Cross-Sectional Associations of Environmental Perception with Leisure-Time Physical Activity and Screen Time among Older Adults

Walking and perception of green space among older adults in Japan: subgroup analysis based self-efficacy

Self-efficacy is the key factor for promoting physical activity. Older adults with low self-efficacy tend to be physical inactive than those with high self-efficacy, and an approach is needed to promote physical activity. Among several approaches, increasing the perception of green space may be an effective approach for low self-efficacy not high self-efficacy, but no study has investigated. This study investigated the association between walking and perception of green space among older adults with high and low self-efficacy, respectively. We conducted a cross-sectional study among 204 community-dwelling older adults (mean age = 78.3 years, 62.3% females). Using the median split, the participants were divided into high and low self-efficacy groups based on the median score of 12. Walking was measured using the International Physical Activity Questionnaire and 'more walking' was defined as ≥150 min of walking time per week. Perception of green space was measured using an 8-item questionnaire. We performed logistic regression analysis to investigate the association between walking and perception of green space adjusted for age, gender, years of education, living with someone and income level. For all participants, 94 participants (46.1%) fell under low self-efficacy. After adjustment, higher perception of green space is associated with more walking among older adults with low self-efficacy [adjusted odds ratio (aOR) = 1.07, 95% confidence interval (CI) = 1.00-1.15], but not among those with high self-efficacy (aOR = 1.09, 95% CI= 0.99-1.20). To increase perception of green space, experts should design/improve green spaces considering beneficiaries' characteristics.

Association between physical activity levels and depressive symptoms in patients with minor ischemic stroke

OBJECTIVE

Post-stroke depression is associated with stroke recurrence and it is necessary to identify its influencing factors. The study aims to determine whether physical activity during hospitalization, as measured by accelerometer, was associated with depression after discharge in patients with minor ischemic stroke.

MATERIALS AND METHODS

This prospective observational study assessed 76 patients with minor ischemic stroke (aged 71.2 years) admitted to an acute care hospital. Depressive symptoms 3 months after discharge from the hospital was assessed using a questionnaire sent by mail. Baseline was set during hospitalization, and accelerometers were used to measure sedentary behavior, light and moderate-to-vigorous physical activities during hospitalization.

RESULTS

Three months after hospital discharge, 14 patients (18.4%) were placed in the depressive symptom group, with significantly more sedentary behavior (p = 0.021), less light physical activity (p = 0.016) and more depressive symptoms during hospitalization (p = 0.005) than in the non-depressive symptom group. Logistic regression analysis showed that sedentary behavior (odds ratio = 1.130, 95% confidence interval = 1.013‒1.281, p = 0.028) and light-intensity physical activity (odds ratio = 0.853, 95% confidence interval = 0.746‒0.976, p = 0.021) were independent factors for depressive symptoms at three months after discharge. Moderate to vigorous physical activity was not an independent factor.

CONCLUSIONS

Sedentary behavior and light-intensity physical activity during hospitalization were associated with depressive symptoms in patients with minor ischemic stroke after discharge. Reducing sedentary behavior and increasing light-intensity physical activity as part of inpatient rehabilitation may help prevent post-stroke depression.

Physical activity and perceived environment among adults from a city in Southern Brazilian

The article aimed to verify the association between physical activity (PA) and perceived environment among adults from a city in southern Brazil. This is a population-based cross-sectional study with 820 adults living in the city of Criciúma-SC. Perceived environment was assessed using the Neighborhood Environmental Walkability scale and PA in the leisure and transportation domains using the long version of the International PA Questionnaire. It was observed that the neighborhood with public spaces for the practice of physical exercises and dog walking was associated with higher prevalence of compliance with moderate-to-vigorous physical activity (MVPA) guidelines. The fact of having an invitation from friends and/or relatives for PA, sporting events and the habit of dog walking were associated with leisure-time walking. Access to places for the purchase of fresh fruits/ vegetables, light/diet foods, to have sidewalks in most streets, to have pedestrian crossings and sporting events in the neighborhood were associated with higher prevalence of active transportation. Conversely, places for snacks or fast food in the neighborhood were associated with lower prevalence of active transportation. The perception of environmental variables was associated with MVPA, walking and active transportation.

Spatial distribution of sedentary behavior and unhealthy eating habits in Belo Horizonte, Brazil: the role of the neighborhood environment

The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.

