Introduction to the
Active Living Research Reference List 2011
The following pages are citations of studies of the relationships between the environment,
physical activity, and obesity published in 2011. We have organized the publications into
8 categories to make them easier to review. The categories are:
1.
2.
3.
4.
5.
6.
7.
8.
Built Environment – Child Physical Activity/Obesity,
Built Environment – Adult Physical Activity/Obesity,
Policy – Physical Activity/Obesity,
Social, Cultural & Family Environments – Child Physical Activity/Obesity,
Social, Cultural & Family Environments – Adult Physical Activity/Obesity,
Measurement,
Community Based Interventions – Physical Activity and Obesity,
Childhood Obesity & Miscellaneous
The searches were conducted using several databases and were designed to represent
the multiple disciplines in the active living research field. The number of citations continues
to grow, especially as there is an extraordinary amount of literature on built environment
and policy related to physical activity and obesity. Some citations do not include a journal
issue or page numbers; these are articles that are available online ahead of print
publication.
We have improved upon our search terms and hope that this list is inclusive. Please send
us relevant citations we have missed. Studies that focus on food environments will be
covered by the RWJF Healthy Eating Research program.
We will continue to publish yearly literature updates as the literature is expanding so
rapidly. Papers that specifically report environmental correlates of physical activity
behavior or obesity will be included in the online ALR literature database
(http://www.activelivingresearch.org/resourcesearch/literaturedatabase).
If you have questions or comments please contact Chad Spoon at scspoon@ucsd.edu.
We would like acknowledgement the hard work of the Active Living Research staff for
searching several databases and compiling the 2011 reference list.
2011 Search terms
Physical Activity/Obesity terms (title or
abstract)
Environment terms (title or abstract)
Obese OR overweight OR obesity OR
“weight gain” OR BMI OR “Body mass
index” OR “body fat” OR “body composition”
OR Accelerom* OR pedomet* OR “step
count” OR “heart rate monitor” OR fitness
OR exercise OR “activity monitor” OR “Total
energy expenditure” OR “metabolic
equivalent” OR “physical activity”
“Physical environment” OR neighborhood
OR “built environment” OR “urban form” OR
“urban design” OR "urban sprawl" OR
"walkability" OR "land use mix" OR
"residential density" OR sidewalks OR
"green space" OR "recreational facilities"
OR “public transit” OR “public
transportation” OR “block size” OR “street
connectivity” OR “food environment” OR
“food store” OR supermarket OR grocer*
OR “farmer’s market” OR “fast food” OR
restaurant OR bodega OR “convenience
store”
Databases used in the literature searches included Pub Med, ISI Web of Knowledge,
SPORTDiscus, Leisure and Recreation Journals and other non-indexed journals.
For more specific information please contact Chad Spoon at scspoon@ucsd.edu.
Journal Counts:
These may indicate journals more interested in built environment research where
you could send your manuscripts. Note that only journals with more than one count
were included.
American Journal of Health Promotion - 5
American Journal of Preventive Medicine - 10
American Journal of Public health -6
BMC Public Health – 10
British Journal of Sports Medicine - 2
Health and Place - 15
Health Psychology - 2
International Journal of Behavioral Nutrition and Physical Activity- 17
International Journal of Environment and Public Health - 4
International Journal of Pediatric Obesity- 3
The Journal of Physical Activity and Health - 18
Journal of Adolescent Health - 2
Journal of Aging and Health - 4
Journal of Community Health - 3
Journal of Epidemiology and Community Health - 2
Journal of School Health- 3
Journal of Urban Health - 5
Pediatrics - 2
Preventive Medicine- 9
Public Health Nutrition- 3
Social Science and Medicine- 5
Transportation Research and Record -2
BUILT ENVIROMENT AND PHYSICAL ACTIVITY/ OBESITY AMONG YOUTH
Ajibade, P. B. (2011). "Physical Activity Patterns by Campus Housing Status
Among African American Female College Students." Journal of Black Studies
42(4): 548-560.
Physical activity protects against heart disease, diabetes, high blood
pressure, obesity, and cancer. Fewer than 40% of African American women
obtain recommended amounts of physical activity. Healthy Campus 2010
identifies physical activity as a top priority for improving the health of college
students. However, during college, women tend to reduce their levels of
physical activity. This study examines the relationship between campus
housing and physical activity behaviors in a sample of African American
female college students (N = 138). Participants who lived on campus were
significantly more likely to meet the recommended amounts of both
moderate and vigorous physical activity than students who lived off campus
(44% vs. 19%). The results demonstrate the importance of campus fitness
resources in explaining the role that the built environment can play in
increased physical activity among this population. Recommendations for the
use of the campus's built environment and fitness resources are provided.
Almanza, E., M. Jerrett, et al. (2011). "A study of community design, greenness,
and physical activity in children using satellite, GPS and accelerometer data."
Health Place 18(1): 46-54.
This study examined relationships between greenness exposure and freeliving physical activity behavior of children in smart growth and
conventionally designed communities. Normalized Difference Vegetation
Index (NDVI) was used to quantify children's (n=208) greenness exposure
at 30-s epoch accelerometer and GPS data points. A generalized linear
mixed model with a kernel density smoothing term for addressing spatial
autocorrelation was fit to analyze residential neighborhood activity data.
Excluding activity at home and during school-hours, an epoch-level analysis
found momentary greenness exposure was positively associated with the
likelihood of contemporaneous moderate-to-vigorous physical activity
(MVPA). This association was stronger for smart growth residents who
experienced a 39% increase in odds of MVPA for a 10th to 90th percentile
increase in exposure to greenness (OR=1.39, 95% CI 1.36-1.44). An
individual-level analysis found children who experienced >20 min of daily
exposure to greener spaces (>90th percentile) engaged in nearly 5 times
the daily rate of MVPA of children with nearly zero daily exposure to greener
spaces (95% CI 3.09-7.20).
Anthamatten, P., L. Brink, et al. (2011). "An assessment of schoolyard renovation
strategies to encourage children's physical activity." International Journal of
Behavioral Nutrition and Physical Activity 8.
Background: Children in poor and minority neighborhoods often lack
adequate environmental support for healthy physical development and
community interventions designed to improve physical activity resources
serve as an important approach to addressing obesity. In Denver, the
Learning Landscapes LL) program has constructed over 98 culturallytailored schoolyard play spaces at elementary schools with the goal to
encourage utilization of play spaces and physical activity. In spite of
enthusiasm about such projects to improve urban environments, little work
has evaluated their impact or success in achieving their stated objectives.
This study evaluates the impacts of LL construction and recency of
renovation on schoolyard utilization and the physical activity rates of
children, both during and outside of school, using an observational study
design. Methods: This study employs a quantitative method for evaluating
levels of physical activity of individuals and associated environmental
characteristics in play and leisure environments. Schools were selected on
the basis of their participation in the LL program, the recency of schoolyard
renovation, the size of the school, and the social and demographic
characteristics of the school population. Activity in the schoolyards was
measured using the System for Observing Play and Leisure Activity
(SOPLAY), a validated quantitative method for evaluating levels of physical
activity of individuals in play and leisure environments. Trained observers
collected measurements before school, during school recess, after school,
and on weekends. Overall utilization the total number of children observed
on the grounds) and the rate of activity the percentage of children observed
who were physically active) were analyzed. Observations were compared
using t-tests and the data were stratified by gender for further analysis. In
order to assess the impacts of LL renovation, recently-constructed LL
schoolyards were compared to LL schoolyards with older construction, as
well as un-renovated schoolyards. Results: Overall utilization was
significantly higher at LL schools than at un-renovated schools for most
observation periods. Notably, LL renovation had no impact on girl's
utilization on the weekends, although differences were observed for all other
periods. There were no differences in rates of activity for any comparison.
With the exception of the number of boys observed, there was no
statistically significant difference in activity when recently-constructed LL
schools are compared to LL schools with older construction dates and there
was no difference observed in comparisons of older LL with unrenovated
sites. Conclusions: While we observed greater utilization and physical
activity in schools with LL, the impact of specific features of LL renovation is
not clear. However, schoolyard renovation and programs to encourage
schoolyard use before and after school may offer a means to encourage
greater physical activity among children, and girls in particular. Additional
study of schoolyard renovation may shed light on the specific reasons for
these findings or suggest effective policies to improve the physical activity
resources of poor and minority neighborhoods.
Buck, C., H. Pohlabeln, et al. (2011). "Development and application of a
moveability index to quantify possibilities for physical activity in the built
environment of children." Health Place 17(6): 1191-201.
Several studies show that urban forms are environmental correlates of
physical activity. Most of these studies used data based on questionnaires
while only a few used geographic information systems (GIS) to objectively
assess urban forms. Based on GIS data, we applied a kernel density
method to measure urban forms and combined these measures to a
moveability index to assess the opportunities for physical activity in the
German intervention region of the IDEFICS study. In this proof-of-principal
analysis, we linked the moveability index with physical activity data obtained
from the baseline survey of the IDEFICS study. Regression analyses
revealed a modest but significant impact of the built environment on the
physical activity of 596 school children in the study region, supporting the
potential application of the moveability index.
Buliung, R., G. Faulkner, et al. (2011). "School travel planning: mobilizing school
and community resources to encourage active school transportation." J Sch Health
81(11): 704-12.
BACKGROUND: Active school transport (AST), school travel using an
active mode like walking, may be important to children's overall physical
activity. A "school travel plan" (STP) documents a school's transport
characteristics and provides an action plan to address school and
neighborhood barriers to AST. METHODS: We conducted a pilot STP
intervention at 12 schools in 4 Canadian provinces. Facilitators and school
personnel created and implemented AST action plans. Parent's self-reports
(N = 1489) were the basis for evaluating the intervention. A content analysis
identified type, frequency, and perceived success of initiatives. RESULTS:
School travel plans emphasized education and promotion, and AST
activities and events. Capital improvement projects were more common at
schools in older suburban neighborhoods, whereas enforcement was more
common at schools in newer suburban neighborhoods. Rates of active
transportation increased from 43.8% to 45.9%. At follow-up, 13.3% of
households reported less driving. Parents/caregivers cited weather,
convenience, and trip chaining as primary reasons for continued driving.
CONCLUSION: The STP process may facilitate changes to patterns of
school travel. An STP can expand a school's capacity to address
transportation issues through mobilization of diverse community resources.
Future STP initiatives may benefit from addressing convenience, safety
through enforcement, and by examining how schools can be supported in
implementing infrastructure improvements.
Burns, J. J., S. Goff, et al. (2011). "THE RELATIONSHIP BETWEEN LOCAL
FOOD SOURCES AND OPEN SPACE TO BODY MASS INDEX IN URBAN
CHILDREN." Public Health Reports 126(6): 890-900.
Chiang, P. H., M. L. Wahlqvist, et al. (2011). "Fast-food outlets and walkability in
school neighbourhoods predict fatness in boys and height in girls: a Taiwanese
population study." Public Health Nutr 14(9): 1601-9.
OBJECTIVE: There is increasing evidence that the school food environment
contributes to childhood obesity and health in various locations. We
investigated the influence of fast-food stores and convenience food stores
(FS and CS, respectively) on growth and body composition in a range of
residential densities for North-east Asian food culture. DESIGN:
Anthropometrics and birth weight of schoolchildren were obtained.
Geocoded mapping of schools and food outlets was conducted.
Multivariable linear regression models, adjusted for father's ethnicity and
education, as well as for household income, pocket money, birth weight,
physical activity, television watching, food quality and region, were used to
predict body composition from school food environments. SETTING:
Elementary schools and school neighbourhoods in 359 townships/districts
of Taiwan. SUBJECTS: A total of 2283 schoolchildren aged 6-13 years from
the Elementary School Children's Nutrition and Health Survey in Taiwan
conducted in 2001-2002. RESULTS: Remote and socially disadvantaged
locations had the highest prevalence of lower weight, BMI, waist
circumference and triceps skinfold thickness. Food store densities, FS and
CS, were highest in urban Taiwan and lowest in remote Taiwan. In the fully
adjusted models, FS densities predicted weight and BMI in boys; there was
a similar association for waist circumference, except when adjusted for
region. FS densities also predicted height for girls. Except for weight and
BMI in boys, CS did not have effects evident with FS for either boys or girls.
CONCLUSIONS: A high FS density, more than CS density, in Taiwan
increased the risk of general (BMI) and abdominal (waist circumference)
obesity in boys and stature in girls. These findings have long-term
implications for chronic disease in adulthood.
Chomitz, V. R., D. B. Aske, et al. (2011). "The Role of Recreational Spaces in
Meeting Physical Activity Recommendations Among Middle School Students."
Journal of Physical Activity & Health 8: S8-S16.
Background: There is growing recognition of the importance of recreational
space utilization for promoting physical activity (PA) among youth. Methods:
An cross-sectional study was conducted with a sample of 926 diverse 6th8th grade students in Somerville, MA. Participants completed the 2007
Youth Risk Surveillance Survey (YRBS). Chi-square testing and logistical
regression modeling were performed to predict meeting national PA
recommendations for moderate, vigorous, and 60 minutes or more (60+)
PA. Results: The participants reported meeting recommended PA levels for
moderate (27%), vigorous (70%) and 60+ (21%) PA. In multivariate
analysis, being male and speaking English were significantly associated
with meeting all 3 PA recommendations. Recreational spaces significantly
associated with meeting PA recommendations included neighborhood parks
and walk/bike paths, playing fields and courts, and recreational centers.
Recreational space utilization varied by gender, race/ethnicity, and
language. Conclusions: Recreational space utilization was an important
predictor of meeting PA recommendations among middle school students.
Our results showed that PA attainment and recreational space utilization
varied by demographic characteristics. The role of each recreational space
in predicting PA varied depending on the outcome used. This study
demonstrates the potential use of YRBS data to inform resource allocation
for PA promotion in diverse communities.
Colabianchi, N., A. L. Maslow, et al. (2011). "Features and amenities of school
playgrounds: A direct observation study of utilization and physical activity levels
outside of school time." International Journal of Behavioral Nutrition and Physical
Activity 8.
Background: A significant amount of research has examined whether park
or playground availability is associated with physical activity. However, little
research has examined whether specific features or amenities of parks or
playgrounds, such as the number of unique types of playground equipment
or the safety of the equipment is associated with utilization of the facility or
physical activity levels while at the facility. There are no studies that use
direct observation and a detailed park assessment to examine these
associations. Methods: Twenty urban schoolyards in the Midwest, ten of
which were renovated, were included in this study. Using a detailed
environmental assessment tool (i.e., Environmental Assessment of Public
Recreation Spaces), information on a variety of playground attributes was
collected. Using direct observation (i.e., System for Observing Play and
Leisure Activity in Youth), the number of adults, girls and boys attending
each schoolyard and their physical activity levels were recorded. Each
schoolyard was observed ten times for 90 minutes each time outside of
school hours. Clustered multivariable negative binomial regressions and
linear regressions were completed to examine the association between
playground attributes and utilization of the schoolyard and the proportion
active on the playground, respectively. Effect modification by renovation
status was also examined. Results: At renovated schoolyards, the total
number of play features was significantly associated with greater utilization
in adults and girls; overall cleanliness was significantly associated with less
utilization in girls and boys; and coverage/shade for resting features was
significantly associated with greater utilization in adults and boys. At
unrenovated schoolyards, overall safety was significantly associated with
greater utilization in boys. No playground attribute was associated with the
proportion active on the playground after adjusting for all other significant
playground attributes. Conclusions: Having a large quantity of play features
and shade at renovated playgrounds were positively associated with
utilization of the schoolyard. Modifying playgrounds to have these features
may increase the utilization of these facilities outside of school time.
Additional research should explore what features and amenities are
associated with increased physical activity levels of children and adults who
utilize the facilities.
Corder, K., J. F. Sallis, et al. (2011). "Active children use more locations for
physical activity." Health Place 17(4): 911-9.
We examined frequency of use of 11 physical activity (PA) locations among
539 San Diego children (45.0% males, 41.2% Latinos; mean +/- SD age:
6.6 +/- 0.7 years) and explored associations between location use, PA and
potential correlates. Parents reported child's use (visits/week) of 11
locations. Child PA was assessed by accelerometry (subsample n = 178).
The most frequently used locations (mean +/- SD times/week) were homes
(3.2 +/- 2.3) and parks/playground (1.6 +/- 1.3). Children used 4.0 +/- 2.0
locations in a typical week, and made a total of 12.5 +/- 6.8 visits/week to all
locations. Latinos used fewer locations regularly (3.6 +/- 2.1 vs. 4.3 +/- 1.9
locations; p < 0.001) and had fewer visits to all locations (11.4 +/- 7.4 vs.
13.2 +/- 6.4 visits/week; p = 0.003) than non-Latinos. Accelerometryassessed vigorous PA (VPA) was positively associated with the number of
locations regularly used (ss = 0.04, p = 0.03) and total visits to all locations
among Latinos (ss = 0.09, p = 0.005). Parental PA support was positively
associated with locations used (ss = 0.64, p < 0.001) and visits to all
locations (ss = 2.56, p < 0.001). Children using a greater variety of locations
did more VPA. Latinos making more total visits to all locations had higher
VPA.
D'Haese, S., F. De Meester, et al. (2011). "Criterion distances and environmental
correlates of active commuting to school in children." Int J Behav Nutr Phys Act 8:
88.
BACKGROUND: Active commuting to school can contribute to daily
physical activity levels in children. Insight into the determinants of active
commuting is needed, to promote such behavior in children living within a
feasible commuting distance from school. This study determined feasible
distances for walking and cycling to school (criterion distances) in 11- to 12year-old Belgian children. For children living within these criterion distances
from school, the correlation between parental perceptions of the
environment, the number of motorized vehicles per family and the
commuting mode (active/passive) to school was investigated. METHODS:
Parents (n = 696) were contacted through 44 randomly selected classes of
the final year (sixth grade) in elementary schools in East- and WestFlanders. Parental environmental perceptions were obtained using the
parent version of Neighborhood Environment Walkability Scale for Youth
(NEWS-Y). Information about active commuting to school was obtained
using a self-reported questionnaire for parents. Distances from the
children's home to school were objectively measured with Routenet online
route planner. Criterion distances were set at the distance in which at least
85% of the active commuters lived. After the determination of these criterion
distances, multilevel analyses were conducted to determine correlates of
active commuting to school within these distances. RESULTS: Almost sixty
percent (59.3%) of the total sample commuted actively to school. Criterion
distances were set at 1.5 kilometers for walking and 3.0 kilometers for
cycling. In the range of 2.01 - 2.50 kilometers household distance from
school, the number of passive commuters exceeded the number of active
commuters. For children who were living less than 3.0 kilometers away from
school, only perceived accessibility by the parents was positively associated
with active commuting to school. Within the group of active commuters, a
longer distance to school was associated with more cycling to school
compared to walking to school. CONCLUSIONS: Household distance from
school is an important correlate of transport mode to school in children.
Interventions to promote active commuting in 11-12 year olds should be
focusing on children who are living within the criterion distance of 3.0
kilometers from school by improving the accessibility en route from
children's home to school.
Eisenmann, J. C., K. Alaimo, et al. (2011). "Project FIT: Rationale, design and
baseline characteristics of a school- and community-based intervention to address
physical activity and healthy eating among low-income elementary school
children." Bmc Public Health 11.
Background: This paper describes Project FIT, a collaboration between the
public school system, local health systems, physicians, neighborhood
associations, businesses, faith-based leaders, community agencies and
university researchers to develop a multi-faceted approach to promote
physical activity and healthy eating toward the general goal of preventing
and reducing childhood obesity among children in Grand Rapids, MI, USA.
Methods/design: There are four overall components to Project FIT: school,
community, social marketing, and school staff wellness -all that focus on: 1)
increasing access to safe and affordable physical activity and nutrition
education opportunities in the schools and surrounding neighborhoods; 2)
improving the affordability and availability of nutritious food in the
neighborhoods surrounding the schools; 3) improving the knowledge,
selfefficacy, attitudes and behaviors regarding nutrition and physical activity
among school staff, parents and students; 4) impacting the 'culture' of the
schools and neighborhoods to incorporate healthful values; and 5)
encouraging dialogue among all community partners to leverage existing
programs and introduce new ones. Discussion: At baseline, there was
generally low physical activity (70% do not meet recommendation of 60
minutes per day), excessive screen time (75% do not meet recommendation
of < 2 hours per day), and low intake of vegetables and whole grains and
high intake of sugar-sweetened beverages, French fries and chips and
desserts as well as a high prevalence of overweight and obesity (48.5%
including 6% with severe obesity) among low income, primarily Hispanic
and African American 3rd-5th grade children (n = 403).
Floyd, M. F., J. N. Bocarro, et al. (2011). "Park-Based Physical Activity Among
Children and Adolescents." American Journal of Preventive Medicine 41(3): 258265.
Background: Availability of parks is associated with higher levels of physical
activity among children and adolescents. Few studies examine actual park
use and park-based physical activity in these populations. Purpose: This
study examined associations among individual, park, and neighborhood
environmental characteristics and children's and adolescent's park-based
physical activity. Methods: Data were collected in 2007 on 2712 children in
20 randomly selected parks in Durham NC. The System for Observing Play
and Recreation in Communities (SOPARC) provided measures of physical
activity. Hierarchic regression analysis assessed associations among
individual, park, and neighborhood environmental characteristics and
children's park-based physical activity. Data were analyzed in 2010.
Results: Of the 2712 children observed, 34.2% and 13.2% were engaged in
walking or vigorous physical activity. Environmental features of parks were
associated with activity levels whereas neighborhood characteristics were
not. Physical activity was negatively associated with gender (girls) (p =
0.003); presence of a parent (p < 0.0001); presence of nonparental adult (p
= 0.006); and an interaction involving the 0-5 years age group and style of
play (p = 0.017). Higher level of physical activity was associated with
presence of other active children (p < 0.0001); courts (e. g., basketball); and
an interaction between number of recreation facilities and formal activities (p
= 0.004). Conclusions: These social factors and design features should be
considered in order to stimulate higher levels of park-based physical activity
among children and adolescents. (Am J Prev Med 2011; 41(3): 258-265) (C)
2011 American Journal of Preventive Medicine
Gay, J. L., M. Dowda, et al. (2011). "Environmental determinants of children's
physical activity in residential children's homes." J Phys Act Health 8(5): 636-44.
BACKGROUND: Children in residential children's homes (RCH) may be at
increased risk for physical inactivity due to decreased access to
opportunities for activity. Little is known about environmental determinants
of physical activity for children in RCH. METHODS: Thirty-minute blocks of
MVPA and Total METs were measured using the 3-Day Physical Activity
Recall (3DPAR). A staff interview, based on the Structural Ecologic Model of
Health Behavior, assessed physical activity opportunities, structures,
characteristics, policies, and social environment. Wilcoxon 2-sample tests
were used to examine differences in environment by location and presence
of a recreation director. Mixed model ANOVAs assessed the differences in
child level activity by environmental variables. RESULTS: There were
significant correlations between opportunities and characteristics of physical
activity, facilities, and equipment with total METS for children. Children in
homes with a recreation director and homes in rural locations reported more
physical activity. Only rural location had a significant effect on physical
activity. Presence of a recreation director was significant in several models.
CONCLUSIONS: Rural location may be conducive for increased physical
activity in children at RCH. Employing a recreation director or other trained
personnel may be an important policy determinant of physical activity for
children.
Grigsby-Toussaint, D. S., S. H. Chi, et al. (2011). "Where they live, how they play:
neighborhood greenness and outdoor physical activity among preschoolers." Int J
Health Geogr 10: 66.
BACKGROUND: Emerging empirical evidence suggests exposure to
"green" environments may encourage higher levels of physical activity
among children. Few studies, however, have explored this association
exclusively in pre-school aged children in the United States. We examined
whether residing in neighborhoods with higher levels of greenness was
associated with higher levels of outdoor physical activity among
preschoolers. In addition, we also explored whether outdoor playing
behaviors (e.g., active vs. quiet) were influenced by levels of neighborhood
greenness independent of demographic and parental support factors.
RESULTS: Higher levels of neighborhood greenness as measured by the
Normalized Difference Vegetation Index (NDVI) was associated with higher
levels of outdoor playing time among preschool-aged children in our
sample. Specifically, a one unit increase in neighborhood greenness
increased a child's outdoor playing time by approximately 3 minutes. A
dose-response relationship was observed between increasing levels of
parental support for physical activity (e.g., time spent playing with children)
and child outdoor physical activity (p < 0.01). CONCLUSIONS: Consistent
with previous studies, neighborhood greenness influences physical activity
behavior. However, for preschoolers, parental involvement may be more
critical for improving physical activity levels.
Howard, P. H., M. Fitzpatrick, et al. (2011). "Proximity of food retailers to schools
and rates of overweight ninth grade students: an ecological study in California."
Bmc Public Health 11.
Background: The prevalence of obesity and overweight in youth has
increased dramatically since the 1980s, and some researchers hypothesize
that increased consumption of low-nutrient, energy-dense foods is a key
contributor. The potential importance of food retailers near schools has
received increasing attention, but public health research and policy has
focused primarily on fast food restaurants. Less is known about the
relationship between overweight/obesity and other types of retailers. This
study aims to investigate the potential associations between nearby 1) fast
food restaurants, 2) convenience stores, and 3) supermarkets, and rates of
overweight students in California schools. Methods: We examined the rate
of overweight ninth grade students in public schools in 2007 using linear
regression. The percentage of overweight students per school was
determined by a state required physical fitness test, with three different
options for measuring individual body composition. Our key independent
variables were the presence of three different types of retailers within 800 m
network buffers of the schools. Additional independent variables included
school ethnic, gender and socioeconomic composition, as well as
urban/non-urban location. We obtained the data from the California
Department of Education and ESRI, Inc. Results: The presence of a
convenience store within a 10-minute walking distance of a school was
associated with a higher rate of overweight students than schools without
nearby convenience stores, after controlling for all school-level variables in
the regression (1.2%, 95% confidence interval 0.03, 2.36). Nearby fast food
restaurants and supermarkets, however, were not associated with school
rates of overweight students. Conclusions: Public health researchers and
policy-makers interested in the food environments outside schools should
expand their recent focus on nearby fast food restaurants to include
convenience stores, which may also be important sources of low-nutrient,
energy-dense foods for students.
Isgor, Z. and L. M. Powell (2011). "Availability of Commercial Physical Activity
Facilities and Physical Activity Outside of School Among High School Students."
Journal of Physical Activity & Health 8(5): 707-715.
Background: Environmental factors may play an important role in the
determination of physical activity behaviors. Methods: This study used the
Child Development Supplement of the Panel Study of Income Dynamics to
examine the association between the availability of objectively measured
commercial physical activity-related instruction facilities and weekly physical
activity participation among high school students outside of school physical
education classes. A Negative Binomial count model was used to examine
the number of days of vigorous physical activity (at least 30 minutes/day)
per week and a Probit model was used to examine the probability of
frequent (4 or more days/week) vigorous physical activity participation.
Results: The results indicated that an additional instruction school per
10,000 capita per 10 square miles was associated with an 8-percent
increase in the weekly number of days of vigorous physical activity
participation and a 4 percentage point increase in the likelihood of frequent
physical activity participation for female adolescents only. By income,
associations were larger for low- versus high-income female youths.
Conclusion: Increased availability of local area physical activity-related
instruction facilities may help to increase female high school students'
physical activity levels, particularly among low-income female students.
Jilcott, S. B., S. Wade, et al. (2011). "The association between the food
environment and weight status among eastern North Carolina youth." Public
Health Nutr 14(9): 1610-7.
OBJECTIVE: To examine associations between various measures of the
food environment and BMI percentile among youth. DESIGN: Crosssectional, observational. SETTING: Pitt County, eastern North Carolina.
SUBJECTS: We extracted the electronic medical records for youth receiving
well child check-ups from January 2007 to June 2008. We obtained
addresses for food venues from two secondary sources and groundtruthing. A geographic information systems database was constructed by
geocoding home addresses of 744 youth and food venues. We quantified
participants' accessibility to food venues by calculating 'coverage', number
of food venues in buffers of 0.25, 0.5, 1 and 5 miles (0.4, 0.8, 1.6 and 8.0
km) and by calculating 'proximity' or distance to the closest food venue. We
examined associations between BMI percentile and food venue accessibility
using correlation and regression analyses. RESULTS: There were negative
associations between BMI percentile and coverage of farmers'
markets/produce markets in 0.25 and 0.5 mile Euclidean and 0.25, 0.5 and
1 mile road network buffers. There were positive associations between BMI
percentile and coverage of fast-food and pizza places in the 0.25 mile
Euclidean and network buffers. In multivariate analyses adjusted for race,
insurance status and rural/urban residence, proximity (network distance) to
convenience stores was negatively associated with BMI percentile and
proximity to farmers' markets was positively associated with BMI percentile.
CONCLUSIONS: Accessibility to various types of food venues is associated
with BMI percentile in eastern North Carolina youth. Future longitudinal work
should examine correlations between accessibility to and use of traditional
and non-traditional food venues.
Kemperman, A. D. A. M. and H. J. P. Timmermans (2011). "Children's
Recreational Physical Activity." Leisure Sciences 33(3): 183-204.
This study explored children's participation in recreational (physical)
activities and the extent to which this participation was influenced by
individual and household socio-demographics and characteristics of the
social and physical environment. Travel and activity diaries were used to
collect data on out-of-home recreational activities for a random sample of
4,293 children in primary schools in the Netherlands. These data were
investigated in relation to measures describing the social and physical living
environment. Specifically, a Bayesian belief network was proposed because
it derives and represents simultaneously all direct and indirect relationships
between the selected variables. Results indicated that participation in
various types of recreational activities was directly related to the socioeconomic status of the household, the perceived safety of the
neighborhood, the size of agricultural area in the neighborhood, travel
distance, and day of the week. Planners and designers are recommended
to find a good land use mix, and specifically make sure that they focus their
attention on safety issues, as these factors stimulate children's participation
in recreational physical activities.
Lange, D., M. Wahrendorf, et al. (2011). "Associations between neighbourhood
characteristics, body mass index and health-related behaviours of adolescents in
the Kiel Obesity Prevention Study: a multilevel analysis." European Journal of
Clinical Nutrition 65(6): 711-719.
Background/Objectives: To understand determinants of overweight, several
studies addressed the association between neighbourhood characteristics
and adult obesity. However, little is known about the association of such
characteristics with adolescents' overweight. This study aims at the
influence of neighbourhood characteristics on adolescent body mass index
(BMI) and lifestyle and to what extent BMI and lifestyle variation between
neighbourhoods can be explained by neighbourhood characteristics.
Subjects/Methods: We used cross-sectional data from the Kiel Obesity
Prevention Study collected between 2004 and 2008 in 28 different
residential districts of the city of Kiel (North Germany). Anthropometric data
were available for 1675 boys and 1765 girls (n = 3440) aged 13-15 years,
and individual lifestyle factors and sociodemographic data were included in
the analysis. At the macro level, six different neighbourhood characteristics
were used: unemployment rate, population density, traffic density,
prevalence of energy-dense food supply, number of sports fields and parks,
and crime rate. To test our main hypothesis, linear and logistic multilevel
regression analyses were performed to predict BMI and lifestyle factors in
individuals nested in neighbourhoods. Results: Findings of multilevel
analysis show little between-neighbourhood variations in BMI and healthrelated behaviours. In all, 2% of BMI variation, 4% of media time variation
and 3% of variation in snacking behaviour could be attributed to differences
in neighbourhoods. Conclusions: Environmental factors are significantly
associated with adolescent BMI and health-related behaviour; however,
their total effect is small. Owing to these results, recommendations for
structural policy measures as part of prevention of overweight in
adolescents must be made cautiously. European Journal of Clinical Nutrition
(2011) 65, 711-719; doi:10.1038/ejcn.2011.21; published online 30 March
2011
Leatherdale, S. T., T. Pouliou, et al. (2011). "The association between overweight
and opportunity structures in the built environment: a multi-level analysis among
elementary school youth in the PLAY-ON study." International Journal of Public
Health 56(3): 237-246.
To examine school-level opportunity structures of the built environment and
student characteristics associated with being overweight. Multi-level logistic
regression analysis were used to examine the school- and student-level
characteristics associated with the odds of a student being overweight
among grade 5-8 students attending 30 elementary schools in Ontario,
Canada, as part of the Play-Ontario (PLAY-ON) study. Significant between
school random variation in overweight was identified [sigma (mu 0) (2) =
0.187 (0.084), P < 0.001]; school-level differences accounted for 5.4% of
the variability in the odds of a student being overweight. The more fast-food
retailers there were surrounding a school, the more likely a student was to
be overweight; students in grade 5 were at increased risk relative to
students in grades 6-8. The more grocery stores there were surrounding a
school, the more likely a student was to be overweight; students in grade 5
were at increased risk relative to students in grades 6-8. Developing a better
understanding of the school- and student-level characteristics associated
with overweight among youth is critical for informing intervention programs
and policies.
Leung, C. W., B. A. Laraia, et al. (2011). "The Influence of Neighborhood Food
Stores on Change in Young Girls' Body Mass Index." American Journal of
Preventive Medicine 41(1): 43-51.
Background: As the prevalence of childhood obesity has risen in past
decades, more attention has been given to how the neighborhood food
environment affects children's health outcomes. Purpose: This exploratory
study examined the relationship between the presence of neighborhood
food stores within a girl's neighborhood and 3-year risk of
overweight/obesity and change in BMI, in girls aged 6 or 7 years at
baseline. Methods: A longitudinal analysis of participants in the Cohort
Study of Young Girls' Nutrition, Environment and Transitions (CYGNET)
was conducted from 2005 to 2008. Neighborhood food stores were
identified from a commercial database and classified according to industry
codes in 2006. Generalized linear and logistic models were used to examine
how availability of food stores within 0.25-mile and 1.0-mile network buffers
of a girl's residence were associated with BMI z-score change and risk of
overweight or obesity, adjusting for baseline BMI/weight and family
sociodemographic characteristics. Data were analyzed in 2010. Results:
Availability of convenience stores within a 0.25-mile network buffer of a girl's
residence was associated with greater risk of overweight/obesity (OR=3.38,
95% CI=1.07, 10.68) and an increase in BMI z-score (beta=0.13, 95%
CI=0.00, 0.25). Availability of produce vendors/farmer's markets within a
1.0-mile network buffer of a girl's residence was inversely associated with
overweight/obesity (OR=0.22, 95% CI=0.05, 1.06). A significant trend was
observed between availability of produce vendors/farmer's markets and
lower risk of overweight/obesity after 3 years. Conclusions: Although food
store inventories were not assessed and food store indices were not
created, the availability of neighborhood food stores may affect a young
girl's weight trajectory over time. (Am J Prev Med 2011; 41(1): 43-51) (C)
2011 American Journal of Preventive Medicine
Li, M., M. J. Dibley, et al. (2011). "School environment factors were associated with
BMI among adolescents in Xi'an City, China." Bmc Public Health 11.
