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Umstattd Meyer MR, Houghtaling B, Wende ME, Kheshaifaty KH, Delgado H, Eze SA, Mecate C, Summerall Woodward R, Morgan RL, Krey KJ. A scoping review of policies to encourage breastfeeding, healthy eating, and physical activity among rural people and places in the United States. BMC Public Health 2024; 24:2160. [PMID: 39123168 PMCID: PMC11313091 DOI: 10.1186/s12889-024-19173-7] [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: 12/29/2023] [Accepted: 06/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. METHODS A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. RESULTS Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. CONCLUSIONS Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S.
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Affiliation(s)
- M Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
| | | | - Marilyn E Wende
- Department of Health Education and Behavior, College of Health and Human Performance University of Florida, Gainesville, FL, USA
| | - Khawlah H Kheshaifaty
- School of Nutrition and Food Science, Louisiana State University Agricultural Center, Louisiana State University, Baton Rouge, LA, USA
| | - Haley Delgado
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Stephanie A Eze
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Cassady Mecate
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Rebekah Summerall Woodward
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | | | - Kathy J Krey
- School of Education, Baylor University, Waco, TX, USA
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Ocaña-Ortiz A, Gea-Caballero V, Juárez-Vela R, Peiró R, Pérez-Sanz E, Santolalla-Arnedo I, Sufrate-Sorzano T, Garrote-Cámara ME, Paredes-Carbonell JJ. Health equity in urban and rural settings: implementation of the place standard tool in Spain. Front Public Health 2024; 12:1292032. [PMID: 38803816 PMCID: PMC11129683 DOI: 10.3389/fpubh.2024.1292032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
The physical, social, and economic characteristics of neighborhoods and municipalities determine the health of their residents, shaping their behaviors and choices regarding health and well-being. Addressing local environmental inequalities requires an intersectoral, participatory, and equity-focused approach. Community participation plays a vital role by providing deeper insights into local contexts, integrating community knowledge and values into processes, and promoting healthier, fairer, and more equitable actions. In recent years, various tools have been developed to assess places and transform them into health-promoting settings. One such tool, the Place Standard Tool (PST), facilitates discussions on Social Determinants of Health grouped into 14 themes, serving as a starting point for local health interventions. In this study, that took place between August 2019 and February 2020, we described the resident's perceptions of two municipalities in the Valencian Community, Spain, using the validated Spanish version of the PST. A mixed-method convergent-parallel design was used to gain a holistic insight into residents' experiences concerning their physical, economic, and social environment. A total of 356 individuals from both municipalities participated in the study through discussion groups, structured interviews, and online survey. Descriptive analysis of the individual questionnaire answers was conducted, and differences between municipalities were explored. Qualitative thematic analysis was conducted on structured interviews and discussion groups. Quantitative and qualitative data were integrated to facilitate their comparison and identify areas of convergence or divergence in the findings. Overall, rural areas received more favorable evaluations compared to urban ones. Public Transport as well as Work and Local Economy were consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. In the urban area, additional negative ratings were observed for Traffic and Parking, Housing and Community, and Care and Maintenance. Conversely, Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were given to Walking or Cycling, Traffic and Parking, Housing and Community, and Influence and Sense of Control. Significant differences (p < 0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. Our study illustrated the capacity of the PST to identifying aspects within local settings that influence health, revealing both positive and challenging factors. Successful implementation requires appropriate territorial delineation, support from local authorities, and effective management of expectations. Furthermore, the tool facilitated community participation in decision-making about local environments, promoting equity by connecting institutional processes with citizen needs.
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Affiliation(s)
- Ana Ocaña-Ortiz
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Gandia Health Department, Gandia, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, VIU Valencia International University, Valencia, Spain
- Research Group SALCOM Community Health and Care, Valencia International University, Valencia, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Rosana Peiró
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Publica Health General Directorate, Health Department, Generalitat Valenciana, Valencia, Spain
- CIBERESP ISCIII, Madrid, Spain
| | - Elena Pérez-Sanz
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Publica Health General Directorate, Health Department, Generalitat Valenciana, Valencia, Spain
| | - Iván Santolalla-Arnedo
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Teresa Sufrate-Sorzano
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - María Elena Garrote-Cámara
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain
- GRUPAC, University of La Rioja, Logroño, La Rioja, Spain
| | - Joan Josep Paredes-Carbonell
- Local Action and Health Equity Group (ALES Group), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- Public Health Center of Alzira, Valencia, Spain
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Müller C, Paulsen L, Bucksch J, Wallmann-Sperlich B. Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review. Int J Behav Nutr Phys Act 2024; 21:52. [PMID: 38702772 PMCID: PMC11067138 DOI: 10.1186/s12966-024-01598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking. METHODS We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results. RESULTS Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting). CONCLUSIONS Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults. TRIAL REGISTRATION PROSPERO: CRD42021283508.
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Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Würzburg, Judenbühlweg 11, 97082, Würzburg, Germany.
| | - Lisa Paulsen
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
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Mesa-Castrillon CI, Simic M, Ferreira ML, Bennell KL, Luscombe GM, Gater K, Beckenkamp PR, Michell A, Bauman A, de Luca K, Bunker S, Clavisi O, Ferreira PH. Effectiveness of an eHealth-Delivered Program to Empower People With Musculoskeletal Pain in Rural Australia: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2024; 76:570-581. [PMID: 37984995 DOI: 10.1002/acr.25272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/08/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Our objective was to evaluate the effectiveness of a three-month physiotherapist-delivered eHealth physical activity program compared with usual care to improve function in adults with low back pain or knee osteoarthritis in rural Australia. METHODS This was a parallel, two-group, pragmatic, superiority, randomized controlled trial involving three- and six-month posttreatment follow-ups. There was a total of 156 adults with chronic nonspecific low back pain (n = 97) or knee osteoarthritis (n = 59) from rural Australia. The intervention involved an eHealth physical activity and an exercise program that included five to eight teleconsultations with a physiotherapist (primary time point three months) or usual care (eg, general practitioner, physiotherapy, and pain medication). The primary outcome was the Patient-Specific Functional Scale (0-30), with a three-point difference between groups being considered the minimum clinically important difference. RESULTS Participants receiving the eHealth intervention (n = 78) reported significantly greater and clinically worthwhile improvements in function (mean between-group difference 3.6; 95% confidence interval [CI] 1.3-5.9) compared to participants receiving usual care (n = 78). Small but statistically significantly greater improvements in disability (7.2 of 100; 95% CI 2.1-12.3) and quality of life (4.5 of 100; 95% CI 0.0-9.0) also favored the eHealth group. No clinical or statistical differences between groups were found for the secondary outcomes of pain, coping skills, and physical activity levels. CONCLUSION A physiotherapist-delivered eHealth intervention is effective and provides clinically meaningful improvements in function compared to usual care for people with musculoskeletal pain in rural communities. These findings highlight the potential for eHealth-based programs to improve access to evidence-based exercise interventions for people with musculoskeletal pain in rural communities.
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Affiliation(s)
- Carlos I Mesa-Castrillon
- University of Sydney, Sydney, New South Wales, Australia
- Sydney Musculoskeletal Health, Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Milena Simic
- University of Sydney, Sydney, New South Wales, Australia
| | | | - Kim L Bennell
- University of Melbourne, Melbourne, Victoria, Australia
| | | | - Kristy Gater
- Dubbo Health Service, Dubbo, New South Wales, Australia
| | | | | | - Adrian Bauman
- University of Sydney, Sydney, New South Wales, Australia
| | - Katie de Luca
- Central Queensland University Brisbane, Queensland, Australia
| | | | | | - Paulo H Ferreira
- University of Sydney, Sydney, New South Wales, Australia
- Sydney Musculoskeletal Health, Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Andreae SJ, Casey T, Lindberg A, Doyle K, Pickett KA. An exploratory study of mothers engaging in physical activity in rural communities. Women Health 2024; 64:235-249. [PMID: 38273717 PMCID: PMC10939792 DOI: 10.1080/03630242.2024.2310050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Gender gaps in physical activity (PA) exist with women being less active than men. Multiple cultural and psychosocial factors influence women's ability to successfully negotiate barriers to PA and other health promoting behaviors. The goal of this exploratory descriptive study was to better understand the daily experiences of mothers in making health promoting decisions for themselves and their families. Semi-structured interviews (N = 17) were conducted with rural dwelling mothers who were the primary caregivers of children in the home. Participants were asked to share their experiences with PA and other health behaviors, focusing on their motivators, barriers, and facilitators. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Emerging themes focused on 1) feeling internal and external pressures to prioritize family's needs over one's health, 2) family exerting both positive and negative influences on health choices, and 3) living in a rural community often resulting in a lack of opportunities to engage in physical activity and feelings of being isolated from social networks. To close the gender gap in PA, interventions should support mothers in navigating their multiple roles and competing demands while engaging in health promoting behaviors such as physical activity.
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Affiliation(s)
- Susan J. Andreae
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Thomas Casey
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna Lindberg
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kecia Doyle
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kristen A. Pickett
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
- Program in Occupational Therapy, University of Wisconsin-Madison, Madison, Wisconsin
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Prince SA, Lang JJ, de Groh M, Badland H, Barnett A, Littlejohns LB, Brandon NC, Butler GP, Casu G, Cerin E, Colley RC, de Lannoy L, Demchenko I, Ellingwood HN, Evenson KR, Faulkner G, Fridman L, Friedenreich CM, Fuller DL, Fuselli P, Giangregorio LM, Gupta N, Hino AA, Hume C, Isernhagen B, Jalaludin B, Lakerveld J, Larouche R, Lemon SC, Loucaides CA, Maddock JE, McCormack GR, Mehta A, Milton K, Mota J, Ngo VD, Owen N, Oyeyemi AL, Palmeira AL, Rainham DG, Rhodes RE, Ridgers ND, Roosendaal I, Rosenberg DE, Schipperijn J, Slater SJ, Storey KE, Tremblay MS, Tully MA, Vanderloo LM, Veitch J, Vietinghoff C, Whiting S, Winters M, Yang L, Geneau R. Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users. Int J Behav Nutr Phys Act 2023; 20:144. [PMID: 38062460 PMCID: PMC10704660 DOI: 10.1186/s12966-023-01533-y] [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: 06/28/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Adelaide, South Australia
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, Australia
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Lori Baugh Littlejohns
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Gregory P Butler
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
| | - Géna Casu
- Association pour la santé publique du Québec (ASPQ), Montréal, Québec, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rachel C Colley
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | | | - Iryna Demchenko
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Liraz Fridman
- Department of Mechanical and Industrial Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Daniel L Fuller
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Lora M Giangregorio
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Neeru Gupta
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Adriano A Hino
- Health Sciences Graduate Program, School of Medicine and Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Clare Hume
- School of Public Health, University of Adelaide, Adelaide, Australia
| | | | - Bin Jalaludin
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Stephenie C Lemon
- Prevention Research Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | | | - Jay E Maddock
- School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- School of Planning, Architecture, and Landscape, University of Calgary, Calgary, Alberta, Canada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Aman Mehta
- Maroondah City Council, Victoria, Australia
| | - Karen Milton
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jorge Mota
- Research Center in Physical Activity, health and Leisure (CIAFEL)-Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Victor D Ngo
- Canadian Institute of Planners, Ottawa, Ontario, Canada
| | - Neville Owen
- Swinburne University of Technology, Melbourne, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | | | - Daniel G Rainham
- Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Nicola D Ridgers
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Adelaide, South Australia
| | | | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sandra J Slater
- Bachelor of Science in Public Health Program, School of Pharmacy, Concordia University Wisconsin, Mequon, Wisconsin, USA
| | - Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Mark S Tremblay
- Outdoor Play Canada, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Mark A Tully
- School of Medicine, Ulster University, Londonberry, United Kingdom
| | - Leigh M Vanderloo
- ParticipACTION, Toronto, Ontario, Canada
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | | | - Stephen Whiting
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Linchuan Yang
- Department of Urban and Rural Planning, School of Architecture, Southwest Jiaotong University, Chengdu, China
| | - Robert Geneau
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
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Crouch E, Abshire DA, Wirth MD, Hung P, Benavidez GA. Rural-Urban Differences in Overweight and Obesity, Physical Activity, and Food Security Among Children and Adolescents. Prev Chronic Dis 2023; 20:E92. [PMID: 37857462 PMCID: PMC10599326 DOI: 10.5888/pcd20.230136] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Childhood obesity has been associated with numerous poor health conditions, with geographic disparities demonstrated. Limited research has examined the association between rurality and food security, physical activity, and overweight or obesity among children. We examined rates of food security, physical inactivity, and overweight or obesity among rural and urban children and adolescents, and associations between rurality and these 3 outcomes. METHODS We used cross-sectional data from a nationally representative sample of children and adolescents aged 10 to 17 years from the 2019-2020 National Survey of Children's Health (N = 23,199). We calculated frequencies, proportions, and unadjusted associations for each variable by using descriptive statistics and bivariate analyses. We used multivariable logistic regression models to examine the association between rurality and food security, physical activity, and overweight or obesity. RESULTS After adjusting for sociodemographic factors, rural children and adolescents had higher odds than urban children and adolescents of being overweight or obese (adjusted odds ratio = 1.30; 95% CI, 1.11-1.52); associations between rurality and physical inactivity and food insecurity were not significant. CONCLUSION The information from this study is timely for policy makers and community partners to make informed decisions on the allocation of healthy weight and obesity prevention programs for children and adolescents in rural settings. Our study provides information for public health programming and the designing of appropriate dietary and physical activity interventions needed to reduce disparities in obesity prevention among children and adolescents.