Social vulnerability associated with the self-reported diagnosis of type II diabetes: a multilevel analysis

OBJECTIVE

To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City.

METHODS

Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level.

RESULTS

The prevalence of diabetes was 6.2% (95%CI 5.54 - 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics.

CONCLUSION

Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.

Neighborhood Environment and Objectively Measured Sedentary Behavior Among Older Adults: A Cross-Sectional Study

Background: We examined the relationships between objectively assessed neighborhood environment and the patterns of sedentary behavior among older adults. Methods: A total of 126 community-dwelling older adults (aged 65 years or above) were recruited. Data on neighborhood environmental attributes (resident density, street intersection density, sidewalk availability, accessible destinations, and accessible public transportation), accelerometer-assessed total time and patterns of sedentary behavior (number and duration of bouts), and sociodemographic characteristics were collected. Multiple linear regression models were developed. Results: After adjustment for potential confounders, greater sidewalk availability was negatively related to the number of sedentary bouts (β = -0.185; 95% CI: -0.362, 0.015; p = 0.034) and sedentary bout duration (β = -0.180; 95% CI: -0.354, -0.011; p = 0.037). Conclusions: This study revealed that a favorable neighborhood environment characterized by sidewalk availability is negatively associated with sedentary behavior patterns in Taiwanese older adults. These findings are critical to inform environmental policy initiatives to prevent sedentary lifestyle in older adults.

The associations between neighborhood walkability attributes and objectively measured physical activity in older adults

A limited number of studies have used objective measures to examine the associations between the built environment and physical activity (PA) among older adults. This study aimed to examine geographic information systems-derived neighborhood walkability attributes and accelerometer measured PA in older adults. Data were collected from 124 older Taiwanese adults aged over 60 years (mean age: 69.9). Adjusted multiple linear regression was performed to explore the associations between five neighborhood walkability factors (population density, street connectivity, sidewalk availability, access to destinations, and public transportation) and five metrics of accelerometer-measured physical activity (total PA, moderate-to-vigorous PA, light PA, long moderate-to-vigorous PA bouts, and daily step counts). After adjusting for potential confounders, we found that greater sidewalk availability was positively associated with daily step counts in older adults (β = 0.165; 95% confidence interval: 0.006, 0.412; P = 0.043). No associations between other neighborhood environment attributes and PA metrics were observed. In conclusion, high sidewalk availability in the neighborhood may be supportive for older adults’ daily step counts. Further longitudinal research is needed to establish the causality between the built environment and objectively measured PA in older adults.

The perceived neighborhood environment is associated with health-enhancing physical activity among adults: a cross-sectional survey of 13 townships in Taiwan

Background

Many environmental factors have been associated with physical activity. The environment is considered a key factor in terms of the rate of engagement in physical activity. This study examined the perceived effect of environmental factors on different levels of health-enhancing physical activity among Taiwanese adults.

Methods

Data were collected from 549 adults aged at least 18 years from the northern, central, southern and eastern regions of Taiwan. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) showcard version, and participants were divided into three categories: those who performed low-, moderate-, or high-levels of physical activity, as suggested by the IPAQ scoring protocol. The perceived neighborhood environment in relation to physical activity was adapted from the Physical Activity Neighborhood Environment Scale. A multinomial logistic regression was conducted to ascertain associations between individual perceptions of the neighborhood environment and different physical activity levels.

Results

Respondents who perceived their neighborhood environment as having easy access to services and stores, and higher traffic safety were more likely to be moderate level of physical activity (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.07–3.37; OR: 1.77, 95% CI: 1.12–2.80). The perception of having easy access to services and stores and seeing many physically active people in the neighborhood were both positively associated with a high level of physical activity (OR: 2.25, 95% CI: 1.01–5.01; OR: 2.40, 95% CI: 1.11–5.23).

Conclusions

Different perceived neighborhood environmental factors were associated with moderate and high levels of physical activity, respectively. These findings highlight the importance of an activity-friendly neighborhood environment to stimulate engagement in physical activity among adults in Taiwan. Therefore, policies and programs should focus on improving friendliness and diversity in neighborhoods to facilitate individuals’ transitions from inactive to active lifestyles.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6848-4) contains supplementary material, which is available to authorized users.