Background: School environment influences students' behaviours. The
purpose of this research was to identify school environment factors
associated with BMI. Methods: A cross-sectional study was conducted
among 1792 school-aged adolescents from 30 schools in six districts in
Xi'an City in 2004. Height and weight were taken from students by trained
field staff. School environment characteristics such as physical factors
(school facilities, school shops and fast food outlets in school area), school
curricula and policies were collected from school doctors using school
environment questionnaire. School environment factors were identified in
linear mixed effect models with BMI as outcome and adjusted for sociodemographic factors. Results: After adjusted for socio-demographic factors,
BMI was associated with the availability of soft drinks at school shops, the
availability and the number of western food outlet in the school vicinity.
School curricula such as sports-meeting and health education session were
also associated with BMI. Conclusions: Urgent actions are needed to
address the obesogenic elements of school environments. Community and
school policy makers should make efforts for students to avoid exposure to
fast food outlet in school area and soft drinks at school shops, and to
improve school curricula to promote healthy behaviours.
Lightfoot, K. and C. Blanchard (2011). "Does Race or Sex Moderate the Perceived
Built Environment/Physical Activity Relationship in College Students?" Behavioral
Medicine 37(2): 54-59.
The purpose of this research was to explore the relationship between the
perceived built environment and physical activity (PA) among college
students, and to determine whether race and/or sex moderate this
relationship. Participants were 785 college students (435 students in Study
1 and 350 in Study 2). Students completed questionnaires assessing
characteristics of their neighborhood, and were followed up 1 (Study 1) or 2
(Study 2) weeks later to measure PA levels. Seeing others in one's
neighbourhood being active was found to be significantly related (p .01) to
higher levels of PA for students in both studies. In Study 2, race was found
to moderate the relationship between having many places within walking
distance and PA, affecting African Americans more strongly than
Caucasians. Sex was not found to moderate the perceived built
environment/PA relationship. It appears that certain aspects of the
perceived built environment may have an effect on the level of PA in college
students, with race moderating this relationship.
Lovasi, G. S., J. S. Jacobson, et al. (2011). "Is the Environment Near Home and
School Associated with Physical Activity and Adiposity of Urban Preschool
Children?" Journal of Urban Health-Bulletin of the New York Academy of Medicine
88(6): 1143-1157.
Preventing sedentary behavior and adiposity in childhood has become a
public health priority. We examined urban social and built environment
characteristics as correlates of physical activity and anthropometry among
428 preschool children from low-income families in New York City. We
measured the children's height, weight, skinfold thicknesses, physical
activity by accelerometer, and covariates. We geocoded home and Head
Start center addresses and estimated the following for an area within 0.5 km
of those two locations using a detailed geographic database: neighborhood
composition, walkability, crime and traffic safety, and aesthetic
characteristics. Generalized estimating equations were used to examine the
associations of area characteristics with physical activity or adiposity,
adjusted for characteristics of the child, mother, and home. Participants
were 2-5 years old, 53% female, 83% Hispanic, and 43% either overweight
or obese. Of the walkability indicators, land use mix was associated with
physical activity (26 more activity counts/minute per standard deviation
increase in mixed land use, p = 0.015) and subway stop density was
associated with adiposity (1.2 mm smaller sums of skinfold thicknesses sum
per standard deviation increase in subway stop density, p = 0.001). The
pedestrian-auto injury rate, an indicator of traffic safety problems, was
associated with physical activity and adiposity (16 fewer activity
counts/minute, p = 0.033, and 1.0 mm greater skinfold thickness per
standard deviation increase in pedestrian-auto injuries, p = 0.018). Children
living in areas with more street trees were more physically active and those
living in areas with more park access had smaller skinfolds. However, many
of the tested associations were not statistically significant and some trends
were not in the hypothesized direction. Efforts to enhance walkability,
safety, and green spaces in the local environment may be relevant to
physical activity and adiposity, and therefore to the health of preschool-aged
children from low-income families.
Maslow, A. L. and N. Colabianchi (2011). "Youth Physical Activity Resource Use
and Activity Measured by Accelerometry." American Journal of Health Behavior
35(2): 219-227.
Objectives: To examine whether use of physical activity resources (eg,
parks) was associated with daily physical activity measured by
accelerometry. Methods: One hundred eleven adolescents completed a
travel diary with concurrent accelerometry. The main exposure was selfreported use of a physical activity resource (none/1+ resources). The main
outcomes were total minutes spent in daily (1) moderate-vigorous physical
activity and (2) vigorous physical activity. Results: Using a physical activity
resource was significantly associated with total minutes in moderatevigorous physical activity. African Americans and males had significantly
greater moderate-vigorous physical activity. Conclusions: Results from this
study support the development and use of physical activity resources.
McCormack, G. R., B. Giles-Corti, et al. (2011). "A cross-sectional study of the
individual, social, and built environmental correlates of pedometer-based physical
activity among elementary school children." International Journal of Behavioral
Nutrition and Physical Activity 8.
Background: Children who participate in regular physical activity obtain
health benefits. Preliminary pedometer-based cut-points representing
sufficient levels of physical activity among youth have been established;
however limited evidence regarding correlates of achieving these cut-points
exists. The purpose of this study was to identify correlates of pedometerbased cut-points among elementary school-aged children. Method: A crosssection of children in grades 5-7 (10-12 years of age) were randomly
selected from the most (n = 13) and least (n = 12) 'walkable' public
elementary schools (Perth, Western Australia), stratified by socioeconomic
status. Children (n = 1480; response rate = 56.6%) and parents (n = 1332;
response rate = 88.8%) completed a survey, and steps were collected from
children using pedometers. Pedometer data were categorized to reflect the
sex-specific pedometer-based cut-points of >= 15000 steps/day for boys
and >= 12000 steps/day for girls. Associations between socio-demographic
characteristics, sedentary and active leisure-time behavior, independent
mobility, active transportation and built environmental variables - collected
from the child and parent surveys - and meeting pedometer-based cutpoints were estimated (odds ratios: OR) using generalized estimating
equations. Results: Overall 927 children participated in all components of
the study and provided complete data. On average, children took 11407 +/3136 steps/day (boys: 12270 +/- 3350 vs. girls: 10681 +/- 2745 steps/day; p
< 0.001) and 25.9% (boys: 19.1 vs. girls: 31.6%; p < 0.001) achieved the
pedometer-based cut-points. After adjusting for all other variables and
school clustering, meeting the pedometer-based cut-points was negatively
associated (p < 0.05) with being male (OR = 0.42), parent self-reported
number of different destinations in the neighborhood (OR 0.93), and a
friend's (OR 0.62) or relative's (OR 0.44, boys only) house being at least a
10-minute walk from home. Achieving the pedometer-based cut-points was
positively associated with participating in screen-time < 2 hours/day (OR
1.88), not being driven to school (OR 1.48), attending a school located in a
high SES neighborhood (OR 1.33), the average number of steps among
children within the respondent's grade (for each 500 step/day increase: OR
1.29), and living further than a 10-minute walk from a relative's house (OR
1.69, girls only). Conclusions: Comprehensive multi-level interventions that
reduce screen-time, encourage active travel to/from school and foster a
physically active classroom culture might encourage more physical activity
among children.
Mecredy, G., W. Pickett, et al. (2011). "Street Connectivity is Negatively
Associated with Physical Activity in Canadian Youth." International Journal of
Environmental Research and Public Health 8(8): 3333-3350.
Street connectivity, defined as how well streets connect to one and other
and the density of intersections, is positively associated with active
transportation in adults. Our objective was to study the relation between
street connectivity and physical activity in youth. Study participants
consisted of 8,535 students in grades 6-10 from 180 schools across Canada
who completed the 2006 Health Behaviour in School-aged Children (HBSC)
survey. Street connectivity was measured in a 5 km circular buffer around
these schools using established geographic information system measures.
Physical activity performed outside of school hours was assessed by
questionnaire, and multi-level regression analyses were used to estimate
associations with street connectivity after controlling for several covariates.
Compared to students living in the highest street connectivity quartile, those
in the second (relative risk = 1.22, 95% confidence interval = 1.10-1.35),
third (1.25, 1.13-1.37), and fourth (1.21, 1.09-1.34) quartiles were more
likely to be physically active outside of school. In conclusion, youth in
neighbourhoods with the most highly connected streets reported less
physical activity outside of school than youth from neighbourhoods with less
connected streets. Relationships between street connectivity and physical
activity reported in this national study are in the opposite direction to those
previously observed for active transportation in adult populations.
Mendoza, J. A., K. Watson, et al. (2011). "The Walking School Bus and Children's
Physical Activity: A Pilot Cluster Randomized Controlled Trial." Pediatrics 128(3):
E537-E544.
OBJECTIVE: To evaluate the impact of a "walking school bus" program on
children's rates of active commuting to school and physical activity.
METHODS: We conducted a pilot cluster randomized controlled trial among
4th-graders from 8 schools in Houston, Texas (N = 149). Random allocation
to treatment or control conditions was at the school level. Study staff walked
with children to and from school up to 5 days/week. Outcomes were
measured the week before (time 1) and during weeks 4 and 5 of the
intervention (time 2). The main outcome was the weekly rate of active
commuting, and a secondary outcome was moderate-to-vigorous physical
activity. Covariates included sociodemographics, distance from home to
school, neighborhood safety, child BMI z score, parent self-efficacy/outcome
expectations, and child self-efficacy for active commuting. A mixed-model
repeated measures regression accounted for clustering by school, and
stepwise procedures with backward elimination of nonsignificant covariates
were used to identify significant predictors. RESULTS: Intervention children
increased active commuting (mean +/- SD) from 23.8% +/- 9.2% (time 1) to
54% +/- 9.2% (time 2), whereas control subjects decreased from 40.2% +/8.9% (time 1) to 32.6% +/- 8.9% (time 2) (P < .0001). Intervention children
increased their minutes of daily moderate-to-vigorous physical activity from
46.6 +/- 4.5 (time 1) to 48.8 +/- 4.5 (time 2), whereas control children
decreased from 46.1 +/- 4.3 (time 1) to 41.3 +/- 4.3 (time 2) (P = .029).
CONCLUSIONS: The program improved children's active commuting to
school and daily moderate-to-vigorous physical activity. Pediatrics 2011;
128: e537-e544
Mota, J., R. Santos, et al. (2011). "Perceived neighbourhood environmental
characteristics and physical activity according to socioeconomic status in
adolescent girls." Annals of Human Biology 38(1): 1-6.
Objective: The purpose of this study was to analyse the associations
between physical activity (PA) and several characteristics of the built
environment with socioeconomic status (SES) in adolescent girls. Methods:
The sample comprised 599 girls (mean age 14.7, SD = 1.6 years) living in
the Aveiro Region of Portugal. Questionnaires were used to describe
physical activity level and perceived neighbourhood environments. SES was
established by maternal education level. Girls were grouped into low, middle
or high SES group. Results: Logistic regression analysis showed that girls
assigned to the higher SES group were more likely (OR = 2.4; 95%CI = 1.34.5) to belong to the active group than their low SES peers. Girls in high
(OR = 2.4; 95%CC = 1.3-4.4) and medium (OR = 1.6; 95%CC = 1.14-2.3)
SES groups were more likely to have a higher perception of better
aesthetics in their neighbourhoods than their low SES peers and higher
SES was also associated with better perception of a street connectivity (OR
= 2.9; 95%CI = 1.7-5.4). Conclusion: The study showed that girls of higher
SES are more active than those of lower SES and that social background
might be associated with differences in neighbourhood environmental
perceptions.
Oliver, M., K. Witten, et al. (2011). "Kids in the city study: research design and
methodology." Bmc Public Health 11: 587.
BACKGROUND: Physical activity is essential for optimal physical and
psychological health but substantial declines in children's activity levels
have occurred in New Zealand and internationally. Children's independent
mobility (i.e., outdoor play and traveling to destinations unsupervised), an
integral component of physical activity in childhood, has also declined
radically in recent decades. Safety-conscious parenting practices, car
reliance and auto-centric urban design have converged to produce children
living increasingly sedentary lives. This research investigates how urban
neighborhood environments can support or enable or restrict children's
independent mobility, thereby influencing physical activity accumulation and
participation in daily life. METHODS/DESIGN: The study is located in six
Auckland, New Zealand neighborhoods, diverse in terms of urban design
attributes, particularly residential density. Participants comprise 160 children
aged 9-11 years and their parents/caregivers. Objective measures (global
positioning systems, accelerometers, geographical information systems,
observational audits) assessed children's independent mobility and physical
activity, neighborhood infrastructure, and streetscape attributes. Parent and
child neighborhood perceptions and experiences were assessed using
qualitative research methods. DISCUSSION: This study is one of the first
internationally to examine the association of specific urban design attributes
with child independent mobility. Using robust, appropriate, and best practice
objective measures, this study provides robust epidemiological information
regarding the relationships between the built environment and health
outcomes for this population.
O'Loghlen, S., J. W. Pickett, et al. (2011). "Active transportation environments
surrounding Canadian schools." Can J Public Health 102(5): 364-8.
OBJECTIVES: Walking or cycling to school represents an opportunity for
children to engage in physical activity. The study objectives were to: 1)
describe active transportation policies, programs, and built environments of
Canadian schools and their surrounding neighbourhoods, and 2) document
variations based on urban-rural location and school type (primary vs.
secondary vs. mixed primary/secondary schools). METHODS: 397 schools
from across Canada were studied. A school administrator completed a
questionnaire and responses were used to assess schools' policies and
programs related to active transportation and the safety and aesthetics of
their respective neighbourhoods. Built environment features in a 1 kmradius circular buffer around each school were measured using geographic
information systems. RESULTS: Greater than 70% of schools had passive
policies (e.g., skateboards permitted on school grounds) and facilities (e.g.,
bicycle racks in secure area to avoid theft) to encourage bicycle and smallwheeled vehicle use. Less than 40% of schools had active programs
designed to encourage active transportation, such as organized 'walk to
school' days. Garbage in the streets, crime and substance abuse were
barriers in most school neighbourhoods. Approximately 42% of schools
were located on high-speed roads not amenable to active transportation and
14% did not have a sidewalk leading to the school. Secondary schools had
less favourable active transportation policies/programs and neighbourhood
safety/aesthetics compared to primary schools. Rural schools had less
favourable built environments than urban schools. CONCLUSION:
Canadian children, particularly those from rural areas, face a number of
impediments to active transportation as a method of travelling to school.
Price, A. E., D. M. Pluto, et al. (2011). "School administrators' perceptions of
factors that influence children's active travel to school." J Sch Health 81(12): 741-8.
BACKGROUND: Increasing children's active travel to school may be 1
strategy for addressing the growing prevalence of obesity among school
age children. Using the School Travel Survey, we examined South Carolina
school district leaders' perceptions of factors that influence elementary and
middle school students walking to school. METHODS: Frequency
distributions and chi-square tests were used to analyze the survey
responses; open-ended questions were reviewed qualitatively for recurring
topics and themes. RESULTS: School and district leaders (N = 314) most
often reported street crossing safety (54.0%) and number of sidewalks
(54.0%) as priority factors that should be addressed to increase students'
active travel to school, followed by distance to school (46.0%), traffic volume
(42.4%), parental attitudes (27.0%), traffic speed (26.7%), neighborhood
condition (24.4%), and student attitudes (10.0%). Several respondents
expressed concerns about liability issues related to students' active travel to
school while others reported that schools are not responsible for students'
safety once students leave school grounds. Independent of their comments
about liability, respondents were concerned about the safety of students
while walking to school. CONCLUSIONS: Those promoting active travel to
school may benefit from addressing those factors perceived as most
important by school and district leaders, including street crossing safety,
number of sidewalks, and by educating school and district leaders about
liability and safety issues related to students walking to school.
Prins, R. G., K. Ball, et al. (2011). "Associations between availability of facilities
within three different neighbourhood buffer sizes and objectively assessed physical
activity in adolescents." Health & Place 17(6): 1228-1234.
This study aims to explore whether objectively measured availability of
parks and sports facilities within three different buffer sizes are associated
with moderate-to-vigorous physical activity (MVPA) among adolescents, and
to identify potential cognitive mediators of this association. Data were
obtained from adolescents (N=209, mean age: 14.5 (SD: 0.6) years) at the
follow-up measurement of the Children Living in Active Neighbourhoods
study in 2004. MVPA was measured using accelerometers. Availability of
parks and sport facilities were measured within 400, 800 and 2000 m
buffers around participants' residential homes. Potential mediators (selfefficacy, attitude and the perceived availability of parks and sports grounds)
were measured by self-administered questionnaires. No direct association
was found between the objectively measured availability of facilities and
objective assessments of MVPA and no evidence for mediation by
cognitions was found in any of the buffer sizes. More specific and sensitive
measures may be needed to understand environmental correlates of MVPA.
(C) 2011 Elsevier Ltd. All rights reserved.
Rodriguez, D. A., G. H. Cho, et al. (2011). "Out and about: association of the built
environment with physical activity behaviors of adolescent females." Health Place
18(1): 55-62.
Locational data, logged on portable GPS units and matched with
accelerometer data, was used to examine associations of the built
environment with physical activity and sedentary behaviors of adolescent
females. In a sample of 293 adolescent females aged 15 to 18 years old in
Minneapolis and San Diego, the built environment around each GPS point
and its corresponding sedentary, light, and moderate-to-vigorous intensity
physical activity was examined using random intercept multinomial logistic
regression models. The odds of higher physical activity intensity (3-level
outcome: sedentary, light, MVPA) were higher in places with parks, schools,
and high population density, during weekdays, and lower in places with
more roads and food outlets. Understanding the places where physical
activity and sedentary behaviors occur appears to be a promising strategy
to clarify relationships and inform policy aimed at increasing physical activity
and reducing sedentary behaviors.
Stevens, R. B. and B. B. Brown (2011). "Walkable new urban
LEED_Neighborhood-Development (LEED-ND) community design and children's
physical activity: selection, environmental, or catalyst effects?" International
Journal of Behavioral Nutrition and Physical Activity 8.
Background: Interest is growing in physical activity-friendly community
designs, but few tests exist of communities explicitly designed to be
walkable. We test whether students living in a new urbanist community that
is also a pilot LEED_ND (Leadership in Energy and Environmental DesignNeighborhood Development) community have greater accelerometermeasured moderate-to-vigorous physical activity (MVPA) across particular
time periods compared to students from other communities. We test various
time/place periods to see if the data best conform to one of three
explanations for MVPA. Environmental effects suggest that MVPA occurs
when individuals are exposed to activity-friendly settings; selection effects
suggest that walkable community residents prefer MVPA, which leads to
both their choice of a walkable community and their high levels of MVPA;
catalyst effects occur when walking to school creates more MVPA, beyond
the school commute, on schooldays but not weekends. Methods: Fifth
graders (n = 187) were sampled from two schools representing three
communities: (1) a walkable community, Daybreak, designed with new
urbanist and LEED-ND pilot design standards; (2) a mixed community
(where students lived in a less walkable community but attended the
walkable school so that part of the route to school was walkable), and (3) a
less walkable community. Selection threats were addressed through
controlling for parental preferences for their child to walk to school as well
as comparing in-school MVPA for the walkable and mixed groups. Results:
Minutes of MVPA were tested with 3 x 2 (Community by Gender) analyses
of covariance (ANCOVAs). Community walkability related to more MVPA
during the half hour before and after school and, among boys only, more
MVPA after school. Boys were more active than girls, except during the half
hour after school. Students from the mixed and walkable communities-who
attended the same school-had similar in-school MVPA levels, and
community groups did not differ in weekend MVPA, providing little evidence
of selection effects. Conclusions: Even after our controls for selection
effects, we find evidence of environmental effects on MVPA. These results
suggest that walkable community design, according to new urbanist and
LEED_ND pilot design standards, is related to higher MVPA among
students at certain times.
Trapp, G. S., B. Giles-Corti, et al. (2011). "Increasing children's physical activity:
individual, social, and environmental factors associated with walking to and from
school." Health Educ Behav 39(2): 172-82.
BACKGROUND: Efforts to increase the prevalence of children's active
school transport require evidence to inform the development of
comprehensive interventions. This study used a multilevel ecological
framework to investigate individual, social, and environmental factors
associated with walking to and from school among elementary school-aged
children, stratified by gender. METHOD: Boys aged 10 to 13 years (n = 617)
and girls aged 9 to 13 years (n = 681) attending 25 Australian primary
schools located in high or low walkable neighborhoods completed a 1-week
travel diary and a parent/child questionnaire on travel habits and attitudes.
RESULTS: Boys were more likely (odds ratio [OR] = 3.37; p < .05) to walk if
their school neighborhood had high connectivity and low traffic and less
likely to walk if they had to cross a busy road (OR = 0.49; p < .05). For girls,
confidence in their ability to walk to or from school without an adult (OR =
2.03), school encouragement (OR = 2.43), scheduling commitments (OR =
0.41), and parent-perceived convenience of driving (OR = 0.24) were
significantly associated (p < .05) with walking. Irrespective of gender and
proximity to school, child-perceived convenience of walking (boys OR =
2.17 and girls OR = 1.84) and preference to walk to school (child perceived,
boys OR = 5.57, girls OR = 1.84 and parent perceived, boys OR = 2.82,
girls OR = 1.90) were consistently associated (p < .05) with walking to and
from school. CONCLUSION: Although there are gender differences in
factors influencing children walking to and from school, proximity to school,
the safety of the route, and family time constraints are consistent correlates.
These need to be addressed if more children are to be encouraged to walk
to and from school.
Trapp, G. S., B. Giles-Corti, et al. (2011). "On your bike! a cross-sectional study of
the individual, social and environmental correlates of cycling to school." Int J
Behav Nutr Phys Act 8: 123.
BACKGROUND: Active school transport (AST) has declined rapidly in
recent decades. While many studies have examined walking, cycling to
school has received very little attention. Correlates of cycling are likely to
differ to those from walking and cycling enables AST from further distances.
This study examined individual, social and environmental factors associated
with cycling to school among elementary school-aged children, stratified by
gender. METHODS: Children (n = 1197) attending 25 Australian primary
schools located in high or low walkable neighborhoods, completed a oneweek travel diary and a parent/child questionnaire on travel habits and
attitudes. RESULTS: Overall, 31.2% of boys and 14.6% of girls cycled >/= 1
trip/week, however 59.4% of boys and 36.7% of girls reported cycling as
their preferred school transport mode. In boys (but not girls), school
neighborhood design was significantly associated with cycling: i.e., boys
attending schools in neighborhoods with high connectivity and low traffic
were 5.58 times more likely to cycle (95% CI 1.11-27.96) and for each
kilometer boys lived from school the odds of cycling reduced by 0.70 (95%
CI 0.63-0.99). Irrespective of gender, cycling to school was associated with
parental confidence in their child's cycling ability (boys: OR 10.39; 95% CI
3.79-28.48; girls: OR 4.03; 95% CI 2.02-8.05), parental perceived
convenience of driving (boys: OR 0.42; 95% CI 0.23-0.74; girls: OR 0.40;
95% CI 0.20-0.82); and child's preference to cycle (boys: OR 5.68; 95% CI
3.23-9.98; girls: OR 3.73; 95% CI 2.26-6.17). CONCLUSION: School
proximity, street network connectivity and traffic exposure in school
neighborhoods was associated with boys (but not girls) cycling to school.
Irrespective of gender, parents need to be confident in their child's cycling
ability and must prioritize cycling over driving.
Voorhees, C. C., A. F. Yan, et al. (2011). "Neighborhood Environment, Selfefficacy, and Physical Activity in Urban Adolescents." American Journal of Health
Behavior 35(6): 674-688.
Objectives: To test the pathways between perceptions of built environment
factors and physical activity in urban youth. Methods: Three hundred fifty
high school students' perceptions of neighborhood, and barrier self efficacy
were measured by a Web survey. Physical activities were assessed using a
one-week diary and accelerometers. Results: Land-use mix/accessibility
and neighborhood satisfaction had direct pathways to walking. Barrier selfefficacy had a direct pathway to walking. In addition, land use, specifically
neighborhood accessibility, influenced adolescents' walking behavior via
self-efficacy. Similar pathways were found in MVPA models. Conclusions:
Neighborhood factors appear to work together with self-efficacy to facilitate
physical activity.
BUILT ENVIROMENT AND PHYSICAL ACTIVITY/ OBESITY AMONG ADULTS
Adams, M. A., J. F. Sallis, et al. (2011). "Neighborhood environment profiles
related to physical activity and weight status: A latent profile analysis." Preventive
Medicine 52(5): 326-331.
Background. Neighborhood built environments (BE) include combinations of
co-existing stimuli influencing physical activity (PA). Dealing with numerous
environmental variables and complexity presents a significant challenge.
The current analysis explored whether a range of reported BE features
associated with adults' physical activity produced distinct multivariate
patterns, and tested whether adults' PA and body mass differed by BE
profiles. Methods. Participants (20-65 years, 48.2% female, 26% ethnic
minority) were recruited between 2002 and 2005 from 32 neighborhoods
from Seattle-King County, WA (N = 1287) and Baltimore, MD-Washington,
DC regions (N= 912). Independent Latent Profile Analyses were conducted
in each region with 11 environmental variables from the Neighborhood
Environment Walkability Scale. Validity of the neighborhood profiles was
examined by their relationship to PA (accelerometer-derived moderate-tovigorous minutes/day, self-reported minutes/week of walking for
transportation and leisure) and self-reported BMI using ANCOVA models.
Results. Neighborhood profiles for Seattle and Baltimore regions were
visually similar, suggesting generalizability. High-walkable recreationallydense neighborhoods differed significantly from other neighborhood types
by as much as 13 MVPA minutes/day, almost 60 minutes/week of walking
for transportation, and 75 min/week of leisure-time activity. Neighborhood
profiles also differed significantly for BMI. Discussion. These findings could
help identify optimal patterns of environmental attributes that facilitate
physical activity and improve weight status. (C) 2011 Elsevier Inc. All rights
reserved.
Block, J. P., N. A. Christakis, et al. (2011). "Proximity to Food Establishments and
Body Mass Index in the Framingham Heart Study Offspring Cohort Over 30
Years." American Journal of Epidemiology 174(10): 1108-1114.
Existing evidence linking residential proximity to food establishments with
body mass index (BMI; weight (kg)/height (m)(2)) has been inconclusive. In
this study, the authors assessed the relation between BMI and proximity to
food establishments over a 30-year period among 3,113 subjects in the
Framingham Heart Study Offspring Cohort living in 4 Massachusetts towns
during 1971-2001. The authors used novel data that included repeated
measures of BMI and accounted for residential mobility and the appearance
and disappearance of food establishments. They calculated proximity to
food establishments as the driving distance between each subject's
residence and nearby food establishments, divided into 6 categories. The
authors used cross-classified linear mixed models to account for timevarying attributes of individuals and residential neighborhoods. Each 1-km
increase in distance to the closest fast-food restaurant was associated with
a 0.11-unit decrease in BMI (95% credible interval: -0.20, -0.04). In sex-
stratified analyses, this association was present only for women. Other
aspects of the food environment were either inconsistently associated or not
at all associated with BMI. Contrary to much prior research, the authors did
not find a consistent relation between access to fast-food restaurants and
individual BMI, necessitating a reevaluation of policy discussions on the
anticipated impact of the food environment on weight gain.
Boone-Heinonen, J. and P. Gordon-Larsen (2011). "Life stage and sex specificity
in relationships between the built and socioeconomic environments and physical
activity." Journal of Epidemiology and Community Health 65(10): 847-852.
Background In the largely cross-sectional literature, built environment
characteristics such as walkability and recreation centres are variably
related to physical activity. Subgroup-specific effects could help explain
inconsistent findings, yet few studies have compared built environment
associations by key characteristics such as sex or life stage. Methods Using
data from the National Longitudinal Study of Adolescent Health (wave I
1994-5, wave III 2001-2; n=12 701) and a linked geographic information
system, cross-sectional relationships between moderate to vigorous
physical activity (MVPA) bouts and built and socioeconomic environment
measures were estimated. Negative binomial generalised estimating
equation regression modelled MVPA as a function of log-transformed
environment measures, controlling for individual sociodemographics and
testing for interactions with sex and life stage (waves I and III, when
respondents were adolescents and young adults, respectively). Results
Higher landscape diversity (coefficient 0.040; 95% CI 0.019 to 0.062) and
lower crime (coefficient -0.047; 95% CI -0.071 to -0.022) were related to
greater weekly MVPA regardless of sex or life stage. Higher street
connectivity was marginally related to lower MVPA (coefficient -0.176; 95%
CI -0.357 to 0.005) in females but not males. Pay facilities and public
facilities per 10 000 population and median household income were
unrelated to MVPA. Conclusions Similar relationships between higher
MVPA and higher landscape diversity and lower crime rate across sex and
life stage suggest that application of these environment features may benefit
broad populations. Sex-specific associations for street connectivity may
partly account for the variation in findings across studies and have
implications for targeting physical activity promotion strategies.
Carlson, J. A., J. F. Sallis, et al. (2011). "Interactions between psychosocial and
built environment factors in explaining older adults' physical activity." Prev Med
54(1): 68-73.
OBJECTIVE: To evaluate ecological model predictions of cross-level
interactions among psychosocial and environmental correlates of physical
activity in 719 community-dwelling older adults in the Baltimore, Maryland
and Seattle, Washington areas during 2005-2008. METHOD: Walkability,
access to parks and recreation facilities and moderate-to-vigorous physical
activity (MVPA) minutes per week (min/week) were measured objectively.
Neighborhood aesthetics, walking facilities, social support, self-efficacy,
barriers and transportation and leisure walking min/week were self-reported.
RESULTS: Walkability interacted with social support in explaining total
MVPA (B=13.71) and with social support (B=7.90), self-efficacy (B=7.66)
and barriers (B=-8.26) in explaining walking for transportation. Aesthetics
interacted with barriers in explaining total MVPA (B=-12.20) and walking
facilities interacted with self-efficacy in explaining walking for leisure (B=10.88; Ps<.05). Summarizing across the interactions, living in a supportive
environment (vs. unsupportive) was related to 30-59 more min/week of
physical activity for participants with more positive psychosocial attributes,
but only 0-28 more min/week for participants with less positive psychosocial
attributes. CONCLUSION: Results supported synergistic interactions
between built environment and psychosocial factors in explaining physical
activity among older adults. Findings suggest multilevel interventions may
be most effective in increasing physical activity.
Carr, L. J., S. I. Dunsiger, et al. (2011). "Validation of Walk Score for estimating
access to walkable amenities." Br J Sports Med 45(14): 1144-8.
BACKGROUND: Proximity to walkable destinations or amenities is thought
to influence physical activity behaviour. Previous efforts attempting to
calculate neighbourhood walkability have relied on self-report or timeintensive and costly measures. Walk Score is a novel and publicly available
website that estimates neighbourhood walkability based on proximity to 13
amenity categories (eg, grocery stores, coffee shops, restaurants, bars,
movie theatres, schools, parks, libraries, book stores, fitness centres, drug
stores, hardware stores, clothing/music stores). OBJECTIVE: The purpose
of this study is to test the validity and reliability of Walk Score for estimating
access to objectively measured walkable amenities. METHODS: Walk
Scores of 379 residential/non-residential addresses in Rhode Island were
manually calculated. Geographic information systems (GIS) was used to
objectively measure 4194 walkable amenities in the 13 Walk Score
categories. GIS data were aggregated from publicly available data sources.
Sums of amenities within each category were matched to address data, and
Pearson correlations were calculated between the category sums and
address Walk Scores. RESULTS: Significant correlations were identified
between Walk Score and all categories of aggregated walkable destinations
within a 1-mile buffer of the 379 residential and non-residential addresses.
Test-retest reliability correlation coefficients for a subsample of 100
addresses were 1.0. CONCLUSION: These results support Walk Score as a
reliable and valid measure of estimating access to walkable amenities. Walk
Score may be a convenient and inexpensive option for researchers
interested in exploring the relationship between access to walkable
amenities and health behaviours such as physical activity.
Christian, H., B. Giles-Corti, et al. (2011). "The influence of the built environment,
social environment and health behaviors on body mass index. Results from
RESIDE." Preventive Medicine 53(1-2): 57-60.
Objective. To examine the individual, behavioral, social and built
environment correlates of body mass index (BMI) in an Australian adult
population. Method. Using data from 2003 to 2005 on 1151 participants in
the RESIDential Environments project (RESIDE), Perth, Western Australia,
linear regression was used to construct multivariate models to examine the
variance in BMI explained by significant socio-demographic. environmental
and health behavior variables. Both self-report and GIS-derived measures
of the built environment were examined. Results. Age, gender, hours of
work, total physical activity. sedentary leisure time and dietary fat were all
associated with BMI (p <= 0.05). BMI was not associated with any objective
measures of the built environment or social capital, social cohesion or dog
ownership but was independently associated with one perceived
environment measure (perceived safety from crime). Overall. 3.3% of the
variance in BMI was explained by socio-demographic factors, a further 2.7%
by health behaviors and a further 1.5% by perceived environment factors.
Conclusion. Whilst evidence mounts of built environment correlates to
physical activity, the demonstrated translation of these effects on BMI
remain more elusive. Nevertheless, built environment factors that constrain
physical activity warrant further exploration. (C) 2011 Elsevier Inc. All rights
reserved.
Coogan, P. F., L. F. White, et al. (2011). "Longitudinal Assessment of Urban Form
and Weight Gain in African-American Women." American Journal of Preventive
Medicine 40(4): 411-418.
Background: Numerous cross-sectional studies have found higher levels of
obesity among residents of auto-oriented, sprawling areas compared to
residents of more urban areas. Purpose: The association between
neighborhood urban form and 6-year weight change was prospectively
analyzed in the Black Women's Health Study, a cohort study of U. S. black
women who enrolled in 1995 and are followed biennially with mailed
questionnaires. Methods: The analysis included 17,968 women who lived in
New York City, Chicago, or Los Angeles and were followed from 1995 to
2001. Factor analysis was used to combine variables describing the urban
form of participants' residential neighborhoods into an "urbanicity" score.
Mixed linear regression models were used to calculate least-squares means
for weight change across quintiles of the urbanicity score. Incidence rate
ratios (IRRs) and 95% CIs for incident obesity in relation to the urbanicity
score among women who were not obese at baseline were derived from
Cox regression models. All results were adjusted for age, region, lifestyle
factors, and neighborhood SES. Analyses were conducted in 2008-2010.
Results: In multivariate analysis, mean weight gain for women in the highest
quintile of urbanicity score (most urban) was 0.79 kg less than for those in
the lowest quintile, with a significant trend (p = 0.003). The IRR for incident
obesity in the highest quintile relative to the lowest was 0.83 (95% CI =
0.71, 0.97), with a significant trend (p = 0.042). Conclusions: Policies that
encourage dense, urban residential development may have a positive role
to play in addressing obesity in black women. (Am J Prev Med
2011;40(4):411-418) (C) 2011 American Journal of Preventive Medicine
Corral, I., H. Landrine, et al. (2011). "Residential segregation, health behavior and
overweight/obesity among a national sample of African American adults." J Health
Psychol 17(3): 371-8.
