1
|
Høyer-Kruse J, Schmidt EB, Hansen AF, Pedersen MRL. The interplay between social environment and opportunities for physical activity within the built environment: a scoping review. BMC Public Health 2024; 24:2361. [PMID: 39215315 PMCID: PMC11363614 DOI: 10.1186/s12889-024-19733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The association between social and built environments plays a crucial role in influencing physical activity levels. However, a thorough understanding of their combined impact remains unclear. This scoping review seeks to clarify the interplay between social environments and opportunities for physical activity within different built environments, with a particular focus on the implications of socioeconomic status and urban planning on physical activity participation. METHODS We conducted a systematic literature search across several databases to identify studies exploring the associations between social factors, built environment characteristics, and physical activity levels. The inclusion criteria were studies published in English between 2000 and 2022, encompassing urban, suburban, and rural contexts. Thematic analysis was employed to categorise studies based on the specific aspects of the built environment they investigated (walking infrastructure, cycling infrastructure, parks and open spaces, and sports facilities) and the social determinants they examined. RESULTS A total of 72 studies were included in the review, illustrating a multifaceted relationship between access to physical activity opportunities and social determinants such as socioeconomic status, community engagement, and urban design. The findings highlight the significant role of socioeconomic factors and the quality of PA infrastructure in promoting or hindering PA across communities. Effective urban planning was identified as crucial in providing expanded physical activity opportunities, notably through more pedestrian-friendly environments, comprehensive cycling infrastructure, and accessible green spaces and sports facilities. CONCLUSIONS This review emphasises the significant impact of socioeconomic status and urban planning on access to physical activity opportunities. This underscores the necessity for urban planning policies to adopt an inclusive approach, considering the varied needs of different population groups to ensure equitable access to physical activity resources. Such strategies are crucial for public health initiatives aimed at enhancing physical activity levels across diverse community sectors, offering a potential avenue to alleviate health disparities associated with inactivity.
Collapse
Affiliation(s)
- Jens Høyer-Kruse
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, 5230, Denmark
| | - Eva Berthelsen Schmidt
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, 5230, Denmark
| | - Anne Faber Hansen
- Department of Teaching and Dissemination, University Library of Southern Denmark, Odense M, 5230, Denmark
| | | |
Collapse
|
2
|
Bai P, Schipperijn J, Rosenberg M, Christian H. Preschool children's physical activity in the home, childcare and neighbourhood environment: A latent profile analysis using device-based measures. J Sports Sci 2024; 42:1173-1183. [PMID: 39120486 DOI: 10.1080/02640414.2024.2376392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 06/28/2024] [Indexed: 08/10/2024]
Abstract
Based on the socioecological conceptual model, the physical environment within the home, childcare and neighbourhood domains are key factors that influence preschool children's physical activity; however, the relative importance of each of these domains for preschool children's physical activity is unclear. We explored the physical environment characteristics within three latent profiles of 115 preschool children aged 2-5 years based on where they accumulated moderate-to-vigorous physical activity (MVPA) across five GPS-derived environmental domains. The three profiles were "Active at home" (n = 41), "Active except close to home" (n = 61), and "Active except in local neighbourhood" (n = 13). Compared to other profiles, "Active at home" had fewer parks and playgrounds within their 500-1600 m neighbourhood. Findings suggest preschool children's MVPA profiles are reflections of their physical environmental opportunities.
Collapse
Affiliation(s)
- Pulan Bai
- School of Population and Global Health, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Hayley Christian
- School of Population and Global Health, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| |
Collapse
|
3
|
Gripko M, Joseph A. The Role of the Built Environment in Supporting Older Adults' Engagement: A Narrative Literature Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024:19375867241250320. [PMID: 38738947 DOI: 10.1177/19375867241250320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVE This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods. BACKGROUND Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts. METHODS A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being. RESULTS Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security. CONCLUSIONS Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.
Collapse
Affiliation(s)
- Monica Gripko
- Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| |
Collapse
|
4
|
Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes. DATA SOURCES PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021. STUDY SECTION Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted. DATA EXTRACTION The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted. DATA SYNTHESIS Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors. CONCLUSIONS Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.
