Medicine, Group of Epidemiology at the Universidad de los Andes, Bogotá, Colombia.
| | | | - Ana Paola Ríos
- School of Medicine, Group of Epidemiology at the Universidad de los Andes, Bogotá, Colombia
| | - Diana C Páez
- School of Medicine, Group of Epidemiology at the Universidad de los Andes, Bogotá, Colombia
| | - Andrea Torres
- School of Public Health, Georgia State University, Atlanta, GA, United States
| | - María Paula Díaz
- School of Medicine, Group of Epidemiology at the Universidad de los Andes, Bogotá, Colombia
| | - Michael Pratt
- Institute for Public Health, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, United States
| | - Olga L Sarmiento
- School of Medicine, Group of Epidemiology at the Universidad de los Andes, Bogotá, Colombia
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Springer AE, Evans AE, Ortuño J, Salvo D, Varela Arévalo MT. Health by Design: Interweaving Health Promotion into Environments and Settings. Front Public Health 2017; 5:268. [PMID: 29043248 PMCID: PMC5632521 DOI: 10.3389/fpubh.2017.00268] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/19/2017] [Indexed: 01/06/2023] Open
Abstract
The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach.
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Affiliation(s)
- Andrew E Springer
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health-Austin, Michael & Susan Dell Center for Healthy Living, Austin, TX, United States
| | - Alexandra E Evans
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health-Austin, Michael & Susan Dell Center for Healthy Living, Austin, TX, United States
| | - Jaquelin Ortuño
- St. Edward's University, Austin, TX, United States.,Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health-Austin, Austin, TX, United States
| | - Deborah Salvo
- Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health-Austin/Michael & Susan Dell Center for Healthy Living, Austin, TX, United States.,Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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Barradas SC, Finck Barboza C, Sarmiento OL. Differences between leisure-time physical activity, health-related quality of life and life satisfaction: Al Ritmo de las Comunidades, a natural experiment from Colombia. Glob Health Promot 2017; 26:5-14. [PMID: 28762871 DOI: 10.1177/1757975917703303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Physical inactivity is one of the major public health problems worldwide. Community-based interventions have been pointed out as a promising strategy to increase physical activity (PA) levels and impact population health. Recreovía is a community program with a potential to promote PA. There is growing evidence for two benefits derived from the practice of PA: an increased perception of health-related quality of life (HRQoL) and life satisfaction (LS). The purpose of this study was to assess differences between leisure-time PA and perceptions of both HRQoL and LS, as well as to assess differences between perceptions of both HRQoL and LS for Recreovía and non-Recreovía participants. Data were obtained using the baseline cross-sectional survey of 1533 participants (501 belonged to the intervention group) as part of the natural experiment Al Ritmo de las Comunidades. HRQoL was measured with the European Organization for Research and Treatment of Cancer 30-item questionnaire, LS was measured with Questions on Life Satisfaction Scale, and self-reported minutes of leisure-time PA were measured with the long version of the International Physical Activity Questionnaire. The mean age of participants was 41.7 years (standard deviation (SD) = 16.3). The participants had a good overall HRQoL and LS. The mean minutes of leisure-time PA were 158.1 min (SD = 230.2) a week. Results showed that those participants who reported higher leisure-time PA levels also reported a significantly higher LS (M = 41.9, SD = 35.0) relative to participants with lower levels (M = 37.6, SD = 34.2, t(1532) = -2.36, p < 0.01). There were no statistical differences in the perception of HRQoL and leisure-time PA (t(1532) = -1.03, p = 0.30), although active people had higher scores. Both HRQoL and LS scores were higher in individuals who were participating in Recreovía (p < 0.001). Higher LS scores were found in the group with higher leisure-time PA, while HRQoL showed no differences. Better psychological well-being indices were found in the Recreovía group.
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Affiliation(s)
- Susana C Barradas
- 1. Psychology Department, School of Social Sciences, Universidad de los Andes, Bogotá, Colombia.,2. School of Social and Human Sciences, Psychology Program, Universidad Externado de Colombia, Bogotá, Colombia
| | - Carolyn Finck Barboza
- 1. Psychology Department, School of Social Sciences, Universidad de los Andes, Bogotá, Colombia
| | - Olga L Sarmiento
- 3. Public Health Department, School of Medicine, Universidad de los Andes, Bogotá, Colombia
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Corvalán C, Garmendia ML, Jones-Smith J, Lutter CK, Miranda JJ, Pedraza LS, Popkin BM, Ramirez-Zea M, Salvo D, Stein AD. Nutrition status of children in Latin America. Obes Rev 2017; 18 Suppl 2:7-18. [PMID: 28741907 PMCID: PMC5601284 DOI: 10.1111/obr.12571] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/03/2017] [Indexed: 12/30/2022]
Abstract
The prevalence of overweight and obesity is rapidly increasing among Latin American children, posing challenges for current healthcare systems and increasing the risk for a wide range of diseases. To understand the factors contributing to childhood obesity in Latin America, this paper reviews the current nutrition status and physical activity situation, the disparities between and within countries and the potential challenges for ensuring adequate nutrition and physical activity. Across the region, children face a dual burden of undernutrition and excess weight. While efforts to address undernutrition have made marked improvements, childhood obesity is on the rise as a result of diets that favour energy-dense, nutrient-poor foods and the adoption of a sedentary lifestyle. Over the last decade, changes in socioeconomic conditions, urbanization, retail foods and public transportation have all contributed to childhood obesity in the region. Additional research and research capacity are needed to address this growing epidemic, particularly with respect to designing, implementing and evaluating the impact of evidence-based obesity prevention interventions.