We examined the role of residential segregation in 5+ daily fruit/vegetable
consumption, exercise, and overweight/obesity among African Americans
by linking data on the 11,142 African American adults in the 2000
Behavioral Risk Factor Surveillance System to 2000 census data on the
segregation of metropolitan statistical areas (MSAs). Multi-level modeling
revealed that after controlling for individual-level variables, MSA
Segregation and Poverty contributed to fruit/vegetable consumption, MSA
Poverty alone contributed to exercise, and MSA Segregation alone
contributed to overweight/obesity. These findings highlight the need for
research on the built-environments of the segregated neighborhoods in
which most African Americans reside, and suggest that neighborhood
disparities may contribute to health disparities.
Davis, M. G., K. R. Fox, et al. (2011). "Getting out and about in older adults: the
nature of daily trips and their association with objectively assessed physical
activity." International Journal of Behavioral Nutrition and Physical Activity 8.
Background: A key public health objective is increasing health-enhancing
physical activity (PA) for older adults (OAs). Daily trip frequency is
independently associated with objectively assessed PA volumes (OAs).
Little is known about correlates and these trips' transport mode, and how
these elements relate to PA. Purpose: to describe the frequency, purpose,
and travel mode of daily trips in OAs, and their association with participant
characteristics and objectively-assessed PA. Methods: Participants (n =
214, aged 78.1 SD 5.7 years), completed a seven-day trips log recording
daily-trip frequency, purpose and transport mode. Concurrently participants
wore an accelerometer which provided mean daily steps (steps.d(-1)), and
minutes of moderate to vigorous PA (MVPA.d(-1)). Participants' physical
function (PF) was estimated and demographic, height and weight data
obtained. Results: Trip frequency was associated with gender, age, physical
function, walking-aid use, educational attainment, number of amenities
within walking distance and cars in the household. Participants reported 9.6
(SD 4.2) trips per week (trips.wk(-1)). Most trips (61%) were by car (driver
44%, passenger 17%), 30% walking or cycling (active) and 9% public
transport/other. Driving trips.wk(-1) were more common in participants who
were males (5.3 SD 3.6), well-educated (5.0 SD 4.3), high functioning (5.1
SD 4.6), younger (5.6 SD 4.9), affluent area residents (5.1 SD 4.2) and
accessing > one car (7.2 SD 4.7). Active trips.wk(-1) were more frequent in
participants who were males (3.4 SD 3.6), normal weight (3.2 SD 3.4), not
requiring walking aids (3.5 SD 3.3), well-educated (3.7 SD 0.7), from less
deprived neighbourhoods (3.9 SD 3.9) and with = 8 amenities nearby (4.4
SD 3.8). Public transport, and active trip frequency, were significantly
associated with steps.d(-1) (p < 0.001), even after adjustment for other trip
modes and potential confounders. Public transport, active, or car driving
trips were independently associated with minutes MVPA.d(-1) (p < 0.01).
Conclusions: Daily trips are associated with objectively-measured PA as
indicated by daily MVPA and steps. Public transport and active trips are
associated with greater PA than those by car, especially as a car
passenger. Strategies encouraging increased trips, particularly active or
public transport trips, in OAs can potentially increase their PA and benefit
public health.
Deka, D. and M. Connelly (2011). "Does Proximity to Activity-Inducing Facilities
Explain Lower Rates of Physical Activity by Low-Income and Minority
Populations?" Transportation Research Record(2264): 83-91.
As in the rest of the nation, low-income and minority populations in New
Jersey have higher rates of obesity and lower rates of participation in
physical activity. This study examined whether a lower level of geographic
proximity to activity-inducing infrastructure and facilities, including bicycling
routes and gymnasiums, could be a reason for lower rates of participation in
physical activity for New Jersey minority populations. Results of past studies
revealed that proximity to activity-inducing facilities was generally
associated with greater participation in physical activity for the general
population. Some study results showed that low-income and minority
populations had a lower level of geographic proximity to such facilities.
Other studies indicated that proximity to facilities might not have influenced
their participation in physical activity to the same extent as the general
population. This study made a statewide assessment of proximity to existing
fitness facilities, existing bicycling facilities, and programmed bicycling and
pedestrian projects in New Jersey. One-way analysis of variance was used
to examine if proximity to activity-inducing facilities was lower for lowincome and minority populations. Analysis was carried out at the census
block group and municipal levels. The results provided no evidence that
low-income and minority populations had a lower level of geographic
proximity to activity-inducing facilities. The analysis also showed that
programmed bicycling and pedestrian projects were favorably located for
these populations. The study concluded that the lower rates of participation
of low-income and minority populations in New Jersey were caused by
behavioral factors rather than proximity to facilities.
Dunn, R. A., J. R. Sharkey, et al. (2011). "The effect of fast-food availability on
fast-food consumption and obesity among rural residents: an analysis by
race/ethnicity." Econ Hum Biol 10(1): 1-13.
Rural areas of the United States tend to have higher obesity rates than
urban areas, particularly in regions with high proportions of non-white
residents. This paper analyzes the effect of fast-food availability on the level
of fast-food consumption and obesity risk among both white and non-white
residents of central Texas. Potential endogeneity of fast-food availability is
addressed through instrumental variables regression using distance to the
nearest major highway as an instrument. We find that non-whites tend to
exhibit higher obesity rates, greater access to fast-food establishments and
higher consumption of fast-food meals compared to their white counterparts.
In addition, we found that whites and non-whites respond differently to the
availability of fast-food in rural environments. Greater availability is not
associated with either greater consumption of fast-food meals or a higher
obesity risk among the sample of whites. In contrast, greater availability of
fast-food is positively associated with both the number of meals consumed
for non-white rural residents and their obesity. While our results are robust
to specification, the effect of availability on weight outcomes is notably
weaker when indirectly calculated from the implied relationship between
consumption and caloric intake. This highlights the importance of directly
examining the proposed mechanism through which an environmental factor
influences weight outcomes.
Eugeni, M. L., M. Baxter, et al. (2011). "Disconnections of African American Public
Housing Residents: Connections to Physical Activity, Dietary Habits and Obesity."
American Journal of Community Psychology 47(3-4): 264-276.
African American (AA) and low SES populations report poor health
behaviors and outcomes. This study aimed to increase understanding of
barriers to participating in healthful behaviors and programs in AA residents
of public housing. Twenty two apparently healthy, AA residents (50%
female, M = 43.9 years) completed in depth interviews, which were taped,
transcribed and analyzed using a constant comparison approach. Residents
demonstrated some awareness of health recommendations, but described
limited adherence. Physical activity for recreation was reported as primarily
for youth, with adults engaging in limited physical activity (primarily
incidental to other activities). Barriers reported by residents were both
personal and environmental. Few residents were aware of local
neighborhood opportunities for physical activity or healthful eating. Future
efforts should focus on increasing understanding of health promoting
behaviors and awareness and efficacy of residents to connect with the
resources of their surrounding communities.
Ford, P. B. and D. A. Dzewaltowski (2011). "Neighborhood Deprivation,
Supermarket Availability, and BMI in Low-Income Women: A Multilevel Analysis."
Journal of Community Health 36(5): 785-796.
High levels of neighborhood deprivation and lack of access to supermarkets
have been associated with increased risk of obesity in women. This
multilevel study used a statewide dataset (n = 21,166) of low-income
women in the Special Supplemental Nutrition Program for Women, Infants,
and Children to determine whether the association between neighborhood
deprivation and BMI is mediated by the availability of retail food stores, and
whether this relationship varied across the urban rural continuum.
Residence in a high deprivation neighborhood was associated with a 0.94
unit increase in BMI among women in metropolitan areas. The relationship
between tract deprivation and BMI was not linear among women in
micropolitan areas, and no association was observed in rural areas. The
presence of supermarkets or other retail food stores did not mediate the
association between deprivation and BMI among women residing in any of
the study areas. These results suggest that level of urbanity influences the
effect of neighborhood condition on BMI among low-income women, and
that the availability of supermarkets and other food stores does not directly
influence BMI among low-income populations.
Fox, K. R., M. Hillsdon, et al. (2011). "Neighbourhood deprivation and physical
activity in UK older adults." Health & Place 17(2): 633-640.
The benefits of regular physical activity for older adults are now wellestablished but this group remain the least active sector of the population. In
this paper, the association between levels of neighbourhood deprivation and
physical activity was assessed. A sample of 125 males with a mean age of
77.5 (+/- 5.6) years, and 115 females with a mean age of age 78.6 (+/- 8.6)
underwent 7-day accelerometry, a physical performance battery, and
completed a daily journeys log. Univariate associations between physical
activity parameters and level of deprivation of neighbourhood were
extinguished in regression models controlling for age, gender, and level of
educational attainment. Age, gender, educational attainment, body mass
index, physical function, and frequency of journeys from the home explained
between 50% and 54% of variance in activity parameters. These results
suggest the importance of strategies to help older adults maintain physical
function, healthy weight, and remain active in their communities. (C) 2011
Elsevier Ltd. All rights reserved.
Fuller, D., L. Gauvin, et al. (2011). "Use of a new public bicycle share program in
Montreal, Canada." Am J Prev Med 41(1): 80-3.
BACKGROUND: Cycling contributes to physical activity and health. Public
bicycle share programs (PBSPs) increase population access to bicycles by
deploying bicycles at docking stations throughout a city. Minimal research
has systematically examined the prevalence and correlates of PBSP use.
PURPOSE: To determine the prevalence and correlates of use of a new
public bicycle share program called BIXI (name merges the word BIcycle
and taXI) implemented in May 2009 in Montreal, Canada. METHODS: A
total of 2502 adults were recruited to a telephone survey in autumn 2009 via
random-digit dialing according to a stratified random sampling design. The
prevalence of BIXI bicycle use was estimated. Multivariate logistic
regression allowed for identification of correlates of use. Data analysis was
conducted in spring and summer 2010. RESULTS: The unweighted mean
age of respondents was 47.4 (SD=16.8) years and 61.4% were female. The
weighted prevalence for use of BIXI bicycles at least once was 8.2%.
Significant correlates of BIXI bicycle use were having a BIXI docking station
within 250 m of home, being aged 18-24 years, being university educated,
being on work leave, and using cycling as the primary mode of
transportation to work. CONCLUSIONS: A newly implemented public
bicycle share program attracts a substantial fraction of the population and is
more likely to attract younger and more educated people who currently use
cycling as a primary transportation mode.
Gebel, K., A. E. Bauman, et al. (2011). "Does the environment moderate the
impact of a mass media campaign to promote walking?" Am J Health Promot
26(1): 45-8.
PURPOSE: To examine if a mass media campaign influenced walking
differently in people in different physical environments. DESIGN: Quasiexperimental study. Setting . Wheeling, West Virginia. PARTICIPANTS:
Random sample of adults age 50 to 65 years, response rate: 72.1% (n =
719 in intervention community, n = 753 in comparison community).
INTERVENTION: Mass media campaign. MEASURES: Self-reported
measures were used in before and after telephone surveys for walking and
the physical environment. Measures included 11 environmental walkability
items, from which two subscales (i.e., usable sidewalks/aesthetics and
facilities) were extracted. ANALYSIS: Multiple linear regression. RESULTS:
Overall, walking increased by 2.7 minutes per week (standard deviation
[SD] = 231.1, not significant [NS]). When confined to those insufficiently
active at baseline (i.e., <30 minutes per day) the minutes walked increased
by 92.1 minutes (SD = 152.9, p < .001). For the insufficiently active at
baseline in the top half of the environmental factor of usable sidewalks,
walking increased by 19 minutes more than in the bottom half (NS). For the
factor of aesthetics and facilities, people in the more walkable environment
increased walking by 87 minutes more than those in the bottom half (p <
.001). CONCLUSION: In this community-wide physical activity, intervention
changes in walking after the campaign were significantly moderated by
some environmental attributes. This contributes to the limited evidence on
the impact of the environment in enhancing community physical activity
interventions. This finding needs to be replicated in other community
interventions with greater environmental variation.
Gebel, K., A. E. Bauman, et al. (2011). "Mismatch between perceived and
objectively assessed neighborhood walkability attributes: Prospective relationships
with walking and weight gain." Health & Place 17(2): 519-524.
We examined prospectively whether persons who perceive their objectively
measured high walkable environment as low walkable decrease their
walking more and gain more weight than those with matched perceptions.
Walkability was measured objectively using GIS. Corresponding perceptions
were collected using the Neighborhood Environment Walkability Scale from
1027 urban Australian adults. Objective and perceived measures were
dichotomized and categories of match and mismatch were created. Overall,
walking levels decreased and BMI increased significantly over the four year
follow-up period. Those who perceived high walkability, dwelling density or
land use mix as low decreased their walking for transport significantly more
than those with matched perceptions. Those who perceived high walkability,
land use mix or retail density as low increased their BMI significantly more
than those with concordant perceptions. These prospective findings
corroborate recommendations from previous cross-sectional studies.
Interventions to improve negative perceptions of walkability among those
living in high walkable areas may be a relevant public health intervention to
increase physical activity and support weight maintenance. (C) 2010
Elsevier Ltd. All rights reserved.
Gomes, G. A., R. S. Reis, et al. (2011). "Walking for leisure among adults from
three Brazilian cities and its association with perceived environment attributes and
personal factors." Int J Behav Nutr Phys Act 8: 111.
BACKGROUND: Walking is a popular form of physical activity and a
convenient option to prevent chronic diseases. However, most of the
evidence on this topic derives from high-income countries and little is known
about walking patterns and its association with environmental features in
low and middle income countries. OBJECTIVES: To describe walking for
leisure and to identify its association with perceived environment and
personal factors among residents of three state capitals from different
regions of Brazil METHODS: Cross sectional phone surveys were
conducted in Recife, Curitiba and Vitoria (n = 6,166) in 2007, 2008 and
2009 respectively. Physical activity was measured using the leisure-time
sections of the long version of the International Physical Activity
Questionnaire (IPAQ). Perceived environment characteristics were
assessed using a modified version of the Neighborhood Environment
Walkability Scale (NEWS). Multivariable analysis tested the associations
between walking for leisure and perceived environment characteristics
across the cities using logistic regression. RESULTS: The proportions of
respondents meeting physical activity recommendations through walking for
leisure were 9.6%, 16.0% and 8.8% in Curitiba, Recife and Vitoria,
respectively. Engaging in 150 min/wk or more of walking for leisure was
significantly associated with younger age, higher education, better self-rated
health and with lack of sidewalks on nearby streets. We did not find positive
associations between walking for leisure and traffic conditions and safety
related to cycling/walking during the day or night. CONCLUSION: Most
environmental features were not associated with walking for leisure.
Personal factors were stronger predictors of walking for leisure as compared
with perceived environment factors.
Hanibuchi, T., I. Kawachi, et al. (2011). "Neighborhood built environment and
physical activity of Japanese older adults: results from the Aichi Gerontological
Evaluation Study (AGES)." Bmc Public Health 11.
Background: Although many studies have reported the association between
neighborhood built environment (BE) and physical activity (PA), less is
known about the associations for older populations or in countries besides
the US and Australia. The aim of this paper is to examine the associations
for older adult populations in Japan. Methods: Our analyses were based on
cross-sectional data from the Aichi Gerontological Evaluation Study
(AGES), conducted in 2003. The respondents were older adults, aged 65
years or over (n = 9,414), from 8 municipalities across urban, suburban, and
rural areas. The frequency of leisure time sports activity and total walking
time were used as the outcome variables. Using geographic information
systems (GIS), we measured residential density, street connectivity, number
of local destinations, access to recreational spaces, and land slope of the
respondents' neighborhoods, based on network distances with multiple radii
(250 m, 500 m, 1,000 m). An ordinal logistic regression model was used to
analyze the association between PA and BE measures. Results: Population
density and presence of parks or green spaces had positive associations
with the frequency of sports activity, regardless of the selected buffer zone.
The analysis of total walking time, however, showed only a few
associations. Conclusions: Our findings provide mixed support for the
association between PA and the characteristics of BE measures, previously
used in Western settings. Some characteristics of the neighborhood built
environment may facilitate leisure time sports activity, but not increase the
total walking time for Japanese older adults.
Hannon, L., 3rd, P. Sawyer, et al. (2011). "The influence of community and the
built environment on physical activity." J Aging Health 24(3): 384-406.
OBJECTIVE: To examine associations between the built environment and
leisure-time physical activity (LTPA) among African Americans and Whites.
METHOD: Independent and control variables were produced from the
literature and theory to represent key components of built environment,
sense of community, sociodemographic, and health status characteristics.
Logistic regression analysis and descriptive statistics were used to
measures correlative relationships with physical activity. RESULTS: Built
environment elements, especially homeownership, were associated with
LTPA, particularly among older African American rural residents.
DISCUSSION: Recommendations include transferring the concept of
community ownership to residents living in areas where rates of physical
activity are low.
Hekler, E. B., C. M. Castro, et al. (2011). "The CHOICE study: a "taste-test" of
utilitarian vs. leisure walking among older adults." Health Psychol 31(1): 126-9.
OBJECTIVE: Utilitarian walking (e.g., walking for transport) and leisure
walking (e.g., walking for health/recreation) are encouraged to promote
health, yet few studies have explored specific preferences for these two
forms of physical activity or factors that impact such preferences. A quasiexperimental crossover design was used to evaluate how training
underactive midlife and older adults in each type of walking impacted total
steps taken and how it was linked to their subsequent choice of walking
types. METHODS: Participants (N = 16) were midlife and older adults (M
age = 64 +/- 8 years) who were mostly women (81%) and white (75%). To
control for order effects, participants were randomized to instruction in either
utilitarian or leisure walking for 2 weeks and then the other type for 2 weeks.
Participants then entered a 2-week "free choice" phase in which they chose
any mixture of the walking types. Outcome variables included walking via
OMRON pedometer and the ratio of utilitarian versus leisure walking during
the free-choice phase. Participants completed surveys about their
neighborhood (NEWS) and daily travel to multiple locations. RESULTS:
Instruction in leisure-only, utilitarian-only, and a freely chosen mixture of the
two each resulted in significant increases in steps taken relative to baseline
(ps < 0.05). Having to go to multiple locations daily and traveling greater
distances to locations were associated with engagement in more utilitarian
walking. In contrast, good walking paths, neighborhood aesthetics, easy
access to exercise facilities, and perceiving easier access to neighborhood
services were associated with more leisure walking. CONCLUSIONS:
Results from this pilot study suggest that midlife and older adults may most
easily meet guidelines through either leisure only or a mixture of leisure and
utilitarian walking, and tailored suggestions based on the person's
neighborhood may be useful.
Hickson, D. A., A. V. Diez Roux, et al. (2011). "Associations of fast food restaurant
availability with dietary intake and weight among African Americans in the Jackson
Heart Study, 2000-2004." Am J Public Health 101 Suppl 1: S301-9.
OBJECTIVES: We examined the associations of fast food restaurant (FFR)
availability with dietary intake and weight among African Americans in the
southeastern United States. METHODS: We investigated cross-sectional
associations of FFR availability with dietary intake and body mass index
(BMI) and waist circumference in 4740 African American Jackson Heart
Study participants (55.2 +/- 12.6 years, 63.3% women). We estimated FFR
availability using circular buffers with differing radii centered at each
participant's geocoded residential location. RESULTS: We observed no
consistent associations between FFR availability and BMI or waist
circumference. Greater FFR availability was associated with higher energy
intake among men and women younger than 55 years, even after
adjustment for individual socioeconomic status. For each standard deviation
increase in 5-mile FFR availability, the energy intake increased by 138
kilocalories (confidence interval [CI] = 70.53, 204.75) for men and 58
kilocalories (CI = 8.55, 105.97) for women. We observed similar
associations for the 2-mile FFR availability, especially in men. FFR
availability was also unexpectedly positively associated with total fiber
intake. CONCLUSIONS: FFR availability may contribute to greater energy
intake in younger African Americans who are also more likely to consume
fast food.
Hino, A. A. F., R. S. Reis, et al. (2011). "The built environment and recreational
physical activity among adults in Curitiba, Brazil." Preventive Medicine 52(6): 419422.
Objective. To examine the relationship between objective measures of the
built environment (BE) and recreational physical activity (PA) in adults from
Curitiba, Brazil. Method. A phone survey was carried among a random
sample of 1206 people. Walking during leisure time (WLT) and moderate
and vigorous recreational PA (MVPA) was measured using IPAQ.
Characteristics of the BE were determined in an area of 500 m surrounding
respondent's homes. Multivariate logistic regression analysis was used to
estimate the associations between recreational PA and BE. Results. After
adjusting for confounders, WLT was associated with area income level
US$971.45-3341.64 vs. US$167.05-461.06 (25.7% vs. 11.1% POR = 2.5;
95% CI = 1.5-4.4), having >= 2 gyms vs. none (26.1% vs. 12.7%, POR =
1.9; 95% CI = 1.2-3.0) and distance to recreation centers, 1769.1-2835.5
km vs. 2835.6-10,212.3 km (22.1% vs. 11.0%, POR = 2.3; 95% CI = (1.02.5). MVPA was associated with neighborhood income US$971.45-3341.64
vs. US$167.05-461.06 (47.6% vs. 22.0% POR = 3.0; 95% CI = 1.5-5.9) and
having >= 2 gyms vs. none (41.7% vs. 26.0%, POR = 1.5; 95% CI = 1.112.1). Conclusion. The presence of some recreational facilities for PA was
associated with recommended levels of PA during leisure time in Curitiba,
Brazil. (C) 2011 Elsevier Inc. All rights reserved.
Hoehner, C. M., S. L. Handy, et al. (2011). "Association between neighborhood
walkability, cardiorespiratory fitness and body-mass index." Social Science &
Medicine 73(12): 1707-1716.
Many studies have found cross-sectional associations between
characteristics of the neighborhood built environment and physical activity
(PA) behavior. However, most are based on self-reported PA, which is
known to result in overestimation of PA and differential misclassification by
demographic and biological characteristics. Cardiorespiratory fitness (CRF)
is an objective marker of PA because it is primarily determined by PA.
Furthermore, it is causally related to long-term health outcomes. Therefore,
analyses of the association between CRF and built environment could
strengthen arguments for the importance of built environment influences on
health. We examined the association between neighborhood walkability and
CRF and body-mass index (BM!). This cross-sectional analysis included
16,543 adults (5017 women, 11,526 men) aged 18-90 years with home
addresses in Texas who had a comprehensive clinical examination between
1987 and 2005. Outcomes included CRF from total duration on a maximal
exercise treadmill test and measured BMI. Three neighborhood walkability
factors emerged from principal components analyses of block-group
measures derived from the U.S. Census. In multilevel adjusted analyses,
the neighborhood walkability factors were significantly associated with CRF
and BMI among men and women in the expected direction. An interaction
between one of the neighborhood factors and age was also observed. The
interaction suggested that living in neighborhoods with older homes and
with residents traveling shorter distances to work was more strongly
positively associated with CRF among younger adults and more strongly
negatively associated with BMI among older adults. In conclusion,
neighborhood characteristics hypothesized to support more PA and less
driving were associated with higher levels of CRF and lower BMI.
Demonstration of an association between built environment characteristics
and CRF is a significant advance over past studies based on self-reported
PA. Nevertheless, stronger causal evidence depends on more robust study
designs and sophisticated measures of the environment, behavior, and their
physiological consequences. (C) 2011 Elsevier Ltd. All rights reserved.
Hoerster, K. D., J. A. Mayer, et al. (2011). "Dog walking: Its association with
physical activity guideline adherence and its correlates." Preventive Medicine
52(1): 33-38.
Objective. We examined the prevalence and correlates of dog walking
among dog owners, and whether dog walking is associated with meeting the
American College of Sports Medicine/American Heart Association physical
activity guidelines. Methods. In March 2008, we mailed a survey to dogowning clients from two San Diego County veterinary clinics. Useable data
were obtained from 984 respondents, and 75 of these completed retest
surveys. We assessed associations between potential correlates and dog
walking (i.e., yes/no dog walking for at least 10 min in past week). Results.
Test-retest reliability of measures was generally high. Approximately onethird of the sample (31.5%) were not dog walkers. Proportions of dog
walkers versus non-dog walkers meeting United States guidelines were
64.3% and 55.0%, respectively. Dog walking was independently associated
with meeting guidelines in a multivariate model (odds ratio = 1.59, p =
0.004). Three variables were independently associated with dog walking in
a multivariate model: dog encouragement of dog walking, dog-walking
obligation, and dog-walking self-efficacy. Conclusion. Dog walking was
associated with meeting physical activity guidelines, making it a viable
method for promoting physical activity. Dog-walking obligation and selfefficacy may be important mediators of dog walking and may need to be
targeted if interventions are to be successful. Published by Elsevier Inc.
Inoue, S., Y. Ohya, et al. (2011). "Perceived neighborhood environment and
walking for specific purposes among elderly Japanese." J Epidemiol 21(6): 481-90.
BACKGROUND: Recent research has revealed the importance of
neighborhood environment as a determinant of physical activity. However,
evidence among elderly adults is limited. This study examined the
association between perceived neighborhood environment and walking for
specific purposes among Japanese elderly adults. METHODS: This
population-based, cross-sectional study enrolled 1921 participants (age: 6574 years, men: 51.9%). Neighborhood environment (International Physical
Activity Questionnaire Environmental Module) and walking for specific
purposes (ie, transportation or recreation) were assessed by self-report.
Multilevel logistic regression analyses with individuals at level 1 and
neighborhoods at level 2 were conducted to examine the association
between environment and walking, after adjustment for potential
confounders. RESULTS: Access to exercise facilities, social environment,
and aesthetics were associated with total neighborhood walking. Odds
ratios (95% CI) were 1.23 (1.00-1.51), 1.39 (1.14-1.71), and 1.48 (1.211.81), respectively. Regarding walking for specific purposes, social
environment and aesthetics were consistent correlates of both
transportation walking and recreational walking. Environmental correlates
differed by specific types of walking and by sex. Transportation walking
significantly correlated with a greater variety of environmental attributes.
Sex differences were observed, especially for transportation walking.
Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor
vehicles were significant correlates among men, while access to shops,
access to exercise facilities, and social environment were important among
women. CONCLUSIONS: Specific environment-walking associations
differed by walking purpose and sex among elderly adults. Social
environment and aesthetics were consistent correlates of both
transportation walking and recreational walking. Improving these
environmental features might be effective in promoting physical activity
among elderly Japanese.
Jaime, P. C., A. C. Duran, et al. (2011). "Investigating Environmental Determinants
of Diet, Physical Activity, and Overweight among Adults in Sao Paulo, Brazil."
Journal of Urban Health-Bulletin of the New York Academy of Medicine 88(3): 567581.
There is worldwide recognition that the burden of noncommunicable
diseases (NCDs) and obesity-related health problems is rapidly increasing
in low- and middle-income countries. Environmental determinants of obesity
are likely to differ between countries, particularly in those undergoing rapid
socioeconomic and nutrition transitions such as Brazil. This study aims to
describe some built environment and local food environment variables and
to explore their association with the overweight rate and diet and physical
activity area-level aggregated indicators of adults living in the city of Sao
Paulo, the largest city in Brazil. This formative study includes an ecological
analysis of environmental factors associated with overweight across 31
submunicipalities of the city of Sao Paulo using statistical and spatial
analyses. Average prevalence of overweight was 41.69% (95% confidence
interval 38.74, 44.64), ranging from 27.14% to 60.75% across the
submunicipalities. There was a wide geographical variation of both
individual diet and physical activity, and indicators of food and built
environments, favoring wealthier areas. After controlling for area
socioeconomic status, there was a positive correlation between regular
fruits and vegetables (FV) intake and density of FV specialized food markets
(r = 0.497; p < 0.001), but no relationship between fast-food restaurant
density and overweight prevalence was found. A negative association
between overweight prevalence and density of parks and public sport
facilities was seen (r = -0.527; p < 0.05). Understanding the relationship
between local neighborhood environments and increasing rates of poor diet,
physical activity, and obesity is essential in countries undergoing rapid
economic and urban development, such as Brazil, in order to provide
insights for policies to reduce increasing rates of NCDs and food access
and health inequalities.
Kaczynski, A. T. and A. J. Mowen (2011). "Does self-selection influence the
relationship between park availability and physical activity?" Preventive Medicine
52(1): 23-25.
Objective. Increased proximity to parkland is associated with physical
activity (PA). This study explored the extent to which self-selection - the idea
that active persons simply seek out neighborhoods more endowed with
active resources - influences the relationship between park availability and
PA. Method. In August 2007, measures of parkland availability within 1 km,
importance placed on living near parks, and park-based PA participation
were assessed for 585 adults in Waterloo, Ontario. Results. Logistic
regression revealed that (i) participants who placed greater importance on
neighborhood open space were not more likely to live near more parkland;
(ii) both park importance and park space availability were associated with
increased, and relatively equal, odds of engaging in at least some parkbased PA; and (iii) participants who placed a low importance on living near
parks but had a higher amount of park space nearby were significantly more
likely to engage in park-based PA than participants who also placed a low
importance on parks but had less nearby park space. Conclusion. The issue
of self-selection does not solely account for the relationship frequently
observed between park space availability and PA. Future prospective and
intervention studies are needed to draw more definitive conclusions about
causality. (c) 2010 Elsevier Inc. All rights reserved.
Kaczynski, A. T., S. A. W. Stanis, et al. (2011). "Variations in Observed Park
Physical Activity Intensity Level by Gender, Race, and Age: Individual and Joint
Effects." Journal of Physical Activity & Health 8: S151-S160.
Background: Parks are important settings for physical activity (PA), but few
studies have documented the actual behaviors of park users. The purpose
of this study was to examine the individual and joint effects of various park
user demographic characteristics on observed PA intensity levels. Methods:
Four parks were observed using the System for Observing Play and
Recreation in Communities. Observers recorded the age group, gender,
race, and intensity level of all park users in 83 activity areas over two
weekends at each park. Logistic regression examined whether male/White,
female/White, and male/non-White users were more likely than female/nonWhite users to be observed engaging in moderate-to-vigorous PA (MVPA)
rather than sedentary activity across 4 age groups. Results: In total, 8612
users were observed during the study. In the child age group, male/White
users were significantly more likely to be observed in MVPA than
female/non-White users. For teens, female/White and male/White users
were less likely to engage in MVPA. For both adults and seniors,
female/White and male/White users were more likely to be observed in
MVPA. Conclusion: Observations revealed significant differences in
intensity levels across gender, age, and race groups. Future interventions
should emphasize park design that promotes increased MVPA among
diverse groups.
Kapinos, K. A. and O. Yakusheva (2011). "Environmental Influences on Young
Adult Weight Gain: Evidence From a Natural Experiment." Journal of Adolescent
Health 48(1): 52-58.
Objectives: This study investigated the importance of environmental
influences in explaining weight gain and related behaviors among freshman
college students. Methods: We exploited a natural experiment that takes
place on most college campuses in the United States - randomized
dormitory assignments. We estimated the effects of living in dormitories with
varying physical environment characteristics on weight gain and related
behaviors (daily number of meals and snacks, weekly frequency of
exercise) among randomly assigned freshman students. Results: We found
strong evidence linking weight and related behaviors to individual
dormitories, as well as to specific characteristics of the dormitories. On
average, students assigned to dormitories with on-site dining halls gained
more weight and exhibited more behaviors consistent with weight gain
during the freshman year as compared with students not assigned to such
dormitories. Females in such dormitories weighed .85 kg (p = .03) more and
exercised 1.43 (p <.01) times fewer; males consumed .22 (p = .02) more
meals and .38 (p = .01) more snacks. For female students, closer proximity
of the dormitory to a campus gym led to more frequent exercise (. 54, p =
.03), whereas living closer to central campus reduced exercise (-.97, p =
.01). Conclusions: Using a natural experiment to deal with the potential
endogeneity of the living environment, this study found that the physical
environment affects both students' weight changes and weight-related
behaviors. (C) 2011 Society for Adolescent Health and Medicine. All rights
reserved.
Keegan, T. H., S. Hurley, et al. (2011). "The association between neighborhood
characteristics and body size and physical activity in the California teachers study
cohort." Am J Public Health 102(4): 689-97.
OBJECTIVES: We considered interactions between physical activity and
body mass index (BMI) and neighborhood factors. METHODS: We used
recursive partitioning to identify predictors of low recreational physical
activity (< 2.5 hours/week) and overweight and obesity (BMI >/= 25.0
kg/m(2)) among 118,315 women in the California Teachers Study.
Neighborhood characteristics were based on 2000 US Census data and
Reference US business listings. RESULTS: Low physical activity and being
overweight or obese were associated with individual sociodemographic
characteristics, including race/ethnicity and age. Among White women aged
36 to 75 years, living in neighborhoods with more household crowding was
associated with a higher probability of low physical activity (54% vs 45% to
51%). In less crowded neighborhoods where more people worked outside
the home, the existence of fewer neighborhood amenities was associated
with a higher probability of low physical activity (51% vs 46%). Among nonAfrican American middle-aged women, living in neighborhoods with a lower
socioeconomic status was associated with a higher probability of being
overweight or obese (46% to 59% vs 38% in high-socioeconomic status
neighborhoods). CONCLUSIONS: Associations between physical activity,
overweight and obesity, and the built environment varied by
sociodemographic characteristics in this educated population.
King, A. C., J. F. Sallis, et al. (2011). "Aging in neighborhoods differing in
walkability and income: Associations with physical activity and obesity in older
adults." Social Science & Medicine 73(10): 1525-1533.
While there is a growing literature on the relations between neighborhood
design and health factors such as physical activity and obesity, less focus
has been placed on older adults, who may be particularly vulnerable to
environmental influences. This study evaluates the relations among
objectively measured neighborhood design, mobility impairment, and
physical activity and body weight in two U.S. regional samples of community
dwelling older adults living in neighborhoods differing in walkability and
income levels. An observational design involving two time points six months
apart was employed between 2005 and 2008. U.S. Census block groups in
Seattle-King County, Washington and Baltimore, Maryland-Washington DC
regions were selected via geographic information systems to maximize
variability in walkability and income. Participants were 719 adults ages 66
years and older who were able to complete surveys in English and walk at
least 10 feet continuously. Measurements included reported walking or
bicycling for errands (i.e., transport activity) and other outdoor aerobic
activities measured via the CHAMPS questionnaire: accelerometry-based
moderate-to-vigorous physical activity; reported body mass index; and
reported lower extremity mobility impairment measured via the Late-Life
Function and Disability Instrument. Across regions, time, and neighborhood
income, older adults living in more walkable neighborhoods had more
transport activity and moderate-to- vigorous physical activity and lower body
mass index relative to those living in less walkable neighborhoods. The
most mobility-impaired adults living in more walkable neighborhoods
reported transport activity levels that were similar to less mobility-impaired
adults living in less walkable neighborhoods. The results add to the small
literature aimed at understanding how neighborhood design may influence
physical activity and related aspects of health linked with day-to-day
function and independence as people age. (C) 2011 Elsevier Ltd. All rights
reserved.