Collapse
Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| |
Collapse
|
5
|
Odden MC, Li Y, Thorpe RJ, Tan A, Sims KD, Ratcliff J, Abdel Magid HS, Sims M. Neighborhood factors and survival to old age: The Jackson Heart Study. Prev Med Rep 2023; 35:102360. [PMID: 37588880 PMCID: PMC10425932 DOI: 10.1016/j.pmedr.2023.102360] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
Few studies have evaluated environmental factors that predict survival to old age. Our study included 913 African American participants in the Jackson Heart Study (JHS) who resided in the tri-county area of the Jackson, MS metropolitan area and were 65-80 years at baseline. Participants were followed from 2000 through 2019 for the outcome of survival to 85 years old. We evaluated each of the following census tract-level measures of the social/physical environment as exposures: socioeconomic status, cohesion, violence, disorder, healthy food stores, residential land use, and walkability. We assessed mediation by physical activity and chronic conditions. As a complementary ecologic analysis, we used census-tract data to examine factors associated with a greater life expectancy. A total of 501 (55%) JHS participants survived to age 85 years or older. Higher social cohesion and greater residential land use were modestly associated with survival to old age (risk difference = 25%, 95% CI: 0-49%; and 4%, 95% CI: 1-7%, respectively). These neighborhood effects were modestly mediated through leisure time physical activity; additionally, social cohesion was mediated through home and yard activity. In our ecologic analysis, a greater percentage of homeowners and a greater proportion of people living in partnered families were associated with higher census-tract level life expectancy. African American older adults living in residential neighborhoods or neighborhoods with high social cohesion were more likely to survive to old age.
Collapse
Affiliation(s)
- Michelle C. Odden
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Yongmei Li
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Roland J. Thorpe
- Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Annabel Tan
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Kendra D. Sims
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Jourdan Ratcliff
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Hoda S. Abdel Magid
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
- Department of Social Medicine, Population and Public Health, University of California Riverside School of Medicine, Riverside, CA, United States
| |
Collapse
|
6
|
Schnettler B, Lobos G, Orellana L, Adasme-Berríos C, Lapo M, Beroíza K. Profiles of older adults according to their life and food-related life satisfaction during the COVID-19 pandemic: the importance of the social environment. Front Public Health 2023; 11:1165256. [PMID: 37663848 PMCID: PMC10470648 DOI: 10.3389/fpubh.2023.1165256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/20/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Older adults are a highly heterogeneous population, as individuals of the same age can show considerable variations in personal characteristics and living conditions. Risk and protective factors for older adults' subjective wellbeing during the COVID-19 pandemic can be explored by examining how life satisfaction, food-related life satisfaction, and associated variables coexist among these individuals. On this basis, this study aimed to identify older adult profiles based on their levels of life and food-related life satisfaction; to characterize these profiles by diet quality, social support, financial wellbeing, and sociodemographic characteristics; and to identify variables associated with higher life and food-related life satisfaction. Methods The sample included 1,371 institutionalized and non-institutionalized individuals over the age of 60, from four cities in Chile. Participants answered a survey, either online or face to face, with questions about life and food-related life satisfaction, perceived social support from family, friends, and others, food quality, financial wellbeing/distress, sociodemographic characteristics, and prior COVID-19 infection. Results Using a latent profile analysis, we identified three profiles of older adults: Profile 1: Unsatisfied with their life, somewhat satisfied with their food-related life (5.40%); Profile 2: Somewhat satisfied with their life, satisfied with their food-related life (65.06%); Profile 3: Extremely satisfied with their life and food-related life (29.54%). Profiles differed by residence (institutionalized vs. independent), age, marital status, social support, financial wellbeing, COVID-19 infection, and city of residence. Discussion The patterns of association between life and food-related satisfaction and related variables indicate conditions of vulnerability and protection related to living conditions, the social dimensions of food consumption, and social support. These results underscore the need for identifying groups of older adults based on diverse characteristics and conditions outside of chronological age.