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Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia
- Rural and Minority Health Research Center, Department of Health Services Policy and Management, University of South Carolina, Discovery Bldg, Ste 345, 915 Greene St, Columbia, SC 29208
| | - Demetrius A Abshire
- Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia
| | - Michael D Wirth
- Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia
| | - Peiyin Hung
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia
| | - Gabriel A Benavidez
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia
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Müller C, Domokos B, Amersbach T, Hausmayer EM, Roßmann C, Wallmann-Sperlich B, Bucksch J. Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany. Front Public Health 2023; 11:1153088. [PMID: 37637797 PMCID: PMC10449332 DOI: 10.3389/fpubh.2023.1153088] [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: 01/28/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Background According to socio-ecological theories, physical activity behaviors are linked to the physical and social neighborhood environment. Reliable and contextually adapted instruments are needed to assess environmental characteristics related to physical activity. This work aims to develop an audit toolbox adapted to the German context, to urban and rural settings, for different population groups, and different types of physical activity; and to evaluate its inter-rater reliability. Methods We conducted a systematic literature search to collect existing audit tools and to identify the latest evidence of environmental factors influencing physical activity in general, as well as in German populations. The results guided the construction of a category system for the toolbox. Items were assigned to the categories based on their relevance to physical activity and to the German context as well as their comprehensibility. We piloted the toolbox in different urban and rural areas (100 street segments, 15 parks, and 21 playgrounds) and calculated inter-rater reliability by Cohen's Kappa. Results The audit toolbox comprises a basic streetscape audit with seven categories (land use and destinations, traffic safety, pedestrian infrastructure, cycling infrastructure, attractiveness, social environment, and subjective assessment), as well as supplementary tools for children and adolescents, seniors and people with impaired mobility, parks and public open spaces, playgrounds, and rural areas. 76 % of all included items had moderate, substantial, or almost perfect inter-rater reliability (κ > 0.4). Conclusions The audit toolbox is an innovative and reliable instrument for the assessment of the physical activity friendliness of urban and rural environments in Germany.
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Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Bruno Domokos
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Tanja Amersbach
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Eva-Maria Hausmayer
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | | | | | - Jens Bucksch
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
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9
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Hofer-Fischanger K, Tuttner S, Amort FM, Helms K, Unger J, Hödl J, Strüver A, van Poppel MNM. Promoting active transport in rural communities through infrastructural modifications: the PABEM needs assessment tool. Health Promot Int 2023; 38:daab186. [PMID: 34849929 DOI: 10.1093/heapro/daab186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The design of the built environment in communities influences active transport and physical activity levels of citizens. Existing instruments for quantitatively assessing built environments were developed for use in urban areas and mainly by experts. Participative assessment of built environment modifications (PABEM) is a needs assessment tool that involves citizens and community decision-makers within a structured process for identifying needed changes to promote walking and cycling in rural areas. This article describes the development of the PABEM process and evaluates its initial use in three rural towns in Austria. PABEM consists of the following seven steps: (i) qualitative interviews; (ii) expert assessment of the built environment; (iii) citizen assessment of the built environment; (iv) social media interaction; (v) household questionnaire; (vi) participatory workshop; and (vii) evaluation and scoring workshop. The main modifications identified as necessary in rural towns were the revitalization of existing walking and cycling facilities and the construction of new barrier-free and safe sidewalks. In addition cycling routes to schools, to public transport facilities and to central public places as well as cleaner and inviting seating, a car-free school environment, speed reduction in town centres, more crosswalks and improved cleanliness in public places were also deemed necessary modifications. PABEM's provisions to ensure collaborative participation of citizens and local decision-makers fostered a continuous dialogue about the requirements of the built environment, user needs and opportunities for realization throughout the whole process.
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Affiliation(s)
- Kathrin Hofer-Fischanger
- Institute of Health and Tourism Management, FH JOANNEUM University of Applied Sciences, Kaiser-Franz-Josef Straße 24, Bad Gleichenberg 8344, Austria
| | - Silvia Tuttner
- Institute of Health and Tourism Management, FH JOANNEUM University of Applied Sciences, Kaiser-Franz-Josef Straße 24, Bad Gleichenberg 8344, Austria
| | - Frank M Amort
- Institute of Health and Tourism Management, FH JOANNEUM University of Applied Sciences, Kaiser-Franz-Josef Straße 24, Bad Gleichenberg 8344, Austria
| | - Katja Helms
- Institute of Construction Design and Economics, FH JOANNEUM University of Applied Sciences, Alte Poststraße 154, Graz 8020, Austria
| | - Julia Unger
- Institute of Occupational Therapy, FH JOANNEUM University of Applied Sciences, Kaiser-Franz-Josef Straße 24, Bad Gleichenberg 8344, Austria
| | - Josef Hödl
- Institute of Social Work, FH JOANNEUM University of Applied Sciences, Eggenberger Allee 11, Graz 8020, Austria
| | - Anke Strüver
- Institute of Geography and Regional Sciences, University of Graz, Heinrichstraße 36, Graz 8010, Austria
| | - Mireille N M van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Mozartgasse 14, Graz 8010, Austria
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10
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Forster GK, Aarø LE, Alme MN, Hansen T, Nilsen TS, Vedaa Ø. Built Environment Accessibility and Disability as Predictors of Well-Being among Older Adults: A Norwegian Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105898. [PMID: 37239625 DOI: 10.3390/ijerph20105898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Knowledge about the influence environmental factors have on well-being is important to deliver policies supporting healthy ageing and sustainable health equity. An under-researched question is whether and how the built environment plays a role on well-being among older adults with disabilities. This study explores the relationship between built environment accessibility and disability on psychosocial well-being among older adults. Data were used from the Norwegian Counties Public Health Survey collected during February 2021 in Møre and Romsdal county (N = 8274; age = 60-97, mean = 68.6). General linear modelling was performed to examine the relationship and interaction between built environment accessibility (services, transportation, and nature) and disability on psychosocial well-being (quality of life, thriving, loneliness, and psychological distress). Higher levels of disability and poorer accessibility were each significantly related to lower psychosocial well-being across all variables (p < 0.001). Significant interaction effects were observed between disability and built environment accessibility on thriving (F(8, 5936) = 4.97, p < 0.001, η2 = 0.006) and psychological distress (F(8, 5957) = 3.09, p = 0.002, η2 = 0.004). No significant interaction effects were found for quality of life and loneliness. These findings indicate good built environment accessibility is associated with thriving and reduces psychological distress among older adults with disabilities. This study supports and extends previous findings on the importance of accessible and equipped environments for well-being and may aid policy makers when planning built environments to foster healthy ageing among this population group.
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Affiliation(s)
- Grace Katharine Forster
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, NO-7047 Trondheim, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
- Department of Health and Functioning, Western Norway University of Applied Sciences, HVL, NO-5063 Bergen, Norway
| | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
| | - Maria Nordheim Alme
- Department of Health and Functioning, Western Norway University of Applied Sciences, HVL, NO-5063 Bergen, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, NIPH, NO-0456 Oslo, Norway
- Centre for Welfare and Labour Research, Oslo Metropolitan University, NO-0170 Oslo, Norway
- Promenta Research Center, University of Oslo, NO-0317 Oslo, Norway
| | - Thomas Sevenius Nilsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, NIPH, NO-0456 Oslo, Norway
- Promenta Research Center, University of Oslo, NO-0317 Oslo, Norway
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
- Department of Psychosocial Science, University of Bergen, UiB, NO-5015 Bergen, Norway
- Voss District Psychiatric Hospital NKS Bjørkeli, NO-5705 Voss, Norway
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11
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Stevens CJ, Liao Y, Chen M, Heredia NI, Arem H, Sukumar J, Joffe L, Schmitz KH, Mama SK. Linking social and built environmental factors to leisure-time physical activity in rural cancer survivors. J Natl Cancer Inst Monogr 2023; 2023:125-132. [PMID: 37139981 PMCID: PMC10157784 DOI: 10.1093/jncimonographs/lgad004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/06/2023] [Accepted: 01/25/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND This study explored associations between social and built environmental factors and leisure-time physical activity (LTPA) in rural cancer survivors (RCS) and whether these associations differed by exercise stage of change (SOC). METHOD RCS (n = 219) completed questionnaires assessing LTPA, SOC, and social (social status, connectedness, support) and environmental (home environment, neighborhood environment) factors. Linear regression models examined associations between social and built environmental factors and LTPA and tested for moderation by SOC. RESULTS Half (50.7%) of RCS were physically active, and 49.3% were not active. Social factors positively associated with LTPA included subjective social status in the community (B = 89.0, P = .014) and in the United States (B = 181.3, P < .001), social connectedness (B = 122.3, P = .024), and social support for physical activity from family (B = 41.9, P < .001) and friends (B = 44.3, P < .001). Environmental factors positively associated with LTPA included the home environment (B = 111.2, P < .001), perceived environmental support for PA (B = 355.4, P = .004), and neighborhood attributes, including bicycling infrastructure (B = 191.3, P = .003), proximity to recreation facilities (B = 140.1, P = .021), traffic safety (B = 184.5, P = .025), and aesthetics (B = 342.6, P < .001). SOC statistically significantly moderated the association between social status in the United States and LTPA (B = 160.3, P = .031). CONCLUSIONS Social and built environmental factors were consistently linked with LTPA and provide context for multilevel interventions promoting LTPA in RCS.