Lachapelle, U., L. Frank, et al. (2011). "Commuting by Public Transit and Physical
Activity: Where You Live, Where You Work, and How You Get There." Journal of
Physical Activity & Health 8: S72-S82.
Background: Most public transit users walk to and from transit. We analyzed
the relationship between transit commuting and objectively measured
physical activity. Methods: Adults aged 20 to 65 working outside the home
(n = 1237) were randomly selected from neighborhoods in Seattle and
Baltimore regions. Neighborhoods had high or low median income and high
or low mean walkability. Mean daily minutes of accelerometer-measured
moderate-intensity physical activity (MPA) were regressed on frequency of
commuting by transit and neighborhood walkability, adjusting for
demographic factors and enjoyment of physical activity. Interaction terms
and stratification were used to assess moderating effect of walkability on the
relation between transit commuting and MPA. Associations between transit
commuting and self-reported days walked to destinations near home and
work were assessed using Chi Square tests. Results: Regardless of
neighborhood walkability, those commuting by transit accumulated more
MPA (approximately 5 to 10 minutes) and walked more to services and
destinations near home and near the workplace than transit nonusers.
Enjoyment of physical activity was not associated with more transit
commute, nor did it confound the relationships between MPA and
commuting. Conclusion: Investments in infrastructure and service to
promote commuting by transit could contribute to increased physical activity
and improved health.
Lee, R. E., S. K. Mama, et al. (2011). "Neighborhood and PA: Neighborhood
Factors and Physical Activity in African American Public Housing Residents."
Journal of Physical Activity & Health 8: S83-S90.
Background: In the US, public housing developments are typically located in
lower socioeconomic status neighborhoods that may have poorer quality
street level conditions, placing residents in neighborhoods that are less
supportive for physical activity (PA). This study investigated the relationship
of detailed, objectively assessed street-level pedestrian features with selfreported and measured PA in African American public housing residents.
Methods: Every street segment (N = 2093) within an 800 m radius
surrounding each housing development (N = 12) was systematically
assessed using the Pedestrian Environment Data Scan (PEDS).
Participants completed an interviewer administered International Physical
Activity Questionnaire (IPAQ) Short Form and wore a pedometer for 1 week.
Results: Women reported significantly less vigorous (mean = 1955 vs. 2896
METs), moderate (mean = 733 vs. 1309 mets), walking (mean = 1080 vs.
1376 METs), and total (mean = 3768 vs. 5581 METs) PA on the IPAQ
compared with men (all P < .05). Women took fewer pedometer steps per
day (M = 3753 vs. 4589) compared with men, but this was not statistically
significant. Regression analyses showed that for women, lower speed limits
were associated with vigorous; higher street segment density was
associated with more moderate PA; lower speed limits, fewer crossing aids,
and more lanes were associated with more walking; and, fewer lanes was
associated with more overall PA. For men, fewer sidewalk connections were
associated with more moderate PA; lower speed limits were associated with
more walking; and, lower speed limits was associated with more overall PA.
Conclusions: Neighborhood factors influence physical activity; in particular,
lower speed limits appear most commonly linked with increased physical
activity in both men and women.
Liao, Y., K. Harada, et al. (2011). "Perceived Environmental Factors Associated
with Physical Activity among Normal-Weight and Overweight Japanese Men."
International Journal of Environmental Research and Public Health 8(4): 931-943.
Although it is crucial to examine the environmental correlates of physical
activity (PA) for developing more effective interventions for overweight
populations, limited studies have investigated differences in the
environmental correlates on body mass index (BMI). The purpose of the
present study was to examine the perceived environmental correlates of PA
among normal-weight and overweight Japanese men. Data were analyzed
for 1,420 men (aged 44.4 +/- 8.3 years), who responded to an internetbased cross-sectional survey of answering the short version of the
International Physical Activity Questionnaire and its Environment Module.
Binary logistic regression analyses were utilized to examine the
environmental factors associated with meeting the PA recommendation
(150 minutes/week) between the normal-weight and overweight men. After
adjusting for socio-demographic variables, common and different
environmental correlates of PA were observed among normal-weight and
overweight men. Furthermore, significant interactions regarding PA were
observed between BMI status and two environmental correlates: access to
public transportation (P = 0.03) and crime safety during the day (P = 0.01).
The results indicated that BMI status is a potential moderator between
perceived environmental factors and PA and suggested that different
environmental intervention approaches should be developed for overweight
populations.
Macdonald, L., A. Ellaway, et al. (2011). "Is proximity to a food retail store
associated with diet and BMI in Glasgow, Scotland?" Bmc Public Health 11.
Background: Access to healthy food is often seen as a potentially important
contributor to diet. Policy documents in many countries suggest that
variations in access contribute to inequalities in diet and in health. Some
studies, mostly in the USA, have found that proximity to food stores is
associated with dietary patterns, body weight and socio-economic
differences in diet and obesity, whilst others have found no such
relationships. We aim to investigate whether proximity to food retail stores is
associated with dietary patterns or Body Mass Index in Glasgow, a large city
in the UK. Methods: We mapped data from a 'Health and Well-Being
Survey' (n = 991), and a list of food stores (n = 741) in Glasgow City, using
ArcGIS, and undertook network analysis to find the distance from
respondents' home addresses to the nearest fruit and vegetable store, small
general store, and supermarket. Results: We found few statistically
significant associations between proximity to food retail outlets and diet or
obesity, for unadjusted or adjusted models, or when stratifying by gender,
car ownership or employment. Conclusions: The findings suggest that in
urban settings in the UK the distribution of retail food stores may not be a
major influence on diet and weight, possibly because most urban residents
have reasonable access to food stores.
McAlexander, K. M., S. K. Mama, et al. (2011). "The concordance of directly and
indirectly measured built environment attributes and physical activity adoption."
International Journal of Behavioral Nutrition and Physical Activity 8.
Background: Physical activity (PA) adoption is essential for obesity
prevention and control, yet ethnic minority women report lower levels of PA
and are at higher risk for obesity and its comorbidities compared to
Caucasians. Epidemiological studies and ecologic models of health
behavior suggest that built environmental factors are associated with health
behaviors like PA, but few studies have examined the association between
built environment attribute concordance and PA, and no known studies have
examined attribute concordance and PA adoption. Purpose: The purpose of
this study was to associate the degree of concordance between directly and
indirectly measured built environment attributes with changes in PA over
time among African American and Hispanic Latina women participating in a
PA intervention. Method: Women (N = 410) completed measures of PA at
Time 1 (T1) and Time 2 (T2); environmental data collected at T1 were used
to compute concordance between directly and indirectly measured built
environment attributes. The association between changes in PA and the
degree of concordance between each directly and indirectly measured
environmental attribute was assessed using repeated measures analyses.
Results: There were no significant associations between built environment
attribute concordance values and change in self-reported or objectively
measured PA. Self-reported PA significantly increased over time (F(1,184) =
7.82, p = .006), but this increase did not vary by ethnicity or any built
environment attribute concordance variable. Conclusions: Built environment
attribute concordance may not be associated with PA changes over time
among minority women. In an effort to promote PA, investigators should
clarify specific built environment attributes that are important for PA
adoption and whether accurate perceptions of these attributes are
necessary, particularly among the vulnerable population of minority women.
Metaxatos, P. (2011). "Built Environment, Individual Attributes, and Variability of
Body Mass Index of Drivers in the Chicago, Illinois, Metropolitan Area Empirical
Analysis." Transportation Research Record(2231): 93-101.
The body mass index (BMI) and the propensity of being overweight or
obese among drivers in the Chicago, Illinois, metropolitan area are affected
by factors related to the built environment. A multilevel analysis
distinguished the contributions of individual attributes and areal
environmental factors. The empirical analysis provided evidence that BMI
variability and the propensity of being overweight or obese could mostly be
attributed to the educational and ethnicity profiles of residential areas.
Drivers living closer to the city were also likely to have slightly lower BMI
values than their counterparts who lived in areas far from the city. Finally,
the effects of drivers' gender and age are significant and provide additional
insights.
Michael, Y. L., R. Gold, et al. (2011). "Built environment and lower extremity
physical performance: prospective findings from the study of osteoporotic fractures
in women." J Aging Health 23(8): 1246-62.
OBJECTIVE: We examined the association between walkability of the built
environment and changes in physical performance among women aged 65
or older (n = 1,671, 253 neighborhoods). METHOD: Street connectivity and
street density, markers for neighborhood walkability, were assessed through
linkage to secondary data sources. Physical performance was measured
with timed-walk and chair-stand tests assessed during follow-up visits about
every 2 years for 12 to 14 years. Multilevel models predicted change in
physical performance, controlling for age, number of incident comorbidities,
self-rated health, and death during follow-up. RESULTS: Overall, physical
performance declined during follow-up (p < .001). Neighborhood walkability
had no effect on change in physical performance among women who
reported not walking at baseline. However, among women who walked,
greater neighborhood walkability was associated with a slower decline in
dynamic leg strength, indicated by score on chair stand. DISCUSSION:
Neighborhood walkability may protect against decline in physical
performance.
Montemurro, G. R., T. R. Berry, et al. (2011). ""Walkable by Willpower": resident
perceptions of neighbourhood environments." Health Place 17(4): 895-901.
Resident perceptions of neighbourhood walkability, physical activity
opportunities, food choice and factors influencing choice of neighbourhood
were examined through focus group discussion in higher and lower
walkability neighbourhoods. Almost all participants perceived their
neighbourhoods as very or reasonably walkable with high food choice.
Walking was described as primarily leisure or exercise focused and less
frequently as destination or task-oriented. Factors influencing walking and
physical activity included connectivity, path quality, weather and traffic. The
ability to drive easily was a key factor in neighbourhood choice. Our findings
identified important environmental factors perceived by residents as either
positively or negatively influencing behaviour related to physical activity and
food choice. Future research should examine the relationship between
perceived and actual walkability features as well as residential selection.
Mumford, K. G., C. K. Contant, et al. (2011). "Changes in Physical Activity and
Travel Behaviors in Residents of a Mixed-Use Development." American Journal of
Preventive Medicine 41(5): 504-507.
Background: Mixed-use developments may be especially promising settings
for encouraging walking and other types of physical activity. Purpose: This
study examined the physical activity and travel behaviors of individuals
before and after they relocated to Atlantic Station, a mixed-use
redevelopment community in metropolitan Atlanta. Methods: A survey study
was conducted to compare the behaviors, experiences, and attitudes of
Atlantic Station residents before and after moving to a mixed-use
neighborhood. Data were collected in 2008 and 2009 and analyzed in 2010.
Key dependent variables were self-reported physical activity and travel
behaviors including walking for recreation and transport, automobile use,
and use of public transportation. Results: Study participants included 101
adult residents of Atlantic Station, most of whom were female, young, and
well educated. There were significant increases in walking for recreation or
fitness (46%-54%; p<0.05) and walking for transportation (44%-84%;
p<0.001) after moving into the mixed-use development. Respondents also
reported reduced automobile travel and increased time spent using public
transportation after moving to Atlantic Station. Because this study used
individuals as their own controls, there is more control over confounding
lifestyle variables compared to cross-sectional studies of individuals living in
different neighborhoods. Conclusions: Adults who move to a denser, mixeduse neighborhood increase their levels of walking for both recreation and
transportation, decrease their automobile travel, and increase their use of
public transportation. (Am J Prev Med 2011; 41(5):504-507) (C) 2011
American Journal of Preventive Medicine
Oliver, L., N. Schuurman, et al. (2011). "Assessing the influence of the built
environment on physical activity for utility and recreation in suburban metro
Vancouver." Bmc Public Health 11.
Background: Physical inactivity and associated co-morbidities such as
obesity and cardiovascular disease are estimated to have large societal
costs. There is increasing interest in examining the role of the built
environment in shaping patterns of physical activity. However, few studies
have: (1) simultaneously examined physical activity for leisure and utility; (2)
selected study areas with a range of built environment characteristics; and
(3) assessed the built environment using high-resolution land use data.
Methods: Data on individuals used for this study are from a survey of 1602
adults in selected sites across suburban Metro Vancouver. Four types of
physical activity were assessed: walking to work/school, walking for errands,
walking for leisure and moderate physical activity for exercise. The built
environment was assessed by constructing one-kilometre road network
buffers around each respondent's postal code. Measures of the built
environment include terciles of recreational and park land, residential land,
institutional land, commercial land and land use mix. Results: Logistic
regression analyses showed that walking to work/school and moderate
physical activity were not associated with any built environment measure.
Living in areas with lower land use mix, lower commercial and lower
recreational land increased the odds of low levels of walking for errands.
Individuals living in the lower third of land use mix and institutional land were
more likely to report low levels of walking for leisure. Conclusions: These
results suggest that walking for errands and leisure have a greater
association with the built environment than other dimensions of physical
activity.
Oyeyemi, A. L., B. O. A. Adegoke, et al. (2011). "Perceived environmental
correlates of physical activity and walking in African young adults." American
journal of health promotion : AJHP 25(5): e10-9.
UNLABELLED: Purpose: Evidence on environmental correlates of physical
activity (PA) conducted in Western developed countries may not be
generalizable to Africa. This study examined the associations between
perception of the neighborhood environment and PA and walking in African
young adults. DESIGN: Cross-sectional analysis of self-reported survey.
SETTING: University of Ibadan, in the capital city of Oyo State, Nigeria.
SUBJECTS: A representative sample of undergraduates of a Nigerian
university, age 16 to 39 years and 50.7% female. MEASURES: Total
walking activity and PA were measured with the short version of the
International Physical Activity Questionnaire. Sixteen perceived
neighborhood environmental variables were measured using the Physical
Activity Neighborhood Environment Scale (PANES), which was used to
assess environmental correlates of PA that are internationally relevant.
Outcomes were meeting health-related guidelines for sufficient PA and
walking activity. RESULTS: After adjustments for demographics and
dormitory site, the proximity of bus/transit stop (odds ratio [OR]=1.41), traffic
as not a problem (OR=.45; unexpected direction), and not many four-way
intersections (OR=.72; unexpected direction) were significantly associated
with sufficient PA. Low crime rate at night (OR=1.53), many interesting
things to look at (OR=1.90), and seeing many people active (OR=.59;
unexpected direction) were significantly associated with sufficient walking.
Inconsistent patterns were also observed in gender-specific analyses.
CONCLUSION: Few neighborhood environment correlates of PA or walking
reported in the international literature were replicated with African young
adults. Environmental measures need to be developed that are tailored to
low- and middle-income countries, such as those in Africa, so that research
in understudied regions can advance.
Panter, J. R., A. P. Jones, et al. (2011). "Environmental and psychological
correlates of older adult's active commuting." Med Sci Sports Exerc 43(7): 123543.
PURPOSE: This study explored the environmental and psychological
correlates of active commuting in a sample of adults from the European
Prospective Investigation into Cancer Norfolk cohort. METHODS: Members
of the cohort who were in employment, lived within 10 km of work, and did
not report a limitation that precluded walking were included in this analysis.
Psychological factors, perceptions of the neighborhood environment and
travel mode to work were reported using questionnaires. Neighborhood and
route environmental characteristics were estimated objectively using a
geographical information system. The mediating effects of psychological
factors were assessed using a series of regression models. RESULTS: A
total of 1279 adults (mean age=60.4 yr, SD=5.4 yr) were included in this
analysis, of whom 25% actively commuted to work. In multivariable
regression analyses, those who reported strong habits for walking or cycling
were more likely to actively commute, whereas those living 4-10 km from
work were less likely to actively commute. In addition, living in a rural area
was associated with a decreased likelihood of men's active commuting, and
in women, living in a neighborhood with high road density and having a
route to work that was not on a main or secondary road was associated with
an increased likelihood of active commuting. There was weak evidence that
habit acted to partly mediate the associations between environmental
correlates and active commuting in both sexes. CONCLUSIONS: The
findings suggest that interventions designed to encourage the development
of habitual behaviors for active commuting may be effective, especially
among those living close to work.
Parra, D. C., C. M. Hoehner, et al. (2011). "Perceived environmental correlates of
physical activity for leisure and transportation in Curitiba, Brazil." Preventive
Medicine 52(3-4): 234-238.
Background. Physical activity (PA) has consistently been associated with
perceived environmental characteristics. Objective. To examine the
association between perceived environmental attributes and various forms
of PA in Curitiba, Brazil. Methods. A cross-sectional phone survey of adults
was conducted in 2008 (n = 2097). The questionnaire included
environmental perceptions and PA. Principal components analysis was
used to identify groups of perceived environmental attributes. Multivariate
methods tested the associations of PA with perceived environment
characteristics. Results. Perceptions of moderate and high personal safety
were positively associated with walking for transportation (53.0%, 53.1% vs.
47.3%, both adjusted ORs [aOR] = 1.5). Number of destinations within a 10minute walk (4 and > 6 vs. < 3) was positively associated with bicycling for
transportation (7.8%, 9.9% vs.4.8%, aOR = 2.5). Perception of high
accessibility was positively associated with MVPA during leisure time
(35.1% vs. 19.1, aOR = 1.7) and meeting recommendations for total PA
(58.7% vs. 45.1%, aOR = 1.4). Perception of high quality of the pedestrian
space (57.3% vs. 46.5%, aOR = 1.4) and moderate levels of personal safety
(54.3% vs. 47.6%, aOR = 1.3) were also positively associated with meeting
recommendations for total PA. Conclusions. Different environmental
attributes were associated with different PA outcomes, suggesting that
these relationships are complex and may differ from those in high-income
countries. (C) 2010 Elsevier Inc. All rights reserved.
Reed, J. A., S. P. Hooker, et al. (2011). "User Demographics and Physical Activity
Behaviors on a Newly Constructed Urban Rail/Trail Conversion." Journal of
Physical Activity & Health 8(4): 534-542.
Background: To examine demographic characteristics and physical activity
(PA) behaviors of trail users on a newly constructed 2-mile urban rail/trail
(ie, abandoned rail line converted to a recreational trail). Methods: A
systematic evaluation process was initiated to monitor PA behaviors using
the System for Observing Play and Recreation in Communities (SOPARC).
Results: Slightly more males (n = 2578, 54%) than females (n = 2198, 46%)
were observed using the rail/trail since its inception. A significant age group
difference (F = 16.68, P < .001) was observed among users with the vast
majority being adults (n = 3317, 69%). Women were 2.2 times more likely
than men (95% CI 1.7-3.0) to be sedentary rather than vigorously active
adjusted for age and race. Whites were 2.8 times more likely than
nonwhites (95% CI 2.4-3.2) to engage in vigorous activity rather than
walking, adjusted for age and gender. Rail/trail users resided on average
2.89 miles from the trail. Discussion: The most frequent users of the rail/trail
were male, white adults, and observed PA varied for gender and age. More
research is needed to better understand differences in patterns of trail use
by various population groups.
Sallis, J. F., D. J. Slymen, et al. (2011). "Income disparities in perceived
neighborhood built and social environment attributes." Health Place 17(6): 127483.
The present study explored whether perceived neighborhood environmental
attributes associated with physical activity differ by neighborhood income.
Adults aged 20-65 years (n=2199; 48% female; mean age=45 years; 26%
ethnic minority) were recruited from 32 neighborhoods from the Seattle, WA
and Baltimore, MD regions that varied in objectively measured walkability
and neighborhood income. Perceived built and social environment variables
were assessed with the Neighborhood Environment Walkability Scale.
There were neighborhood income disparities on 10 of 15 variables.
Residents from high-income neighborhoods reported more favorable
esthetics, pedestrian/biking facilities, safety from traffic, safety from crime,
and access to recreation facilities than residents of low-income areas (all p's
<0.001). Low-income neighborhoods may lack amenities and safety
attributes that can facilitate high levels of physical activity for both
transportation and recreation purposes.
Sawchuk, C. N., J. E. Russo, et al. (2011). "Barriers and Facilitators to Walking
and Physical Activity Among American Indian Elders." Preventing Chronic Disease
8(3).
Introduction Physical inactivity is common among older American Indians.
Several barriers impede the establishment and maintenance of routine
exercise. We examined personal and built-environment barriers and
facilitators to walking and physical activity and their relationship with healthrelated quality of life in American Indian elders. Methods We used
descriptive statistics to report barriers and facilitators to walking and
physical activity among a sample of 75 American Indians aged 50 to 74
years. Pearson correlation coefficients were used to examine the
relationship between health-related quality of life and barriers to walking and
physical activity after adjusting for caloric expenditure and total frequency of
all exercise activities. Results Lack of willpower was the most commonly
reported barrier. Elders were more likely to report personal as opposed to
built-environment reasons for physical inactivity. Better health and being
closer to interesting places were common walking facilitators. Health-related
quality of life was inversely related to physical activity barriers, and poor
mental health quality of life was more strongly associated with total barriers
than poor physical health. Conclusion We identified a variety of barriers and
facilitators that may influence walking and physical activity among American
Indian elders. More research is needed to determine if interventions to
reduce barriers and promote facilitators can lead to objective, functional
health outcomes.
Shin, W.-H., B.-S. Kweon, et al. (2011). "The distance effects of environmental
variables on older African American women's physical activity in Texas."
Landscape and Urban Planning 103(2): 217-229.
Older African American women are one of the most inactive segments of
the population in Texas. Because older adults are strongly impacted by their
environmental settings, the environmental attributes that affect the level of
physical activity among older African American women need to be
investigated. This cross-sectional study empirically investigates the
objective environmental variables that might encourage or discourage
physical activity among older African American women. The study sample
was composed of African American women aged 55-84 and residing in
independent housing in Bryan, Texas (N = 80). Two environmental
boundaries were defined in the investigation of the influences of natural and
built environments: (1) nearby environment: half-mile street distance from
the participant's house: and (2) neighborhood environment: 1 mile street
distance from the participant's house. The findings revealed that at the
nearby level, greenery density was positively associated with older African
American women's physical activity, and intersection density influenced
their physical activity at the neighborhood level. These results are expected
to be useful to landscape architects, urban designers, and policy makers
who seek to build healthy, safe, and active environments for older African
American women. (C) 2011 Elsevier B.V. All rights reserved.
Sigmundova, D., W. El Ansari, et al. (2011). "Neighbourhood Environment
Correlates of Physical Activity: A Study of Eight Czech Regional Towns."
International Journal of Environmental Research and Public Health 8(2): 341-357.
An adequate amount of physical activity (PA) is a key factor that is
associated with good health. This study assessed socio-environmental
factors associated with meeting the health recommendations for PA
(achieving 10,000 steps per day). In total, 1,653 respondents randomly
selected from across eight regional towns (each >90,000 inhabitants) in the
Czech Republic participated in the study. The ANEWS questionnaire
assessed the environment in neighbourhoods, and participants` weekly PA
was objectively monitored (Yamax Digiwalker SW-700 pedometer). About
24% of participants were sufficiently active, 27% were highly active; 28%
participants were overweight and 5% were obese. Although BMI was
significantly inversely associated with the daily step counts achieved only in
females, for both genders, BMI was generally not significantly associated
with the criterion of achieving 10,000 steps per day during the week.
Increased BMI in both genders was accompanied with a decline in
participation in organized PA and with increasing age. As regards to the
demographic/lifestyle factors, for females, more participation in organized
PA was significantly positively correlated with the achieved daily step
counts. In contrast, older age and higher BMI (for females) and smoking (for
males) were significantly negatively correlated with the achieved daily step
counts. In terms of the environmental aspects, pleasant environments were
significantly positively correlated to daily step counts for both genders.
Additionally, for males, better residencies (more family homes rather than
apartment blocks) in the neighbourhood were significantly positively
correlated with their daily step counts. For females, less accessibility of
shops and non-sport facilities (depending on walking distance in minutes)
were significantly negatively correlated to the achieved daily step counts.
Individuals who lived in pleasant neighbourhoods, with better access to
shops and who participated in organized PA (>= 2 times a week) tended to
meet the recommendations for health-enhancing PA levels. The creation of
physical activity-friendly environments could be associated with enhancing
people's achieved daily step counts and meeting the health criteria for PA.
Sundquist, K., U. Eriksson, et al. (2011). "Neighborhood walkability, physical
activity, and walking behavior: The Swedish Neighborhood and Physical Activity
(SNAP) study." Social Science & Medicine 72(8): 1266-1273.
More knowledge concerning the association between physical activity and
objectively measured attributes of the built environment is needed. Previous
studies on the association between objectively measured neighborhood
walkability, physical activity, and walking have been conducted in the U.S.
or Australia and research findings are available from only one country in
Europe - Belgium. The first aim of this Swedish study of 2269 adults was to
examine the associations between neighborhood walkability and walking for
active transportation or leisure, and moderate-to-vigorous physical activity
(MVPA) and whether these hypothesized associations are moderated by
age, gender, income, marital status and neighborhood-level socioeconomic
status. The second aim was to determine how much of the total variance of
the walking and physical activity outcomes can be attributed to
neighborhood-level differences. Neighborhood walkability was objectively
measured by GIS methods. An index consisting of residential density, street
connectivity, and land use mix was constructed to define 32 highly and less
walkable neighborhoods in Stockholm City. MVPA was measured
objectively during 7 days with an accelerometer and walking was assessed
using the validated International Physical Activity Questionnaire (IPAQ).
Multilevel linear as well as logistic models (mixed-effects, mixed-distribution
models) were used in the analysis. The statistically significant and
"adjusted" results for individuals living in highly walkable neighborhoods, as
compared to those living in less walkable neighborhoods, were: (1) 77% and
28% higher odds for walking for active transportation and walking for
leisure, respectively, (2) 50 min more walking for active transportation/week,
and (3) 3.1 min more MVPA/day. The proportion of the total variance at the
neighborhood level was low and ranged between 0.0% and 2.1% in the
adjusted models. The findings of the present study stress that future policies
concerning the built environment must be based on context-specific
evidence, particularly in the light of the fact that neighborhood
redevelopments are time-consuming and expensive. (C) 2011 Elsevier Ltd.
All rights reserved.
Temple, V., R. Rhodes, et al. (2011). "Unleashing Physical Activity: An
Observational Study of Park Use, Dog Walking, and Physical Activity." Journal of
Physical Activity & Health 8(6): 766-774.
Background: Walking has been identified as a low resourced yet effective
means of achieving physical activity levels required for optimal health. From
studies conducted around the world, we know that dog owners walk more
than nondog owners. However, this evidence is largely self-reported which
may not accurately reflect dog-owners' behaviors. Method: To address this
concern, we systematically observed the use of 6 different public parks in
Victoria, British Columbia during fair and inclement weather. Using a
modified version of the SOPARC tool, we documented visitors' types of
physical activity, and the presence or absence of dogs. The Physical Activity
Resource Assessment was used to consider park features, amenities, and
incivilities. Results: More people without dogs (73%) visited the parks than
those with dogs (27%), largely because of attendance at the multiuse sport
parks during the summer months. Despite the opportunities to engage in
multiple sports, most people used the parks to walk. However, when
inclement weather struck, dog owners continued visiting parks and
sustained their walking practices significantly more than nondog owners.
Conclusion: Our observational snapshot of park use supports earlier work
that dogs serve as a motivational support for their owners' walking practices
through fair and foul weather.
Toftager, M., O. Ekholm, et al. (2011). "Distance to Green Space and Physical
Activity: A Danish National Representative Survey." Journal of Physical Activity &
Health 8(6): 741-749.
Background: This study examines the relationship between distance to
green space and the level of physical activity among the population of
Denmark. In addition, the relationship between distance to green space and
obesity is investigated. Methods: Data derived from the Danish National
Health Interview Survey 2005, a cross-sectional survey based on a regionstratified random nationally representative sample of 21,832 Danish adults.
All data are self-reported. Results: Respondents living more than 1 km from
green space had lower odds of using green space to exercise and keep in
shape compared with persons living closer than 300 m to green space (OR:
0.71; 95% CI: 0.60-0.83). A relationship between moderate/vigorous
physical activity during leisure time and distance to green space can also be
found. Persons living more than 1 km from green space had higher odds of
being obese (BMI >= 30) than those living less than 300 m from green
space (OR: 1.36; 95% Cl: 1.08-1.71). Conclusions: Self-reported distance to
green space is related to self-reported physical activity and obesity. To
exercise and keep in shape is an important reason for visiting green space,
and distance to green space is associated with moderate/vigorous physical
activity in leisure time.
Troped, P. J., K. Tamura, et al. (2011). "Perceived Built Environment and Physical
Activity in US Women by Sprawl and Region." American Journal of Preventive
Medicine 41(5): 473-479.
Background: A number of studies have demonstrated relationships between
the perceived built environment and physical activity among adults.
However, little is known about whether these associations differ by U. S.
region and level of urban sprawl. Purpose: To examine associations
between the perceived built environment and physical activity in U. S.
women by region and urban sprawl. Methods: Nurses' Health Study II
participants (N = 68,968) completed four perceived neighborhood
environment survey items in 2005. Logistic regression was used to estimate
associations with meeting physical activity recommendations, adjusting for
demographic and weight-status variables, and stratifying by region and
sprawl. Data analyses were completed in 2011. Results: Perceived
proximity to shops/stores was positively associated with physical activity
across regions and levels of sprawl (ORs = 1.21-1.46). Perceived access to
recreation facilities was also a positive physical activity correlate in most
region-sprawl strata, with strongest relationships found in the West (ORs =
1.31-1.70). Perceived crime and presence of sidewalks did not show
statistically significant associations with physical activity in most regionsprawl strata, although ORs for perceived crime showed a consistent
pattern of negative associations (ORs = 0.60-0.95). A higher number of
positive environmental attributes was associated with a greater odds of
meeting physical activity recommendations. Conclusions: Findings indicate
that perceived proximity to shops/stores and access to recreation facilities
are important correlates of physical activity for women, irrespective of region
or sprawl. (Am J Prev Med 2011;41(5):473-479) (C) 2011 American Journal
of Preventive Medicine
Van Dyck, D., G. Cardon, et al. (2011). "Do adults like living in high-walkable
neighborhoods? Associations of walkability parameters with neighborhood
satisfaction and possible mediators." Health Place 17(4): 971-7.
The aims were to examine the associations between objective walkability
characteristics and neighborhood satisfaction in adults, and the possible
mediating effects of environmental perceptions and physical activity on
these associations. In total, 1391 adults completed a questionnaire on
neighborhood satisfaction, physical activity, socio-demographics and
environmental perceptions. Walkability characteristics were measured
objectively using Geographic Information System databases. Overall
walkability and residential density were negatively related to neighborhood
satisfaction, while connectivity and land use mix showed no significant
associations. In total, 56.6% and 39.4%, respectively, of the negative
associations of walkability and density with neighborhood satisfaction were
mediated by perceptions of more esthetic-related problems, pollution, crime
and less overall safety in highly walkable/dense neighborhoods. Moderateto-vigorous physical activity was not a significant mediator. Urban planners
should not be discouraged to build high-walkable environments, but next to
objective walkability, environmental perceptions should also be considered
to achieve neighborhood satisfaction.
Van Dyck, D., G. Cardon, et al. (2011). "Environmental and Psychosocial
Correlates of Accelerometer-Assessed and Self-Reported Physical Activity in
Belgian Adults." International Journal of Behavioral Medicine 18(3): 235-245.
Background Despite the well-known benefits of physical activity (PA) on
overall health, the majority of the adult population does not engage in
sufficient PA. To develop effective interventions to increase PA, it is
necessary to understand the most important PA correlates and to
investigate whether correlates are similar in different population subgroups.
Purpose This study examined associations between physical environmental
perceptions and self-reported and objectively assessed PA in Belgian
adults. Moreover, associations between psychosocial factors and PA, and
the moderating effects of sociodemographic factors were investigated.
Method A sample of 1,200 Belgian adults (20-65 years; 47.9% males)
completed a survey measuring sociodemographic variables and
psychosocial correlates, the Neighborhood Environmental Walkability Scale
and the long-version International Physical Activity Questionnaire. They
wore an accelerometer for 7 days. Results Perceiving neighborhoods to be
high walkable (high residential density, high land use mix access, and high
land use mix diversity) and recreation facilities to be convenient, and the
availability of home PA equipment were the most consistent physical
environmental correlates of PA. The strongest psychosocial correlates were
social support from friends and family and self-efficacy. The psychosocial
associations were most consistent for self-reported leisure-time PA and less
clear for self-reported active transportation and accelerometer-assessed
PA. Few significant sociodemographic moderators were found. Conclusion
Both physical environmental and psychosocial factors were associated with
PA in adults, with psychosocial factors being important especially for
leisure-time PA. Correlates of PA were similar regardless of gender, age, or
socio-economic status, so interventions to change these factors could have
population-wide effects.
Van Dyck, D., G. Cardon, et al. (2011). "Relationships between neighborhood
walkability and adults' physical activity: How important is residential self-selection?"
Health & Place 17(4): 1011-1014.
The study's aims were to examine whether residential self-selection differed
according to socio-demographic characteristics and objectively assessed
neighborhood walkability; and, whether objectively assessed walkability was
a significant correlate of physical activity (PA) beyond residential selfselection. In total, 412 adults (aged 20-65 years) completed a sociodemographic questionnaire, the long IPAQ a neighborhood selection
questionnaire and wore an accelerometer for seven days. Walkability
characteristics were an important reason for selecting the current
neighborhood and were more important for women, older and less-educated
adults, but not for high-walkable neighborhood residents. Both in the total
sample and in participants with high residential self-selection scores,
walkability was positively related to active transportation and objectively
measured moderate-to-vigorous PA. Designing walkable neighborhoods
may help to increase adults' PA, even in those for whom walkability is an
important criterion when choosing their neighborhood. However, findings
from studies with longitudinal and controlled designs are required to provide
more strongly causal evidence. (C) 2011 Elsevier Ltd. All rights reserved.
Wen, M. and T. N. Maloney (2011). "Latino Residential Isolation and the Risk of
Obesity in Utah: The Role of Neighborhood Socioeconomic, Built-Environmental,
and Subcultural Context." Journal of Immigrant and Minority Health 13(6): 11341141.
The prevalence rate of obesity in the United States has been persistently
high in recent decades, and disparities in obesity risks are routinely
observed. Both individual and contextual factors should be considered when
addressing health disparities. This study examines how Latino-white spatial
segregation is associated with the risk of obesity for Latinos and whites,
whether neighborhood socioeconomic resources, the built environment, and
subcultural orientation serve as the underlying mechanisms, and whether
neighborhood context helps explain obesity disparities across ethnic and
immigrant groups. The study was based on an extensive database
containing self-reported BMI measures obtained from driver license records
in Utah merged with census data and several GIS-based data. Multilevel
analyses were performed to examine the research questions. For both men
and women, Latino residential isolation is significantly and positively linked
to the risk of obesity; after controlling for immigrant concentration, this effect
gets amplified. Moreover, for men and women, the segregation effect is
partly attributable to neighborhood SES and the built environment; and only
for women is it partly attributable to obesity prevalence in the neighborhood.