Collapse
Affiliation(s)
- Berta Schnettler
- Facultad de Ciencias Agropecuarias y Medioambiente, Universidad de La Frontera, Temuco, Chile
- Scientific and Technological Bioresource Nucleus (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Germán Lobos
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile
| | - Ligia Orellana
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Núcleo de Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
- Departamento de Psicología, Universidad de La Frontera, Temuco, Chile
| | | | - María Lapo
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Katherine Beroíza
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
| |
Collapse
|
7
|
Wei L, Xu J, Luo C, Lu R, Shi H. Latent Profile Analysis of Self-Supporting Ability among Rural Empty-Nesters in Northwestern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:711. [PMID: 36613031 PMCID: PMC9819806 DOI: 10.3390/ijerph20010711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
The present study aimed to examine the multi-faceted self-supporting ability profiles of rural empty-nesters in northwestern China on the basis of the self-care ability, economic self-support ability, health self-maintenance ability, physical health self-maintenance ability, and psychological health self-maintenance ability using latent profile analysis. It identified the association of self-supporting ability profiles with demographic variables and sense of coherence. The analysis included 1066 participants (mean age = 70.2; SD = 4.3). The results of latent profile analysis identified three distinctive patterns of self-supporting ability―low physical health self-maintenance ability (C1, 20.5%), low psychological health self-maintenance ability (C2, 31.4%), and high social self-adaption ability (C3, 48.0%). The specific demographic variable age (p < 0.05), monthly income (p < 0.05), education level (p < 0.05), how often their children visit (p < 0.05), how often their children contact them (p < 0.05), whether they drink (p < 0.05), the frequency of physical exercise (p < 0.05), relationship with children (p < 0.05), relationship with neighbours (p < 0.05), medical insurance (p < 0.05), and the number of chronic diseases (p < 0.05) were significantly different among the identified three profiles. A statistically significant positive association existed between self-supporting ability profiles and sense of coherence (SOC) (p < 0.001). The results of multinomial logistic regression showed that a greater sense of coherence (SOC), age ≥ 80, monthly income (RMB) (RMB is the abbreviation for Renminbi) < 1000, a good relationship with neighbours, and one type of chronic disease were significantly associated with C1 when compared with C3 (p < 0.05). Furthermore, a greater SOC, their children visiting and contacting them many times per week or once per week were more significantly related to C2 than to C3 (p < 0.05). This study revealed three groups of self-supporting ability and its related predictors in empty-nesters. The predictors related to particular classes of self-supporting ability can provide information for targeted interventions to improve the self-supporting ability of empty-nesters living in rural areas.
Collapse
|
8
|
Paydar M, Kamani Fard A. Walking Behavior of Older Adults in Temuco, Chile: The Contribution of the Built Environment and Socio-Demographic Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14625. [PMID: 36429346 PMCID: PMC9690361 DOI: 10.3390/ijerph192214625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The amount of walking for daily transport has decreased significantly over the last decades in Temuco, Chile. Moreover, the percentage of older adults (aged over 65) who did not meet the recommendations of at least 150 min of physical activity per week has increased during this time. In this regard, the present study examines the contribution of socio-demographic and built environment factors on the walking behavior of older adults in Temuco, Chile, with a view to improving their level of physical activity. A cross-sectional study was conducted among 463 older adults aged 60 years and over. Travel Diary Data taken from "Encuesta Origin Destino" (EOD) 2013, Geographic information systems (GIS), audits (PEDS with certain revisions) and finally, multiple regression analysis, were used to examine the objectives. Associations were found between the walking behavior of older adults and several socio-demographic factors, as well as several built environment factors including destination (the number of parks and the land use mix), functionality (street connectivity, length of street sections and off-street parking lots) and aesthetics (views of nature, building height, and articulation in building design). These findings should be considered by urban/transport policymakers to improve the walking behavior of older adults in this city.
Collapse
Affiliation(s)
- Mohammad Paydar
- Escuela de Arquitectura Temuco, Facultad de Ciencias Sociales y Artes, Universidad Mayor, Av. Alemania 0281, Temuco 4780000, Chile
| | - Asal Kamani Fard
- Universidad Católica del Maule, San Miguel 3605, Talca 3460000, Chile
| |
Collapse
|
9
|
Pontin FL, Jenneson VL, Morris MA, Clarke GP, Lomax NM. Objectively measuring the association between the built environment and physical activity: a systematic review and reporting framework. Int J Behav Nutr Phys Act 2022; 19:119. [PMID: 36104757 PMCID: PMC9476279 DOI: 10.1186/s12966-022-01352-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Objective measures of built environment and physical activity provide the opportunity to directly compare their relationship across different populations and spatial contexts. This systematic review synthesises the current body of knowledge and knowledge gaps around the impact of objectively measured built environment metrics on physical activity levels in adults (≥ 18 years). Additionally, this review aims to address the need for improved quality of methodological reporting to evaluate studies and improve inter-study comparability though the creation of a reporting framework.
Methods
A systematic search of the literature was conducted following the PRISMA guidelines. After abstract and full-text screening, 94 studies were included in the final review. Results were synthesised using an association matrix to show overall association between built environment and physical activity variables. Finally, the new PERFORM (’Physical and Environmental Reporting Framework for Objectively Recorded Measures’) checklist was created and applied to the included studies rating them on their reporting quality across four key areas: study design and characteristics, built environment exposures, physical activity metrics, and the association between built environment and physical activity.