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Affiliation(s)
- Courtney J Stevens
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Cancer Population Sciences, Dartmouth Cancer Center, Lebanon, NH, USA
| | - Yue Liao
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Minxing Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hannah Arem
- Healthcare Delivery Research Program, Medstar Health Research Institute, Washington, DC, USA
- Department of Oncology, Georgetown University, Washington, DC, USA
| | - Jasmine Sukumar
- Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lenat Joffe
- Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Cohen Children’s Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Kathryn H Schmitz
- Hillman Cancer Center and Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Scherezade K Mama
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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12
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Yamanaka AB, Strasburger S, Chow C, Butel J, Wilkens L, Davis JD, Deenik J, Shallcross L, Novotny R. Food and Physical Activity Environment in the US-Affiliated Pacific Region: The Children's Healthy Living Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:96-104. [PMID: 36372662 DOI: 10.1016/j.jneb.2022.08.009] [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: 06/10/2021] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To describe the quality of food and physical activity (PA) environments by World Bank Income level in jurisdictions from the Children's Healthy Living Program. DESIGN Baseline cross-sectional community data were analyzed from 11 jurisdictions categorized by World Bank Income levels to describe exposure to different food and PA outlets. The Children's Healthy Living Program was a multilevel, multijurisdictional prevalence study and community intervention trial that reduced child obesity in the US-Affiliated Pacific region. SETTING US-Affiliated Pacific region. PARTICIPANTS Food (n = 426) and PA (n = 552) Outlets. MAIN OUTCOME MEASURES Physical activity and food scores that reflect the quality of the outlets that support being physically active and healthy eating options, respectively. ANALYSIS Descriptive statistics are presented as means ± SD or percentages. RESULTS High-income-income level jurisdictions had higher food and PA scores than middle-income level jurisdictions. CONCLUSIONS AND IMPLICATIONS The US-Affiliated Pacific region has limited quality food and PA outlets in underserved communities at risk for obesity. The findings in this paper can be used to develop tools and design interventions to improve the food and PA environment to increase a healthier, active lifestyle.
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Affiliation(s)
- Ashley B Yamanaka
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI.
| | - Sabine Strasburger
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI
| | - Courtney Chow
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI
| | - Jean Butel
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI
| | - Lynne Wilkens
- Biostatistics and Informatics Shared Resource, University of Hawai'i Cancer Center, Honolulu, HI
| | - James D Davis
- Department of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI
| | - Jonathan Deenik
- Department of Tropical Plant and Soil Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI
| | - Leslie Shallcross
- Health, Home and Family Development, Institute of Agriculture, Natural Resources and Extension, University of Alaska, Fairbanks, AK
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Manoa, Honolulu, HI
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13
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McCormack GR, Koohsari MJ, Vena JE, Oka K, Nakaya T, Chapman J, Martinson R, Matsalla G. Associations between neighborhood walkability and walking following residential relocation: Findings from Alberta's Tomorrow Project. Front Public Health 2023; 10:1116691. [PMID: 36726629 PMCID: PMC9885132 DOI: 10.3389/fpubh.2022.1116691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Cross-sectional studies consistently find that the neighborhood built environment (e.g., walkability) is associated with walking. However, findings from the few existing longitudinal residential relocation studies that have estimated associations between changes in neighborhood built characteristics and walking are equivocal. The study objective was to estimate whether changes in neighborhood walkability resulting from residential relocation were associated with leisure, transportation, and total walking levels among adults. Methods This study included longitudinal data from the "Alberta's Tomorrow Project"-a province-wide cohort study (Alberta, Canada). The analysis included data collected at two time points (i.e., baseline and follow-up) from 5,977 urban adults. The International Physical Activity Questionnaire (IPAQ) captured self-reported walking. We estimated neighborhood walkability, an index capturing intersection, destination, and population counts for the 400 m Euclidean buffer around participants' homes. Using household postal codes reported at baseline and follow-up, we categorized participants into three groups reflecting residential relocation ("non-movers:" n = 5,679; "movers to less walkability:" n = 164, and; "movers to more walkability:" n = 134). We used Inverse-Probability-Weighted Regression Adjustment to estimate differences [i.e., average treatment effects in the treated (ATET)] in weekly minutes of leisure, transportation, and total walking at follow-up between residential relocation groups, adjusting for baseline walking, sociodemographic characteristics, and walkability. The median time between baseline and follow-up was 2-years. Results The three residential relocation groups mainly included women (61.6-67.2%) and had a mean age of between 52.2 and 55.7 years. Compared to "non-movers" (reference group), weekly minutes of transportation walking at follow-up was significantly lower among adults who moved to less walkable neighborhoods (ATET: -41.34, 95 CI: -68.30, -14.39; p < 0.01). We found no other statistically significant differences in walking between the groups. Discussion Our findings suggest that relocating to less walkable neighborhoods could have detrimental effects on transportation walking to the extent of adversely affecting health. Public health strategies that counteract the negative impacts of low walkable neighborhoods and leverage the supportiveness of high walkable neighborhoods might promote more walking.
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Affiliation(s)
- Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,School of Architecture, Planning and Landscape, University of Calgary, Calgary, AB, Canada,School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan,*Correspondence: Gavin R. McCormack ✉
| | - Mohammad Javad Koohsari
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan,Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jennifer E. Vena
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Jonathan Chapman
- Public Space and Mobility Policy, Planning and Development Services Department, Calgary, AB, Canada
| | | | - Graham Matsalla
- Mental Health Promotion and Illness Prevention, Alberta Health Services, Calgary, AB, Canada
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14
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Yang L, Guo D, Zheng J, Guo Y, Li Z. Association between Social Participation and Remaining Teeth and Urban-Rural Difference among Older Adults in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1283. [PMID: 36674039 PMCID: PMC9859502 DOI: 10.3390/ijerph20021283] [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: 10/18/2022] [Revised: 12/11/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Oral health is an important part of older adults' general health. The study examined the association between social participation (formal and informal) and remaining teeth and the urban-rural difference based on a national survey of older adults in China. The data of older adults were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed. A total of 11,948 respondents were ultimately involved, including 6836 urban respondents and 5112 rural respondents. Informal social participation and formal social participation were used to assess social participation. The number of remaining natural teeth was measured. Social participation was significantly associated with remaining teeth among older adults, after adjusting for confounders, a one-level increase in the informal social participation was associated with a decrease in natural teeth by 0.152 (95% CI = -0.274; -0.030) and a one-level increase in the formal social participation was associated with a decrease in natural teeth by 0.370 (95% CI = -0.585; -0.156). In addition, the association between social participation (formal and informal) and remaining teeth was observed among urban older adults, but not rural older adults. A high level of social participation may effectively decrease the risk of oral-health problems for the Chinese older adults. The findings suggest recommendations for an older adults-targeted policy and the practice of oral-health promotion. However, the urban-rural difference should be taken into full consideration in social-participation-driven oral-health promotion interventions.
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Affiliation(s)
- Le Yang
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan 030001, China
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15
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Norman-Burgdolf H, DeWitt E, Gillespie R, Cardarelli KM, Slone S, Gustafson A. Impact of community-driven interventions on dietary and physical activity outcomes among a cohort of adults in a rural Appalachian county in Eastern Kentucky, 2019-2022. Front Public Health 2023; 11:1142478. [PMID: 37124781 PMCID: PMC10140309 DOI: 10.3389/fpubh.2023.1142478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Several environmental level factors exacerbate poor health outcomes in rural populations in the United States, such as lack of access to healthy food and locations to be physically active, which support healthy choices at the individual level. Thus, utilizing innovative place-based approaches in rural locations is essential to improve health outcomes. Leveraging community assets, like Cooperative Extension, is a novel strategy for implementing community-driven interventions. This prospective cohort study (n = 152), recruited in 2019 and surveyed again in 2020 and 2021, examined individual level changes in diet and physical activity in one rural Appalachian county. During this time, multiple community-driven interventions were implemented alongside Cooperative Extension and several community partners. Across the three-year study, the cohort indicated increases in other vegetables and water and reductions in fruits and legumes. There were also reductions in less healthy items such as French fries and sugar-sweetened beverages. The cohort also reported being less likely to engage in physical activity. Our findings suggest that key community-driven programs may have indirect effects on dietary and physical activity choices over time. Outcomes from this study are relevant for public health practitioners and community organizations working within rural Appalachian communities to address health-related behaviors.
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Affiliation(s)
- Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
- *Correspondence: Heather Norman-Burgdolf,
| | - Emily DeWitt
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
| | - Rachel Gillespie
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Kathryn M. Cardarelli
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Stacey Slone
- Dr. Bing Zhang Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, KY, United States
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
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16
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Dixon BN, Hong YR, Perri MG, Allen A, Aufmuth J, Ross KM. Access to Food and Physical Activity Environment Resources in Rural Communities: Impact of Using Driving Time Versus Physical Distance Indicators. JOURNAL OF TRANSPORT & HEALTH 2022; 27:101521. [PMID: 37982034 PMCID: PMC10655550 DOI: 10.1016/j.jth.2022.101521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Brittney N. Dixon
- Department of Health Services Research, Management & Policy, University of Florida, Gainesville, FL
| | - Young-Rock Hong
- Department of Health Services Research, Management & Policy, University of Florida, Gainesville, FL
| | - Michael G. Perri
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Acquel Allen
- Department of Health Services Research, Management & Policy, University of Florida, Gainesville, FL
| | - Joe Aufmuth
- Marston Science Library, University of Florida, Gainesville, FL
| | - Kathryn M. Ross
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
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17
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Pelletier C, White N, Duchesne A, Sluggett L. Rural-urban differences in individual and environmental correlates of physical activity in Canadian Adults. Prev Med Rep 2022; 30:102061. [DOI: 10.1016/j.pmedr.2022.102061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022] Open
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Physical Activity Among Older Women Living in Rural Areas in Canada: A Scoping Review. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09380-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractAlthough there is strong evidence linking physical activity in older age with wellbeing and health benefits, these relationships tend to be under-researched in a rural context. A scoping review was conducted to identify what is known about physical activity among older women living in rural Canada. The search strategy was intentionally broad, with eight databases, academic journals, and websites scanned for research and grey literature related to Canada, in English, from 2000 to 2022. 33 studies, reviews, and reports were included in the final selection. These articles indicate that physical activity among older women living in rural Canada is influenced by a multitude of layers, contexts, conditions, and environments, with outcomes dependent on a mixture of personal, relational, community, societal, and governmental factors. In general, the women are committed to creating and maintaining an active lifestyle, and supporting their local rural community to enable these activities. While the social environment can proscribe physical activity through ageist attitudes and restrictive socio-cultural norms, social support from family and community members mitigates against these constraints. Rural infrastructure, geography, climate (seasons and weather), as well as transportation and policy issues may also impede the physical activity opportunities of the women. Some of the problems related to sustaining and resourcing recreational activity in rural communities are partly addressed through the implications presented in the articles. Among others, these suggestions relate to leadership and learning opportunities, public engagement, and the partnership working involved in supporting physical activity in rural areas. However, further research is long overdue.