Place matters for individual risk of obesity for both men and women and
there are multifarious pathways linking residence to obesity. Among the
demographic, socioeconomic, physical, and cultural aspects of
neighborhood context examined in this study, perhaps the most modifiable
environment features that could prevent weight gain and its associated
problems would be the built environmental factors such as greenness, park
access, and mixed land use.
Zhang, Y., L. Chen, et al. (2011). "Relationship between physical activity and
environment in Shanghai, China: analysis and evaluation in adults aged 45-80."
Medicina Dello Sport 64(3): 269-284.
Aim. The aim of the study was to investigate the associations between
physical activity level, social demographic characteristics and environment
in Chinese middle-aged and older adults, and to evaluate the physical
activity-related environment of urban areas. Methods. Sociodemographics
and perceived environment were assessed by questionnaires distributed to
1100 participants, aged 45-80 years, of 13 selected communities belonging
to three districts from urban centers, subcivic centers and suburbs of
Shanghai between April-October 2009. Physical activity was measured by a
pedometer. The analysis of relationship between physical activity and
environment and the evaluation of communities and districts of Shanghai
were conducted with the method of gray correlation analysis in JanuaryJune, 2010. Results. Bivariate relationship analysis showed how
employment status, education, "whether walking is the main exercise",
health status have positive and body mass index has negative associations
with physical activity; body-building club, traffic safety, street design, ground
surface, crossing the street and activity environment are the largest six
factors affecting physical activities. The order of comprehensive evaluation
of the three districts is: LuWan, YangPu and MinHang; the order of 13
communities is: N(3) > N(2) > N(4) > N(10) > N(9) > N(11) > N(7) > N(6) >
N(5) > N(8) > N(1) > N(12) > N(13). From above, the urban center
environment is most appropriate for physical activity, subcivil center ranks
the second position and suburbs the last. The urban environment is most
appropriate for physical activity, subcivil center ranks the second position
and suburb the last. The logical result proved the gray correlation analysis is
an effective method to study the relationship between physical activity and
environment. Conclusion. These findings collectively suggest that public
health, city planning and environment protecting need to consider how to
create more livable and pedestrian-friendly community areas, especially in
developing countries, as China.
POLICY
Coffield, J. E., J. M. Metos, et al. (2011). "A Multivariate Analysis of Federally
Mandated School Wellness Policies on Adolescent Obesity." Journal of Adolescent
Health 49(4): 363-370.
Purpose: To evaluate the effects of school wellness policies mandated by
the 2004 Child Nutrition and WIC Reauthorization Act on the prevalence of
overweight and obesity among adolescents. Methods: Multivariate logistic
regressions, adjusted for clustering within school districts, were used to
estimate the effects of district-level wellness policies on the odds of
overweight and obesity among adolescents. The analyses were performed
on a population-based sample obtained from the Utah Population Database,
a compilation of vital characteristic, administrative, and genealogical records
on all residents in Utah. Models controlled for individual, maternal, and
familial characteristics, as well as characteristics of school district of
residence. Self-reported body mass index was taken from drivers license
data. Results: Each additional component included in a district's wellness
policy was associated with as much as: 3.2% lower odds in the prevalence
of adolescent overweight (OR = .968; 95% CI = .941-.997), 2.5% lower odds
of obesity (OR = .975; CI = .952-.997), and 3.4% lower odds of severe
obesity (OR = .966; CI = .938-.995). Wellness policy components related to
diet were significantly associated with lower body mass indexes across all
three thresholds, whereas those related to physical activity had significant
associations for lower odds of severe obesity only. Conclusion: Results
suggest that school wellness policies can significantly reduce the risk of
adolescent obesity. Further research should address specific policy
components that are most effective in various populations, as well as the
level of commitment that is required at both the school-and district-levels for
sustained effect. (C) 2011 Society for Adolescent Health and Medicine. All
rights reserved.
Dill, J. and D. Howe (2011). "The Role of Health and Physical Activity in the
Adoption of Innovative Land Use Policy: Findings From Surveys of Local
Governments." Journal of Physical Activity & Health 8: S116-S124.
Background: Research has established that built environments, including
street networks, bicycle and pedestrian infrastructure, and land uses, can
positively affect the frequency and duration of daily physical activity.
Attention is now being given to policy frameworks such as zoning codes that
set the standards and expectations for this built environment. Methods: We
examined the adoption and implementation of mixed-use and related zoning
provisions with specific attention to the role that physical activity serves as a
motivation for such policies and to what extent public health agencies
influence the adoption process. A sample of planning directors from 53
communities with outstanding examples of mixed-use developments and
145 randomly selected midsized communities were surveyed. Results:
Physical activity is not a dominant motivator in master plans and/or zoning
codes and public health agencies played minor roles in policy adoption.
However, physical activity as a motivation appears to be increasing in
recent years and is associated with higher levels of policy innovation.
Conclusions: Recommendations include framing the importance of physical
activity in terms of other dominant concerns such as livability, dynamic
centers, and economic development. Health agencies are encouraged to
work in coalitions to focus arguments on behalf of physical activity.
Edwards, K. L., G. P. Clarke, et al. (2011). "The neighbourhood matters: studying
exposures relevant to childhood obesity and the policy implications in Leeds, UK
(vol 64, pg 194, 2010)." Journal of Epidemiology and Community Health 65(1): 7777.
Background Reducing childhood obesity is a key UK government target.
Obesogenic environments are one of the major explanations for the rising
prevalence and thus a constructive focus for preventive strategies. Spatial
analysis techniques are used to provide more information about obesity at
the neighbourhood level in order to help to shape local obesity-prevention
policies.
Methods Childhood obesity was defined by body mass index, using crosssectional height and weight data for children aged 3–13 years (obesity>98th
centile; British reference dataset). Relationships between childhood obesity
and 12 simulated obesogenic variables were assessed using geographically
weighted regression. These results were applied to three wards with
different socio-economic backgrounds, tailoring local obesity-prevention
policy.
Results The spatial distribution of childhood obesity varied, with high
prevalence in deprived and affluent areas. Key local covariates strongly
associated with childhood obesity differed: in the affluent ward, they were
perceived neighbourhood safety and fruit and vegetable consumption; in the
deprived ward, expenditure on food, purchasing school meals, multiple
television ownership and internet access; in all wards, perceived access to
supermarkets and leisure facilities. Accordingly, different
interventions/strategies may be more appropriate/effective in different areas.
Conclusions These analyses identify the covariates with the strongest local
relationships with obesity and suggest how policy can be tailored to the
specific needs of each micro-area: solutions need to be tailored to the
locality to be most effective. This paper demonstrates the importance of
small-area analysis in order to provide health planners with detailed
information that may help them to prioritise interventions for maximum
benefit.
SOCIAL ENVIRONMENT AND PHYSICAL ACTIVITY/OBESITY AMONG YOUTH
Craggs, C., E. M. van Sluijs, et al. (2011). "Do children's individual correlates of
physical activity differ by home setting?" Health Place 17(5): 1105-12.
We investigated whether physical activity (PA) correlates differed for 9-10
year-old British children living in urban, suburban and rural settings. We
analysed cross-sectional data on 1653 children (SPEEDY study). Exposure
variables were self-reported, whilst PA was measured using Actigraph
accelerometers. Data were analysed using multilevel hierarchical regression
models, stratified by home setting. PA levels did not differ by home setting.
Boys, those of normal weight and those having a preference for PA had
higher PA levels in all strata, but additional correlates were identified within
each setting. These results highlight the potential importance of tailoring
interventions to specific environmental and population strata.
Crawford, D. A., K. Ball, et al. (2011). "Home and neighbourhood correlates of BMI
among children living in socioeconomically disadvantaged neighbourhoods." Br J
Nutr 107(7): 1028-36.
A detailed understanding of the underlying drivers of obesity-risk behaviours
is needed to inform prevention initiatives, particularly for individuals of low
socioeconomic position who are at increased risk of unhealthy weight gain.
However, few studies have concurrently considered factors in the home and
local neighbourhood environments, and little research has examined
determinants among children from low socioeconomic backgrounds. The
present study examined home, social and neighbourhood correlates of BMI
(kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional
data were collected from 491 women with children aged 5-12 years living in
forty urban and forty rural socioeconomically disadvantaged areas (suburbs)
of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires
about the home environment (maternal efficacy, perceived
importance/beliefs, rewards, rules and access to equipment), social norms
and perceived neighbourhood environment in relation to physical activity,
healthy eating and sedentary behaviour. Children's height and weight were
measured at school or home. Linear regression analyses controlled for child
sex and age. In multivariable analyses, children whose mothers had higher
efficacy for them doing physical activity tended to have lower BMI z scores
(B = - 0.04, 95 % CI - 0.06, - 0.02), and children who had a television (TV) in
their bedroom (B = 0.24, 95 % CI 0.04, 0.44) and whose mothers made
greater use of food as a reward for good behaviour (B = 0.05, 95 % CI 0.01,
0.09) tended to have higher BMI z scores. Increasing efficacy among
mothers to promote physical activity, limiting use of food as a reward and
not placing TV in children's bedrooms may be important targets for future
obesity prevention initiatives in disadvantaged communities.
De Bourdeaudhuij, I., C. Simon, et al. (2011). "Are physical activity interventions
equally effective in adolescents of low and high socio-economic status (SES):
results from the European Teenage project." Health Education Research 26(1):
119-130.
The aim was to study whether physical activity (PA) interventions in
European teenagers are equally effective in adolescents of low versus high
socio-economic status (SES). Based on a systematic review (Project
TEENAGE), three school-based studies for secondary analyses were
selected. SES stratified analyses were run in: (i) a Belgian multi-component
intervention, (ii) a French multi-component intervention and (iii) a Belgian
computer-tailored education trial. Results of the secondary analyses
showed that no overall significant differences between low and high SES
groups were found, but some interesting specific effects were revealed.
Results from the first study showed an increase in objective PA in the low
SES group (P = 0.015) compared with no significant effects in the high SES
group. In the second study, larger effects were found in adolescents of high
SES (increase of 11 min day(-1) P < 0.001), compared with adolescents of
lower SES (increase of 7 min day(-1), P = 0.02) at the longer term. The third
study showed a positive effect on school-related PA in adolescents of high
SES (P < 0.05) and on leisure time transportation in adolescents of low SES
(P < 0.05). To conclude, we were not able to show a significant widening or
narrowing of inequalities in European adolescents.
de Farias Junior, J. C., A. d. S. Lopes, et al. (2011). "Perception of the social and
built environment and physical activity among Northeastern Brazil adolescents."
Preventive Medicine 52(2): 114-119.
Objective. To evaluate the association between levels of physical activity
and perception of the social and built environmental in adolescents from
Northeastern Brazil. Methods. The sample comprised 2874 adolescents
aged 14 to 19 years (57.8% females) enrolled in private or public secondary
schools in the municipality of Joao Pessoa, Northeastern Brazil. Level of
physical activity was measured by questionnaire. Perception of
environmental characteristics was measured by means of fifteen questions
rated on four-point Likert-type scales ranging from 1 ("strongly disagree") to
4 ("strongly agree"). The association between physical activity and
perception of environmental characteristics was investigated using
multivariate binary logistic regression. Results. Multivariate analysis showed
that adolescents living in neighborhoods where other adolescents were
physically active (68.7% vs. 60.1%, OR = 1.20; 95%CI: 1.05-1.56, among
boys only) or who lived close to places they liked to frequent (71.8% vs.
53.4%, OR = 1.96; 95%CI: 1.40-2.78 among boys; and 42.0% vs. 32.3%
OR= 1.33; 95%CI: 1.10-1.74 among girls) were more likely to be physically
active. Conclusions. Adolescents with positive perceptions of certain
environmental characteristics were more likely to be physically active.
Environmental characteristics may relate differently to levels of physical
activity among boys and girls. Published by Elsevier Inc.
de Jong, E., D. F. Schokker, et al. (2011). "Behavioural and socio-demographic
characteristics of Dutch neighbourhoods with high prevalence of childhood
obesity." International Journal of Pediatric Obesity 6(3-4): 298-305.
Objective. To identify neighbourhoods with increased prevalence of
overweight children and to examine whether the association between
neighbourhood and overweight can be explained by demographic
characteristics and energy-related behaviours. Method. This cross-sectional
study was carried out among 4,072 primary schoolchildren in the city of
Zwolle, The Netherlands. Data collection consisted of measured height,
weight and waist circumference, and a parental questionnaire on sociodemographic characteristics, dietary and (in) activity behaviour of their child.
With Multivariate Logistic regressions, associations between unhealthy
behaviours and neighbourhoods (defined by postal code) with high and low
prevalence of childhood overweight were investigated. Results. In three
neighbourhoods the prevalence of overweight was significantly higher
(16.5% vs. 10.6%, p < 0.05). The odds of living in these neighbourhoods
were higher among children watching >2 h television/day (OR: 1.57; 95%
CI: 1.15-2.14), not eating breakfast daily (OR: 2.86; 95% CI: 1.93-4.23),
drinking >3 glasses/day sugared drinks (OR: 1.23; 95% CI: 1.01-1.50) on
weekdays and not participating in organized sports (OR: 1.32; 95% CI: 1.091.59). This odds was however lower among children eating <2 fruit/day (OR:
0.83; 95% CI: 0.69 1.00) on weekends. The association between
neighbourhood and overweight altered slightly after adjustment for sociodemographic and behavioural characteristics during weekdays (OR: 1.42;
95% CI: 1.05-1.92) and weekends (OR: 1.50; 95% CI; 1.11-2.02).
Conclusion. Three neighbourhoods with higher prevalence of overweight
were identified. A small part of the association between overweight and
neighbourhood is explained by socio-demographic factors and unhealthy
behaviours measured in this study. Neighbourhoods with higher overweight
prevalence are a priority setting for targeted interventions to prevent
overweight. The association between neighbourhood and overweight needs
to be explored further to understand the role the neighbourhood can play in
tackling overweight.
de Meij, J. S. B., M. J. M. Chinapaw, et al. (2011). "Effectiveness of JUMP-in, a
Dutch primary school-based community intervention aimed at the promotion of
physical activity." British Journal of Sports Medicine 45(13): 1052-1057.
Purpose The aim of the present study was to investigate the effect of the
JUMP-in programme on sports participation, overall physical activity (PA),
shuttle run score and body composition in 6-12-year-old children. Methods
JUMP-in is a school-based strategy combining environmental policy,
neighbourhood, parents-and personal components. A controlled trial was
carried out in 19 primary schools including 2848 children (50% boys).
Measures were performed at the beginning of the first school year (T0:
2006) and repeated at the end of the first (T1: 2007) and second school
year (T2: 2008). Results A significant beneficial intervention effect was
found on organised sports participation (OR 2.8 (2.2 to 3.6)). Effects were
stronger for girls (OR 3.6 (2.3 to 5.6)), and for Moroccan (OR 4.2 (3.6 to
5.7)) and Turkish children (OR 3.2 (1.9 to 5.2)). Participation in organised
sports was associated with increased shuttle run score. No significant
intervention effects on overall daily PA rates and body composition were
observed. Conclusion The present study proves that a school-based
strategy combining environmental and personal interventions was
successful in improving structural sports participation among children.
de Silva-Sanigorski, A., D. Elea, et al. (2011). "Obesity prevention in the family day
care setting: impact of the Romp & Chomp intervention on opportunities for
children's physical activity and healthy eating." Child Care Health and
Development 37(3): 385-393.
Background The Romp & Chomp intervention reduced the prevalence of
overweight/obesity in pre-school children in Geelong, Victoria, Australia
through an intervention promoting healthy eating and active play in early
childhood settings. This study aims to determine if the intervention
successfully created more health promoting family day care (FDC)
environments. Methods The evaluation had a cross-sectional, quasiexperimental design with the intervention FDC service in Geelong and a
comparison sample from 17 FDC services across Victoria. A 45-item
questionnaire capturing nutrition-and physical activity-related aspects of the
policy, socio-cultural and physical environments of the FDC service was
completed by FDC care providers (in 2008) in the intervention (n = 28) and
comparison (n = 223) samples. Results Select results showed intervention
children spent less time in screen-based activities (P = 0.03), organized
active play (P < 0.001) and free inside play (P = 0.03) than comparison
children. There were more rules related to healthy eating (P < 0.001), more
care provider practices that supported children's positive meal experiences
(P < 0.001), fewer unhealthy food items allowed (P = 0.05), higher odds of
staff being trained in nutrition (P = 0.04) and physical activity (P < 0.001),
lower odds of having set minimum times for outside (P < 0.001) and
organized (P = 0.01) active play, and of rewarding children with food (P <
0.001). Conclusions Romp & Chomp improved the FDC service to one that
discourages sedentary behaviours and promotes opportunities for children
to eat nutritious foods. Ongoing investment to increase children's physical
activity within the setting and improving the capacity and health literacy of
care providers is required to extend and sustain the improvements.
DeBate, R. D., E. J. Koby, et al. (2011). "Utility of the Physical Activity Resource
Assessment for Child-centric Physical Activity Intervention Planning in Two Urban
Neighborhoods." Journal of Community Health 36(1): 132-140.
Children's physical activity (PA) may be determined, in part, by
environmental influences such as access to diverse and safe places to play.
As part of the development of a community-based PA program, a PA asset
assessment was conducted in two low-income urban neighborhoods that
support elementary schools serving minority youth. Resources were rated
using an adapted version of the Physical Activity Resource Assessment
(PARA), a multi-dimensional instrument that rates various venues on their
features, amenities, and incivilities. Seventy-one child-centric venues (e.g.,
parks, playgrounds, community centers, sports facilities, fitness centers,
etc.) were assessed within a three-mile radius of each school. Community
member feedback via interviews with parent-child dyads revealed issues
(e.g., bullying) not captured by the PARA that can influence venue use.
Whereas the PARA can be a useful needs assessment and program
planning tool for community-based PA programs, supplementing PARA data
with community-based input may reduce contextual error in program
development.
Gubbels, J. S., S. P. J. Kremers, et al. (2011). "Interaction Between Physical
Environment, Social Environment, and Child Characteristics in Determining
Physical Activity at Child Care." Health Psychology 30(1): 84-90.
Objective: To investigate the association between the child-care
environment and physical activity of 2- and 3-year-olds. Based on an
ecological view of environmental influences on health behavior, we
hypothesized that the social and physical environment, as well as child
characteristics (age and gender), would show independent and interactive
effects on children's physical activity intensity. Design: Observations of
physical activity intensity were performed among children (N = 175) at 9
Dutch child-care centers. Aspects of the child-care environment were
assessed using the validated Environment and Policy Assessment and
Observation (EPAO) Instrument. Multilevel linear regression analyses
examined the association of environment and child characteristics with
children's activity intensity. Moderation was tested by including interaction
terms in the analyses, with subsequent post hoc analyses for significant
interaction terms. Main Outcome Measure: Observed child physical activity
intensity, measured with the Observational System for Recording Physical
Activity in Children - Preschool Version. Results: A large proportion of the
observed activities were classified as sedentary, while far fewer
observations were classified as moderate or vigorous. Activity opportunities
in the physical environment (assessed using EPAO) and prompts by staff
and peers were significantly and positively related to physical activity
intensity, while group size was negatively related to activity intensity. The
influence of the physical environment was moderated by social environment
(peer group size), while the social environment in turn interacted with child
characteristics (age and gender) in determining activity intensity.
Conclusion: Our findings are in line with the ecological perspective
regarding environmental influences on behavior, and stress the importance
of incorporating the child-care environment in efforts to prevent childhood
overweight and obesity.
Guedes, D. P., G. D. Rocha, et al. (2011). "Effects of social and environmental
determinants on overweight and obesity among Brazilian schoolchildren from a
developing region." Revista Panamericana De Salud Publica-Pan American
Journal of Public Health 30(4): 295-302.
Objective. To identify the social and environmental determinants most
strongly associated with overweight and obesity in Brazilian schoolchildren
from a developing region. Methods. Data were collected from a community-
based survey of schoolchildren from the Valley of Jequitinhonha, Minas
Gerais, Brazil. The sample was composed of 5 100 schoolchildren aged 618 years. Overweight and obesity were defined by body mass index based
on the current method recommended by the World Health Organization in
2007. Social and environmental determinants were collected by using a
structured questionnaire. Results. The prevalence of overweight and obesity
was 11.1% and 2.7% in girls and 8.2% and 1.5% in boys, respectively. The
chance of overweight was higher in schoolchildren who engaged in
remunerated work (odds ratio [OR] = 2.19, 95% confidence interval [CI]
1.30-3.26), whose parents had higher education levels (OR = 1.52, 95% CI
1.12-2.07), who had two or fewer siblings (OR = 1.74, 95% CI 1.21-2.49),
and who were in a high economic class (OR = 1.93, 95% CI 1.32-2.85).
Schoolchildren who traveled by car to school (OR = 1.50, 95% CI 1.141.91), lived <= 5 km from school (OR = 1.64, 95% CI 1.06-2.39), and
consumed foods sold in the school cafeteria (OR = 1.56, 95% CI 1.19-2.16)
presented high odds of being overweight. Conclusions. The background
from a particular region of a country should be considered when
implementing preventive measures regarding overweight and obesity,
especially for very poor, developing regions like the Valley of Jequitinhonha.
Measures taken should consider a multilevel intervention that includes the
family, school, and physical environment.
Hernandez, D. C., L. A. Francis, et al. (2011). "National School Lunch Program
Participation and Sex Differences in Body Mass Index Trajectories of Children
From Low-Income Families." Archives of Pediatrics & Adolescent Medicine 165(4):
346-353.
Objectives: To investigate participation patterns in the National School
Lunch Program (NSLP) among low-income children from kindergarten to
fifth grade and to examine the ways in which participation influences sex
differences in the trajectories of body mass index (BMI) through the eighth
grade. Design: Longitudinal, secondary data analysis. Setting: Sample of
low-income US children who entered kindergarten in 1998. Participants:
Girls (n = 574) and boys (n = 566) from low-income families who
participated in the Early Childhood Longitudinal Study, Kindergarten Cohort.
Main Exposure: Participation in the NSLP. Main Outcome Measures:
Temporary and persistent patterns of NSLP participation, and age-specific
and sex-specific BMI raw scores calculated at 5 data points. Results:
Among the low-income children who attended schools that participated in
the NSLP, both the children who persistently participated in the program
and those who temporarily participated in the program displayed similar
socioeconomically disadvantaged factors. Nonlinear mixed models indicated
a larger rate of change in BMI (ie, an increase) among low-income,
participating girls than among low-income, nonparticipating girls; however,
mean BMIs did not significantly differ between low-income girls who
participated and those who did not participate. No significant differences
were observed among low-income boys. Conclusions: Results suggest that
participation in the NSLP is associated with rapid weight gain for low-income
girls but not for low-income boys.
Madsen, K. A., K. Hicks, et al. (2011). "Physical Activity and Positive Youth
Development: Impact of a School-Based Program." Journal of School Health 81(8):
462-470.
BACKGROUND: Protective factors associated with positive youth
development predict health and education outcomes. This study explored
trends in these protective factors and in physical activity among low-income
students, and determined the impact of a school-based youth development
program on these trends. METHODS: This study used a quasi-experimental
time series design including data from 158 low-income schools from 2001 to
2007. Ninety-four schools had exposure to a school-based program
promoting physical activity and youth development through structured play;
64 schools served as controls. Primary outcomes were 5th-grade student
scores (n = 13,109) on a California statewide survey for physical activity (16 scale) and measures of protective factors including problem solving skills,
meaningful participation in school, and caring adults (1-4 scales). Predictors
were time (year) and school's number of years of exposure to the program.
RESULTS: Overall, significant annual declines were seen in protective
factors, including students' report of feeling safe (-0.03, 95% CI [-0.03, 0.01]), caring adults at school (-0.03 [-0.05, -0.02]), and problem solving
skills (-0.03 [-0.04, -0.02]). Cumulative declines over 6 years were
equivalent to a drop of 1 school-level SD. Each additional year of exposure
to the program predicted greater meaningful participation (0.02 [0.001, 0.5]),
problem-solving skills (0.03 [0.0001, 0.06]), and increased physical activity
(0.06 [0.01, 0.10]); exposure throughout elementary school (6 years)
increased scores by 1 school-level SD. CONCLUSIONS: Low-income
students reported a significant decline in protective factors since 2001.
School partnerships with youth development programs promoting physical
activity may ameliorate declines in emotional well-being and increase
physical activity.
Millstein, R. A., J. Strobel, et al. (2011). "Home, School, and Neighborhood
Environment Factors and Youth Physical Activity." Pediatric Exercise Science
23(4): 487-503.
This study examined the contributions of home, school, and neighborhood
factors related to youth physical activity (PA). Adolescents (ages 12-18; N =
137) and parents of younger children (ages 5-11; N = 104) from three US
metropolitan areas completed surveys. Youth PA was estimated from six
items assessing overall physical activity. Bivariate analyses between
environment factors and PA determined variable selection for adjusted
hierarchical regression models. There were significant correlations in each
environmental setting for adolescents (r's: 0.16-0.28), but for parents of
children, only for the home and neighborhood settings (r's: 0.14-0.39). For
adolescents, pieces of equipment at home, family recreation membership,
equipment at school, and neighborhood aesthetics explained 15.8% of
variance in PA. For younger children (based on parent report), pieces of
equipment at home, neighborhood traffic safety, walking/cycling facilities,
and street connectivity explained 21.4% of the variance in PA. Modifiable
factors like increasing access to equipment at home and school, and
improving neighborhood aesthetics may impact youth PA. To optimize
explanation of youth PA, factors from multiple environments need to be
considered.
Mushtaq, M. U., S. Gull, et al. (2011). "Dietary behaviors, physical activity and
sedentary lifestyle associated with overweight and obesity, and their sociodemographic correlates, among Pakistani primary school children." International
Journal of Behavioral Nutrition and Physical Activity 8.
Background: There is no data on diet-and activity-related behaviors
associated with overweight and obesity among Pakistani school-aged
children. The study aimed to explore dietary behaviors, physical activity and
sedentary lifestyle associated with overweight and obesity, and their sociodemographic correlates, among Pakistani primary school children. Methods:
A population-based cross-sectional study was conducted with a
representative multistage random cluster sample of 1860 children aged five
to twelve years in Lahore, Pakistan. Overweight (> +1 SD) and obesity (> +2
SD) were defined using the World Health Organization reference 2007. Chisquare test was used as the test of trend. Linear regression was used to
examine the predictive power of independent variables in relation to body
mass index (BMI). Logistic regression was used to quantify the independent
predictors and adjusted odds ratios (aOR) with 95% confidence intervals
(CI) were obtained. Statistical significance was considered at P < 0.05.
Results: Children skipping breakfast (8%), eating fast food and snacks >=
once a week (43%) and being involved in sedentary lifestyle > one hour a
day (49%) were significantly more likely to be overweight and obese while
those participating in physical activity > twice a week (53%) were
significantly less likely to be overweight and obese (all P < 0.01). Skipping
breakfast (P < 0.001), eating fast food and snacks (P = 0.001) and
sedentary lifestyle (P < 0.001) showed an independent positive association
with BMI while physical activity showed an independent inverse association
(P = 0.001). Skipping breakfast (aOR 1.82, 95% CI 1.22-2.71), eating fast
food and snacks = once a week (OR 1.41, 95% CI 1.07-1.86), physical
activity > twice a week (aOR 0.49, 95% CI 0.34-0.70) and sedentary lifestyle
> one hour a day (aOR 1.56, 95% CI 1.19-2.03) were independent
predictors of being overweight. Skipping breakfast had independent inverse
association with physical activity (aOR 0.63, 95% CI 0.45-0.89) and eating
fast food and snacks had independent positive association with sedentary
lifestyle (aOR 1.79, 95% CI 1.49-2.16). Female gender was independently
associated with skipping breakfast (aOR 1.50, 95% CI 1.04-2.16). Male
gender (aOR 1.64, 95% CI 1.33-2.02), urban area with high SES (aOR 5.09,
95% CI 3.02-8.60) and higher parental education (aOR 1.74, 95% CI 1.122.68) were significant independent predictors of eating fast food and snacks
>= once a week. Living in the rural area was independently associated
(aOR 2.51, 95% CI 1.71-3.68) with physical activity > twice a week. Male
gender (aOR 1.60, 95% CI 1.31-1.95), urban area with low SES (aOR 1.46,
95% CI 1.02-2.09), high-income neighborhoods (aOR 1.52, 95% CI 1.022.25), higher parental education (aOR 1.55, 95% CI 1.03-2.34) and fewer
siblings (aOR 1.38, 95% CI 1.10-1.73) were independent predictors of
sedentary lifestyle > one hour a day. Conclusions: Dietary behaviors,
physical activity and sedentary lifestyle are independent predictors of
overweight and higher BMI among Pakistani primary school children, and
are significantly affected by the child's socio-demographic characteristics.
These findings support the urgent need to develop a National strategy for
diet and physical activity and to implement culturally relevant behavioral
interventions in the resource-poor developing country settings.
Pabayo, R., J. Belsky, et al. (2011). "Do area characteristics predict change in
moderate-to-vigorous physical activity from ages 11 to 15 years?" Social Science
& Medicine 72(3): 430-438.
In light of geographical and epidemiological research suggesting that the
socioeconomic environment beyond the family may influence children's
physical activity, this study investigated the extent to which neighbourhood
socioeconomic conditions predict change in physical activity from ages 10
through 15 years, controlling for the attributes of the individual child and
family. Data came from 889 children participating in the National Institute of
Child Health and Human Development Study of Early Child Care and Youth
Development cohort study. Accelerometers measured Moderate-toVigorous Physical Activity (MVPA) during the week and weekend, when the
children were aged 10, 11, and 15 years. Selected US census block
variables were used to create 'independent' area measures of economic
deprivation and social fragmentation scores for child's area of residence at
age 10 years. Also, parents' perception of neighbourhood social cohesion
was measured in terms of relationships with neighbours. All analyses
controlled for participant characteristics: gender, ethnicity, household
income-to-needs ratio, maternal education, and for United States region of
residence. Growth curve analyses indicated that whereas social
fragmentation did not predict MVPA over time, greater area deprivation at
age 10 years was associated with lower weekday MVPA for boys at 10
years (beta= -0.5, p = 0.03) and these differences persisted to age 11 and
15 years. This relationship was reversed for girls. Weekend MVPA was not
significantly associated with the level of deprivation in the place of residence
at age 10 years. Although the census measure of social fragmentation in the
area of residence showed no significant association with MVPA, parentreported neighbourhood social cohesion was positively associated with
weekday (beta = 2.0, p <0.01) and weekend (beta= 3.1, p <0.01) MVPA
minutes across time. This association was most pronounced for boys. Area
level factors may be determinants of physical activity among children and
youth in complex ways and parental perception of area social environment
may be as important for children's activity levels as 'independently
assessed' socioeconomic conditions. (C) 2010 Elsevier Ltd. All rights
reserved.
Ries, A. V., A. F. Yan, et al. (2011). "The Neighborhood Recreational Environment
and Physical Activity Among Urban Youth: An Examination of Public and Private
Recreational Facilities." Journal of Community Health 36(4): 640-649.
Recreational facility availability has been shown to associate positively with
youth physical activity levels. Nonetheless, little is known about additional
facility characteristics affecting their use for physical activity as well as
differences between private and public facilities. This study examines (1)
perceptions and use of public and private recreational facilities and (2)
environmental and individual-level correlates of both facility use and
physical activity among urban adolescents. Physical activity was assessed
using accelerometry, objective measures of facility availability were obtained
using Geographical Information Systems data, and facility use and
perceptions were measured with a survey (N = 327). Adolescents were
more likely to use public than private facilities despite perceiving that private
facilities were of higher quality. Adolescents' use of both public and private
facilities was associated with perceived (but not objective) availability,
perceived quality, and use by friends and family. Public, but not private,
facility use was associated with physical activity. This study reveals the
importance of public facilities to the physical activity of urban youth.
Schwartz, B. S., W. F. Stewart, et al. (2011). "Body Mass Index and the Built and
Social Environments in Children and Adolescents Using Electronic Health
Records." American Journal of Preventive Medicine 41(4): E17-E28.
Background: No prior studies in children have evaluated how age may
modify relationships of the built and social environments with BMI, nor
evaluated the range of scales and contexts over which places may influence
health. Purpose: To systematically evaluate associations of 33
environmental measures in three domains (land use, physical activity, and
social environments) with BMI in children and adolescents in five
geographies. Methods: Across-sectional, multilevel analysis was completed
in 2009-2010 of electronic health record data (2001-2008) from 47,769
children aged 5-18 years residing in a 31-county region of Pennsylvania.
Associations of environmental measures with BMI were evaluated using
0.5-mile network buffers; census tracts; minor civil divisions (i.e., townships,
boroughs, cities); a mixed definition of place (townships, boroughs, and
census tracts in cities); and counties, overall and by age strata. Results:
Among all children, lower levels of community socioeconomic deprivation
and greater diversity of physical activity establishments were associated
with lower BMI. Associations of environmental measures differed by age,
depending on scale and context. For example, higher population density
was associated with lower BMI in older children; this effect was strongest in
the larger geographies. Similarly, a lower level of county sprawl was
associated with lower BMI in older children. Conclusions: Associations
differed by age and definition of place, suggesting that the benefits of
environmental intervention may not be uniform across the childhood age
range. The study demonstrated the utility of using electronic patient
information for large-scale, population-based epidemiologic research, a
research area of growing interest and investment in the U.S. (Am J Prev
Med 2011;41(4):e17-e28) (C) 2011 American Journal of Preventive
Medicine
Serene, T. E. H., S. Shamarina, et al. (2011). "Familial and socio-environmental
predictors of overweight and obesity among primary school children in Selangor
and Kuala Lumpur." Malaysian journal of nutrition 17(2): 151-62.
INTRODUCTION: A cross-sectional study was conducted to determine the
familial and socio-environmental predictors of overweight and obesity
among 1430, 9-12 year-old primary school children and their parents in
Selangor and Kuala Lumpur. METHODOLOGY: Body weight and height
were measured and body mass index was calculated. Modified Child
Feeding (CFQ) and Determinants of Adolescent Social Well-being and
Health (DASH) questionnaires were used to measure familial and socioenvironmental factors. RESULTS: A total of 17.9% of the children were
overweight while 16.0% were obese. Positive relationships were found
between child's BMI and parent's BMI (r = 0.129, p < or = 0.01), concern
about child's weight (r = 0.125, p < or = 0.01) and restriction (r = 0.057, p <
or = 0.05) to unhealthy foods. However, negative relationships were found
between child's BMI with pressure to eat (r = -0.135, p < or = 0.01) and
neighbourhood safety perception (r = -0.053, p < or = 0.05). The logistic
regression analysis showed that being male (Exp (beta) = 0.538; 95% CI =
0.421-0.687), higher parent's BMI (Exp (beta) = 1.055; 95% CI = 1.0281.082), higher concern about child's weight (Exp (beta) = 1.082; 95% CI =
1.030-1.127), low pressure to eat (Exp (beta) = 0.857; 95% CI = 0.8010.916) and low perception of neighbourhood safety (Exp (beta) = 0.951;
95% CI = 0.913-0.990) were significantly associated with increased risk of
overweight. CONCLUSION: Parents should be the main target for education
to modify children's weight status. Further research should be carried out to
understand the mechanism of influence of parents and the socioenvironment on child's health.