Results
Studies came from 21 countries and ranged from two days to six years in duration. Accelerometers and using geographic information system (GIS) to define the spatial extent of exposure around a pre-defined geocoded location were the most popular tools to capture physical activity and built environment respectively. Ethnicity and socio-economic status of participants were generally poorly reported. Moderate-to-vigorous physical activity (MVPA) was the most common metric of physical activity used followed by walking. Commonly investigated elements of the built environment included walkability, access to parks and green space. Areas where there was a strong body of evidence for a positive or negative association between the built environment and physical activity were identified. The new PERFORM checklist was devised and poorly reported areas identified, included poor reporting of built environment data sources and poor justification of method choice.
Conclusions
This systematic review highlights key gaps in studies objectively measuring the built environment and physical activity both in terms of the breadth and quality of reporting. Broadening the variety measures of the built environment and physical activity across different demographic groups and spatial areas will grow the body and quality of evidence around built environment effect on activity behaviour. Whilst following the PERFORM reporting guidance will ensure the high quality, reproducibility, and comparability of future research.
Collapse
|
10
|
Akinci ZS, Delclòs-Alió X, Vich G, Salvo D, Ibarluzea J, Miralles-Guasch C. How different are objective operationalizations of walkability for older adults compared to the general population? A systematic review. BMC Geriatr 2022; 22:673. [PMID: 35971086 PMCID: PMC9377138 DOI: 10.1186/s12877-022-03233-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/09/2022] [Indexed: 01/10/2023] Open
Abstract
Background Walking is an essential activity for everyone and for older adults in particular, given that it is the most accessible form of physical activity and one of the healthiest transportation modes. Understanding how walkability (the potential of the environment to enable and/or encourage walking) has been objectively measured and analyzed for older adults is critical to create more inclusive, healthy, and sustainable environments and to promote healthy aging. Despite the numerous reviews on physical activity among older adults and its relationship with the built environment, the literature still lacks comparison reviews focusing specifically on objective operationalizations of walkability for older adults vs. the general population. Methods We conducted a systematic review of 146 empirical studies that measured walkability objectively in relation to walking-related outcomes. We compared studies focused on older adults (n = 24) and the general population (n = 122). Content analysis included the characteristics of the study design, walkability measures, spatial extent, and associations found between walkability and walking-related outcomes. Results In both groups of publications, the majority of studies were conducted in the US, Canada, and Europe, and largely in high-income countries. They were mostly published in health-related journals and used cross-sectional designs, operationalized walkability by using indexes, employed self-reported measures for walking-related outcomes, and found positive associations between walkability and walking outcomes. However, we observed some differences among studies focusing on older adults. Compared to studies focusing on the general population, a larger proportion of studies on older adults was conducted in the Middle East and Asia, and they used longitudinal designs, mixed methods to measure walking-related outcomes, variables related with land-use characteristics, safety from traffic and crime, and greenery, and a larger proportion found positive, as well as no associations between walkability and walking-related outcomes. Conclusion Although there is a promising increase in interest in older adults-focused walkability studies in the last decade, there is still a need for more studies focusing on different settings, using wider spatial extents, longitudinal designs, objective or mixed methods to collect outcome data, and specific variables and/or specially created indexes for older adults and for settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03233-x.
Collapse
Affiliation(s)
- Zeynep S Akinci
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.