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Psychosocial and environmental determinants of active transport to school in Austrian rural communities: a cross-sectional study among schoolchildren and their parents. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background
Active transport to school (ATS) is an effective health-promoting intervention to integrate physical activity into children’s everyday lives. While previous studies have examined environmental and behavioural determinants on ATS in urban areas, evidence on rural areas is rare.
Method
This study examined whether environmental and psychosocial characteristics are associated with ATS in two rural communities in Austria. Participants from four schools (two primary / two secondary schools) returned a self-reported questionnaire on individual and environmental determinants of ATS consisting of one section for parents and one for children, with 382 of the 467 total responses being included in the analysis.
Results
Bivariate analyses showed a significant association of psychosocial characteristics of parents and children (intention, attitude, social norm, perceived behavioural control: p < 0.001), one environmental item (walking and cycling network: p ≤ 0.001) as well as distance and duration for walking to/from school between ATS. In a multiple regression model, the chances of participating in ATS were higher among children who have higher perceived behavioural control, walk between 5 to 10 minutes to school, and whose parents have a higher commitment to ATS.
Conclusions
Future initiatives to enhance ATS in rural areas should focus on the control beliefs of parents and children, and should involve parents in order to increase parents’ commitment to ATS. Additionally, measures should explore the effects of active transport promotion in the context of public transport and school buses. Above all, further opportunities for ATS should be considered in spatial and community planning.
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Examining the state, quality and strength of the evidence in the research on built environments and physical activity among adults: An overview of reviews from high income countries. Health Place 2022; 77:102874. [DOI: 10.1016/j.healthplace.2022.102874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/29/2022] [Accepted: 05/24/2022] [Indexed: 11/19/2022]
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Kegler MC, Gauthreaux N, Hermstad A, Arriola KJ, Mickens A, Ditzel K, Hernandez C, Haardörfer R. Inequities in Physical Activity Environments and Leisure-Time Physical Activity in Rural Communities. Prev Chronic Dis 2022; 19:E40. [PMID: 35797473 PMCID: PMC9336193 DOI: 10.5888/pcd19.210417] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Differential access to environments supportive of physical activity (PA) may help explain racial and socioeconomic disparities in leisure-time physical activity (LTPA) in rural communities. METHODS We used baseline data from a mailed survey (N = 728) conducted in 2019 as part of an evaluation of The Two Georgias Initiative to examine the relationships among LTPA, sociodemographic characteristics, and perceived access to supportive PA environments (eg, areas around the home/neighborhood, indoor and outdoor exercise areas, town center connectivity) in 3 rural Georgia counties. RESULTS More than half of respondents (53.5%) engaged in LTPA in the previous month. Perceptions of PA environments were generally neutral to somewhat negative. In multivariable models, overall PA environment was associated with LTPA (OR, 1.58; 95% CI, 1.06-2.35), as was annual household income >$50,000 relative to ≤$20,000 (OR, 2.72; 95% CI, 1.53-4.83) and race, with Black respondents less likely to engage in LTPA than White respondents (OR, 0.49; 95% CI, 0.29-0.85). Of the 5 PA environment domains examined, town center connectivity was significantly associated with LTPA (OR, 1.68, 95% CI, 1.20-2.36). Both the overall PA score (β = -0.014; 95% CI, -0.029 to -0.002) and town center connectivity (β = -0.020; 95% CI, -0.038 to -0.005) partially mediated associations between annual household income and LTPA. Areas supportive of PA around the home/neighborhood partially mediated the association by race (β = 0.016; 95% CI, 0.001-0.034). CONCLUSION Findings lend support for investing in town centers and racially diverse neighborhoods to increase walkability and PA infrastructure as potential strategies to reduce inequities in LTPA.
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Affiliation(s)
- Michelle C. Kegler
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Nicole Gauthreaux
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - April Hermstad
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kimberly Jacob Arriola
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Kelley Ditzel
- Public Administration, Georgia College & State University, Milledgeville, Georgia
| | - Clarisa Hernandez
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
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22
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Becker TB, Contreras D, Porth O. Differences in Eating and Physical Activity Behaviors, and Perceived Accessibility and Availability Barriers between Midwestern Rural and Urban Adults. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2021.1930318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tyler Brian Becker
- Department of Food Science and Human Nutrition, Michigan State University(MSU), East Lansing, Michigan, USA
- Health and Nutrition Institute, Michigan State University(MSU), East Lansing, Michigan, USA
| | - Dawn Contreras
- Health and Nutrition Institute, Michigan State University(MSU), East Lansing, Michigan, USA
| | - Olivia Porth
- Department of Food Science and Human Nutrition, Michigan State University(MSU), East Lansing, Michigan, USA
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23
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Saint Onge JM, Fagan M, Befort CA. The association between the obesogenic environment and 6-month and 24-month weight change in a rural weight loss intervention trial in the United States. Prev Med 2022; 158:107040. [PMID: 35398370 DOI: 10.1016/j.ypmed.2022.107040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/05/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
The unique obesogenic environment may influence the ability to effectively maintain weight loss in rural areas. The aim of this study was to examine the contextual relationship of neighborhood disadvantage, distance to supermarkets and supercenters, and fast food, dollar store, and exercise facility environments on weight loss following a weight-loss intervention in the United States. This analysis (n = 1177) linked weight loss outcomes from a rural, primary care-based randomized controlled trial to contextual data collected from residential addresses. Outcomes include 6-month and 24-month percent weight loss. These outcomes were compared across contextual variables, including tract level disadvantage, food accessibility, and food/exercise availability. Covariates were included in ordinary least squares (OLS) multivariable regression models for 6-month and 24-month weight loss measures, across three weight loss interventions. Contextual variables were not significantly related to percent weight loss overall across treatment arms. Participants living in a 5-mile buffer to dollar stores experienced approximately a 2% (p < 0.05) lower weight loss, but only in the least effective counseling arm (individual clinic visits), while controlling for both individual and contextual factors. Our results suggest that specific contextual variables in rural populations may play an important role in moderating weight loss outcomes especially under the conditions of less effective interventions.
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Affiliation(s)
- Jarron M Saint Onge
- Department of Sociology, University of Kansas, USA; Department of Population Health, University of Kansas Medical Center, USA.
| | | | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, USA
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24
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Jayasinghe S, Flies EJ, Soward R, Kendal D, Kilpatrick M, Holloway TP, Patterson KAE, Ahuja KDK, Hughes R, Byrne NM, Hills AP. A Spatial Analysis of Access to Physical Activity Infrastructure and Healthy Food in Regional Tasmania. Front Public Health 2021; 9:773609. [PMID: 34926390 PMCID: PMC8671161 DOI: 10.3389/fpubh.2021.773609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Prevalence of physical inactivity and obesity continues to increase in regional areas such as North-West (NW) Tasmania and show no signs of abating. It is possible that limited access to physical activity infrastructure (PAI) and healthier food options are exacerbating the low levels of habitual physical activity and obesity prevalence in these communities. Despite a burgeoning research base, concomitant exploration of both physical activity and food environments in rural and regional areas remain scarce. This research evaluated access (i.e., coverage, variety, density, and proximity) to physical activity resources and food outlets in relation to socioeconomic status (SES) in three NW Tasmanian communities. In all three study areas, the PAI and food outlets were largely concentrated in the main urban areas with most recreational tracks and natural amenities located along the coastline or river areas. Circular Head had the lowest total number of PAI (n = 43) but a greater proportion (30%) of free-to-access outdoor amenities. There was marked variation in accessibility to infrastructure across different areas of disadvantage within and between sites. For a considerable proportion of the population, free-to-access natural amenities/green spaces and recreational tracks (73 and 57%, respectively) were beyond 800 m from their households. In relation to food accessibility, only a small proportion of the food outlets across the region sells predominantly healthy (i.e., Tier 1) foods (~6, 13, and 10% in Burnie, Circular Head and Devonport, respectively). Similarly, only a small proportion of the residents are within a reasonable walking distance (i.e., 5–10 min walk) from outlets. In contrast, a much larger proportion of residents lived close to food outlets selling predominantly energy-dense, highly processed food (i.e., Tier 2 outlets). Circular Head had at least twice as many Tier 1 food stores per capita than Devonport and Burnie (0.23 vs. 0.10 and 0.06; respectively) despite recording the highest average distance (4.35 and 5.66 km to Tier 2/Tier 1 stores) to a food outlet. As such, it is possible that both food and physical activity environment layouts in each site are contributing to the obesogenic nature of each community.
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Affiliation(s)
- Sisitha Jayasinghe
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Emily J Flies
- School of Natural Sciences, University of Tasmania, Hobart, TAS, Australia.,Healthy Landscapes Research Group, University of Tasmania, Hobart, TAS, Australia
| | - Robert Soward
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Dave Kendal
- Healthy Landscapes Research Group, University of Tasmania, Hobart, TAS, Australia.,School of Geography, Planning and Spatial Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Michelle Kilpatrick
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Timothy P Holloway
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kira A E Patterson
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kiran D K Ahuja
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Roger Hughes
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Nuala M Byrne
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Andrew P Hills
- College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
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Quantifying the Food and Physical Activity Environments in Rural, High Obesity Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413344. [PMID: 34948951 PMCID: PMC8703759 DOI: 10.3390/ijerph182413344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/11/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022]
Abstract
The built environment contributes to an individual’s health, and rural geographies face unique challenges for healthy eating and active living. The purpose of this descriptive study was to assess the nutrition and physical activity environments in rural communities with high obesity prevalence. One community within each of six high obesity prevalence counties in a rural Midwest state completed the Nutrition Environment Measures Survey for Stores (NEMS-S) and the Rural Active Living Assessment (RALA). Data were collected by trained community members and study staff. All communities had at least one grocery store and five had at least one convenience store. Grocery stores had higher mean total NEMS-S scores than convenience stores (26.6 vs. 6.0, p < 0.001), and higher scores for availability (18.7 vs. 5.3, p < 0.001) and quality (5.4 vs. 0, p < 0.001) of healthful foods (higher scores are preferable). The mean RALA town-wide assessment score across communities was 56.5 + 15.6 out of a possible 100 points. The mean RALA program and policy assessment score was 40.8 + 20.4 out of a possible 100 points. While grocery stores and schools are important for enhancing food and physical environments in rural areas, many opportunities exist for improvements to impact behaviors and address obesity.
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Supporting a rural wellness intervention through assessing and mapping rural physical activity environments. Prev Med Rep 2021; 24:101567. [PMID: 34976633 PMCID: PMC8683888 DOI: 10.1016/j.pmedr.2021.101567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/16/2021] [Accepted: 09/15/2021] [Indexed: 01/19/2023] Open
Abstract
Rural residents are more likely to be physically inactive than their urban counterparts and are therefore at higher risk for obesity and cardiovascular disease. Research has shown that these disparities are driven in part by the physical environment, policies, and programming in rural communities. The purpose of this study was to use the Rural Active Living Assessment (RALA) to assess the physical activity environment of four Midwestern towns and to develop physical activity maps to support Enhanced Win With Wellness, a community-based cardiovascular risk reduction program. The RALA Town Wide (TWA) and Program and Policy (PPA) assessments were conducted in all four towns and are scored from (0–100). The TWA scores ranged from 69 to 96 (mean = 82.25) and the PPA scores ranged from 47 to 70 (mean = 59.75), indicating the towns had more amenities that supported physical activity than policies and programming. Using data gathered from the RALA assessments, digital physical activity maps were created for each town using the Google Maps platform and accessible through QR codes. The maps were advertised through Facebook and flyers to program participants and were viewed 3,073 times during the study period. Our study illustrates how the results from the TWA and PPA can be transformed into an easily accessible map that can used to reach populations residing in rural communities to increase awareness of physical activity amenities and improve engagement. It is also useful in helping identify gaps in recreational opportunities and to assist in developing policies or programs supporting physical activity.