Silva, K. S., M. V. Nahas, et al. (2011). "Factors associated with active commuting
to school and to work among Brazilian adolescents." J Phys Act Health 8(7): 92633.
BACKGROUND: Active commuting has decreased substantially in recent
decades and has been more frequent in specific demographic and
socioeconomic profiles. The objective of this study was to describe the
prevalence of active trips and the possible associations with demographic
and socioeconomic variables. METHODS: A questionnaire on lifestyle and
risk behavior was administered to a sample population of 5028 adolescents,
ages 15 to 19 years, attending public high schools in the state of Santa
Catarina, Brazil. Logistic regressions (odds ratio--OR; 95% confidence
interval) were used to test associations. RESULTS: Active commuting to
school was reported for 56.7% of students, and active commuting to work
was reported for 70.0%. The likelihood of commuting passively was greater
among girls (school: OR = 1.27; 1.10-1.45), older adolescents (school: OR =
1.17; 1.02-1.33; work: OR = 1.49; 1.22-1.82), those who lived in rural areas
(school: OR = 12.1; 9.91-14.8), those who spent more time in commuting
(school: OR = 2.33; 2.01-2.69; work: OR = 4.35; 3.52-5.38), and those from
high-income families (school: OR = 1.40; 1.21-1.62; work: OR = 1.69; 1.372.08). CONCLUSIONS: The proportion of students taking active trips was
higher when going to work than to school. All indicators were associated
with the mode of commuting, except gender and place of residence for
commuting to work.
Spengler, J. O., M. F. Floyd, et al. (2011). "Correlates of park-based physical
activity among children in diverse communities: results from an observational study
in two cities." American journal of health promotion : AJHP 25(5): e1-9.
PURPOSE: This study examined correlates of park-based physical activity
(PA) among children in neighborhood parks. DESIGN: Direct observation
was used to assess PA among children. SETTING: Public parks in Tampa,
Florida (n=10), and Chicago, Illinois (n=18), from low income and high
income and racially/ethnically diverse communities. Subjects. Children
(n=3410), coded as anyone who appeared to be 10 years or younger,
observed at parks in Tampa and Chicago. MEASURES: Physical activity
was measured by a modified version of the System for Observing Play and
Leisure Among Youth (SOPLAY). ANALYSIS: Descriptive statistics and
multilevel regression models were used in data analysis. RESULTS: At the
activity observation level, children's PA was positively related to
temperature and unstructured activities in Tampa and Chicago parks.
Among park activity area predictors, type of activity area was significantly
related to PA. In Tampa, more PA was observed on courts, and less PA
was observed in shelter areas compared with open space areas. In
Chicago, less PA was observed on courts and fields compared with open
space areas. Neighborhood income was associated with lower PA in Tampa
parks. Neighborhood race/ethnicity was not a significant predictor of
children's PA in either city. CONCLUSIONS: Children's PA was linked to
modifiable social and environmental features within parks. Strategies to
increase PA among children in parks should promote courts, playgrounds,
informal activities, and free play.
Suminski, R. R., D. Ding, et al. (2011). "Youth Physical Activity Opportunities in
Lower and Higher Income Neighborhoods." Journal of Urban Health-Bulletin of the
New York Academy of Medicine 88(4): 599-615.
The presence of youth physical activity opportunities is one of the strongest
environmental correlates of youth physical activity. More detailed
information about such opportunities is needed to maximize their
contributions to physical activity promotion especially in under resourced,
lower income areas. The objectives of this study were to construct a
comprehensive profile of youth physical activity opportunities and contrast
profile characteristics between lower and higher income neighborhoods.
Youth physical activity opportunities in eight lower (median household
income <$36,000) and eight higher (>$36,000) income neighborhoods were
identified and described using interviews, neighborhood tours, site visits,
and systematic searches of various sources (e.g., Internet). Lower income
neighborhoods had a greater number of locations offering youth physical
activity opportunities but similar quantities of amenities. Lower income
neighborhoods had more faith-based locations and court, trail/path, event,
and water-type amenities. Higher income neighborhoods had significantly
more for-profit businesses offering youth physical activity opportunities.
Funding for youth physical activity opportunities in lower income
neighborhoods was more likely to come from donations and government
revenue (e.g., taxes), whereas the majority of youth physical activity
opportunities in the higher income neighborhoods were supported by forprofit business revenue. Differences between lower and higher income
neighborhoods in the type and amenities of youth physical activity
opportunities may be driven by funding sources. Attention to these
differences could help create more effective and efficient strategies for
promoting physical activity among youth.
Timperio, A., J. Salmon, et al. (2011). "Neighborhood characteristics and TV
viewing in youth: nothing to do but watch TV?" J Sci Med Sport 15(2): 122-8.
OBJECTIVES: Neighborhoods that discourage physical activity may
encourage indoor activities such as television viewing; however few studies
have examined associations between neighborhood characteristics and
sedentary activities. This study examined cross-sectional and longitudinal
associations between perceived and objective measures of the physical and
social neighborhood environment and TV viewing among children and
adolescents. DESIGN: Cross-sectional and longitudinal. METHODS:
Parents of 190 children and 169 adolescents completed questionnaire items
regarding facilities for physical activity, neighborhood safety (general and
traffic), social trust/cohesion, social networks and their child's TV viewing in
2006. Adolescents self-reported their TV viewing. Objective measures of
reported crime and neighborhood destinations, road connectivity and traffic
exposure were also collected. Questions about TV viewing were repeated in
2008 (longitudinal sample: 157 children; 105 adolescents). RESULTS: In
children, cul-de-sac density and reported crime were positively and parental
agreement that their neighborhood has good sporting facilities was
negatively associated with TV viewing in cross-sectional analyses. There
were no longitudinal associations among children. In adolescents, number
of sports options and parental agreement that there is so much traffic that it
is difficult/unpleasant for their child to walk were negatively associated with
TV viewing 2 years later. CONCLUSIONS: Crime and a lack of quality
sporting facilities or options may contribute to greater TV viewing among
youth.
Toftager, M., L. B. Christiansen, et al. (2011). "SPACE for physical activity - a
multicomponent intervention study: study design and baseline findings from a
cluster randomized controlled trial." Bmc Public Health 11.
Background: The aim of the School site, Play Spot, Active transport, Club
fitness and Environment (SPACE) Study was to develop, document, and
assess a comprehensive intervention in local school districts that promote
everyday physical activity (PA) among 11-15-year-old adolescents. The
study is based on a social ecological framework, and is designed to
implement organizational and structural changes in the physical
environment. Methods/design: The SPACE Study used a cluster
randomized controlled study design. Twenty-one eligible schools in the
Region of Southern Denmark were matched and randomized in seven pairs
according to eight matching variables summarized in an audit tool (crow-fly
distance from residence to school for 5-6(th) graders; area household
income; area education level; area ethnicity distribution; school district
urbanity; condition and characteristics of school outdoor areas; school
health policy; and active transport in the local area). Baseline
measurements with accelerometers, questionnaires, diaries, and physical
fitness tests were obtained in Spring 2010 in 5-6(th) grade in 7 intervention
and 7 control schools, with follow-up measurements to be taken in Spring
2012 in 7-8(th) grade. The primary outcome measure is objective average
daily physical activity and will be supported by analyses of time spent in
moderate to vigorous activity and time spent sedentary. Other secondary
outcome measures will be obtained, such as, overweight, physical fitness,
active commuting to/from school and physical activity in recess periods.
Discussion: A total of 1348 adolescents in 5-6(th) grade in the Region of
Southern Denmark participated at baseline (n = 14 schools). The response
rate was high in all type of measurements (72.6-97.4%). There were no
significant differences between intervention and control groups at baseline
according to selected background variables and outcome measures: gender
(p = .54), age (p = .17), BMI (p = .59), waist circumference (p = .17),
physical fitness (p = .93), and physical activity (accelerometer) (p = .09).
The randomization and matched pair design produced equivalent groups
according to central outcome measures and background variables. The
SPACE for physical activity Study will provide new insights on the
effectiveness of multicomponent interventions to improve adolescents'
physical activity level.
Utter, J., S. Denny, et al. (2011). "Social and Physical Contexts of Schools and
Neighborhoods: Associations With Physical Activity Among Young People in New
Zealand." American Journal of Public Health 101(9): 1690-1695.
Objectives. We sought to determine the association between school- and
neighborhood-level characteristics and physical activity among young
people. Methods. We collected the data as part of Youth'07, a nationally
representative survey of the health and well-being of high school students in
New Zealand. In total, 9107 students from 96 schools participated (63%
response rate). Students answered questions about their schools (e.g.,
support for physical activity) and neighborhoods (e.g., community cohesion,
disintegration, safety, and recreational facilities). We created school-level
measures by aggregating the students' reports within their schools and we
created neighborhood-level measures by aggregating the students' reports
of their neighborhoods to the census area unit of their residential address.
We conducted analyses by using cross-classified random-effects models
controlling for individual variables, with school and neighborhoods treated
as random effects. Results. Schools characterized by high sports team
participation and neighborhoods characterized by high social connections
were positively associated with student physical activity. We observed few
other significant characteristics of school and neighborhood environments.
Conclusions. Our findings highlight that opportunity for sports participation
and strong social connections in neighborhoods are particularly important
for youths' physical activity. (Am J Public Health. 2011;101:1690-1695.
doi:10.2105/AJPH.2011.300171)
Van Sluijs, E. M. F., N. R. Jones, et al. (2011). "School-level correlates of physical
activity intensity in 10-year-old children." International Journal of Pediatric Obesity
6(2-2): E574-E581.
Purpose. Little is known about school environmental factors that promote or
inhibit activity, especially from studies using objective measures in large
representative samples. We therefore aimed to study associations between
activity intensities and physical and social school environmental factors.
Methods. A population-based sample of 1 908 British children (SPEEDY
study), mean age 10.3 years (Standard deviation [SD]: 0.3), recruited from
92 schools across Norfolk, UK, with valid activity data (assessed with
Actigraph accelerometers). Outcome measures were school-based (8 am-4
pm on weekdays) time (in minutes) spent in sedentary (<100 counts/min),
moderate (2000-3999 counts/min) and vigorous (>= 4 000 counts/min)
activity. A total of 40 school physical and social environmental factors were
assessed. Multivariable multilevel linear regression analyses adjusted for
children's sex and body mass index were conducted; interactions with sex
were investigated. Results. Availability of a 'Park and Stride' scheme was
negatively associated with sedentary minutes (-7.74; 95% CI: -14.8; -0.70).
Minutes of moderate activity were associated with the availability of a
lollypop person (1.33, 95% CI: 0.35; 2.62) and objectively-assessed walking
provision (1.70, 95% CI: 0.85; 2.56). The number of sports facilities of at
least medium quality (0.47, 95% CI: 0.16; 0.79), not having a policy on
physical activity (-2.28, 95% CI: -3.62; -0.95), and, in boys only, provision of
pedestrian training (1.89; 95% CI: 0.77; 3.01) were associated with minutes
of vigorous activity. Conclusions. Only a small number of school-level
factors were associated with children's objectively-measured physical
activity intensity, giving few pointers for potential future intervention efforts.
Further research should focus on using objective measures to elucidate
what factors may explain the school-level variance in activity levels.
Wilson, D. K., H. G. Lawman, et al. (2011). "Neighborhood and Parental Supports
for Physical Activity in Minority Adolescents." American Journal of Preventive
Medicine 41(4): 399-406.
Background: Few studies have examined environmental, home, and
parental supports for physical activity in underserved adolescents (low
income, ethnic minority). Given the increasing incidence of obesity in
minority adolescents, it is important to better understand ecologic
determinants of physical activity in these youth. This study used an ecologic
model to evaluate the significance of neighborhood, home, and parental
supports for physical activity on moderate-to-vigorous (MV) physical activity
in underserved adolescents. Design: The study was a secondary data
analysis of a randomized controlled school-based trial "Active by Choice
Today" (ACT) for increasing physical activity in underserved sixth-graders.
Schools were matched on school size, percentage minorities, percentage
entitled to free or reduced-price lunch, and urban or rural setting prior to
randomization. This study used a randomly selected sample of parents
(n=280) from the intervention and control schools whose adolescent was
enrolled in the larger trial. Setting/participants: A total of 679 6th-grade
students (mean age=11.4 years, 70% African-American, 76% free or
reduced-price lunch, 52% female) participated in the larger trial. Parents of
280 youth were contacted to participate in a telephone survey and 198
(71%) took part in the study. Interventions: The ACT trial was designed to
test the efficacy of a 17-week (1 academic year) motivational plus
behavioral skills intervention versus comparison after-school programs on
increasing physical activity. A telephone survey was developed and was
administered within 6 months after the trial began on parents of 198
adolescents from the ACT randomized school-based trial during 2005-2007.
Main outcome measures: The primary outcome measure was adolescent
MVPA based on 7-day accelerometry estimates from baseline to midintervention. The data were analyzed in 2010-2011 and included both
parent and adolescent self-reports of environmental, home, and family
supports for physical activity. Results: Regression analyses indicated a
significant effect of parental and neighborhood supports for physical activity
on adolescent MVPA. Adolescents who perceived higher (vs lower) levels of
parental support for physical activity engaged in more minutes of MVPA
(B=3.01, SE=1.38, p<0.05) at mid-intervention. Adolescents who lived in
neighborhoods with more (vs fewer) supports for physical activity (parks,
lighting), also engaged in more minutes MVPA (B=4.27, SE=2.15, p<0.05).
Conclusions: Support from parents and neighborhood quality are both
associated with increased physical activity in underserved adolescents. (Am
J Prev Med 2011;41(4):399-406) (C) 2011 American Journal of Preventive
Medicine
SOCIAL ENVIRONMENT AND PHYSICAL ACTIVITY/OBESITY AMONG
ADULTS
Arps, S. (2011). "Socioeconomic status and body size among women in Honduran
Miskito communities." Ann Hum Biol 38(4): 508-19.
BACKGROUND: This study investigates evidence of the nutrition transition
among women in Miskito communities on the northeastern coast of
Honduras. AIM: The hypothesis that socioeconomic status (SES) is
positively associated with body size and fatness is tested; and dietary and
physical activity patterns are examined among SES groups. SUBJECTS
AND METHODS: An anthropometric survey was conducted with 200 nonpregnant women following standard procedures. Dietary intake and physical
activity data were collected using 24-hour recall methods. Women were
categorized into three SES groups (high, medium and low) based on
economic and social attributes. Differences in anthropometric measures,
diet and physical activity among SES groups were analysed. RESULTS:
More than 70% (n = 142) of women in the sample were overweight or
obese. Mean height, weight, skin-fold thicknesses, arm and calf
circumferences, percentage body fat and upper-arm fat area were
significantly greater among high SES women than low SES women. Women
with high SES had lower rates of physical activity and higher rates of
obesity, perceived food sufficiency, meat consumption, milk/dairy intake and
general dietary diversity. CONCLUSION: High SES women were
significantly fatter than low SES women; and variation observed among
groups is likely related to different patterns of dietary intake and physical
activity.
August, K. J. and D. H. Sorkin (2011). "Racial/Ethnic Disparities in Exercise and
Dietary Behaviors of Middle-Aged and Older Adults." Journal of General Internal
Medicine 26(3): 245-250.
Differences in health behaviors may be important contributors to
racial/ethnic disparities in the health status of adults. Studies to date have
not compared whether there are health behavior differences in exercise and
dietary behaviors among middle-age and older adults in the four largest
racial/ethnic categories. To investigate racial/ethnic differences in exercise
and dietary behaviors of middle-aged and older adults. We used data from
the 2007 California Health Interview Survey. Multivariable logistic regression
was used to examine interactions between age and race/ethnicity in
predicting two categories of health behaviors. Analyses were conducted
adjusting for sociodemographic characteristics, health insurance status, and
healthcare utilization. A population-based sample of 33,189 California adults
45 years old and older: 26,522 non-Hispanic whites, 1,686 African
American/blacks, 2,565 Asian/Pacific Islanders (1,741 English-proficient;
824 limited English-proficient), and 2,416 Latinos (1,538 English-proficient;
878 limited English-proficient). Self-report leisure-time physical activity
(moderate and vigorous) and daily consumption of fruits and vegetables.
Racial/ethnic minorities generally engaged in less healthy exercise and
dietary behaviors than whites, with differences more pronounced in middle
adulthood. The disparities were the greatest among English-proficient
minorities. Specifically, among middle-aged respondents, all racial/ethnic
minorities engaged in less vigorous physical activity than whites (ORs range
= 0.28 to 0.73; 95% CI range = 0.16-1.00). Additionally, middle-aged,
English-proficient minorities engaged in less moderate physical activity
compared to whites (ORs range =0.57 to 0.67; 95% CI range = 0.45-0.79).
Furthermore, middle-aged, English-proficient Latinos had a poorer diet than
whites (OR = 0.54; 0.39-0.75). Few significant racial/ethnic differences
emerged in the exercise and dietary behaviors of older adults. Racial/ethnic
disparities in exercise and dietary behaviors are most notable among
middle-aged, acculturated minorities. Results highlight the need to promote
positive exercise and dietary behaviors during critical preventive ages, when
racial/ethnic disparities are large and the potential to prevent chronic
disease is great.
Beenackers, M. A., C. B. Kamphuis, et al. (2011). "Sports participation, perceived
neighborhood safety, and individual cognitions: how do they interact?" Int J Behav
Nutr Phys Act 8: 76.
BACKGROUND: Little is known about the interaction between individual
and environmental determinants of physical activity, although this may be
important information for the development of effective interventions. The
goal of this paper is to investigate whether perceived neighborhood safety
modifies associations between individual cognitions and sports participation.
METHODS: Cross-sectional data were obtained from residents (age 25-75)
of 87 neighborhoods in the city of Eindhoven, who participated in the Dutch
GLOBE study in 2004 (N = 2474). We used multilevel logistic regression to
analyze the interactions between perceived neighborhood safety and
individual cognitions (attitude, self-efficacy, social influence, and intention)
on sports participation (yes/no). RESULTS: In its association with sports
participation, perceived neighborhood safety interacted significantly with
self-efficacy and attitude (p < 0.05). Among persons who perceived their
neighborhood as safe, a positive attitude was strongly associated with
sports participation (OR = 2.00, 95%CI = 1.48-2.71). In contrast, attitude
was not associated with sports participation in persons who perceived their
neighborhood as unsafe (OR = 0.65, 95%CI = 0.34-1.24). Further, selfefficacy was significantly stronger associated with sports participation in
persons who perceived their neighborhood as unsafe (OR = 1.85, 95%CI =
1.31-2.60) than in those who perceived their neighborhood as safe (OR =
1.19, 95%CI = 1.05-1.36). Social influence and intention did not interact with
perceived neighborhood safety. CONCLUSIONS: Associations between
individual cognitions and sports participation depend on neighborhood
circumstances, such as perceived neighborhood safety. Interventions to
promote sports participation in adults should take the interaction between
environmental and individual characteristics into account. More research is
needed to find out the causal pathways in individual-environment
interactions.
Bennett, K. J., J. C. Probst, et al. (2011). "Obesity among working age adults: The
role of county-level persistent poverty in rural disparities." Health & Place 17(5):
1174-1181.
Little research has investigated the relationship between county-level
poverty and obesity rates. We examined the factors related to obesity
among residents of Rural Persistent Poverty counties, finding that these
counties had a larger proportion of obese residents (34.5%) than Other
Rural (28.4%) or Urban counties (24.9%). In adjusted analysis, the
statistically significant association between persistent poverty and obesity
was attenuated. Both individual characteristics (race, age) and county-level
food availability and access factors were found to be significantly related to
obesity. Improved access to quality food may be beneficial to residents of
impoverished areas. (C) 2011 Elsevier Ltd. All rights reserved.
Bertoldo Benedetti, T. N. R., A. Schwingel, et al. (2011). "Physical activity acting as
a resource for social support among older adults in Brazil." Journal of Human Sport
& Exercise 6(2): 452-461.
As people age, their various social roles and relationships change. The aim
of this study was to explore the impact of physical activity participation on
social engagement among older adults living in Brazil. The participants of
the study were selected using probabilistic sampling, stratified by Census
tracts (neighborhoods) and gender. The participants' information was
assessed by two standardized questionnaires: "Brazil Old Age Schedule"
(BOAS) and "Physical Activities International Questionnaire" (IPAQ). A total
of 875 older adults living in Southern Brazil participated in this study. Their
average age was 71.6 (SD=7.9), 61.4% were married, and 66.6% of the
individuals lived with their children. The results show that older adults who
were more physically active had a satisfactory level of social relations with
their family (84.8%), friends (97%), and neighbors (96%). Also, physically
active older adults were four times more likely to engage in social clubs than
their less active counterparts (OR = 3.82). Similar trends were observed
when comparing more and less active older adults in regard to their
participation in other social group opportunities in the community, such as
residents' association (OR=1.97) and social interaction groups (OR=1.52).
This study underscores the positive role of physical activity in older adults'
perceptions and participation in social groups available in the community.
ABSTRACT FROM AUTHOR
Bjornstrom, E. E. (2011). "An examination of the relationship between
neighborhood income inequality, social resources, and obesity in Los Angeles
county." Am J Health Promot 26(2): 109-15.
PURPOSE. This study examines whether local income inequality is
associated with an increased likelihood of obesity among Los Angeles
County residents and whether collective efficacy mediates the relationship.
DESIGN. A cross-sectional study of 2875 adults in 65 neighborhoods that
took part in wave 1 of the Los Angeles Family and Neighborhood Survey in
2000-2001. Neighborhood measures are taken from the Los Angeles
Neighborhood Services and Characteristics Database and decennial
census. MEASURES. Obesity is defined as a body mass index over 30.
Income inequality is operationalized with the Gini coefficient. Collective
efficacy is a neighborhood-level measure comprised of aggregated
responses to items that capture trust, cohesion, and the willingness to
intervene for the common good among residents. Controls are included at
the individual level for demographics and health characteristics, and at the
neighborhood level for median household income. ANALYSIS. Logistic
regression models of individuals within neighborhoods. RESULTS. When
neighborhood economic well-being is controlled, income inequality is
associated with a significant reduction in the likelihood of obesity while also
controlling for individual demographic and health-related characteristics.
Collective efficacy exerts an independent and beneficial effect but does not
mediate the relationship between inequality and obesity. CONCLUSION.
Neighborhood social resources and economic heterogeneity are associated
with a lower likelihood of obesity. It may be that economically
heterogeneous neighborhoods, perhaps especially in Los Angeles County,
contain characteristics that promote health.
Boone-Heinonen, J., A. V. D. Roux, et al. (2011). "Neighborhood socioeconomic
status predictors of physical activity through young to middle adulthood: The
CARDIA study." Social Science & Medicine 72(5): 641-649.
Neighborhood socioeconomic status (SES) is related to a wide range of
health outcomes, but existing research is dominated by cross-sectional
study designs, which are particularly vulnerable to bias by unmeasured
characteristics related to both residential location decisions and healthrelated outcomes. Further, little is known about the mechanisms by which
neighborhood SES might influence health. Therefore, we estimated
longitudinal relationships between neighborhood SES and physical activity
(PA), a theorized mediator of the neighborhood SES-health association. We
used data from four years of the Coronary Artery Risk Development in
Young Adults (CARDIA) study (n = 5115, 18-30 years at baseline, 19851986), a cohort of U.S. young adults followed over 15 years, and a timevarying geographic information system. Using two longitudinal modeling
strategies, this is the first study to explicitly examine how the estimated
association between neighborhood SES (deprivation) and PA is biased by
(a) measured characteristics theorized to influence residential decisions
(e.g., controlling for individual SES, marriage, and children in random effects
models), and (b) time-invariant, unmeasured characteristics (e.g., controlling
for unmeasured motivation to exercise that is constant over time using
repeated measures regression modeling, conditioned on the individual).
After controlling for sociodemographics (age, sex, race) and individual SES,
associations between higher neighborhood deprivation and lower PA were
strong and incremental in blacks, but less consistent in whites. Furthermore,
adjustment for measured characteristics beyond sociodemographics and
individual SES had little influence on the estimated associations: adjustment
for unmeasured characteristics attenuated negative associations more
strongly in whites than in blacks. (C) 2011 Elsevier Ltd. All rights reserved.
Brown, S. C., S. Huang, et al. (2011). "The relationship of perceived neighborhood
social climate to walking in Hispanic older adults: a longitudinal, cross-lagged
panel analysis." J Aging Health 23(8): 1325-51.
OBJECTIVE: This study examines possible bidirectional relationships
between neighborhood climate (i.e., perceived neighborhood social
environment) and walking behavior across a 12-month period in older
Hispanics. METHOD: A population-based sample of 217 communitydwelling older Hispanics in Miami, Florida, completed measures of
perceived neighborhood climate and neighborhood walking, at two
assessment time points (12 months apart). RESULTS: Structural equation
modeling analyses revealed that neighborhood climate predicted
subsequent walking 12 months later, such that more positive perceptions of
neighborhood climate predicted more walking. Follow-up analyses revealed
that older adults who resided in the top half of neighborhoods based on
perceived neighborhood climate scores at initial assessment were 2.57
times as likely to have walked at least one block in the last week at followup, relative to older adults residing in neighborhoods whose climate was in
the lower half. DISCUSSION: Perceptions of a more positive neighborhood
social environment may promote walking in urban, older Hispanics.
Buehler, R., J. Pucher, et al. (2011). "Active Travel in Germany and the U.S.
Contributions of Daily Walking and Cycling to Physical Activity." American Journal
of Preventive Medicine 41(3): 241-250.
Background: Travel surveys in Europe and the U. S. show large differences
in the proportion of walking and cycling trips without considering implications
for physical activity. Purpose: This study estimates differences between
Germany and the U. S. over time in population levels of daily walking and
cycling at different health-enhancing thresholds across sociodemographic
groups. Methods: Uniquely comparable national travel surveys for the U. S.
(NHTS 2001 and 2009) and Germany (MiD 2002 and 2008) were used to
calculate the number, duration, and distance of active trips per capita. The
population-weighted person and trip files for each survey were merged to
calculate population levels of any walking/cycling, walking/cycling 30
minutes/day, and achieving 30 minutes in bouts of at least 10 minutes.
Logistic regression models controlled for the influence of socioeconomic
variables. Data were analyzed in 2010. Results: Between 2001/2002 and
2008/2009, the proportion of "any walking" was stable in the U. S. (18.5%)
but increased in Germany from 36.5% to 42.3%. The proportion of "any
cycling" in the U. S. remained at 1.8% but increased in Germany from
12.1% to 14.1%. In 2008/2009, the proportion of "30 minutes of walking and
cycling" in Germany was 21.2% and 7.8%, respectively, compared to 7.7%
and 1.0% in the U. S. There is much less variation in active travel among
socioeconomic groups in Germany than in the U. S. German women,
children, and seniors walk and cycle much more than their counterparts in
the U. S. Conclusions: The high prevalence of active travel in Germany
shows that daily walking and cycling can help a large proportion of the
population to meet recommended physical activity levels. (Am J Prev Med
2011; 41(3): 241-250) (C) 2011 American Journal of Preventive Medicine
Casagrande, S. S., M. Franco, et al. (2011). "Healthy food availability and the
association with BMI in Baltimore, Maryland." Public Health Nutrition 14(6): 10011007.
Objective: To study the association between the availability of healthy foods
and BMI by neighbourhood race and socio-economic status (SES). Design:
Trained staff collected demographic information, height, weight and 24 h
dietary recalls between 2004 and 2008. Healthy food availability was
determined in thirty-four census tracts of varying racial and SES
composition using the Nutrition Environment Measures Survey-Stores in
2007. Multilevel linear regression was used to estimate associations
between healthy food availability and BMI. Setting: Baltimore City,
Maryland, USA. Subjects: Adults aged 30-64 years (n 2616) who
participated in the Healthy Aging in Neighborhoods of Diversity across the
Life Span study. Results: Among individuals living in predominantly white
neighbourhoods, high availability of healthy foods was associated with
significantly higher BMI compared with individuals living in neighbourhoods
with low availability of healthy food after adjustment for demographic
variables (beta = 3.22, P = 0.001). Associations were attenuated but
remained significant after controlling for dietary quality (beta = 2.81, P =
0.012). Conclusions: Contrary to expectations, there was a positive
association between the availability of healthy food and higher BMI among
individuals living in predominantly white neighbourhoods. This result could
be due to individuals in neighbourhoods with low healthy food availability
travelling outside their neighbourhood to obtain healthy food.
Casagrande, S. S., J. Gittelsohn, et al. (2011). "Association of Walkability With
Obesity in Baltimore City, Maryland." American Journal of Public Health 101:
S318-S324.
Objectives. To investigate the association between walkability and obesity,
we studied adults residing in Baltimore City, Maryland, in neighborhoods of
varying racial and socioeconomic composition. Methods. We conducted a
cross-sectional study of 3493 participants from the study Healthy Aging in
Neighborhoods of Diversity across the Life Span. We used the Pedestrian
Environment Data Scan to measure neighborhood walkability in 34
neighborhoods of diverse racial and socioeconomic composition in which
the study participants lived. Confirmatory factor analysis was used to
determine walkability scores. Multilevel modeling was used to determine
prevalence ratios for the association between walkability and obesity.
Results. Among individuals living in predominately White and highsocioeconomic status (SES) neighborhoods, residing in highly walkable
neighborhoods was associated with a lower prevalence of obesity when
compared with individuals living in poorly walkable neighborhoods, after
adjusting for individual-level demographic variables (prevalence ratio-
[PR]=0.58; P=<.001 vs PR=0.80; P=.004). Prevalence ratios were similar
after controlling for the perception of crime, physical activity, and main mode
of transportation. The association between walkability and obesity for
individuals living in low-SES neighborhoods was not significant after
accounting for main mode of transportation (PR=0.85; P=.060).
Conclusions. Future research is needed to determine how differences in
associations by neighborhood characteristics may contribute to racial
disparities in obesity. (Am J Public Health. 2011;101:S318-S324.
doi:10.2105/AJPH.2009.187492)
Corseuil, M. W., I. J. C. Schneider, et al. (2011). "Perception of environmental
obstacles to commuting physical activity in Brazilian elderly." Preventive Medicine
53(4-5): 289-292.
Objective. To evaluate the association between perceived environmental
attributes and commuting physical activity (PA) in a population-based
sample of elderly persons. Methods. Cross-sectional study was performed
in 2009/2010, including 1652 elderly individuals aged 60 years or greater
living in Florianopolis-SC, Brazil. Physical activity was measured using the
long version of the International Physical Activity Questionnaire. Perceived
environmental variables were assessed using a modified version of the
Neighborhood Environment Walkability Scale. Multinomial logistic
regression was used and a 5% significance level was taken into account.
Results. 36.8% and 35.2% of the subjects were inactive or did not reach
150 min/week on transport-related physical activity, respectively. Physical
and social environmental characteristics, such as the absence of parks and
athletic courts (OR(Inactive):1.75; 95% CI:1.22-2.51); presence of garbage
(OR(Low-active):1.55; 1.04-2.30); street lighting (OR(Low-active):2.51; 95%
CI:1.36-4.64; OR(Low-active):2.43; 95% CI:1.43-4.15); not walking with the
dog (OR(Inactive): 3.08; 95% CI:1.42-6.69) and don't have a dog
(OR(Inactive):2.45; 95% CI:1.06-5.66) were associated with lower levels of
commuting PA. Conclusions. Results showed that poor physical and social
environmental characteristics were related to lower commuting. Building
public facilities and promoting physical activity in groups are likely to impact
in active commuting among the elderly in Brazil. (c) 2011 Elsevier Inc. All
rights reserved.
De Greef, K., D. Van Dyck, et al. (2011). "Physical environmental correlates of selfreported and objectively assessed physical activity in Belgian type 2 diabetes
patients." Health & Social Care in the Community 19(2): 178-188.
Despite the well-known beneficial effects of physical activity (PA) on the
long-term outcomes of type 2 diabetes patients, the majority of this patient
group remains inactive. Therefore, it is necessary to understand the most
important PA determinants in type 2 diabetes patients in order to develop
efficacious interventions to increase PA participation. The main aim of this
study was to investigate the associations of physical environmental factors
with objectively assessed and self-reported PA in type 2 diabetes patients.
A total of 133 type 2 diabetes patients participated in this cross-sectional
study (response rate: 43.3%). All participants completed the long
International PA Questionnaire and two validated questionnaires to measure
physical environmental perceptions and psychosocial factors. They also
wore an accelerometer and a pedometer to measure PA objectively.
Selection criteria were age 35-80, BMI 25-35 kg m-superset of, treated for
type 2 diabetes and no PA limitations. Data were collected in 2007. Physical
environmental factors contributed significantly to the explained variance of
all objective and self-reported PA measures (explained variance from 4% to
18%) after controlling for sociodemographic variables. Home PA equipment,
walkability, aesthetics and convenience of PA facilities were the most
consistent environmental correlates. The contribution of physical
environmental factors remained significant for most PA measures after
taking into account the variance explained by psychosocial factors
(explained variance from 4% to 10%), except for step counts and
recreational walking. Physical environmental factors could be important
correlates of PA in type 2 diabetes patients, even beyond the contribution of
sociodemographic and psychosocial variables, but additional research is
needed. Nevertheless, sociodemographic and psychosocial factors remain
very important and when developing future interventions, all these
multidimensional correlates should be kept in mind.
Ding, D., J. F. Sallis, et al. (2011). "Physical activity and sedentary behaviours
among rural adults in suixi, china: a cross-sectional study." International Journal of
Behavioral Nutrition and Physical Activity 8.
Background: Modernisation and urbanisation have led to lifestyle changes
and increasing risks for chronic diseases in China. Physical activity and
sedentary behaviours among rural populations need to be better
understood, as the rural areas are undergoing rapid transitions. This study
assessed levels of physical activity and sedentary behaviours of farming
and non-farming adults in rural Suixi, described activity differences between
farming and non-farming seasons, and examined correlates of leisure-time
physical activity (LTPA) and TV viewing. Methods: A random sample of rural
adults (n = 287) in Suixi County, Guangdong, China were surveyed in 2009
by trained interviewers. Questionnaires assessed multiple physical activities
and sedentary behaviours, and their correlates. Analysis of covariance
compared activity patterns across occupations, and multiple logistic
regressions assessed correlates of LTPA and TV viewing. Quantitative data
analyses were followed by community consultation for validation and
interpretation of findings. Results: Activity patterns differed by occupation.
Farmers were more active through their work than other occupations, but
were less active and more sedentary during the non-farming season than
the farming season. Rural adults in Suixi generally had a low level of LTPA
and a high level of TV viewing. Marital status, household size, social
modelling for LTPA and owning sports equipment were significantly
associated with LTPA but not with TV time. Most findings were validated
through community consultation. Conclusions: For chronic disease
prevention, attention should be paid to the currently decreasing
occupational physical activity and increasing sedentary behaviours in rural
China. Community and socially-based initiatives provide opportunities to
promote LTPA and prevent further increase in sedentary behaviours.