| | - Xavier Delclòs-Alió
- Grup de Recerca en Anàlisi Territorial i Estudis Turístics (GRATET), Departament de Geografia, Universitat Rovira i Virgili, Vila-seca, Spain
| | - Guillem Vich
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,ISGlobal (Barcelona Institute for Global Health), Doctor Aiguader, 88, 08003, Barcelona, Spain
| | - Deborah Salvo
- People, Health and Place Unit; Prevention Research Center in St. Louis; Brown School; Washington University in St Louis , St. Louis, Missouri, USA
| | - Jesús Ibarluzea
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain.,Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain.,Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Carme Miralles-Guasch
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona - Edifici ICTA-ICP, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain
| |
Collapse
|
11
|
Park KH, Yoo EY, Kim J, Hong I, Lee JS, Park JH. Applying Latent Profile Analysis to Identify Lifestyle Profiles and Their Association with Loneliness and Quality of Life among Community-Dwelling Middle- and Older-Aged Adults in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12374. [PMID: 34886100 PMCID: PMC8656840 DOI: 10.3390/ijerph182312374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022]
Abstract
This study aimed to examine the multi-faceted lifestyle profiles of community-dwelling middle- and older-aged adults based on their physical activity, participation in various activities, and nutrition. It identified the association of lifestyle profiles with demographic variables, quality of life, and mental health. The analysis included 569 participants (mean age = 60.2; SD = 4.3). Latent profile analysis identified three distinctive lifestyle profiles: "inactive and unbalanced" (36.4%), "basic life maintenance" (54.6%), and "active and balanced" (9.1%). Sex (p < 0.001), age (p < 0.001), and regular medication intake (p < 0.01) were statistically significantly different among the three profiles. Of the "inactive and unbalanced" lifestyle group, 63.3% of it was comprised of by females, and a relatively large distribution was aged over 65. In the "basic life maintenance" subgroup, males showed a relatively large distribution, and 92.6% of participants were aged 55-64. People with active and balanced lifestyles demonstrated high quality of life levels (p < 0.001) and low loneliness levels (p < 0.01). Multinomial logistic regression revealed a statistically significant positive association between lifestyle profiles and quality of life (p < 0.001) as well as mental health (p < 0.01). Therefore, health promotion that considers multi-faceted lifestyle factors would need to improve health and quality of life among community-dwelling middle- and older-aged adults in South Korea.
Collapse
Affiliation(s)
- Kang-Hyun Park
- Super-Aged Society New Normal Lifestyle Research Institute, Yonsei University, Wonju 26493, Korea;
| | - Eun-Young Yoo
- Department of Occupational Therapy, Yonsei University, Wonju 26493, Korea; (E.-Y.Y.); (J.K.); (I.H.)
| | - Jongbae Kim
- Department of Occupational Therapy, Yonsei University, Wonju 26493, Korea; (E.-Y.Y.); (J.K.); (I.H.)
| | - Ickpyo Hong
- Department of Occupational Therapy, Yonsei University, Wonju 26493, Korea; (E.-Y.Y.); (J.K.); (I.H.)
| | - Jae-Shin Lee
- Department of Occupational Therapy, Konyang University, Daejeon 35365, Korea;
| | - Ji-Hyuk Park
- Super-Aged Society New Normal Lifestyle Research Institute, Yonsei University, Wonju 26493, Korea;
- Department of Occupational Therapy, Yonsei University, Wonju 26493, Korea; (E.-Y.Y.); (J.K.); (I.H.)
| |
Collapse
|
12
|
Longitudinal association of built environment pattern with DXA-derived body fat in elderly Hong Kong Chinese: a latent profile analysis. Int J Obes (Lond) 2021; 45:2629-2637. [PMID: 34433908 DOI: 10.1038/s41366-021-00949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 07/23/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND One major limitation of prior studies regarding the associations between built environment (BE) and obesity has been the use of anthropometric indices (e.g., body mass index [BMI]) for assessing obesity status, and there has been limited evidence of associations between BE and body fat. This study aimed to explore the longitudinal association between BE and body fat in a cohort of elderly Hong Kong Chinese and examine whether the BE-body fat associations differed by BMI categories. METHODS Between 2001 and 2003, 3944 participants aged 65-98 years were recruited and followed for a mean of 6.4 years. BE characteristics were assessed via Geographic Information System. Body fat (%) at whole body and regional areas (trunk, limbs, android, and gynoid) were assessed by dual energy X-ray absorptiometry at baseline and three follow-ups. Latent profile analysis was used to derive BE class, and linear mixed-effects models were used to investigate the associations of BE class with changes in body fat. Stratified analyses by BMI categories were also conducted. RESULTS Three BE classes were identified. Participants in Class 2 (characterized by greater open space and proportion of residential land use) had a slower increase in whole body fat (B = -0.403, 95% confidence interval [CI]: -0.780, -0.014) and limbs fat (-0.471, 95% CI: -0.870, -0.071) compared with participants in Class 1 (characterized by high proportion of commercial land use). There were significant interactions of BE class with BMI, and participants in Class 2 had a slower increase in whole body fat and regional fat compared with participants in Class 1 (B ranging from -0.987 [limbs] to -0.523 [gynoid]) among overweight and obese participants only. CONCLUSIONS We found that those who resided in the areas characterized by greater open space and proportion of residential land use had a slower body fat increase.