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Kaminska ME, Roots RK, Singh A. Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation. Can J Kidney Health Dis 2021; 8:20543581211056233. [PMID: 34777843 PMCID: PMC8586186 DOI: 10.1177/20543581211056233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/11/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for patients on kidney replacement therapy living in remote northern communities is inhibited by inclement weather and lack of access to resources and infrastructure that support physical activity. The integration of intradialytic cycling during hemodialysis offers patients a form of safe physical activity year-round. OBJECTIVE This study focuses on better understanding the feasibility and acceptability of implementing intradialytic cycling in a remote northern geographical context. DESIGN A feasibility study using a mixed-methods explanatory design was adopted for this study. SETTING The research is conducted in Prince George, British Columbia. PARTICIPANTS The participants are patients attending a community-based dialysis unit in remote northern British Columbia and health professionals working in the same facility. METHODS Quantitative measures were captured through cycling logbooks and quality of life measure, and qualitative data were obtained through semi-structured interviews and analyzed using thematic analysis. RESULTS Six (43%) eligible patients used leg ergometers more than once for a median of 2.5 (interquartile range: 1-4) months and 87% of hemodialysis sessions. Participants cycled for a median of 65 (interquartile range: 39-76) minutes per session, with frequent variability noted between participants and different hemodialysis sessions for the same participant. Nine patients completed the European Quality of Life Health Questionnaire prestudy, with 5 (56%) also completing it poststudy. Interviews with 9 patients, 4 nurses, and 1 physiotherapist led to the identification of themes instrumental to implementation: a supportive community dialysis unit, shared responsibility, knowledge of patients/providers, and benefits associated with engagement. Themes that were identified as being key to acceptability in this remote dialysis unit were trust, connection, and engagement through common values. LIMITATIONS Due to dialysis unit size, we had a small number of participants. CONCLUSIONS This study demonstrates the feasibility of implementing best practice in a remote community and provides insight into the elements of context and participation that contribute to acceptability in the implementation of intradialytic cycling.
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Affiliation(s)
- Malgorzata E. Kaminska
- Northern Medical Program, University of Northern British Columbia, Prince George, Canada
- Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Robin K. Roots
- Northern Medical Program, University of Northern British Columbia, Prince George, Canada
- Department of Physical Therapy, The University of British Columbia, Vancouver, Canada
| | - Anurag Singh
- Division of Nephrology, University Hospital of Northern British Columbia, Prince George, Canada
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28
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Abildso CG, Perry CK, Jacobs L, Umstattd Meyer MR, McClendon M, Edwards MB, Roemmich JN, Ramsey Z, Stout M. What Sets Physically Active Rural Communities Apart from Less Active Ones? A Comparative Case Study of Three US Counties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10574. [PMID: 34682319 PMCID: PMC8535724 DOI: 10.3390/ijerph182010574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rural US communities experience health disparities, including a lower prevalence of physical activity (PA). However, "Positive Deviants"-rural communities with greater PA than their peers-exist. The purpose of this study was to identify the factors that help create physically active rural US communities. METHODS Stakeholder interviews, on-site intercept interviews, and in-person observations were used to form a comparative case study of two rural counties with high PA prevalence (HPAs) and one with low PA prevalence (LPA) from a southern US state, selected based on rurality and adult PA prevalence. Interview transcripts were inductively coded by three readers, resulting in a thematic structure that aligned with a Community Capital Framework, which was then used for deductive coding and analysis. RESULTS Fifteen stakeholder interviews, nine intercept interviews, and on-site observations were conducted. Human and Organizational Capital differed between the HPAs and LPA, manifesting as Social, Built, Financial, and Political Capital differences and a possible "spiraling-up" or cyclical effect through increasing PA and health (Human Capital), highlighting a potential causal model for future study. CONCLUSIONS Multi-organizational PA coalitions may hold promise for rural PA by directly influencing Human and Organizational Capital in the short term and the other forms of capital in the long term.
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Affiliation(s)
- Christiaan G. Abildso
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA;
| | - Cynthia K. Perry
- School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Lauren Jacobs
- School of Kinesiology and Physical Education, College of Education and Human Development, University of Maine, Orono, ME 04469, USA;
| | - M. Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA; (M.R.U.M.); (M.M.)
| | - Megan McClendon
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA; (M.R.U.M.); (M.M.)
| | - Michael B. Edwards
- Department of Parks, Recreation and Tourism Management, College of Natural Resources, North Carolina State University, Raleigh, NC 27695, USA;
| | - James N. Roemmich
- US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND 58201, USA;
| | - Zachary Ramsey
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA;
| | - Margaret Stout
- Department of Public Administration, West Virginia University, Morgantown, WV 26506, USA;
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Pfledderer CD, Burns RD, Byun W, Carson RL, Welk GJ, Brusseau TA. School-based physical activity interventions in rural and urban/suburban communities: A systematic review and meta-analysis. Obes Rev 2021; 22:e13265. [PMID: 33938109 DOI: 10.1111/obr.13265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/20/2022]
Abstract
Disparities in physical activity and health outcomes exist between urban and rural youth. School settings can be utilized to promote physical activity in youth regardless of urban-rural status. This systematic review and meta-analysis aimed to assess and compare the effect of rural and urban/suburban school-based physical activity programs on total physical activity in youth. A search of five databases was conducted. A total of 33 studies remained after the exclusion process, 28 of which took place in urban/suburban schools and five of which took place in rural schools. The DerSimonian and Laird random effects model was employed with the estimates of heterogeneity taken from the inverse-variance fixed-effect model. For rural studies, the Hartung-Knapp-Sidak-Jonkman method was used to obtain error estimates. Results from the total sample indicated a significant but small pooled increase in daily physical activity (Hedge's g = 0.12, 95% confidence interval [CI]: 0.06-0.18), which held for interventions conducted in urban/suburban schools (Hedge's g = 0.12, 95% CI: 0.06-0.19). For rural school-based interventions, there was no significant pooled effect (Hedge's g = 0.06, 95% CI: -0.50 to 0.61). This meta-analysis provides evidence that school-based interventions can be marginally effective for increasing daily physical activity in children and adolescents; however, no effect was observed for interventions implemented in rural settings.
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Affiliation(s)
| | - Ryan D Burns
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, Utah, USA
| | - Wonwoo Byun
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, Utah, USA
| | - Russell L Carson
- Research, Health and Wellness, PlayCore, Chattanooga, Tennessee, USA
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Timothy A Brusseau
- Department of Health, Kinesiology and Recreation, University of Utah, Salt Lake City, Utah, USA
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Abildso CG, Daily SM, Meyer MRU, Edwards MB, Jacobs L, McClendon M, Perry CK, Roemmich JN. Environmental Factors Associated with Physical Activity in Rural U.S. Counties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147688. [PMID: 34300138 PMCID: PMC8307667 DOI: 10.3390/ijerph18147688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/03/2022]
Abstract
Background: Rural U.S. adults’ prevalence of meeting physical activity (PA) guidelines is lower than urban adults, yet rural-urban differences in environmental influences of adults’ PA are largely unknown. The study’s objective was to identify rural-urban variations in environmental factors associated with the prevalence of adults meeting PA guidelines. Methods: County-level data for non-frontier counties (n = 2697) were used. A five-category rurality variable was created using the percentage of a county’s population living in a rural area. Factor scores from Factor Analyses (FA) were used in subsequent Multiple Linear Regression (MLR) analyses stratified by rurality to identify associations between environmental factor scores and the prevalence of males and females meeting PA guidelines. Results: FA revealed a 13-variable, four-factor structure of natural, social, recreation, and transportation environments. MLR revealed that natural, social, and recreation environments were associated with PA for males and females, with variation by sex for social environment. The natural environment was associated with PA in all but urban counties; the recreation environment was associated with PA in the urban counties and the two most rural counties. Conclusions: Variations across the rural-urban continuum in environmental factors associated with adults’ PA, highlight the uniqueness of rural PA and the need to further study what succeeds in creating active rural places.
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Affiliation(s)
- Christiaan G. Abildso
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
- Correspondence: ; Tel.: +1-304-293-5374
| | - Shay M. Daily
- WVU Office of Health Affairs, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26505, USA;
| | - M. Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA; (M.R.U.M.); (M.M.)
| | - Michael B. Edwards
- Department of Parks, Recreation and Tourism Management, College of Natural Resources, North Carolina State University, Raleigh, NC 27695, USA;
| | - Lauren Jacobs
- School of Kinesiology and Physical Education, College of Education and Human Development, University of Maine, Orono, ME 04469, USA;
| | - Megan McClendon
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA; (M.R.U.M.); (M.M.)
| | - Cynthia K. Perry
- School of Nursing, Oregon Health Science University, Portland, OR 97239, USA;
| | - James N. Roemmich
- US Department of Agriculture, Agricultural Research Service, Grand Forks, ND 58201, USA;
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31
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Dixon BN, Ugwoaba UA, Brockmann AN, Ross KM. Associations between the built environment and dietary intake, physical activity, and obesity: A scoping review of reviews. Obes Rev 2021; 22:e13171. [PMID: 33369097 PMCID: PMC8629168 DOI: 10.1111/obr.13171] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
There exists a large body of literature examining the association between built environment factors and dietary intake, physical activity, and weight status; however, synthesis of this literature has been limited. To address this gap, we conducted a scoping review of reviews and identified 74 reviews and meta-analyses that investigated the association between built environment factors and dietary intake, physical activity, and/or weight status. Results across reviews were mixed, with heterogeneous effects demonstrated in terms of strength and statistical significance; however, preliminary support was identified for several built environment factors. For example, quality of dietary intake appeared to be associated with the availability of grocery stores, higher levels of physical activity appeared to be most consistently associated with greater walkability, and lower weight status was associated with greater diversity in land-use mix. Overall, reviews reported substantial concern regarding methodological limitations and poor quality of existing studies. Future research should focus on improving study quality (e.g., using longitudinal methods, including natural experiments, and newer mobile sensing technologies) and consensus should be drawn regarding how to define and measure both built environment factors and weight-related outcomes.