Dyck, D., G. Cardon, et al. (2011). "Environmental and Psychosocial Correlates of
Accelerometer-Assessed and Self-Reported Physical Activity in Belgian Adults."
International Journal of Behavioral Medicine 18(3): 235-245.
Background: Despite the well-known benefits of physical activity (PA) on
overall health, the majority of the adult population does not engage in
sufficient PA. To develop effective interventions to increase PA, it is
necessary to understand the most important PA correlates and to
investigate whether correlates are similar in different population subgroups.
Purpose: This study examined associations between physical environmental
perceptions and self-reported and objectively assessed PA in Belgian
adults. Moreover, associations between psychosocial factors and PA, and
the moderating effects of sociodemographic factors were investigated.
Method: A sample of 1,200 Belgian adults (20-65 years; 47.9% males)
completed a survey measuring sociodemographic variables and
psychosocial correlates, the Neighborhood Environmental Walkability Scale
and the long-version International Physical Activity Questionnaire. They
wore an accelerometer for 7 days. Results: Perceiving neighborhoods to be
high walkable (high residential density, high land use mix access, and high
land use mix diversity) and recreation facilities to be convenient, and the
availability of home PA equipment were the most consistent physical
environmental correlates of PA. The strongest psychosocial correlates were
social support from friends and family and self-efficacy. The psychosocial
associations were most consistent for self-reported leisure-time PA and less
clear for self-reported active transportation and accelerometer-assessed
PA. Few significant sociodemographic moderators were found. Conclusion:
Both physical environmental and psychosocial factors were associated with
PA in adults, with psychosocial factors being important especially for
leisure-time PA. Correlates of PA were similar regardless of gender, age, or
socio-economic status, so interventions to change these factors could have
population-wide effects. ABSTRACT FROM AUTHOR
Dyck, D. V., G. Cardon, et al. (2011). "Urban-rural differences in physical activity in
Belgian adults and the importance of psychosocial factors." Journal of urban health
: bulletin of the New York Academy of Medicine 88(1): 154-67.
Recent research in urban planning and public health has drawn attention to
the associations between urban form and physical activity in adults.
Because little is known on the urban-rural differences in physical activity, the
main aims of the present study were to examine differences in physical
activity between urban and rural adults and to investigate the moderating
effects of the physical environment on the relationship between
psychosocial factors and physical activity. In Flanders, Belgium, five rural
and five urban neighborhoods were selected. A sample of 350 adults (20-65
years of age; 35 adults per neighborhood) participated in the study.
Participants wore a pedometer for 7 days, and self-reported physical activity
and psychosocial data were also collected. Results showed that urban
adults took more steps/day and reported more walking and cycling for
transport in the neighborhood, more recreational walking in the
neighborhood, and more walking for transportation outside the
neighborhood than rural adults. Rural adults reported more recreational
cycling in the neighborhoods. The physical environment was a significant
moderator of the associations between several psychosocial factors
(modeling from family, self-efficacy, and perceived barriers) and physical
activity. In rural participants, adults with psychosocial scores above average
were more physically active, whereas there were no differences in physical
activity according to psychosocial factors in urban participants. These
results are promising and plead for the development of multidimensional
interventions, targeting specific population subgroups. In rural
environments, where changing the environment would be a very challenging
task, interventions focusing on modifiable psychosocial constructs could
possibly be effective.
Eisenstein, A. R., T. R. Prohaska, et al. (2011). "Environmental Correlates of
Overweight and Obesity in Community Residing Older Adults." Journal of Aging
and Health 23(6): 994-1009.
Objective: This study examines the role of environmental correlates of
overweight and obesity among older adults independent of walking activity
and lower body function. Methods: In-person interviews were conducted
with 789 adults aged 65 and older, residing in four areas in the U.S.
Demographic information, general health, lower body function, walking
behavior, and awareness of environmental infrastructure features using the
modified Neighborhood Environment Walking Survey (NEWS) were
obtained. Regression analyses examined the association between Body
Mass Index (BMI) and environmental infrastructure features, adjusting for
demographics and lower body function. Results: Older adults who perceived
their neighborhood as less safe from crime and had reduced access to
services were more likely to have higher BMI. Controlling for demographic
and functional characteristics, access to services remained significant. This
association remained significant for those with lower functional status.
Discussion: This research suggests that neighborhood environment may
have an influence on BMI above and beyond walking activity.
Fish, J. S., S. Ettner, et al. (2011). "Association of perceived neighborhood safety
on body mass index (vol 100, pg 2296, 2010)." American Journal of Public Health
101(5): 776-776.
Florindo, A. A., E. P. Salvador, et al. (2011). "Perception of the environment and
practice of physical activity by adults in a low socioeconomic area." Revista De
Saude Publica 45(2): 302-310.
OBJECTIVE: To analyze the association between practice of physical
activity and the perception of the community environment among adults.
METHODS: A cross-sectional study of 890 adults carried out in Ermelino
Matarazzo district in Sao Paulo, Southeastern Brazil, 2007. The dependent
variables were the practice of at least 150 minutes per week in leisure time
physical activity and walking for commuting. Independent variables
concerned the environment, and adjustment variables were sex, age,
education and length of time living in the neighborhood. RESULTS:
Variables associated with leisure time physical activity were: invitation from
friends/neighbors, the presence of facilities less than ten minutes walking
from the house and the absence of bars within ten minutes walking distance
of the house. Public safety was associated with walking for commuting.
CONCLUSIONS: To promote physical activity in areas of low
socioeconomic status, it is fundamental to invest in public safety and
facilities for physical activity, in addition to promoting social support
networks.
Gay, J. L., R. P. Saunders, et al. (2011). "The Relationship of Physical Activity and
the Built Environment within the Context of Self-Determination Theory." Annals of
Behavioral Medicine 42(2): 188-196.
Background Evidence is emerging of the combined effects of psychosocial
and environmental determinants on exercise. Purpose This study aims to
examine the moderating effects of convenience, facilities at places of
worship, access, crime/safety, and neighborhood characteristics on the
relationship between exercise and psychosocial needs satisfaction
(autonomy, competence, and relatedness). Methods Adults from four cities
enrolling in a weight loss program (N=477; 72.1% White, BMI=32.21 +/7.67) completed questionnaires on current exercise levels, perceptions of
the environment for exercise, and autonomy, competence, and relatedness.
Results There were significant interaction effects for neighborhood
characteristics with all three psychological needs satisfaction, and for
convenience with competence and relatedness, such that the relationship
between psychosocial needs satisfaction and exercise is stronger for
participants with better perceptions of convenience and neighborhood
characteristics. Conclusions Results indicate that the relationship between
exercise and autonomy, competence, and relatedness is different for low
and high perceptions of convenience to places for exercise and
neighborhood characteristics.
Gerber, Y., V. Myers, et al. (2011). "Neighborhood socioeconomic status and
leisure-time physical activity after myocardial infarction: A longitudinal study." Am J
Prev Med 41(3): 266-73.
BACKGROUND: Area-level SES is independently associated with
myocardial infarction (MI) prognosis, yet the mechanisms for this
association remain speculative. PURPOSE: Using a population-based
cohort of MI patients, this study examined whether neighborhood SES
predicts long-term trajectory of leisure-time physical activity (LTPA), an
established prognostic factor. METHODS: Patients aged </=65 years
(n=1410) admitted to hospital in central Israel with first MI in 1992-1993,
were followed up through 2005. LTPA was reported on five successive
occasions: at baseline, 3-6 months, 1-2 years, 5 years, and 10-13 years
post-MI. Generalized estimating equations (GEEs) with ordinal outcome
variable (LTPA classified as regular, irregular, or none) were used to
determine the independent predictive role of neighborhood SES in LTPA
trajectory post-MI. Analyses were conducted in 2010-2011. RESULTS:
Engagement in LTPA was poor, with point prevalence rates ranging from
33% to 37% for inactivity and from 19% to 27% for irregular activity
throughout follow-up. The GEE-derived ORs (95% CIs) for decreased LTPA
level in the lower and middle vs upper neighborhood SES tertiles were 2.49
(2.05, 3.02) and 1.60 (1.33, 1.92) after age and gender adjustment, and
1.55 (1.26, 1.90) and 1.23 (1.02, 1.49) after multivariable adjustment for
individual SES measures, cardiovascular risk factors, MI characteristics,
and disease-severity indices, respectively (p for trend <0.001).
CONCLUSIONS: Low neighborhood SES is a powerful predictor of poor
LTPA uptake in MI survivors, even after extensive adjustment for individual
SES and baseline clinical profile. LTPA may thus represent an intermediate
mechanism between neighborhood SES and post-MI outcome, which
provides prevention opportunities.
Hall, K. S. and E. McAuley (2011). "Examining indirect associations between
physical activity, function, and disability in independent- and assisted-living
residents." J Phys Act Health 8(5): 716-23.
BACKGROUND: Few studies have examined physical activity behavior and
its associated outcomes in older adults living in retirement communities.
Guided by the disablement model and social cognitive theory, we tested a
cross-sectional model in which physical activity was hypothesized to
influence disability indirectly through self-efficacy, functional performance,
and functional limitations. METHODS: One hundred six older men and
women residing in independent-living (ILF) assisted-living (ALF) facilities
completed self-report measures of self-efficacy, function, and disability.
Objective assessments of physical activity and functional performance were
conducted using waist-mounted accelerometers and the short physical
performance battery (SPPB), respectively. Path analysis was used to
examine the proposed associations among constructs. RESULTS: Older
adults who were more active were also more efficacious and had better
physical function and fewer functional limitations. Only higher levels of selfefficacy were associated with less disability. The effects of individual-level
covariates were also examined. CONCLUSIONS: This cross-sectional study
is among the first to examine the associations between physical activity,
function, and disability among older adults residing in ILFs and ALFs. Future
research addressing the physical and psychological needs of this growing
population is warranted.
Kanning, M. and W. Schlicht (2011). "The association between intra-individual and
extra-individual determinants, and lifetime sports behavior on leisure time physical
activity. A cross-sectional study with older adults." International Journal of Sport
Psychology 42(5): 493-511.
There exists convincing evidence that physical activity (PA) helps older
people stay healthy. Nevertheless, many older people remain inactive.
Interventions can enhance PA, but they focus mainly on social-cognitive
determinants and often neglect environmental influences. In this crosssectional study, we examined the association between individual and
environmental factors and PA. We asked 592 people between 50 and 60
years old about intra-individual and extra-individual factors, their lifetime
sports behavior and their current volume of PA. Structural equation
modeling revealed an acceptable model-fit (RMSEA =.0,3; SRMR =.05; CFI.
=.95). The model showed that lifetime sports behavior was most strongly
associated with PA (beta=.27), followed by intra-individual (beta=.22) and
extra-individual (beta =.10) factors. We also explored moderators via twostep cluster analyses. These findings illustrated that lifestyle and place of
residence primarily moderated the associations. Interventions intended to
enhance the PA of older people should include both intra-individual and
extra-individual factors, and it may be helpful to support these people when
they are younger. Additionally, they should be targeted by lifestyle and place
of residence.
Komar-Samardzija, M., L. T. Braun, et al. (2011). "Factors associated with physical
activity levels in African-American women with type 2 diabetes." J Am Acad Nurse
Pract 24(4): 209-17.
PURPOSE: To examine how family/friend social support, exercise selfefficacy, physical environment, sense of community, social issues and roles,
socioeconomic status, and body image discrepancy influence physical
activity levels in African American females with type 2 diabetes. DATA
SOURCES: A sample of 50 African American females with type 2 diabetes
was recruited from a Midwest diabetes center for this descriptive, crosssectional, correlational study. A series of self-report instruments were
administered to examine the relationships between the independent study
variables and physical activity levels. CONCLUSIONS: Results of the study
suggested that higher levels of exercise self-efficacy, family social support
for exercise, and a decrease in physical environmental barriers may serve
to increase physical activity levels in this population. No significant
relationships were observed between the other study variables and physical
activity levels. IMPLICATIONS FOR PRACTICE: Nurse practitioners
working with African American females with type 2 diabetes need to assess
family social support, exercise self-efficacy, and physical environmental
barriers and plan interventions that incorporate family support and the
principles of self-efficacy while minimizing environmental barriers. Further
exploration is warranted to examine the relationship between body image
discrepancy and physical activity in this population.
Lindstrom, M. (2011). "Social capital, desire to increase physical activity and
leisure-time physical activity: A population-based study." Public Health 125(7):
442-447.
Objectives: To investigate the associations between social capital (trust)
and leisure-time physical activity. Study design: The 2004 Public Health
Survey in Skane is a cross-sectional study. Methods: In total, 27,757
individuals aged 18-80 years answered a postal questionnaire (59%
participation). Logistic regression models were used to investigate the
associations between trust, desire to increase physical activity and leisuretime physical activity. Results: The prevalence of low leisure-time physical
activity was 15.3% among men and 13.2% among women. Middle-aged
men and older women, respondents born abroad, those with medium/low
education, those with the desire to increase physical activity but needing
support, and those reporting low trust had significantly higher odds ratios of
low leisure-time physical activity than their respective reference groups. The
associations between low trust and desire to increase physical activity and
between low trust and low leisure-time physical activity remained in the
multiple models. Conclusions: The positive association between low trust
and low leisure-time physical activity remained after multiple adjustments.
There is a concentration of men and women with low leisure-time physical
activity who report the desire to increase their physical activity but think that
they need support to do so. This group also has a significantly higher
prevalence of low trust. (C) 2011 The Royal Society for Public Health.
Published by Elsevier Ltd. All rights reserved.
Lobaszewski, J., K. Przewozniak, et al. (2011). "Patterns of leisure time physical
activity and its determinants among a sample of adults from Kielce region, Poland the 'PONS' study." Ann Agric Environ Med 18(2): 241-5.
The aim of the study was to evaluate the prevalence, socio-demographic
patterns and behavioural characteristics of leisure time physical activity in a
pilot group of respondents of the Polish-Norwegian Study (PONS).
MATERIALS AND METHODS: PONS is an open-ended prospective study
set in Swietokrzyski Province with study cohort consisting of adults aged 4564 years. The physical activity section of the questionnaire was based on
the International Physical Activity Questionnaire. RESULTS: 43% of the
respondents had not walked for at least 10 minutes in their leisure time
during the last week. The majority did not engage in any moderate or
vigorous physical activity (PA). Being physically active was more prevalent
among residents of urban areas and among respondents with a higher level
of education. Performing PA was also positively associated with higher net
income per household member. On average, respondents had spent 47
hours in a sedentary position during last week. The majority of subjects
reported watching TV for 6-20 hours per week. Not having enough time and
lack of willingness were given as the main reasons for being inactive.
CONCLUSIONS: A significant proportion of participants were inactive in
their leisure time, even activity less than 10 minutes during the last 7 days
was common. Walking was the most popular form of PA in this domain.
Urban residence, higher level of education and better financial situation
were strongly associated with higher levels of PA.
Ludwig, J., L. Sanbonmatsu, et al. (2011). "Neighborhoods, obesity, and diabetes-a randomized social experiment." N Engl J Med 365(16): 1509-19.
BACKGROUND: The question of whether neighborhood environment
contributes directly to the development of obesity and diabetes remains
unresolved. The study reported on here uses data from a social experiment
to assess the association of randomly assigned variation in neighborhood
conditions with obesity and diabetes. METHODS: From 1994 through 1998,
the Department of Housing and Urban Development (HUD) randomly
assigned 4498 women with children living in public housing in high-poverty
urban census tracts (in which >/=40% of residents had incomes below the
federal poverty threshold) to one of three groups: 1788 were assigned to
receive housing vouchers, which were redeemable only if they moved to a
low-poverty census tract (where <10% of residents were poor), and
counseling on moving; 1312 were assigned to receive unrestricted,
traditional vouchers, with no special counseling on moving; and 1398 were
assigned to a control group that was offered neither of these opportunities.
From 2008 through 2010, as part of a long-term follow-up survey, we
measured data indicating health outcomes, including height, weight, and
level of glycated hemoglobin (HbA(1c)). RESULTS: As part of our long-term
survey, we obtained data on body-mass index (BMI, the weight in kilograms
divided by the square of the height in meters) for 84.2% of participants and
data on glycated hemoglobin level for 71.3% of participants. Response rates
were similar across randomized groups. The prevalences of a BMI of 35 or
more, a BMI of 40 or more, and a glycated hemoglobin level of 6.5% or
more were lower in the group receiving the low-poverty vouchers than in the
control group, with an absolute difference of 4.61 percentage points (95%
confidence interval [CI], -8.54 to -0.69), 3.38 percentage points (95% CI, 6.39 to -0.36), and 4.31 percentage points (95% CI, -7.82 to -0.80),
respectively. The differences between the group receiving traditional
vouchers and the control group were not significant. CONCLUSIONS: The
opportunity to move from a neighborhood with a high level of poverty to one
with a lower level of poverty was associated with modest but potentially
important reductions in the prevalence of extreme obesity and diabetes. The
mechanisms underlying these associations remain unclear but warrant
further investigation, given their potential to guide the design of communitylevel interventions intended to improve health. (Funded by HUD and
others.).
Martinez, S. M., E. M. Arredondo, et al. (2011). "Walking for Transportation Among
Latino Adults in San Diego County: Who Meets Physical Activity Guidelines?"
Journal of Physical Activity & Health 8(7): 898-906.
Background: U.S. Latinos engage in nonleisure-time walking (NLTW) more
than other ethno-racial groups. Studies are needed to explore factors
associated with NLTW to inform interventions for effective physical activity
promotion. Purpose: To examine the social-ecological correlates of NLTW
among Mexican-origin Latinos. Methods: Individual, social, and
environmental level factors and PA were assessed in a telephone survey
completed by 672 Mexican-origin adults randomly sampled in San Diego
County. Data were collected in 2006 and analyzed in 2009. Results:
Participants were mostly female (71%), with an average age of 39 years.
Less than one-third met PA guidelines for NLTW (29%). Structural equation
modeling showed that NLTW was positively associated with being female,
but negatively associated with living in the U.S. >= 12 years, and being
U.S.-born. Conclusions: In this sample NLTW differed by various indicators
of acculturation and gender. These findings might help inform the
development of interventions to promote NLTW and thus physical activity in
Mexican-origin adults.
Parra-Medina, D. and D. K. H. Messias (2011). "Promotion of Physical Activity
Among Mexican-Origin Women in Texas and South Carolina: An Examination of
Social, Cultural, Economic, and Environmental Factors." Quest 63(1): 100-117.
Interventions to improve physical activity levels among Latinos must take
into consideration the social, cultural, economic, and environmental contexts
of Latino communities. We report findings of formative assessments related
to Mexican-origin women's levels of readiness, willingness, and ability to
participate in regular leisure time physical activity in two diverse locations,
the Texas Lower Rio Grande Valley and the South Carolina Midlands. The
ENLACE project employed a Community-Based Participatory Research
approach. Formative assessment activities focused on identification of
community assets and resources and exploration of community members'
experiences, opinions, values, preferences, and perceived needs related to
physical activity. Data sources included windshield tours, walk-ability
assessments of local neighborhoods; community inventory exercises, focus
groups, and individual interviews. Barriers to regular physical activity
included the dominance of work and family responsibilities, social norms,
lack of social support, social isolation, environmental constraints,
economics, and low levels of personal knowledge and motivation.
Perez, D. F., P. G. Ritvo, et al. (2011). "Perceived Walkability, Social Support, Age,
Native Language, and Vehicle Access as Correlates of Physical Activity: A CrossSectional Study of Low-Socioeconomic Status, Ethnic, Minority Women." Journal
of Physical Activity & Health 8(8): 1098-1107.
Background: The role of social-environmental factors in physical activity
(PA) within lower income and ethnic minority populations is understudied.
This study explored correlates of age-related PA and perceived walkability
(PW). Methods: Cross-sectional data (N = 401 women; >18 y) were
collected within the Jane-Finch community in Toronto, Ontario using
questionnaires. Generalized additive models, an extension to multiple
regression, were used to estimate effect sizes and standard errors. Results:
Significant interactions between native language and car access (CA) were
observed in PA variation across the lifespan. Individuals were evenly
distributed across 4 comparison groups: 29.2% English-NoCA, 24.1%
English-CA, 20.7% Non-English-NoCA, and 26.0% NonEnglish-CA. Risk of
sedentariness increased with age for native English speakers > 50 years,
but appears unaffected by age for other groups. English speakers without
CA < 60 years appear least likely to be sedentary, followed by English
speakers with CA. In general, an active individual at the 75th percentile of
social support for exercise would have 1.62 (CI: 1.22-2.17) times the METHours of PA than an active individual at the 25th percentile of SSE.
Conclusions: English language facility and car access moderate
relationships of social-environmental factors and PA. Further investigation is
required to better understand correlates of PA for women in this
demographic.
Shelton, R. C., L. H. McNeill, et al. (2011). "The association between social factors
and physical activity among low-income adults living in public housing." Am J
Public Health 101(11): 2102-10.
OBJECTIVES: We sought to examine the association between structural,
functional, and normative social factors and physical activity among urban,
low-income, racially/ethnically diverse adults. METHODS: We conducted a
baseline cross-sectional survey among residents of 12 low-income housing
communities in metropolitan Boston, Massachusetts. Participants were also
asked to wear a pedometer for 5 days. We analyzed complete data from
1112 residents (weighted n = 1635). RESULTS: Residents with smaller
social networks were significantly less physically active than were residents
with larger social networks (b = -1503.7; P = .01) and residents with
conflicting demands were more active than were residents with none (b =
601.6; P = .01), when we controlled for employment status, gender, poverty
level, current health status, age, and perceived safety. Social networks were
most strongly associated with physical activity among Hispanics and
younger residents (aged 18-35 years). CONCLUSIONS: These findings
indicate that social factors, including social networks and role-related
conflicting demands, may be important drivers of physical activity among
low-income populations. Researchers and practitioners should consider
social factors in developing multilevel physical activity interventions for this
population.
Van Dyck, D., G. Cardon, et al. (2011). "Urban-Rural Differences in Physical
Activity in Belgian Adults and the Importance of Psychosocial Factors." Journal of
Urban Health-Bulletin of the New York Academy of Medicine 88(1): 154-167.
Recent research in urban planning and public health has drawn attention to
the associations between urban form and physical activity in adults.
Because little is known on the urban-rural differences in physical activity, the
main aims of the present study were to examine differences in physical
activity between urban and rural adults and to investigate the moderating
effects of the physical environment on the relationship between
psychosocial factors and physical activity. In Flanders, Belgium, five rural
and five urban neighborhoods were selected. A sample of 350 adults (20-65
years of age; 35 adults per neighborhood) participated in the study.
Participants wore a pedometer for 7 days, and self-reported physical activity
and psychosocial data were also collected. Results showed that urban
adults took more steps/day and reported more walking and cycling for
transport in the neighborhood, more recreational walking in the
neighborhood, and more walking for transportation outside the
neighborhood than rural adults. Rural adults reported more recreational
cycling in the neighborhoods. The physical environment was a significant
moderator of the associations between several psychosocial factors
(modeling from family, self-efficacy, and perceived barriers) and physical
activity. In rural participants, adults with psychosocial scores above average
were more physically active, whereas there were no differences in physical
activity according to psychosocial factors in urban participants. These
results are promising and plead for the development of multidimensional
interventions, targeting specific population subgroups. In rural
environments, where changing the environment would be a very challenging
task, interventions focusing on modifiable psychosocial constructs could
possibly be effective.
MEASUREMENT
Boarnet, M. G., A. Forsyth, et al. (2011). "The Street Level Built Environment and
Physical Activity and Walking: Results of a Predictive Validity Study for the Irvine
Minnesota Inventory." Environment and Behavior 43(6): 735-775.
The Irvine Minnesota Inventory (IMI) was designed to measure
environmental features that may be associated with physical activity and
particularly walking. This study assesses how well the IMI predicts physical
activity and walking behavior and develops shortened, validated audit tools.
A version of the IMI was used in the Twin Cities Walking Study, a research
project measuring how density, street pattern, mixed use, pedestrian
infrastructure, and a variety of social and economic factors affect walking.
Both bivariate and multivariate analyses were used to assess the predictive
value of the IMI. We find that while this inventory provides reliable
measurement of urban design features, only some of these features present
associations with increased or decreased walking. This article presents two
versions of shortened scales-a prudent scale, requiring association with two
separate measures of a physical activity or walking behavior, and a
moderate scale, requiring association with one measure of physical activity
or walking. The shortened scales provide built environment audit
instruments that have been tested both for inter-rater reliability and for
associations with physical activity and walking. The results are also useful in
showing which built environment variables are more reliably associated with
walking for travel-characteristics of the sidewalk infrastructure, street
crossings and traffic speeds, and land use are more strongly associated
with walking for travel, while factors that measure aesthetics are typically
less strongly associated with walking for travel.
Burton, E. J., L. Mitchell, et al. (2011). "Good places for ageing in place:
development of objective built environment measures for investigating links with
older people's wellbeing." Bmc Public Health 11: 839.
BACKGROUND: There is renewed interest in the role of the built
environment in public health. Relatively little research to date investigates its
impact on healthy ageing. Ageing in place has been adopted as a key
strategy for coping with the challenges of longevity. What is needed is a
better understanding of how individual characteristics of older people's
residential environments (from front door to wider neighbourhood) contribute
to their wellbeing, in order to provide the basis for evidence-based
housing/urban design and development of interventions. This research
aimed to develop a tool to objectively measure a large range of built
environment characteristics, as the basis for a preliminary study of potential
relationships with a number of 'place-related' functional, emotional and
social wellbeing constructs. METHODS: Through a review of urban design
literature, design documents, and existing measures, a new tool, the
NeDeCC (Neighbourhood Design Characteristics Checklist) was developed.
It was piloted, refined, and its reliability validated through inter-rater tests. A
range of place-related wellbeing constructs were identified and measured
through interviews with 200 older people living in a wide variety of ruralurban environments and different types of housing in England. The
NeDeCC was used to measure the residential environment of each
participant, and significant bivariate relationships with wellbeing variables
were identified. RESULTS: The NeDeCC was found to have convincing face
and construct validity and good inter-rater and test/retest reliability, though it
would benefit from use of digital data sources such as Google Earth to
eliminate the need for on-site survey. The significant relationships found in
the study suggest that there may be characteristics of residential
environments of potential relevance for older people's lives that have been
overlooked in research to date, and that it may be worthwhile to question
some of the assumptions about where and how older people want to live
(e.g. villages seem to be positive). They also point to the importance of
considering non-linear relationships. CONCLUSIONS: The NeDeCC
provides the basis for generation of evidence-based design guidance if it is
used in prospective controlled studies or 'natural experiments' in the future.
Ultimately, this will facilitate the creation of better places for ageing in place.
Cerin, E., A. Barnett, et al. (2011). "Measuring walking within and outside the
neighborhood in Chinese elders: reliability and validity." Bmc Public Health 11:
851.
BACKGROUND: Walking is a preferred, prevalent and recommended
activity for aging populations and is influenced by the neighborhood built
environment. To study this influence it is necessary to differentiate whether
walking occurs within or outside of the neighborhood. The Neighborhood
Physical Activity Questionnaire (NPAQ) collects information on settingspecific physical activity, including walking, inside and outside one's
neighborhood. While the NPAQ has shown to be a reliable measure in
adults, its reliability in older adults is unknown. Additionally its validity and
the influence of type of neighborhood on reliability and validity have yet to
be explored. METHODS: The NPAQ walking component was adapted for
Chinese speaking elders (NWQ-CS). Ninety-six Chinese elders, stratified by
social economic status and neighborhood walkability, wore an
accelerometer and completed a log of walks for 7 days. Following the
collection of valid data the NWQ-CS was interviewer-administered. Fourteen
to 20 days (average of 17 days) later the NWQ-CS was re-administered.
Test-retest reliability and validity of the NWQ-CS were assessed.
RESULTS: Reliability and validity estimates did not differ with type of
neighborhood. NWQ-CS measures of walking showed moderate to
excellent reliability. Reliability was generally higher for estimates of weekly
frequency than minutes of walking. Total weekly minutes of walking were
moderately related to all accelerometry measures. Moderate-to-strong
associations were found between the NWQ-CS and log-of-walks variables.
The NWQ-CS yielded statistically significantly lower mean values of total
walking, weekly minutes of walking for transportation and weekly frequency
of walking for transportation outside the neighborhood than the log-of-walks.
CONCLUSIONS: The NWQ-CS showed measurement invariance across
types of neighborhoods. It is a valid measure of walking for recreation and
frequency of walking for transport. However, it may systematically
underestimate the duration of walking for transport in samples that engage
in high levels of this type of walking.
Cohen, D. A., C. Setodji, et al. (2011). "How much observation is enough? Refining
the administration of SOPARC." J Phys Act Health 8(8): 1117-23.
BACKGROUND: The Systematic Observation of Play and Recreation in
Communities (SOPARC) was designed to estimate the number and
characteristics of people using neighborhood parks by assessing them 4
times/day, 7 days/week. We tested whether this schedule was adequate
and determined the minimum number of observations necessary to provide
a robust estimate of park user characteristics and their physical activity
levels. METHODS: We conducted observations every hour for 14 hours per
day during 1 summer and 1 autumn week in 10 urban neighborhood parks:
2 each in Los Angeles, CA; Albuquerque, NM; Columbus, OH; Durham, NC;
and Philadelphia, PA. We counted park users by gender, age group,
apparent race/ethnicity, and activity level. We used a standardized
Cronbach's alpha and intraclass correlation coefficients to test the reliability
of using fewer observations. RESULTS: We observed 76,632 individuals, an
average of 547/park/day (range 155-786). Interobserver reliability ranged
from 0.80 to 0.99. Obtaining a robust estimate of park user characteristics
and their physical activity required a schedule of 4 days/week, 4 times/day.
CONCLUSION: An abbreviated schedule of SOPARC was sufficient for
estimating park use, park user characteristics, and physical activity.
Applying these observation methods can augment physical activity
surveillance.
Dwyer, G. M., L. L. Hardy, et al. (2011). "The validity and reliability of a home
environment preschool-age physical activity questionnaire (Pre-PAQ)."
International Journal of Behavioral Nutrition and Physical Activity 8.
Background: There is a need for valid population level measures of physical
activity in young children. The aim of this paper is to report the
development, and the reliability and validity, of the Preschool-age Children's
Physical Activity Questionnaire (Pre-PAQ) which was designed to measure
activity of preschool-age children in the home environment in population
studies. Methods: Pre-PAQ was completed by 103 families, and validated
against accelerometry for 67 children (mean age 3.8 years, SD 0.74; males
53%). Pre-PAQ categorizes activity into five progressive levels (stationary
no movement, stationary with limb or trunk movement, slow, medium, or
fast-paced activity). Pre-PAQ Levels 1-2 (stationary activities) were
combined for analyses. Accelerometer data were categorized for stationary,
sedentary (SED), non-sedentary (non-SED), light (LPA), moderate (MPA)
and vigorous (VPA) physical activity using manufacturer's advice
(stationary) or the cut-points described by Sirard et al and Reilly et al.
Bland-Altman methods were used to assess agreement between the
questionnaire and the accelerometer measures for corresponding activity
levels. Reliability of the Pre-PAQ over one week was determined using
intraclass correlations (ICC) or kappa (kappa) values and percentage of
agreement of responses between the two questionnaire administrations.
Results: Pre-PAQ had good agreement with LPA (mean difference 1.9
mins.day(-1)) and VPA (mean difference -4.8 mins.day(-1)), was adequate
for stationary activity (mean difference 7.6 mins.day(-1)) and poor for
sedentary activity, whether defined using the cut-points of Sirard et al (mean
difference -235.4 mins.day(-1)) or Reilly et al (mean difference -208.6
mins.day(-1)) cut-points. Mean difference between the measures for total
activity (i.e. Reilly's non-sedentary or Sirard's LMVPA) was 20.9 mins.day(1) and 45.2 mins.day(-1). The limits of agreement were wide for all
categories. The reliability of Pre-PAQ question responses ranged from 0.311.00 (ICC (2, 1)) for continuous measures and 0.60-0.97 (kappa) for
categorical measures. Conclusions: Pre-PAQ has acceptable validity and
reliability and appears promising as a population measure of activity
behavior but it requires further testing on a more broadly representative
population to affirm this. Pre-PAQ fills an important niche for researchers to
measure activity in preschool-age children and concurrently to measure
parental, family and neighborhood factors that influence these behaviors.
Gasevic, D., I. Vukmirovich, et al. (2011). "A direct assessment of "obesogenic"
built environments: challenges and recommendations." J Environ Public Health
2011: 161574.
This paper outlines the challenges faced during direct built environment
(BE) assessments of 42 Canadian communities of various income and
urbanization levels. In addition, we recommend options for overcoming such
challenges during BE community assessments. Direct BE assessments
were performed utilizing two distinct audit methods: (1) modified version of
Irvine-Minnesota Inventory in which a paper version of an audit tool was
used to assess BE features and (2) a Physical Activity and Nutrition
Features audit tool, where the presence and positions of all environmental
features of interest were recorded using a Global-Positioning-System (GPS)
unit. This paper responds to the call for the need of creators and users of
environmental audit tools to share experiences regarding the usability of
tools for BE assessments. The outlined BE assessment challenges plus
recommendations for overcoming them can help improve and refine the
existing audit tools and aid researchers in future assessments of the BE.
Henderson, K. E., G. M. Grode, et al. (2011). "Validity of a Measure to Assess the
Child-Care Nutrition and Physical Activity Environment." Journal of the American
Dietetic Association 111(9): 1306-1313.
Background Licensed child-care centers represent an opportunity to
positively influence children's health behaviors. Valid and easy-to-use
measures of the child-care environment are needed to assess the influence
of environmental change on health. Objective To develop and validate a
self-administered survey to assess the nutrition and physical activity
environment of child-care centers, and to identify domains that may be
evaluated adequately through self-report. Design A survey was developed
to assess four areas related to nutrition and physical activity: center policies,
practices related to the social environment, physical environment, and
nutrition quality. Development involved review of the literature, existing
measures, and regulations/standards as well as collaboration with a working
group. The survey was pilot tested and feedback was sought from expert
consultants. It was administered statewide and validated against a menu
rating tool, interviews with a center director, and a direct observation tool
that was developed for this study. Participants/setting Participating sites
were drawn from Child and Adult Care Food Program-participating licensed
Connecticut child-care centers serving 13 or more children aged 3 to 5
years. Survey responses from 146 center directors were included, as were
62 center menus, and director interviews and observational data from 33
sites. Primary outcomes/statistical analyses Criterion validity of the survey
was assessed through percent agreement with mirroring items in the
additional measures. Healthy and unhealthy food scores were calculated for
menu and survey tools, and Pearson correlations were computed. Results
Percent agreement with criterion outcomes ranged from 39% to 97%, with
61% of items achieving agreement >= 80%. Agreement was highest for
nutrition and policy domains, and lowest for physical activity and barriers to
promoting health. Correlations between food scores across measures were
moderate. Conclusions The self-report survey demonstrated adequate
criterion validity. We make recommendations for improving validity of lowagreement items and for the use of more labor-intensive evaluation
procedures for domains not adequately assessed through self-report. J Am
Diet Assoc. 2011;111:1306-1313.