Collapse
|
13
|
Otto AK, Ketcher D, McCormick R, Davis JL, McIntyre MR, Liao Y, Reblin M, Vadaparampil ST. Using the health belief model to assess racial/ethnic disparities in cancer-related behaviors in an NCI-designated comprehensive cancer center catchment area. Cancer Causes Control 2021; 32:1085-1094. [PMID: 34132914 DOI: 10.1007/s10552-021-01457-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 06/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Racial and ethnic minorities experience well-documented disparities across the cancer trajectory. However, factors underlying these disparities may vary regionally. The Health Belief Model (HBM) was developed to explain and predict health-related prevention and early detection behaviors, particularly uptake of health services. Our goal was to use the HBM to guide an exploration of factors that contribute to racial/ethnic health disparities in the catchment area of a large National Cancer Institute-designated Comprehensive Cancer Center in the Southeastern United States. METHODS We conducted a secondary analysis of data collected by the cancer center for its triennial Community Health Needs Assessment, which sampled adults from the center's 15-county catchment area. White non-Hispanics (WNHs; n = 887), Black non-Hispanics (BNHs; n = 78), Hispanics/Latinxs (H/Ls; n = 185), and those identifying as another race/ethnicity ("Others"; n = 39) were compared across key HBM variables, including demographic/psychosocial information, perceived benefits and barriers to preventive health behaviors, risk perception, and health behavior outcomes. RESULTS Controlling for annual household income, relationship status, and age (for certain screening behaviors), significant differences were seen in information-seeking behaviors, risk perception, community attributes, discrimination, and distress. Non-WNH groups reported worse community attributes, higher everyday discrimination, lower health literacy, less confidence in their ability to get health information, and lower perceived risk of cancer. CONCLUSION This analysis presents a better understanding of how HBM factors may influence health disparities in the cancer center's catchment area. Results describe the needs of community members from racial and ethnic minority groups, which will inform future research, education, outreach, and service activities.
Collapse
Affiliation(s)
- Amy K Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Public Health Sciences, The University of Miami, Miami, FL, USA
| | - Dana Ketcher
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rachael McCormick
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Jenna L Davis
- Moffitt Diversity, Moffitt Cancer Center, Tampa, FL, USA
| | - McKenzie R McIntyre
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Yunqi Liao
- Office of Community Outreach, Engagement, and Equity, Moffitt Cancer Center, Tampa, FL, USA
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
- Department of Family Medicine, University of Vermont, Burlington, VT, USA.
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Office of Community Outreach, Engagement, and Equity, Moffitt Cancer Center, Tampa, FL, USA
| |
Collapse
|
14
|
Abstract
The study investigated the rarely addressed topic of how visual environmental features can influence walking speed. Young adult participants were asked to walk on a route that leads through areas composed of urban parks and areas with a built environment with a large amount of greenery. Their walking speed was measured in selected sections. The participants walked with a small video camera, and their walk was recorded. The temporal information was derived from the video recordings. Subsequently, the participants evaluated the environmental features of the route by specific spatio-cognitive dimensions of environmental preference. The results show that walking speed in specific sections of the walking route systematically differed and reflected the environmental features. The walking speed was lower in sections with high natural characteristics and a high environmental preference. Noise here was perceived as less annoying than in sections with lower natural characteristics. The results are explained in terms of approach avoidance behavior. The findings are in accordance with environmental preference research that documents various benefits of walking in the natural environment.
Collapse
|
15
|
Lin J, Leung J, Yu B, Woo J, Kwok T, Ka-Lun Lau K. Socioeconomic status as an effect modifier of the association between built environment and mortality in elderly Hong Kong Chinese: A latent profile analysis. ENVIRONMENTAL RESEARCH 2021; 195:110830. [PMID: 33548297 DOI: 10.1016/j.envres.2021.110830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have focused on associations between individual built environment (BE) characteristics and mortality, and found the BE-mortality associations differed by socioeconomic status (SES). Different individual BE characteristics may have different impacts on health and thus could interact. Combinations of BE characteristics may be a better approach to explore the BE-mortality associations. OBJECTIVES This study aimed to investigate the associations of BE pattern with mortality in a prospective cohort of elderly Hong Kong Chinese (Mr. OS and Ms. OS Study), and assess whether the BE-mortality association differed by SES. METHODS Between 2001 and 2003, 3944 participants aged 65-98 years at baseline were included in the present analysis. BE characteristics were assessed via Geographic Information System. Data on all-cause and cause-specific mortality were obtained from the Hong Kong Government Death Registry. Latent profile analysis was used to derive BE class, and the Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Three BE classes were identified. During a total of 53276 person-years of follow-up, 1632 deaths were observed. There were no significant associations of BE class with all-cause and cause-specific mortality. However, we found the associations of BE class with all-cause mortality were modified by SES. In comparison with Class 3 (characterized by greater green space), HRs (95%CIs) were 0.72 (0.54, 0.97) for Class 1 (characterized by greater commercial land use) and 0.77 (0.64, 0.94) for Class 2 (characterized by greater residential land use) among low-SES participants. The associations were stronger among high-SES participants, with 0.55 (0.33, 0.89) for Class 1 and 0.68 (0.48, 0.97) for Class 2. In contrast, Class 2 (HR 1.18, 95%CI 1.01-1.39) had a higher mortality risk compared with Class 3 among middle-SES participants. CONCLUSIONS Our findings provide new evidence on the role of SES as an effect modifier of BE pattern and mortality. BE pattern has a varied effect on mortality risk for different SES groups.