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Affiliation(s)
- Brittney N. Dixon
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Umelo A. Ugwoaba
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Andrea N. Brockmann
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Kathryn M. Ross
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
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Orzel B, Keats M, Cui Y, Grandy S. Regional Comparisons of Associations Between Physical Activity Levels and Cardiovascular Disease: The Story of Atlantic Canada. CJC Open 2021; 3:631-638. [PMID: 34027368 PMCID: PMC8134916 DOI: 10.1016/j.cjco.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background Physical inactivity is an important risk factor for cardiovascular disease (CVD). Atlantic Canada is a region with lower physical activity (PA) levels and poorer CVD outcomes than the rest of Canada. Yet, within-region variation is expected. This study aimed to assess the association between PA and CVD and how this relationship varied on a regional level. Methods This cross-sectional study used data from the Atlantic Partnership for Tomorrow's Health (PATH) Study. The cohort included 823 CVD cases and 2469 age-, sex-, and province of residence-matched controls between the ages 35 and 69. Data collected included self-reported CVD and PA levels as well as information on sociodemographic characteristics, health status, and lifestyle behaviours. Simple and multiple logistic regression were used to assess the association between PA and CVD. Results High PA levels were associated with a 26% reduction in the mean probability of CVD compared with low PA levels across the total population. Compared with high PA levels, moderate and low PA levels were associated with increased odds of CVD across all 4 provinces. However, regional variation was observed, with higher odds of CVD for low-to-moderate PA levels in Newfoundland and Labrador and New Brunswick compared with Nova Scotia and Prince Edward Island. Conclusions Atlantic Canadians experience regional inequalities in the association between PA and CVD. Future work needs to explore underlying pathways driving these regional differences, which may be the impetus for interventions that mitigate risk and CVD burden in populations of greatest need.
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Affiliation(s)
- Bartosz Orzel
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Melanie Keats
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.,Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yunsong Cui
- Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Scott Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.,Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Seo Y, Kim M, Shim H, Won CW. Differences in the Association of Neighborhood Environment With Physical Frailty Between Urban and Rural Older Adults: The Korean Frailty and Aging Cohort Study (KFACS). J Am Med Dir Assoc 2020; 22:590-597.e1. [PMID: 33221166 DOI: 10.1016/j.jamda.2020.09.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We examined the difference in the relationship between perceived neighborhood environments and physical frailty between urban and rural older adults. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Urban and rural community in South Korea; a total of 2593 community-dwelling older adults aged 70-84 years (mean age: 76.0 years, 51.0% women) in the Korean Frailty and Aging Cohort Study (KFACS). METHODS The neighborhood environment was assessed using the 17-item Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). The IPAQ-E had 7 environmental factors (residential density, access to destinations, neighborhood infrastructure, neighborhood safety, social environment, aesthetic qualities, and street connectivity). Physical frailty was defined using the Fried frailty criteria with modified cutoffs. RESULTS The number of participants residing in urban and rural areas was 1902 and 691, respectively. The prevalence of frailty was 5.3% and 12.0% in urban and rural areas, respectively. In urban areas, frailty was associated with the total IPAQ-E score (β = -0.007, P = .009) after adjusting for confounding factors. There was no association in the rural areas (β = -0.003, P = .535). In urban older adults, logistic regression showed that absence of destination [odds ratio (OR) 2.58, 95% confidence interval (CI) 1.36-4.90] and no crime safety at night (OR 2.00, 95% CI 1.12-3.57) were associated with a higher risk of frailty. In rural older adults, poor access to recreational facilities (OR 2.17, 95% CI 1.07-4.40) and no aesthetics (OR 2.49, 95% CI 1.22-5.10) were associated with frailty. CONCLUSIONS AND IMPLICATIONS Our study indicated that the presence of destination and crime safety at night was significantly associated with physical frailty among older adults living in urban areas, whereas aesthetics and recreational facilities were significantly associated with physical frailty in rural older adults.
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Affiliation(s)
- Yuri Seo
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea.
| | - Hayoung Shim
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Lopez CJ, Pritlove C, Jones JM, Alibhai SMH, Sabiston CM, Chang E, Santa Mina D. "This is my home-based exercise": exploring environmental influences on home-based exercise participation in oncology. Support Care Cancer 2020; 29:3245-3255. [PMID: 33094360 DOI: 10.1007/s00520-020-05843-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Home-based exercise interventions offer many health benefits; however, the environments that constitute home-based exercise are not well-understood. The purpose of this study was to explore what constitutes the "home" for cancer survivors engaging in home-based exercise and identify factors of the environment that may impact exercise participation. METHODS We conducted a qualitative exploratory study of cancer survivors receiving a home-based exercise prescription to manage their cancer-related impairments. Semi-structured interviews included photo elicitation to actively involve participants in the interview process and provide opportunities to visually "observe" environments utilized for home-based exercise. RESULTS Sixteen participants were interviewed (n = 11 women, median age = 53.5, range = 26-74 years) and three themes emerged: (1) reasons for participating in a home-based exercise program; (2) physical environmental influences and preferences; and (3) social environmental influences and preferences. The ability to self-manage exercise and accommodate competing demands, having access to exercise facilities, feeling comfortable exercising without qualified supervision, and a desire for autonomy were reasons home-based exercise programs were preferred. Participants reported that the physical environment influenced their experience with home-based exercise and sub-themes related to a dynamic environment, indoor and outdoor characteristics, and aesthetics were identified. The social environment, with sub-themes associated with the presence of people, social climate, exercise modeling, connection, and exercise support, also related to exercise behavior. CONCLUSION The findings highlight the influence of the physical and social environment on exercise prescription engagement. They further indicate the need for exercise professionals to consider the environment for exercise when delivering home-based exercise interventions.
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Affiliation(s)
- Christian J Lopez
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, Ontario, M5S 2W6, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Cheryl Pritlove
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Jennifer M Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shabbir M H Alibhai
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, Ontario, M5S 2W6, Canada
| | - Eugene Chang
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord St, Toronto, Ontario, M5S 2W6, Canada. .,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. .,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Gustat J, Anderson CE, Chukwurah QC, Wallace ME, Broyles ST, Bazzano LA. Cross-sectional associations between the neighborhood built environment and physical activity in a rural setting: the Bogalusa Heart Study. BMC Public Health 2020; 20:1426. [PMID: 32948175 PMCID: PMC7501650 DOI: 10.1186/s12889-020-09509-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/06/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Insufficient physical activity (PA) is a common health risk and more prevalent in rural populations. Few studies have assessed relationships between the built environment and PA in rural settings, and community policy guidance to promote PA through built environment interventions is primarily based on evidence from urban studies. METHODS Participants in the Bogalusa Heart Study, a longitudinal study in rural Louisiana, with International Physical Activity Questionnaire data from 2012 to 2013 and a valid residential address (N = 1245) were included. PA was summarized as the number of weekly metabolic equivalent (MET)-minutes of total, transportation, and leisure time PA. The Rural Active Living Assessment street segment audit tool and Google Street View were used to assess features of the built environment overall and in six categories (path features, pedestrian safety features, aesthetics, physical security, destinations and land use) that influence PA. Scores for street segment built environment (overall and in categories) were calculated, for segments and buffers of 0.25, 0.50, 1.00 and 1.50 miles. Associations between built environment scores and PA were assessed with generalized estimating equations. RESULTS Participants reported little weekly total, leisure time, and transportation PA (mean 470, 230 and 43 MET-minutes per week, respectively). A 1-point increase in the overall built environment score was associated with 10.30 additional weekly leisure time MET-minutes within a 1.50 mile buffer (p-value 0.05), with a similar magnitude observed for a 1.00-mile buffer. A 1-point increase in the aesthetic score was associated with significantly higher leisure time PA for all geographic units (from 22.21 to 38.75 MET-minutes weekly) when adjusted for individual covariates, but was attenuated and only significant for the segment of the residence after accounting for other neighborhood characteristics. CONCLUSIONS Significant associations between features of the environment (overall and aesthetic scores) with leisure time PA were observed among adults in this rural population. Built environment interventions in rural settings face additional barriers of lower population density and greater distances for infrastructure projects, and it is important to identify approaches that are both feasible for rural communities and can promote PA.
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Affiliation(s)
- Jeanette Gustat
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2001, New Orleans, LA 70112 USA
| | - Christopher E. Anderson
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2001, New Orleans, LA 70112 USA
| | | | - Maeve E. Wallace
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112 USA
| | - Stephanie T. Broyles
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808 USA
| | - Lydia A. Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2001, New Orleans, LA 70112 USA
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Soroka A, Godlewska A, Krzęcio-Nieczyporuk E, Kozioł P. Identification of motives and barriers to physical activity of polish young mothers. BMC Womens Health 2020; 20:197. [PMID: 32917211 PMCID: PMC7488306 DOI: 10.1186/s12905-020-01061-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 08/30/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of the study was to determine the level of physical activity of young mothers living in rural and urban areas and their free time budget. The article also aims to indicate motivating factors and barriers encountered during physical activity. METHODS A diagnostic survey method, including two survey IPAQ questionnaires - the long version and author's questionnaire, has been applied in the study. A representative sample consisted of 1064 young mothers who gave birth in 2017. Student T test and discriminate function analysis have been used in statistical analysis. RESULTS No significant difference appeared between young mothers from rural areas and urban areas in the level of physical activity. At the same time, the authors of the study identified several smaller differences when analyzing particular aspects of physical activity. Young mothers from rural areas more often declared their participation in physical activity to improve their physical condition and reduce pain complaints. On the other hand, young mothers from urban areas emphasized that physical activity helps them to strengthen self-confidence and improve their position in the family. In case of the main barriers to physical activity, both group of respondents pointed to the lack of money and interest in occasional events. CONCLUSIONS The main conclusion is that more efforts are needed is to strengthen family support and material status of young families. It is also important to eliminate infrastructure barriers, mostly in rural areas and raise awareness on the importance of health education.
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Affiliation(s)
- Andrzej Soroka
- Siedlce University of Natural Sciences and Humanities, Faculty of Medical and Health Sciences, B. Prusa 14 st., 08-110, Siedlce, Poland
| | - Agnieszka Godlewska
- Siedlce University of Natural Sciences and Humanities, Faculty of Medical and Health Sciences, B. Prusa 14 st., 08-110, Siedlce, Poland.
| | - Elżbieta Krzęcio-Nieczyporuk
- Siedlce University of Natural Sciences and Humanities, Faculty of Medical and Health Sciences, B. Prusa 14 st., 08-110, Siedlce, Poland
| | - Paulina Kozioł
- Siedlce University of Natural Sciences and Humanities, Faculty of Medical and Health Sciences, B. Prusa 14 st., 08-110, Siedlce, Poland
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Cleland V, Timperio A, Sharman MJ, Dollman J. Test-retest reliability of a self-reported physical activity environment instrument for use in rural settings. Aust J Rural Health 2020; 28:168-179. [PMID: 32390206 DOI: 10.1111/ajr.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Little is known about how the physical environment impacts physical activity behaviour among rural populations, who are typically less active and at higher risk of chronic disease than urban dwellers. The lack of individual-level instruments to assess the physical environment in rural areas limits advancement of this field. Among rural adults, this study aimed to evaluate (a) the test-retest reliability of a self-reported questionnaire of individual-level perceptions of the physical activity environment, and (b) the stability of a self-reported physical activity questionnaire. DESIGN Cross-sectional questionnaire repeated twice, 2 weeks apart. The questionnaire included 94 items relating to the perceived physical environment (representing nine summary scores), demographic characteristics and physical activity. SETTING Rural Australia. PARTICIPANTS Rurally residing adults (≥18 years) across three Australian states. MAIN OUTCOME MEASURES Test-retest reliability evaluated by weighted Kappa statistics (individual items) and intra-class correlations (summary scores). RESULTS A total of 292 participants (20% men) completed both questionnaires, on average 22 days apart. Test-retest reliability of individual items ranged from weighted Kappa 0.37-0.85 (median: 0.59). Internal reliability for five summary scores was good to excellent (Cronbach's alpha: 0.81-0.97). Test-retest reliability was good to excellent for six summary scores (intra-class correlations: 0.67-0.77). CONCLUSIONS The findings indicated good to excellent test-retest reliability for most items, particularly "fixed" constructs for this new questionnaire measuring the perceived physical environment in rural populations. This study represents an important step towards improving measurement of physical activity environments in rural populations, potentially leading to better tailored interventions to promote active and healthy living in rural areas.