Hosler, A. S. and A. Dharssi (2011). "Reliability of a survey tool for measuring
consumer nutrition environment in urban food stores." J Public Health Manag Pract
17(5): E1-8.
OBJECTIVE: Despite the increase in the volume and importance of food
environment research, there is a general lack of reliable measurement tools.
This study presents the development and reliability assessment of a tool for
measuring consumer nutrition environment in urban food stores. DESIGN:
Cross-sectional design. SETTING: A racially diverse downtown portion (6
ZIP code areas) in Albany, New York. PARTICIPANTS: A sample of 39 food
stores was visited by our research team in 2009 to 2010. These stores were
randomly selected from 123 eligible food stores identified through multiple
government lists and ground-truthing. MAIN OUTCOME MEASURES: The
Food Retail Outlet Survey Tool was developed to assess the presence of
selected food and nonfood items, placement, milk prices, physical
characteristics of the store, policy implementation, and advertisements on
outside windows. For in-store items, agreement of observations between
experienced and lightly trained surveyors was assessed. For window
advertisement assessments, inter-method agreement (on-site sketch vs
digital photo), and inter-rater agreement (both on-site) among lightly trained
surveyors were evaluated. Percent agreement, Kappa, and prevalenceadjusted bias-adjusted kappa were calculated for in-store observations.
Interclass correlation coefficients were calculated for window observations.
RESULTS: Twenty-seven of the 47 in-store items had 100% agreement.
The prevalence-adjusted bias-adjusted kappa indicated excellent
agreement (>/=0.90) on all items, except aisle width (0.74) and darkgreen/orange colored fresh vegetables (0.85). The store type
(nonconvenience store), the order of visits (first half), and the time to
complete survey (>10 minutes) were associated with lower reliability in
these 2 items. Both the inter-method and inter-rater agreements for window
advertisements were uniformly high (intraclass correlation coefficient ranged
0.94-1.00), indicating high reliability. CONCLUSIONS: The Food Retail
Outlet Survey Tool is a reliable tool for quickly measuring consumer nutrition
environment. It can be effectively used by an individual who attended a 30minute group briefing and practiced with 3 to 4 stores.
Huang, Y.-J., S. H. Wong, et al. (2011). "Reliability and validity of psychosocial and
environmental correlates measures of physical activity and screen-based
behaviors among Chinese children in Hong Kong." International Journal of
Behavioral Nutrition and Physical Activity 8.
Background: Insufficient participation in physical activity and excessive
screen time have been observed among Chinese children. The role of social
and environmental factors in shaping physical activity and sedentary
behaviors among Chinese children is under-investigated. The purpose of
the present study was to assess the reliability and validity of a questionnaire
to measure child-and parent-reported psychosocial and environmental
correlates of physical activity and screen-based behaviors among Chinese
children in Hong Kong. Methods: A total of 303 schoolchildren aged 9-14
years and their parents volunteered to participate in this study and 160 of
them completed the questionnaire twice within an interval of 10 days.
Intraclass correlation coefficients (ICCs), kappa statistics, and percent
agreement were performed to evaluate test-retest reliability of the
continuous and categorical variables, respectively. Exploratory factor
analyses (EFAs) were conducted to assess convergent validity of the
emergent scales. Cronbach's alpha and ICCs were performed to assess
internal and test-retest reliability of the emergent scales. Criterion validity
was assessed by correlating psychosocial and environmental measures
with self-reported physical activity and screen-based behaviors, measured
by a validated questionnaire. Results: Reliability statistics for both child-and
parent-reported continuous variables showed acceptable consistency for all
of the ICC values greater than 0.70. Kappa statistics showed fair to perfect
test-retest reliability for the categorical items. Adequate internal consistency
and test-retest reliability were observed in most of the emergent scales.
Criterion validity assessed by correlating psychosocial and environmental
measures with child-reported physical activity found associations with
physical activity in the self-efficacy scale (r = 0.25, P < 0.05), the peer
support for physical activity scale (r = 0.25, P < 0.05) and home physical
activity environmental (r = 0.14, P < 0.05). Children's screen-based
behaviors were associated with the family support for physical activity scale
(r = -0.22, P < 0.05) and parental role modeling of TV (r = 0.12, P = 0.053).
Conclusions: The findings provide psychometric support for using this
questionnaire for examining psychosocial and environmental correlates of
physical activity and screen-based behaviors among Chinese children in
Hong Kong. Further research is needed to develop more robust measures
based on the current questionnaire, especially for peer influence on physical
activity and parental rules on screen-based behaviors.
Imam, B. and W. C. Miller (2011). "Reliability and validity of scores of a Chinese
version of the Frenchay Activities Index." Arch Phys Med Rehabil 93(3): 520-6.
OBJECTIVE: To develop a Chinese version of the Frenchay Activities Index
(FAI-C) and evaluate the reliability and validity of its scores. DESIGN: A 2week test-retest study. SETTING: Chinese community in Vancouver, BC,
Canada. PARTICIPANTS: Data were collected using a convenience sample
of Chinese immigrants living in Vancouver, BC, Canada. Of the 73
participants, data from 66 participants were included in the analysis. The
total sample included 2 subsamples: community dwelling (n=32), and
assisted-living (n=34). Participants were 65 years or older, lived in Canada
for more than 5 years, and were able to read Chinese. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURE: FAI-C scores. RESULTS:
Test-retest reliability of the FAI-C scores assessed using an intraclass
correlation coefficient was .86 (95% confidence interval [CI], .79-.92) for the
total sample, .89 (95% CI, .78-.94) for the community-dwelling subsample,
and .71 (95% CI, .50-.85) for the assisted-living subsample. The minimal
detectable difference at the 95% CI was 8.64. Correlations between the FAIC and the Reintegration to Normal Living Index (r=.61, P<.01), Activitiesspecific Balance Confidence Scale (r=.55, P<.01), and Timed Up & Go test
(r=-.68, P<.01) were in the a priori hypothesized direction and magnitude.
CONCLUSIONS: The FAI-C scores are reliable and there is support for
validity. This tool enables us to measure social participation level in the
Chinese-speaking population.
Layne, C. S., S. K. Mama, et al. (2011). "Development of an ecologically valid
approach to assess moderate physical activity using accelerometry in community
dwelling women of color: A cross-sectional study." International Journal of
Behavioral Nutrition and Physical Activity 8.
Background: Women of color report the lowest levels of physical activity and
highest rates of overweight and obesity in the US. The purpose of this study
was to develop an individualized, ecologically valid, field based method to
assess physical activity over seven days for community dwelling women of
color using accelerometers. Methods: Accelerometer-measured physical
activity, Borg perceived exertion, demographics, blood pressure, heart rate,
and anthropometric measures were collected from African American and
Hispanic or Latina women (N = 209). A threshold for increased physical
activity was determined for each participant by calculating the average
count per minute (plus one standard deviation) for each participant collected
during a self-selected pace that corresponded to a 'recreational' walk about
their neighborhood. The threshold was then used to calculate the amount of
time spent doing increased intensity physical activity during a typical week.
Results: Women were middle-aged and obese (M BMI = 34.3 +/- 9.3). The
average individual activity counts per day ranged from 482-1368 in African
American women and 470-1302 in Hispanic or Latina women. On average,
African American women spent significantly more time doing what was
labeled 'increased' physical activity than Hispanic and Latino women.
However neither group approached recommended physical activity levels,
as African American women, averaged 1.73% and Hispanic and Latino
women averaged 0.83% of their day engaged in increased physical activity
(p < 0.05). Conclusions: This study presents a simple field-based method
for developing accelerometer thresholds that identify personalized
thresholds of moderate intensity physical activity that can be used by in
community-based settings. Findings highlight a need for physical activity
programs whose starting points are based upon the individual's typical
baseline physical activity level, which is likely to be well below the minimum
recommended published guidelines.
Leal, C., K. Bean, et al. (2011). "Are Associations Between Neighborhood
Socioeconomic Characteristics and Body Mass Index or Waist Circumference
Based on Model Extrapolations?" Epidemiology 22(5): 694-703.
Background: We investigated whether neighborhood socioeconomic
characteristics, measured within person-centered areas (ie, centered on
individuals' residences) are associated with body mass index (BMI
[kg/m(2)]) and waist circumference. We used propensity-score matching as
a diagnostic and validation tool to examine whether socio-spatial
segregation (and related structural confounding) allowed us to estimate
neighborhood socioeconomic effects adjusted for individual socioeconomic
characteristics without excessive model extrapolations. Methods: Using the
RECORD (Residential Environment and CORonary heart Disease) Cohort
Study, we conducted cross-sectional analyses of 7230 adults from the Paris
region. We first estimated the relationships of 3 neighborhood
socioeconomic indicators (education, income, real estate prices) with BMI
and waist circumference using traditional multilevel regression models
adjusted for individual covariates. Second, we examined whether these
associations persisted when estimated among participants exchangeable
based on their probability of living in low-socioeconomic-status
neighborhoods (propensity-score matched samples). Results: After
adjustment for covariates, BMI/waist circumference increased with
decreasing neighborhood socioeconomic status, especially with
neighborhood education measured within 500-m radius buffers around
residences; associations were stronger for women. With propensity-score
matching techniques, there was some overlap in the odds of exposure
between exposed and unexposed populations. As a function of socio-spatial
segregation and an indicator of whether the data support inferences, sample
size decreased by 17%-59% from the initial to the propensity-score matched
samples. Propensity-score matched models confirmed relationships
obtained from models in the entire sample. Conclusions: Overall, adjusted
associations between neighborhood socioeconomic variables and BMI/waist
circumference were empirically estimable in the French context, without
excessive model extrapolations, despite the extent of socio-spatial
segregation. (Epidemiology 2011; 22: 694-703)
Ohri-Vachaspati, P., L. Leviton, et al. (2011). "Strategies proposed by Healthy
Kids, Healthy Communities partnerships to prevent childhood obesity." Prev
Chronic Dis 9: E11.
INTRODUCTION: Healthy Kids, Healthy Communities (HKHC) is an
initiative of the Robert Wood Johnson Foundation to prevent obesity among
high-risk children by changing local policies, systems, and environments. In
2009, 105 community partnerships applied for funding from HKHC. Later
that year, the Centers for Disease Control and Prevention (CDC) released
recommended community strategies to prevent obesity by changing
environments and policies. The objective of this analysis was to describe
the strategies proposed by the 41 HKHC partnerships that received funding
and compare them to the CDC recommendations. METHODS: We analyzed
the funded proposals to assess the types and prevalence of the strategies
proposed and mapped them onto the CDC recommendations. RESULTS:
The most prevalent strategies proposed by HKHC-funded partnerships were
providing incentives to retailers to locate and serve healthier foods in
underserved areas, improving mechanisms for purchasing food from farms,
enhancing infrastructure that supports walking and cycling, and improving
access to outdoor recreational facilities. CONCLUSION: The strategies
proposed by HKHC partnerships were well aligned with the CDC
recommendations. The popular strategies proposed by HKHC partnerships
were those for which there were existing examples of successful
implementation. Our analysis provides an example of how information from
communities, obtained through grant-writing efforts, can be used to assess
the status of the field, guide future research, and provide direction for future
investments.
Quintas, R., E. Koutsogeorgou, et al. (2011). "The selection of items for the
preliminary version of the COURAGE in Europe built environment instrument."
Maturitas 71(2): 147-53.
The built environment can increase or decrease disability through its impact
on mobility or accessibility to infrastructures, and through its relation to
social environment. There is a need for the development of a tool which
allows to assess built environment in both objective and self-reported
manner, contemplating also issues of accessibility and disability, and that
allows data comparability across countries and populations. The present
paper describes the preliminary process of the development of a new built
environment instrument. It describes the process of the selection, creation
and categorisation of a pool of items from the 31 instruments resulting from
the UDHP Project. A pool of items was created and was used to produce
two lists: the outdoor checklist, and the self-reported questionnaire. These
two lists formed the basis of the COURAGE in Europe built environment
instrument. The outcome of this selection and categorisation process was
the creation of two lists of items, that are meant to measure the interaction
between the built environment and aspects of health and disability in
ageing.
Rhew, I. C., A. Vander Stoep, et al. (2011). "Validation of the normalized difference
vegetation index as a measure of neighborhood greenness." Ann Epidemiol
21(12): 946-52.
PURPOSE: To assess the validity of a Geographic Information Systems
(GIS) measure, the Normalized Difference Vegetation Index (NDVI), as a
measure of neighborhood greenness for epidemiologic research.
METHODS: Using remote-sensing spectral data, NDVI was calculated for a
100-m radial distance around 124 residences in greater Seattle. The
criterion standard was rating of greenness for corresponding residential
areas by 3 environmental psychologists. Pearson correlations and
regression models were used to assess the association between the
psychologists' ratings of greenness and NDVI. Analyses were also stratified
by residential density to assess whether the correlations differed between
low and high density. RESULTS: The mean NDVI among this sample of
residences was 0.27 (standard deviation [SD], 0.11; range, -0.04 to 0.54),
and the mean psychologist rating of greenness was 2.84 (SD, 0.98; range,
1-5). The correlation between NDVI and expert ratings of greenness was
high (r = 0.69). The correlation was equivalently strong within each strata of
residential density. CONCLUSIONS: NDVI is a useful measure of
neighborhood greenness. In addition to showing a strong correlation with
expert ratings, this measure has practical advantages, including availability
of data and ease of application to various boundaries, which would aid in
replication and comparability across studies.
Sharpe, P. A., S. Wilcox, et al. (2011). "Adherence to accelerometer protocols
among women from economically disadvantaged neighborhoods." J Phys Act
Health 8(5): 699-706.
BACKGROUND: Objective measurement of physical activity with
accelerometers is a challenging task in community-based intervention
research. Challenges include distribution of and orientation to monitors,
nonwear, incorrect placement, and loss of equipment. Data collection
among participants from disadvantaged populations may be further
hindered by factors such as transportation challenges, competing
responsibilities, and cultural considerations. METHODS: Research staff
distributed accelerometers and provided an orientation that was tailored to
the population group. General adherence strategies such as follow-up calls,
daily diaries, verbal and written instructions, and incentives were
accompanied by population-specific strategies such as assisting with
transportation, reducing obstacles to wearing the accelerometer, tailoring
the message to the participant population, and creating a nonjudgmental
environment. RESULTS: Sixty women asked to wear the Actigraph GT1M
returned the accelerometer, and 57 of them provided sufficient data for
analysis (at least 10 hours a day for a minimum of 4 days) resulting in 95%
adherence to the protocol. Participants wore the accelerometers for an
average of 5.98 days and 13.15 hours per day. CONCLUSIONS: The high
accelerometer monitoring adherence among this group of economically
disadvantaged women demonstrates that collection of high-quality, objective
physical activity data from disadvantaged populations in field-based
research is possible.
Thornton, L. E., J. R. Pearce, et al. (2011). "Using Geographic Information
Systems (GIS) to assess the role of the built environment in influencing obesity: a
glossary." International Journal of Behavioral Nutrition and Physical Activity 8.
Features of the built environment are increasingly being recognised as
potentially important determinants of obesity. This has come about, in part,
because of advances in methodological tools such as Geographic
Information Systems (GIS). GIS has made the procurement of data related
to the built environment easier and given researchers the flexibility to create
a new generation of environmental exposure measures such as the travel
time to the nearest supermarket or calculations of the amount of
neighbourhood greenspace. Given the rapid advances in the availability of
GIS data and the relative ease of use of GIS software, a glossary on the use
of GIS to assess the built environment is timely. As a case study, we draw
on aspects the food and physical activity environments as they might apply
to obesity, to define key GIS terms related to data collection, concepts, and
the measurement of environmental features.
Turrell, G., M. Haynes, et al. (2011). "Test-retest reliability of perceptions of the
neighborhood environment for physical activity by socioeconomic status." J Phys
Act Health 8(6): 829-40.
BACKGROUND: Further development of high quality measures of
neighborhood perceptions will require extensions and refinements to our
existing approaches to reliability assessment. This study examined the testretest reliability of perceptions of the neighborhood environment by
socioeconomic status (SES). METHODS: Test and retest surveys were
conducted using a mail survey method with persons aged 40 to 65 years (n
= 222, 78.2% response rate). SES was measured using the respondent's
education level and the socioeconomic characteristics of their neighborhood
of residence. Reliability was assessed using intraclass correlations (ICC)
estimated with random coefficient models. RESULTS: Overall, the 27 items
had moderate-to-substantial reliability (ICC = 0.41-0.74). Few statistically
significant differences were found in ICC between the education groups or
neighborhoods, although the ICCs were significantly larger among the low
SES for items that measured perceptions of neighborhood greenery,
interesting things to see, litter, traffic volume and speed, crime, and rowdy
youth on the streets. CONCLUSION: For the majority of the items, poor
reliability and subsequent exposure misclassification is no more or less
likely among low educated respondents and residents of disadvantaged
neighborhoods. Estimates of the association between neighborhood
perceptions and physical activity therefore are likely to be similarly precise
irrespective of the respondent's socioeconomic background.
Witten, K., J. Pearce, et al. (2011). "Neighbourhood Destination Accessibility
Index: a GIS tool for measuring infrastructure support for neighbourhood physical
activity." Environment and Planning A 43(1): 205-223.
The sharp increase in obesity in recent years has prompted researchers to
examine the various pathways through which urban built environments
influence population-level physical activity. Walking access to everyday
destinations is one such pathway. This paper describes a measure of
pedestrian access to neighbourhood destinations. Using eight domains of
neighbourhood destinations (education, transport, recreation, social and
cultural, food retail, financial, health, and other retail) we developed a GISbased 'Neighbourhood Destination Accessibility Index' (NDAI) for four New
Zealand cities. We found that the intensity of neighbourhood destination
opportunities varied considerably among cities and between
neighbourhoods within cities. Further, access to neighbourhood
infrastructural support tends to be better in more socially deprived places.
Potential explanations for the sociospatial distribution of neighbourhood
destinations in New Zealand cities include historical processes of residential
and economic development and infrastructural investment.
CHILHOOD OBESITY & MISCELLANEOUS
Carver, A., A. F. Timperio, et al. (2011). "How is active transport associated with
children's and adolescents' physical activity over time?" International Journal of
Behavioral Nutrition and Physical Activity 8.
Background: As few longitudinal studies have examined how active
transport is associated with physical activity among children and
adolescents over time, and how active transport tracks through childhood
and adolescence, it is important to understand whether physically active
children retain their activity patterns through adolescence. This study aimed
to examine (a) tracking of active transport and of moderate-to-vigorous
physical activity (MVPA) across childhood and adolescence in two age
cohorts; and (b) associations between active transport and MVPA at three
distinct time-points, over five years. Methods: This longitudinal study of two
cohorts aged 5-6 years (n = 134) and 10-12 years (n = 201) at baseline
(T1), in Melbourne, Australia, gathered follow-up data at three (T2) and five
years (T3). Walking/cycling to local destinations was survey-reported; while
MVPA was recorded using accelerometers and mean time spent daily in
MVPA on week days and on weekends was computed. Tracking of these
behaviours was examined over five years using General Estimating
Equations. Linear regression analyses were performed to examine
associations between active transport and MVPA at each time-point.
Results: Active transport tracked moderately among children (boys, beta(s)
= 0.36; girls, beta(s) = 0.51) but not among adolescents. Physical activity
tracked moderately (beta(s) value range: 0.33-0.55) for both cohorts. Active
transport was not associated with children's MVPA at any time-point, but
was associated with adolescent boys' MVPA on week days at T1 (B = 1.37
(95% CI: 0.15, 2.59)), at T2 (B = 1.27 (95% CI: 0.03, 2.51)) and at T3 (B =
0.74 (95% CI: 0.01, 1.47)), and with adolescent girls' MVPA on week days
(B = 0.40 (95% CI: 0.04, 0.76)) and on weekends (B = 0.54 (95% CI: 0.16,
0.93)) at T3 only. Conclusion: Active transport was associated only with
boys' MVPA during early adolescence and with boys' and girls' MVPA
during late adolescence. While active transport should be encouraged
among all school-aged children, it may provide an important source of
habitual physical activity for adolescent girls, in particular, among whom low
and declining physical activity levels have been reported world-wide.
Chung-Do, J. J., E. Davis, et al. (2011). "An Observational Study of Physical
Activity in Parks in Asian and Pacific Islander Communities in Urban Honolulu,
Hawaii, 2009." Preventing Chronic Disease 8(5).
Introduction Research on park use among Asians and Pacific Islanders is
limited. This study examined use and conditions of 6 urban parks, varying in
size, location, and neighborhood income level, in predominantly Asian and
Pacific Islander communities in Honolulu, Hawaii. Sociodemographic
predictors of park use were also identified. Methods Observations were
conducted from June through October 2009. Raters used the System for
Observing Play and Recreation in Communities to count the number of
people in predesignated zones and to code their physical activity level as
sedentary, moderate, or vigorous. Raters coded park conditions on the
basis of accessibility and usability, whether equipment and supervision were
provided, and whether organized activities were occurring. Differences
associated with sex and age of park users and income level of the
neighborhood were examined by using. X-2 and logistic regression. Results
Raters observed 6,477 park users, most of whom were men. Approximately
60% of users were sedentary, 26% were engaged in moderate activities,
and 14% performed vigorous activities. Women and girls were less active
than men and boys. More users were present in the evenings, but morning
users were more active. Although park users in low-income neighborhoods
were more active than users in high-income neighborhoods, fewer people
used the low-income parks. Most parks were accessible and usable but few
provided equipment and supervision. Organized activities were rarely
observed. Conclusion More efforts should be made to promote parks as a
physical activity resource in Asian and Pacific Islander communities,
particularly for women, girls, and low-income residents. More research
should be conducted to identify barriers and facilitators to park use,
especially among underrepresented populations.
Cleland, V., A. Timperio, et al. (2011). "A Longitudinal Study of the Family Physical
Activity Environment and Physical Activity Among Youth." American Journal of
Health Promotion 25(3): 159-167.
Purpose. Although the family environment is a potentially important
influence on children's physical activity (PA), prospective data investigating
these associations are lacking. This study aimed to examine the longitudinal
relationship between the family environment and PA among youth. Design.
A 5-year prospective cohort study. Setting. Nineteen randomly selected
public schools in Melbourne, Australia. Subjects. Families of 5- to 6-year-old
(n = 190) and 10- to 12-year-old (n = 350) children. Measures. In 2001,
parents reported their participation in PA, family-based PA, and support and
reinforcement for their child's PA. In 2001, 2004, and 2006, moderate to
vigorous intensity PA (MVPA) was assessed among youth using
accelerometers. Weekend and "critical window" (after school until 6:00
P.M.) MVPA were examined because we hypothesized that the family
environment would most likely influence these behaviors. Analysis.
Generalized estimating equations predicted average change in MVPA over
5 years from baseline family environment factors. Results. Maternal role
modeling was positively associated with boys' critical window and weekend
(younger boys) MVPA. Paternal reinforcement of PA was positively
associated with critical window and weekend MVPA among all boys, and
paternal direct support was positively associated with weekend MVPA (older
boys). Among girls, maternal coparticipation in PA predicted critical window
MVPA, and sibling coparticipation in PA was directly associated with
weekend MVPA (younger girls). Conclusions. Longitudinal relationships,
although weak in magnitude, were observed between the family
environment and MVPA among youth. Interventions promoting maternal role
modeling, paternal reinforcement of and support for PA, and Maternal and
sibling coparticipation in PA with youth are warranted. (Am J Health Promot
2011;25131:159-167.)
Hanibuchi, T., K. Kondo, et al. (2011). "Neighborhood food environment and body
mass index among Japanese older adults: results from the Aichi Gerontological
Evaluation Study (AGES)." International Journal of Health Geographics 10.
Background: The majority of studies of the local food environment in relation
to obesity risk have been conducted in the US, UK, and Australia. The
evidence remains limited to western societies. The aim of this paper is to
examine the association of local food environment to body mass index
(BMI) in a study of older Japanese individuals. Methods: The analysis was
based on 12,595 respondents from cross-sectional data of the Aichi
Gerontological Evaluation Study (AGES), conducted in 2006 and 2007.
Using Geographic Information Systems (GIS), we mapped respondents'
access to supermarkets, convenience stores, and fast food outlets, based
on a street network (both the distance to the nearest stores and the number
of stores within 500 m of the respondents' home). Multiple linear regression
and logistic regression analyses were performed to examine the association
between food environment and BMI. Results: In contrast to previous reports,
we found that better access to supermarkets was related to higher BMI.
Better access to fast food outlets or convenience stores was also
associated with higher BMI, but only among those living alone. The logistic
regression analysis, using categorized BMI, showed that the access to
supermarkets was only related to being overweight or obese, but not related
to being underweight. Conclusions: Our findings provide mixed support for
the types of food environment measures previously used in western
settings. Importantly, our results suggest the need to develop culturespecific approaches to characterizing neighborhood contexts when
hypotheses are extrapolated across national borders.
McCormack, G. R., P. Hawe, et al. (2011). "Associations between familial
affluence and obesity risk behaviours among children." Paediatrics & Child Health
16(1): 19-24.
BACKGROUND: Results of studies examining associations between
socioeconomic status and obesity among children are mixed. OBJECTIVE:
To examine whether physical activity, television viewing, computer use, and
fruit, vegetable, soft drink and sweet consumption differed according to
familial affluence of children attending schools in disadvantaged
communities. METHOD: A total of 218 children (seven to 11 years of age)
recruited from three Calgary (Alberta) schools located in two adjacent
socioeconomically disadvantaged neighbourhoods completed online
surveys during the spring of 2005/2006. The number of days per week
participating in vigorous physical activity for more than 20 min, and weekly
frequency of fruit, vegetable, sweet and soft drink consumption were
collected. Time spent watching television and using a computer during a
normal school day was also captured. A family affluence scale was used to
assess socioeconomic status (number of family holidays in the past year,
ownership of motor vehicles and computers, and bedroom sharing).
Associations between familial affluence and obesity risk behaviours were
estimated using Pearson's correlation and demographic-adjusted logistic
regression ORs. RESULTS: Higher family affluence scale scores were
significantly associated with weekly fruit consumption (r= 0.14). Children
with lower affluence were less likely to participate in vigorous physical
activity five days/week or more (OR= 0.39), and to use a computer for more
than 2 h/day (OR= 0.41) than children with higher affluence. Linear trends
between familial affluence and the likelihood of participating in physical
activity and using a computer were also found. However, no other
behaviours were related to affluence. CONCLUSIONS: Increasing
opportunities for physical activity and accessibility to healthy food may be
important for reducing obesity risk among less affluent children.
Mellor, J. M., C. B. Dolan, et al. (2011). "Child body mass index, obesity, and
proximity to fast food restaurants." International Journal of Pediatric Obesity 6(1):
60-68.
Objectives. Using a sample of elementary and middle school students, we
examined the associations between body mass index (BMI), obesity, and
measures of the proximity of fast food and full service restaurants to
students' residences. We controlled for socioeconomic status using a novel
proxy measure based on housing values. Methods. We used BMI and
obesity measures based on height and weight data collected as part of a
school health assessment along with geocoded data on addresses of
residences and food establishments. We constructed a proxy measure of
socioeconomic status from public records of residential property
assessments. These data were used to estimate logistic regression models
of overweight and ordinary least squares models of BMI. Results. Students
residing in homes with higher assessment values were significantly less
likely to be obese, and had significantly lower BMIs. Upon controlling for
socioeconomic status and other characteristics, the associations of BMI and
obesity with proximity to food service establishments were reduced.
Nonetheless, students who resided within one-tenth or one-quarter of a mile
from a fast food restaurant had significantly higher values of BMI. The
proximity of full service restaurants to residences did not have a significant
positive association with either BMI or overweight. Conclusion. Public health
efforts to limit access to fast food among nearby residents could have
beneficial effects on child obesity. Public data on property value
assessments may serve as useful approximations for socioeconomic status
when address data are available.</.
Pabayo, R., L. Gauvin, et al. (2011). "Longitudinal changes in active transportation
to school in Canadian youth aged 6 through 16 years." Pediatrics 128(2): e404-13.
BACKGROUND: Concern has been raised regarding the increased
prevalence of physical inactivity among children. Active transportation, such
as walking and cycling to school, is an opportunity for children to be
physically active. OBJECTIVE: To identify the sociodemographic predictors
of active transportation to schools across time among school-aged children
participating in the Canadian National Longitudinal Survey of Children and
Youth (NLSCY). METHODS: The sample included 7690 school-aged
children attending public schools who were drawn from cycle 2 (1996 and
1997) of the Canadian NLSCY. Data were collected through interviews with
the person most knowledgeable about the child. Parents were asked how
their child usually gets to school. Responses were dichotomized into active
(walking or bicycling) or inactive (school bus, public transit, is driven, or
multiple) modes. Using 3 waves of data from the Canadian NLSCY (19962001), we estimated the effect of sociodemographic factors on the likelihood
of active transportation to school across time using random-effects models.
RESULTS: Longitudinal analyses indicated that as children aged, the
likelihood of using active transportation to school increased, peaked at the
age of 10 years, and then decreased. Urban settings (odds ratio [OR]: 3.66
[95% confidence interval (CI): 3.23-4.15]), households with inadequate
income (OR: 1.21 [95% CI: 1.06-1.38]), living with 1 parent (OR: 1.46 [95%
CI: 1.29-1.65]), and having an older sibling living at home (OR: 1.14 [95%
CI: 1.04-1.25]) were significant predictors of active transportation to school
at baseline and carried through across time. CONCLUSIONS:
Understanding the factors that influence active transportation may support
its adoption by children, which in turn may contribute to meeting physical
activity guidelines.
Prince, S. A., E. A. Kristjansson, et al. (2011). "A Multilevel Analysis of
Neighbourhood Built and Social Environments and Adult Self-Reported Physical
Activity and Body Mass Index in Ottawa, Canada." International Journal of
Environmental Research and Public Health 8(10): 3953-3978.
Canadian research examining the combined effects of social and built
environments on physical activity (PA) and obesity is limited. The purpose of
this study was to determine the relationships among built and social
environments and PA and overweight/obesity in 85 Ottawa neighbourhoods.
Self-reported PA, height and weight were collected from 3,883 adults using
the International PA Questionnaire from the 2003-2007 samples of the
Rapid Risk Factor Surveillance System. Data on neighbourhood
characteristics were obtained from the Ottawa Neighbourhood Study; a
large study of neighbourhoods and health in Ottawa. Two-level binomial
logistic regression models stratified by sex were used to examine the
relationships of environmental and individual variables with PA and
overweight/obesity while using survey weights. Results identified that
approximately half of the adults were insufficiently active or
overweight/obese. Multilevel models identified that for every additional
convenience store, men were two times more likely to be physically active
(OR = 2.08, 95% CI: 1.72, 2.43) and with every additional specialty food
store women were almost two times more likely to be overweight or obese
(OR = 1.77, 95% CI: 1.33, 2.20). Higher green space was associated with a
reduced likelihood of PA (OR = 0.93, 95% CI: 0.86, 0.99) and increased
odds of overweight and obesity in men (OR = 1.10, 95% CI: 1.01, 1.19), and
decreased odds of overweight/obesity in women (OR = 0.66, 95% CI: 0.44,
0.89). In men, neighbourhood socioeconomic scores, voting rates and
sense of community belonging were all significantly associated with
overweight/obesity. Intraclass coefficients were low, but identified that the
majority of neighbourhood variation in outcomes was explained by the
models. Findings identified that green space, food landscapes and social
cohesiveness may play different roles on PA and overweight/obesity in men
and women and future prospective studies are needed.
Rung, A. L., A. J. Mowen, et al. (2011). "The Role of Park Conditions and Features
on Park Visitation and Physical Activity." Journal of Physical Activity & Health:
S178-S187.
Background: Neighborhood parks play an important role in promoting
physical activity. We examined the effect of activity area, condition, and
presence of supporting features on number of park users and park-based
physical activity levels. Methods: 37 parks and 154 activity areas within
parks were assessed during summer 2008 for their features and park-based
physical activity. Outcomes included any park use, number of park users,
mean and total energy expenditure. Independent variables included type
and condition of activity area, supporting features, size of activity area,
gender, and day of week. Multilevel models controlled for clustering of
observations at activity area and park levels. Results: Type of activity area
was associated with number of park users, mean and total energy
expenditure, with basketball courts having the highest number of users and
total energy expenditure, and playgrounds having the highest mean energy
expenditure. Condition of activity areas was positively associated with
number of basketball court users and inversely associated with number of
green space users and total green space energy expenditure. Various
supporting features were both positively and negatively associated with
each outcome. Conclusions: This study provides evidence regarding
characteristics of parks that can contribute to achieving physical activity
goals within recreational spaces. ABSTRACT FROM AUTHOR
Wolch, J., M. Jerrett, et al. (2011). "Childhood obesity and proximity to urban parks
and recreational resources: A longitudinal cohort study." Health & Place 17(1):
207-214.
The objective of the research was to assess how proximity to parks and
recreational resources affects the development of childhood obesity through
a longitudinal study. Data were collected on 3173 children aged 9-10 from
12 communities in Southern California in 1993 and 1996. Children were
followed for eight years to collect longitudinal information, including
objectively measured body mass index (BMI). Multilevel growth curve
models were used to assess associations between attained BMI growth at
age 18 and numerous environmental variables, including park space and
recreational program access. For park acres within a 500 m distance of
children's homes, there were significant inverse associations with attained
BMI at age 18. Effect sizes were larger for boys than for girls. Recreation
programs within a 10 km buffer of children's homes were significantly and
inversely associated with achieved levels in BMI at age 18, with effect sizes
for boys also larger than those for girls. We conclude that children with
better access to parks and recreational resources are less likely to
experience significant increases in attained BMI. (C) 2010 Elsevier Ltd. All
rights reserved.
Zenk, S. N., A. J. Schulz, et al. (2011). "Activity space environment and dietary and
physical activity behaviors: A pilot study." Health & Place 17(5): 1150-1161.
This study examined relationships among individual demographics,
environmental features (e.g., fast food outlet density, park land use) of
residential neighborhoods and activity spaces, and weight-related behaviors
(diet, physical activity). Participants' movement was tracked for 7 days using
global positioning systems (GPS). Two activity space measures (one
standard deviation ellipse, daily path area) were derived from the GPS data.
Activity spaces were generally larger than residential neighborhoods;
environmental features of residential neighborhoods and activity spaces
were weakly associated; and some activity space environmental features
were related to dietary behaviors. Activity spaces may provide new insights
into environmental influences on obesity-related behaviors. (C) 2011
Elsevier Ltd. All rights reserved.