Collapse
Affiliation(s)
- Jiesheng Lin
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong.
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong
| | - Blanche Yu
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Jean Woo
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Timothy Kwok
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong; CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong.
| |
Collapse
|
16
|
Hino K, Asami Y. Change in walking steps and association with built environments during the COVID-19 state of emergency: A longitudinal comparison with the first half of 2019 in Yokohama, Japan. Health Place 2021; 69:102544. [PMID: 33714180 PMCID: PMC8631549 DOI: 10.1016/j.healthplace.2021.102544] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 12/19/2022]
Abstract
In Japan, a state of emergency (SoE) was declared in early April 2020 until late May in response to the first wave of the coronavirus disease (COVID-19). This longitudinal study analyzed the step counts of 18,817 citizens in Yokohama city in the first half of 2020 compared to the previous year, and investigated the association between the change in step counts and the individuals' neighborhood environment by sex and age using generalized linear mixed models. Step counts decreased especially in women and non-elderly people during the SoE. Older women were more susceptible to the neighborhood environment: high walkability (i.e., high population density, proximity to railway stations) adversely affected their step counts, whereas proximity to large parks came to have a positive effect during the SoE.
Collapse
Affiliation(s)
- Kimihiro Hino
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Japan.
| | - Yasushi Asami
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Japan.
| |
Collapse
|
17
|
Choi K, Lee Y, Basrak Z. Identifying Communities of Concern for Older Adults Using Spatial Analysis: Focusing on Accessibility to Health, Social, and Daily Services. J Appl Gerontol 2021; 40:1527-1532. [PMID: 33459129 DOI: 10.1177/0733464820978000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ensuring accessibility to necessary services is critical for older adults. However, there often exist spatial disparities in the levels of accessibility to services. Because the application of Geographic Information System (GIS) has gained attention in the gerontology field, we used spatial analysis to identify communities of concern for older adults from the perspective of accessibility. We defined the communities of concern based on the proportion of older adults and the level of accessibility to health, social, and daily services via two specific modes of transportation-walking and public transit. Our findings show that newly developed communities tend to have less accessibility to necessary services, and aging communities are randomly distributed across the city. Our results call for interdisciplinary collaboration, between urban planning and gerontology professionals, to better understand the spatial pattern of aging communities and its implication for properly addressing the mobility needs of older adults in the communities.
Collapse
Affiliation(s)
- Kwangyul Choi
- University of Calgary, Calgary, AB, Canada.,University of Oklahoma, Norman, OK, USA
| | | | - Zoe Basrak
- University of Calgary, Calgary, AB, Canada
| |
Collapse
|
18
|
Chang SH, Rutherford R, Hsueh MC, Yu YC, Park JH, Wang S, Liao Y. Neighborhood Environment and Objectively Measured Sedentary Behavior Among Older Adults: A Cross-Sectional Study. Front Public Health 2021; 8:552198. [PMID: 33511095 PMCID: PMC7835642 DOI: 10.3389/fpubh.2020.552198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/28/2020] [Indexed: 12/30/2022] Open
Abstract
Background: We examined the relationships between objectively assessed neighborhood environment and the patterns of sedentary behavior among older adults. Methods: A total of 126 community-dwelling older adults (aged 65 years or above) were recruited. Data on neighborhood environmental attributes (resident density, street intersection density, sidewalk availability, accessible destinations, and accessible public transportation), accelerometer-assessed total time and patterns of sedentary behavior (number and duration of bouts), and sociodemographic characteristics were collected. Multiple linear regression models were developed. Results: After adjustment for potential confounders, greater sidewalk availability was negatively related to the number of sedentary bouts (β = -0.185; 95% CI: -0.362, 0.015; p = 0.034) and sedentary bout duration (β = -0.180; 95% CI: -0.354, -0.011; p = 0.037). Conclusions: This study revealed that a favorable neighborhood environment characterized by sidewalk availability is negatively associated with sedentary behavior patterns in Taiwanese older adults. These findings are critical to inform environmental policy initiatives to prevent sedentary lifestyle in older adults.