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Affiliation(s)
- Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic., Australia
| | - Melanie J Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - James Dollman
- Exercise for Health and Human Performance Research Group, School of Health Sciences, University of South Australia, Adelaide, SA, Australia
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DeGuzman PB, Chu C, Keim-Malpass J. Built and Natural Environment Barriers and Facilitators to Physical Activity in Rural, Suburban, and Small Urban Neighborhoods. Oncol Nurs Forum 2020; 46:545-555. [PMID: 31424449 DOI: 10.1188/19.onf.545-555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore built and natural environment barriers and facilitators to walking for exercise in cancer survivors. PARTICIPANTS & SETTING Cancer survivors (N = 7) living in rural, suburban, and small urban neighborhoods in central Virginia. METHODOLOGIC APPROACH The authors used a qualitative descriptive design with photovoice to explore the cancer survivors' experience with residential walkability. FINDINGS The following three themes were identified from the data. IMPLICATIONS FOR NURSING Clinicians should consider an evaluation of the built and natural environment to support walking in cancer survivors. These findings may be used in conjunction with known individual-level barriers to physical activity to develop guidance for oncology nurses to help survivors safely achieve physical activity goals.
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Abe T, Okuyama K, Hamano T, Takeda M, Isomura M, Nabika T. Hilly environment and physical activity among community-dwelling older adults in Japan: a cross-sectional study. BMJ Open 2020; 10:e033338. [PMID: 32220911 PMCID: PMC7170569 DOI: 10.1136/bmjopen-2019-033338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES We investigated whether a moderate-to-vigorous physical activity (MVPA) level and walking time were associated with a hilly environment in rural Japanese older adults. DESIGN Cross-sectional study. SETTING Unnan city, Ohnan and Okinoshima towns in Shimane, Japan. PARTICIPANTS Data were collected from 1115 adults from the Shimane CoHRE study, who were aged 60 years and older and living in rural Japan in 2012. MEASURES We measured the total time spent on MVPA and walking using a Japanese short version of the International Physical Activity Questionnaire. The land slope in 400 or 800 m network buffers was assessed using the geographic information system. A multivariable Poisson regression model examined the prevalence ratios (PR) and 95% CIs of walking time or MVPA levels meeting the WHO guideline (>150 min/week) in the land slope categories (low, middle and high), adjusted for confounders. RESULTS Engaging in the recommended level of MVPA was significantly associated with middle land slope (PR=1.07; p=0.03) and high land slope (PR=1.06; p=0.07) compared with low land slope in the 400 m network buffer, as well as with middle land slope (PR=1.02; p=0.48) and high land slope (PR=1.04; p=0.25) compared with the low land slope in the 800 m network buffer. Walking time was significantly associated with middle land slope (PR=1.13; p=0.04) and high land slope (PR=1.17; p=0.01) compared with low land slope in the 400 m network buffer, and with middle land slope (PR=1.09; p=0.16) and high land slope (PR=1.17; p<0.01) compared with low land slope in the 800 m network buffer. The sensitivity analysis found only a positive association between walking time and land slope in the 400 and 800 m network buffers. CONCLUSIONS This study showed that a hilly environment was positively associated with walking time among older adults living in rural Japan.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kita-ku, Kyoto, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
- Faculty of Human Sciences, Shimane University, Matsue, Shimane, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
- Department of Functional Pathology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan
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Moore JX, Carter SJ, Williams V, Khan S, Lewis-Thames MW, Gilbert K, Howard G. Physical health composite and risk of cancer mortality in the REasons for Geographic and Racial Differences in Stroke Study. Prev Med 2020; 132:105989. [PMID: 31954141 PMCID: PMC7048236 DOI: 10.1016/j.ypmed.2020.105989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/19/2019] [Accepted: 01/12/2020] [Indexed: 10/25/2022]
Abstract
It is unclear how resting myocardial workload, as indexed by baseline measures of rate-pressure product (RPP) and physical activity (PA), is associated with the overall risk of cancer mortality. We performed prospective analyses among 28,810 men and women from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We used a novel physical health (PH) composite index and categorized participants into one of four groups based on combinations from self-reported PA and RPP: 1) No PA and High RPP; 2) No PA and Low RPP; 3) Yes PA and High RPP; and 4) Yes PA and Low RPP. We examined the association between baseline PH composite and cancer mortality adjusted for potential confounders using Cox regression. A total of 1191 cancer deaths were observed over the 10-year observation period, with the majority being lung (26.87%) and gastrointestinal (21.49%) cancers. Even after controlling for sociodemographics, health behaviors, baseline comorbidity score, and medications, participants with No PA and High RPP had 71% greater risk of cancer mortality when compared to participants with PA and Low RPP (adjusted HR: 1.71, 95% CI: 1.42-2.06). These associations persisted after examining BMI, smoking, income, and gender as effect modifiers and all-cause mortality as a competing risk. Poorer physical health composite, including the novel RPP metric, was associated with a nearly 2-fold long-term risk of cancer mortality. The physical health composite has important public health implications as it provides a measure of risk beyond traditional measure of obesity and physical activity.
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Affiliation(s)
- Justin Xavier Moore
- Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA, USA; Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis School of Medicine, St Louis, MO, USA.
| | - Stephen J Carter
- School of Public Health, Department of Kinesiology, Indiana University, Bloomington, IN, USA; Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victoria Williams
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - Marquita W Lewis-Thames
- Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - Keon Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO, USA
| | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
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Rosado JI, Rivera A, Fernandez T. Perceived Role of Built and Social Environments on Childhood Obesity: A PhotoVoice Approach With Latino Migrant Farmworking Families. FAMILY & COMMUNITY HEALTH 2020; 43:221-228. [PMID: 32427669 DOI: 10.1097/fch.0000000000000257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The childhood obesity epidemic in the United States is well documented; however, limited attention has been given to Latino children from migrant farmworking families, and there is little research on how environmental and social factors contribute to overweight among this population. This article presents qualitative themes related to the role of the built and social environments in influencing diet, physical activity, and ultimately, health and weight status. Themes were identified through the PhotoVoice method, with 13 parent participants representing 30 children from a rural farmworking community in Southwest Florida.
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Porskamp T, Ergler C, Pilot E, Sushama P, Mandic S. The importance of social capital for young People's active transport and independent mobility in rural Otago, New Zealand. Health Place 2019; 60:102216. [PMID: 31590078 DOI: 10.1016/j.healthplace.2019.102216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 09/08/2019] [Accepted: 09/18/2019] [Indexed: 12/23/2022]
Abstract
Social capital influences adolescents' licenses for active transport and independent mobility, through parental decision making and safety concerns, and may contribute to increasing adolescents' physical activity. Drawing on 20 parental interviews and 11 focus groups (73 adolescents) from rural New Zealand, this paper shows the importance of social capital and social trust for active transport and independent mobility in an under researched rural context. Change over time in social capital, social trust and parental safety concerns limited adolescents' active transport and independent mobility. Health policy should incorporate social capital measures to increase adolescents' active transport, independent mobility and physical activity.
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Affiliation(s)
- Tessa Porskamp
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; School of Geography, University of Otago, PO Box 56, Dunedin, 9054, New Zealand; Maastricht Centre for Global Health, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Christina Ergler
- School of Geography, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Eva Pilot
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; Maastricht Centre for Global Health, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands
| | - Preeti Sushama
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands; Maastricht Centre for Global Health, Maastricht University, Peter Debyeplein 1, 6229HA, Maastricht, the Netherlands
| | - Sandra Mandic
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, 9054, New Zealand; Centre for Sustainability, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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Carter WM, Morse WC, Brock RW, Struempler B. Improving Physical Activity and Outdoor Recreation in Rural Alabama Through Community Coalitions. Prev Chronic Dis 2019; 16:E116. [PMID: 31469071 PMCID: PMC6716410 DOI: 10.5888/pcd16.190062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Obesity rates in the United States are trending upward, and disadvantaged populations continue to have disproportionate rates of obesity. In Alabama, the ALProHealth initiative used community-based participatory research to work with community coalitions to implement research-based interventions that addressed issues related to the lack of opportunities for physical activity in 14 counties whose populations are at high risk of obesity. Coalitions developed work plans and timelines for implementing interventions on the basis of issues discussed during focus groups at the beginning of the ALProHealth initiative. These 14 coalitions implemented 101 interventions related to physical activity in 16 communities. In this evaluation, we measured potential reach and improvements in amenities. The largest reach for an intervention was achieved through marketing and communication efforts, while the most popular intervention, undertaken by the largest number of communities, centered on installing or repairing playground equipment at community parks. Community-based participatory research is an effective method for addressing health issues at the local level, as interventions are developed and readily adopted through active partnerships with community leaders and residents.
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Affiliation(s)
- William M Carter
- Alabama Cooperative Extension System, Auburn University, Mail: 2121, Rev. Abraham Woods Jr Blvd, Ste 1700, Birmingham, AL 35203.
| | - Wayde C Morse
- School of Forestry and Wildlife Sciences, Auburn University, Auburn, Alabama
| | - Ruth W Brock
- Alabama Cooperative Extension System, Auburn University, Auburn, Alabama
| | - Barbara Struempler
- Alabama Cooperative Extension System, Auburn University, Auburn, Alabama
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Whitfield GP, Carlson SA, Ussery EN, Watson KB, Berrigan D, Fulton JE. National-level environmental perceptions and walking among urban and rural residents: Informing surveillance of walkability. Prev Med 2019; 123:101-108. [PMID: 30878571 PMCID: PMC10885855 DOI: 10.1016/j.ypmed.2019.03.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/05/2019] [Accepted: 03/11/2019] [Indexed: 11/24/2022]
Abstract
Built environments that provide activity-friendly routes (e.g., sidewalks) to everyday destinations (e.g., shops) can increase physical activity. Surveillance of supports and destinations is important, and identifying which are associated with walking could prioritize surveillance questions. Our purpose was to identify the significant associations between supports and destinations with walking among a nationally-representative sample of urban- and rural-dwelling adults. Participants in the 2015 National Health Interview Survey, Cancer Control Supplement (n = 29,925) reported the near-home presence of walkable supports (roads, sidewalks, paths, or trails; sidewalks on most streets), destinations (shops; transit; movies, libraries, or churches; relaxing places), and past-week walking for leisure or transportation. We used stepwise logistic regression to quantify associations between supports and destinations and walking, including by urban/rural residence. We calculated the prevalence of walking across counts of reported elements by urban/rural residence. Among all participants, roads, sidewalks, paths, or trails and relaxing destinations were associated with leisure walking. Among urban residents, sidewalks on most streets and all four destination types were associated with transportation walking; among rural residents, roads, sidewalks, paths, or trails; movies, libraries, or churches; and relaxing destinations were associated with transportation walking. Walking was more common when more environmental elements were reported. To improve efficiency, communities may match surveillance priorities to behavioral priorities (i.e., leisure versus transportation walking) and environmental context (i.e., urban/rural areas). Surveillance of environments supporting leisure walking might focus on recreation-oriented spaces. Surveillance of environments supporting transportation walking might differ for urban and rural areas, and assessing destinations may be particularly important.
