Objectively measured access to recreational destinations and leisure-time physical activity: Associations and demographic moderators in a six-country study

Effects of the leisure-time physical activity environment on odds of glycemic control among a nationwide cohort of United States veterans with a new type-2 diabetes diagnosis

OBJECTIVE

This study examined associations between access to leisure-time physical activity (LTPA) facilities and parks and repeated measures of glycated hemoglobin (A1C) over time, using follow-up tests among United States Veterans with newly diagnosed type-2 diabetes (T2D).

METHODS

Data were analyzed from 274,463 patients in the Veterans Administration Diabetes Risk cohort who were newly diagnosed with T2D between 2008 and 2018 and followed through 2023. Generalized estimating equations with a logit link function and binomial logistic regression were used to examine associations.

RESULTS

Patients were on average 60.5 years of age, predominantly male (95.0 %) and white (66.9 %), and had an average of 11.7 A1C tests during the study follow-up period. In high- and low-density urban communities, a one-unit higher LTPA facility density score was associated with 1 % and 3 % greater likelihood of in-range A1C tests during follow-up, respectively, but no association was observed among patients living in suburban/small town and rural communities. Across community types, closer park distance was not associated with subsequent greater odds of in-range A1C tests. Unexpectedly, in low-density urban areas, the likelihood of in-range A1C tests was 1 % lower at farther park distances.

CONCLUSIONS

These results suggest that broader access to LTPA facilities, but not park proximity, may contribute in small ways to maintaining glycemic control after T2D diagnosis in urban communities. Tailored interventions may be needed to promote patients' effective use of LTPA facilities and parks.

The relationship between exercise habits and mental health among university students in China: a cross-sectional study based on instrumental variable analysis

BACKGROUND

Exercise habits significantly influence the mental health of university students. However, previous research has often neglected the endogeneity issues in this context, leading to biased estimates and limiting the ability to establish a clear causal relationship. This study aimed to address endogeneity issues and investigate the causal effect of exercise habits on the mental health of university students.

METHODS

This cross-sectional study was conducted involving 1,120 university students from China. Data on demographic characteristics, exercise habits, and mental health were collected using both online and offline questionnaires. To evaluate the mental health benefits of exercise habits, we employed both the instrumental variable (IV) approach and ordinary least squares (OLS) regression.

RESULTS

The OLS estimates revealed a positive association between exercise habits and positive affect (β = 0.179, p < .001), life satisfaction (β = 0.134, p < .001), and self-actualization (β = 0.086, p < .001) among university students. The IV analysis indicated that exercise habits positively influenced positive affect (β = 0.263, p < .001), life satisfaction (β = 0.151, p = .006 < .01), and self-actualization (β = 0.102, p = .013 < .05). A comparison of the estimation results suggests that the OLS approach underestimates the mental health benefits of exercise habits.

CONCLUSIONS

This study provides preliminary causal evidence that exercise habits contribute to the promotion of mental health in university students. These findings offer valuable insights into potential preventive strategies for addressing mental health issues in this population through exercise interventions.

Effects of built and natural environments on leisure physical activity in residential and workplace neighborhoods

Few studies have investigated relative contributions of the built and natural environments to and their nonlinear associations with leisure physical activity (PA) in different spatial contexts. Applying gradient boosting decision tree models to data comprising 1049 adults collected in Shanghai, we investigated the associations between built and natural environments and leisure PA in residential and workplace neighborhoods. Results show that the built environment is more important than the natural environment to leisure PA in both residences and workplaces. Environmental attributes have nonlinear and threshold effects. Within certain ranges, land use mix and population density have opposite associations with leisure PA in residences and workplaces, whereas the distance to the city center and the area of water are associated with leisure PA in residences and workplaces with the same direction. These findings help urban planners design context-specific environmental interventions for supporting leisure PA.

Distance to sports facilities and low frequency of exercise and obesity: a cross-sectional study

Background

Little research has investigated the associations between proximity to physical activity facilities and behavior-related health and the majority have focused on proximity from home address. We add to the literature by examining proximity of these facilities to work and home address and including a wide range of physical activity facilities. We assess the associations for proximity of physical activity facilities from home and work address with self-reported frequency of exercise and obesity.

Methods

Our analytical sample of 7358 participants was from the 2018 wave of the Swedish Longitudinal Occupational Survey of Health. We used logistic binomial regression adjusting for age, sex, education, civil status, individual socioeconomic status, neighborhood socioeconomic status, number of children under 12 years of age, work strain, and chronic disease.

Results

Longer distance from home to paid outdoor and paid indoor physical activity facilities was associated with low frequency of exercise (fully adjusted Relative Risk for both 1.01, 95% CI 1.01–1.02). Associations of any or free outdoor facility with low frequency of exercise were not robust. Findings also indicated associations between long distance from workplace to any and paid outdoor facility and low frequency of exercise. Results for obesity were in the similar direction, however, these were not statistically significant.