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Affiliation(s)
- C Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - M L Garmendia
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - J Jones-Smith
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | | | - J J Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L S Pedraza
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - B M Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama, Guatemala
| | - D Salvo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.,Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin, TX, USA
| | - A D Stein
- Hubert Department of Global Health of the Rollins School of Public Health, Emory University, Atlanta, GA, USA
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The Recreovía of Bogotá, a Community-Based Physical Activity Program to Promote Physical Activity among Women: Baseline Results of the Natural Experiment Al Ritmo de las Comunidades. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060633. [PMID: 28608844 PMCID: PMC5486319 DOI: 10.3390/ijerph14060633] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/29/2017] [Accepted: 06/04/2017] [Indexed: 11/17/2022]
Abstract
Community-based physical activity (PA) programs in Latin America have been recognized because of the use of available environmental resources to offer PA classes. Yet, the evaluation of programs focused on PA classes involving dancing in public spaces is limited. The aim of this study was to assess the physical activity levels, park use, and the contextual characteristics of public parks with and without the Recreovía in Bogotá in Colombia. Al Ritmo de las Comunidades is a natural experiment conducted in nine parks (3 parks implementing new Recreovías, 3 control parks and 3 parks with existing Recreovías) during 2013. We used the System for Observing Play and Recreation in Communities to evaluate park use (gender, age, and physical activity level) and target areas. A total of 4925 people were observed during 702 observation visits to parks. The percentage of women was higher in parks with Recreovía, compared to parks without Recreovía (53% vs. 40% vs. 33%; p < 0.001). Women using parks with Recreovía compared to women in parks without Recreovía were less likely to be sedentary (25% vs. 39%; p < 0.0001) and more likely to engage in moderate-to-vigorous activity (75% vs. 61%; p < 0.0001). Among men, the activity pattern was the opposite. The Recreovía is a promising strategy to promote park use and PA, especially among women who are less likely to meet PA recommendations during their leisure time. The provision of a cost-free community program may be an effective approach and a good investment for health.
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Cycling in São Paulo, Brazil (1997-2012): Correlates, time trends and health consequences. Prev Med Rep 2016; 4:540-545. [PMID: 27761356 PMCID: PMC5067980 DOI: 10.1016/j.pmedr.2016.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/26/2016] [Accepted: 10/03/2016] [Indexed: 11/24/2022] Open
Abstract
The purpose of the study was to describe cyclists and cycling trips, and to explore correlates, time trends and health consequences of cycling in São Paulo, Brazil from 1997 to 2012. Cross-sectional analysis using repeated São Paulo Household Travel Surveys (HTS). At all time periods cycling was a minority travel mode in São Paulo (1174 people with cycling trips out of 214,719 people). Poisson regressions for individual correlates were estimated using the entire 2012 HTS sample. Men were six times more likely to cycle than women. We found rates of bicycle use rising over time among the richest quartile but total cycling rates dropped from 1997 to 2012 due to decreasing rates among the poor. Harms from air pollution would negate benefits from physical activity through cycling only at 1997 air pollution levels and at very high cycling levels (≥ 9 h of cycling per day). Exposure-based road injury risk decreased between 2007 and 2012, from 0.76 to 0.56 cyclist deaths per 1000 person-hours travelled. Policies to reduce spatial segregation, measures to tackle air pollution, improvements in dedicated cycling infrastructure, and integrating the bicycle with the public transport system in neighborhoods of all income levels could make cycling safer and prevent more individuals from abandoning the cycling mode in São Paulo. Cycling rates increased between 1997 and 2007 but decreased in 2012. Cycling decreased in the 25% poorest and increased in the 25% richest people. Strong gender and age inequalities were observed, favouring men and young people. In current air pollution levels, benefits from cycling outweigh harms in the city. Exposure-based road injury risk decreased between 1997 and 2012.
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