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Affiliation(s)
- Geoffrey P Whitfield
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - Susan A Carlson
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Emily N Ussery
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Kathleen B Watson
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Janet E Fulton
- Division of Nutrition Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Lu C, Huang G, Corpeleijn E. Environmental correlates of sedentary time and physical activity in preschool children living in a relatively rural setting in the Netherlands: a cross-sectional analysis of the GECKO Drenthe cohort. BMJ Open 2019; 9:e027468. [PMID: 31092663 PMCID: PMC6530350 DOI: 10.1136/bmjopen-2018-027468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES This study examined the relationship between environmental correlates and children's sedentary time (ST), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) in preschool children. DESIGN Cross-sectional study SETTING: A birth cohort in Drenthe, a northern province and relatively rural area of the Netherlands. PARTICIPANTS Valid data both for the ActiGraph and the questionnaire were obtained from 505 child-parent pairs. PRIMARY AND SECONDARY OUTCOME MEASURES ST, LPA and MVPA of children were objectively measured by ActiGraph accelerometry (minimum three wearing days, more than 10 hours/day). Environmental correlates were collected using a questionnaire reported by parents that included household characteristics, parental and children's PA behaviours and neighbourhood environment (eg, traffic safety, road network and presence of PA facilities). Potential correlates were identified using linear regression analysis, adjusted by age, gender, siblings, and maternal age and education level. Ordinary least square regression-based path analysis was used to estimate direct and indirect effects on activity outcomes in mediation models. RESULTS Linear regression analysis showed that 'parents taking children to play sports' was related to less ST, more LPA and MVPA; more outdoor play was also related to less ST and more LPA, but not MVPA. Parents who perceived more PA facilities in their neighbourhood showed more support for 'taking children to play sports', and this was associated with less ST or more MVPA compared with children living with less PA facilities in their neighbourhood. No evidence was found for a relation between traffic safety or road network with ST, LPA and MVPA. CONCLUSIONS This study indicated that parental support and child outdoor play may influence children's daily PA patterns. Convenient neighbourhood PA facilities, such as parks and playgrounds, had an indirect effect through parental support associated with lower children's ST and higher MVPA, even in relatively rural areas.
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Affiliation(s)
- Congchao Lu
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Centre for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Guowei Huang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Centre for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Okuyama K, Abe T, Hamano T, Takeda M, Sundquist K, Sundquist J, Nabika T. Hilly neighborhoods are associated with increased risk of weight gain among older adults in rural Japan: a 3-years follow-up study. Int J Health Geogr 2019; 18:10. [PMID: 31077213 PMCID: PMC6509780 DOI: 10.1186/s12942-019-0174-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/03/2019] [Indexed: 12/27/2022] Open
Abstract
Background Neighborhood environments have been regularly associated with the weight status. Although the evidence is mostly limited to adults residing in western urban settings, the weight status of older adults living in rural areas is also assumed to be significantly affected by their neighborhood environments. This study aimed to identify environmental attributes specific to rural areas that could affect the risk of longitudinal weight gain among older adults (≥ 65 years) in Japan. Methods We examined five environmental attributes, i.e., land slope, public transportation accessibility, residential density, intersection density, and the availability of parks and recreational centers, measured by the geographic information system. Our analysis was based on 714 subjects participated in Shimane Community-based Healthcare Research and Education study in 2012 and 2015. Multinomial logistic regression model was conducted to examine the association between each neighborhood environmental attribute and weight change status (gain, loss and unchanged). Results We observed a significant increase in the risk of weight gain as the steepness of the neighborhood land slope increased. There was no significant association between other environmental attributes and risk of weight gain as well as weight loss among older adults. Conclusion Living in hilly neighborhoods was associated with increased risk of weight gain among rural Japanese older adults. Future research should consider region-specific environmental attributes when investigating their effect on older adults’ weight status.
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Affiliation(s)
- Kenta Okuyama
- Center for Community-based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan.
| | - Takafumi Abe
- Center for Community-based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
| | - Tsuyoshi Hamano
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Motoyama, Kamigamo Kita-ku, Kyoto, 603-8555, Japan
| | - Miwako Takeda
- Center for Community-based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden
| | - Toru Nabika
- Department of Functional Pathology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
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Travert AS, Sidney Annerstedt K, Daivadanam M. Built Environment and Health Behaviors: Deconstructing the Black Box of Interactions-A Review of Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1454. [PMID: 31022911 PMCID: PMC6517917 DOI: 10.3390/ijerph16081454] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/13/2019] [Accepted: 04/15/2019] [Indexed: 01/08/2023]
Abstract
A review of reviews following a scoping review study design was conducted in order to deconstruct the black box of interactions between the built environment and human behaviors pertaining to physical activity and/or diet. In the qualitative analysis 107 records were included, 45 of which were also coded. Most review papers confirmed the influence of the built environment on the behaviors of interest with some noting that a same built environment feature could have different behavioral outcomes. The conceptual model developed sheds light on these mixed results and brings out the role of several personal and behavioral factors in the shift from the measured to the perceived built environment. This shift was found to shape individuals' behaviors critically and to have the power of redefining the strength of every interaction. Apart from its theoretical relevance, this model has high practical relevance especially for the design and implementation of interventions with a behavioral component. Intervention researchers can use the model developed to identify and label the built environment and individual factors that can be measured objectively or perceived as facilitators, concurrent options and barriers, in order to develop comprehensive and multi-component intervention strategies.
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Affiliation(s)
- Anne-Sophie Travert
- School of Public Affairs, Sciences Po, 75007 Paris, France.
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | | | - Meena Daivadanam
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden.
- Department of Food Studies, Nutrition and Dietetics, Uppsala University; 751 22 Uppsala, Sweden.
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Ly H, Irwin JD. Designing effective point-of-choice prompts to promote active transportation and staircase use at a Canadian University. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:215-223. [PMID: 29952735 DOI: 10.1080/07448481.2018.1469503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/01/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the most suitable health messages and designs to create point-of-choice prompts for promoting active transportation and staircase use that would appeal to undergraduate students. PARTICIPANTS Undergraduate students (N = 21; 71% women) were recruited during Fall (2016) and Winter (2017) semesters. METHODS Focus groups (50-80 minutes each) were organized to obtain students' feedback on the kind of messages and poster designs they found motivational. Inductive content analysis was performed on verbatim transcripts. Descriptive statistics were calculated to summarize demographic characteristics of participants. RESULTS The major themes revealed that participants: preferred simple designs with tailored messages; had diverse lifestyle-based values associated with physical activity; and participation in activities were affected by uncontrollable factors (eg, time, built environment, and weather). CONCLUSIONS This study provides insights for designing suitable point-of-choice prompts that are tailored for university students in terms of future interventions that aim to improve their activity levels.
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Affiliation(s)
- Hieu Ly
- a Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, Health Promotion Research Laboratory , Western University , London , Ontario , Canada
- b School of Health Studies, Faculty of Health Sciences , Western University , London , Ontario , Canada
| | - Jennifer D Irwin
- a Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, Health Promotion Research Laboratory , Western University , London , Ontario , Canada
- b School of Health Studies, Faculty of Health Sciences , Western University , London , Ontario , Canada
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Lo BK, Graham ML, Folta SC, Paul LC, Strogatz D, Nelson ME, Parry SA, Carfagno ME, Wing D, Higgins M, Seguin RA. Examining the Associations between Walk Score, Perceived Built Environment, and Physical Activity Behaviors among Women Participating in a Community-Randomized Lifestyle Change Intervention Trial: Strong Hearts, Healthy Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E849. [PMID: 30857189 PMCID: PMC6427661 DOI: 10.3390/ijerph16050849] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/02/2019] [Accepted: 03/06/2019] [Indexed: 11/16/2022]
Abstract
Little is known about the relationship between perceived and objective measures of the built environment and physical activity behavior among rural populations. Within the context of a lifestyle-change intervention trial for rural women, Strong Hearts, Healthy Communities (SHHC), we examined: (1) if Walk Score (WS), an objective built environment measure, was associated with perceived built environment (PBE); (2) if WS and PBE were associated with moderate-to-vigorous physical activity (MVPA); and (3) if MVPA changes were modified by WS and/or PBE. Accelerometers and questionnaires were used to collect MVPA and PBE. Bivariate analyses and linear mixed models were used for statistical analyses. We found that WS was positively associated with perceived proximity to destinations (p < 0.001) and street shoulder availability (p = 0.001). MVPA was generally not associated with WS or PBE. Compared to controls, intervention group participants increased MVPA if they lived in communities with the lowest WS (WS = 0), fewer perceived walkable destinations, or extremely safe perceived traffic (all p < 0.05). Findings suggest that WS appears to be a relevant indicator of walkable amenities in rural towns; results also suggest that the SHHC intervention likely helped rural women with the greatest dearth of built environment assets to improve MVPA.
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Affiliation(s)
- Brian K Lo
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Meredith L Graham
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Lynn C Paul
- College of Education, Health and Human Development, Montana State University, Bozeman, MT 59717, USA.
| | | | | | - Stephen A Parry
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Michelle E Carfagno
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA 92093, USA.
| | - Michael Higgins
- Exercise and Physical Activity Resource Center, University of California, San Diego, CA 92093, USA.
| | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
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A multilevel approach for promoting physical activity in rural communities: a cluster randomized controlled trial. BMC Public Health 2019; 19:126. [PMID: 30700262 PMCID: PMC6354358 DOI: 10.1186/s12889-019-6443-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity (PA) has demonstrated a decreased risk in various cancers and other chronic diseases; however, rural residents are less likely to attain recommended levels of PA compared to urban and suburban counterparts. Given rural residents make up 15% of the United States population, there is a need for novel approaches to increase PA among this population. The goal of the present study is to investigate the effectiveness of a multilevel intervention to increase PA rates among rural residents. Methods/design Guided by an ecological framework, a group-randomized design will be used to evaluate the effects of a three-level intervention for increasing PA among adult residents residing in 6 rural communities (n = 600) along with 6 control communities (n = 600). The intervention includes components at the individual (short message service [SMS] text messages), interpersonal (social support in walking groups), and community levels (events at existing trails). Innovative methods to encourage participation will be employed as well as a focus on life priorities (family, recreation, hobbies) other than health. Aim 1 includes a literature review and key informant interviews to determine the local contexts for intervention adaptation. Aim 2 will employ a set of interventions at the individual, interpersonal, and community-levels to evaluate their impact on moderate-to-vigorous PA as measured by self-reported (telephone survey) and objectively assessed (accelerometry) measures. These data are supplemented by location based on Global Positioning System and community audits, which provide information on recreational amenities, programs/policies, and street segments. Discussion This study is among the first of its kind to test a multilevel intervention in a rural setting, address life priorities that compliment health outcomes, and examine moderation between behavioral interventions and the natural environments where people are physically active. Our results will influence the field by enhancing the ability to scale-up innovative, PA interventions with the potential to reach high-risk, rural populations. Trial registration Clinical Trials NCT03683173, September 25, 2018.
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