Conclusion

Increased distance of paid outdoor and paid indoor physical activity facilities from home and of paid outdoor facilities from work was associated with low frequency of exercise. Longitudinal and larger studies are needed to confirm our findings, particularly regarding obesity.

Understanding different cultural ecosystem services: An exploration of rural landscape preferences based on geographic and social media data

Rural landscapes offer a variety of cultural ecosystem services (CESs). However, the relationship between rural landscape characteristics and different CESs is still poorly understood. Therefore, this study explored the rural areas of Huzhou city, China, as a case study to assess the main rural landscape characteristics of different CESs based on public preferences. First, 148 scenic spots were classified into four CESs (physical, experiential, intellectual and inspirational), and the public preferences for each scenic spot were determined by combining tourists' scores obtained from social media and government assessment scores. Then, the landscape characteristic indicators were constructed from the natural, infrastructural and sensory perspectives by combining geographic and social media data. Finally, the random forest model was used to evaluate the public preferences for rural landscape characteristics overall and for different CESs. The word frequency analysis showed that, in addition to the nature landscape, infrastructure and service had a strong influence on public preferences. The relationship with rural landscape characteristics varied across different CESs. For physical CESs, the convenience of infrastructure played a greater role than natural landscape characteristics. Experiential CESs, on the other hand, were affected by natural landscape characteristics themselves. Intellectual CESs had higher requirements for both infrastructure and nature. Inspirational CESs included sensory evaluation indicators, in addition to their focus on natural landscape characteristics and infrastructure, indicating that this category of CESs was more concerned with inner experience. The use of social media data has enriched the dimensions of sensory elements and provided new ideas and information supplements for comprehensively understanding different CESs, thus better supporting the management, planning and protection of rural landscapes.

The Associations Between Access to Recreational Facilities and Adherence to the American Heart Association's Physical Activity Guidelines in US Adults

Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines. Methodology: This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 (n = 1,750). The main exposure variable was access to free or low-cost recreational facilities. The main outcome variable was meeting the AHA guidelines of 150 min moderate PA or 75 min vigorous PA per week. Covariates included age, sex, level of education, overall health, BMI, ethnicity, hours of work per week, income, and time living at current address. Unadjusted and adjusted logistic regression analysis were used to calculate measures of odds ratio (OR) and corresponding 95% confidence interval (CI). Results: Of the 1,750 included participants, 61.7% (n = 1,079) reported to have access to recreational facilities. Of those with access to facilities, 69.9% met AHA PA guidelines while 30.4% did not. After adjusting for covariates, participants who reported access to recreational facilities were 42% more likely to meet AHA PA guidelines compared with participants who did not (adjusted OR 1.42; 95% CI 1.14-1.76). Secondary results suggest that healthier individuals were more likely to have met AHA PA guidelines. Conclusions: Having access to free or low-cost recreational facilities such as parks, walking trails, bike paths and courts was associated with meeting the AHA PA guidelines. Increasing prevalence and awareness of neighborhood recreational facilities could assist in access to these facilities and increase the ability of individuals to meet AHA PA guidelines. Future research should determine which types of recreational facilities impact physical activity strongest and discover methods of increasing their awareness.

Impact of the COVID-19 Pandemic on Physical Activity and Sedentary Behaviour: A Qualitative Study in a Canadian City

Public health measures introduced to combat the COVID-19 pandemic have impacted the physical activity, health, and well-being of millions of people. This grounded theory study explored how the COVID-19 pandemic has affected physical activity and perceptions of health among adults in a Canadian city (Calgary). Twelve adults (50% females; 20-70 years) were interviewed between June and October (2020) via telephone or videoconferencing. Using a maximum variation strategy, participants with a range of sociodemographic characteristics, physical activity levels, and perceptions of seriousness and anxiety related to COVID-19 were selected. Semi-structured interviews captured participant perceptions of how their physical activity and perceptions of health changed during the pandemic. Using thematic analysis, four themes were identified: (1) Disruption to Daily Routines, (2) Changes in Physical Activity, (3) Balancing Health, and (4) Family Life. Participants experienced different degrees of disruption in their daily routines and physical activity based on their individual circumstances (e.g., pre-pandemic physical activity, family life, and access to resources). Although participants faced challenges in modifying their daily routines and physical activity, many adapted. Some participants reported enhanced feelings of well-being. Public health strategies that encourage physical activity and promote health should be supported as they are needed during pandemics, such as COVID-19.

International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures

INTRODUCTION

Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese).

METHODS AND ANALYSIS

The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status.

ETHICS AND DISSEMINATION

Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.