Collapse
Affiliation(s)
- Shao-Hsi Chang
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ru Rutherford
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Yi-Chien Yu
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sendo Wang
- Department of Geography, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| |
Collapse
|
19
|
Guo Y, Fu Y, Xu Y. Satisfaction with neighbourhood environment moderates the associations between objective neighbourhood environment and leisure-time physical activity in older adults in Beijing, China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:206-214. [PMID: 32677732 DOI: 10.1111/hsc.13083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 05/22/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
Asia is ageing fast. To develop more effective health promotion initiatives among older adults, more knowledge of the environmental correlates of physical activity is needed. However, research in this age group is rare, and most existing studies have been conducted within Western contexts. The present study explores the interaction effects of objective neighbourhood environment and satisfaction with neighbourhood environment on leisure-time physical activity in older adults in Beijing, China. This study follows a cross-sectional design and involves older adults aged 65 years and over. The questionnaire was collected in 2018 and 2,061 older adults living in Yanshan, Beijing, China were included in the analysis. Linear regression was applied to examine the effects. The findings show that residents who live in places with higher levels of walkability, or those who are more satisfied with neighbourhood environment (either path/road/street condition or recreational resources) spent significantly longer participating in leisure-time physical activity. However, the objective neighbourhood accessibility of recreational resources was not a significant factor of physical activity. Satisfaction with neighbourhood recreational resources can significantly moderate the relationship between objective neighbourhood accessibility of recreational resources and leisure-time physical activity respectively. This is the first study conducted in China examining the relationships between objective neighbourhood environment, satisfaction with neighbourhood environment and leisure-time physical activity among older adults. This study may have implications for urban planning and service provision planning. The design of built environments that considers quality rather than only quantity can play a significant role in improving older adults' leisure-time physical activity.
Collapse
Affiliation(s)
- Yingqi Guo
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Yuebin Xu
- Institute of advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| |
Collapse
|
20
|
Hua J, Mendoza-Vasconez AS, Chrisinger BW, Conway TL, Todd M, Adams MA, Sallis JF, Cain KL, Saelens BE, Frank LD, King AC. Associations of social cohesion and quality of life with objective and perceived built environments: a latent profile analysis among seniors. J Public Health (Oxf) 2020; 44:138-147. [PMID: 33367700 DOI: 10.1093/pubmed/fdaa217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/29/2020] [Accepted: 10/30/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Healthy aging requires support from local built and social environments. Using latent profile analysis, this study captured the multidimensionality of the built environment and examined relations between objective and perceived built environment profiles, neighborhood social cohesion and quality of life among seniors. METHODS In total, 693 participants aged 66-97 were sampled from two US locales in 2005-2008 as part of the Senior Neighborhood Quality of Life Study (SNQLS). Perceived social cohesion and quality of life were assessed using validated surveys. Six objective (geographic information system (GIS)-based) and seven perceived built environment latent profiles generated in previous SNQLS publications were used for analyses. Mixed-effects models estimated social cohesion and quality of life separately as a function of the built environment profiles. RESULTS More walkable and destination-rich perceived built environment profiles were associated with higher social cohesion and quality of life. Objective built environment profiles were not associated with social cohesion and only positively associated with quality of life in only one locale (Baltimore/DC). CONCLUSIONS Latent profile analysis offered a comprehensive approach to assessing the built environment. Seniors who perceived their neighborhoods to be highly walkable and recreationally dense experienced higher neighborhood social cohesion and quality of life, which may set the stage for healthier aging.
Collapse
Affiliation(s)
- J Hua
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305 USA
| | - A S Mendoza-Vasconez
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305 USA
| | - B W Chrisinger
- Department of Social Policy and Intervention, University of Oxford, Oxford OX1 2ER, UK
| | - T L Conway
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - M Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
| | - M A Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - J F Sallis
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - K L Cain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - B E Saelens
- Department of Pediatrics, University of Washington & Seattle Children's Research Institute, Seattle, WA 98121, USA
| | - L D Frank
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z2, Canada
| | - A C King
- Department of Epidemiology and Population Health, Department of Medicine, Stanford Prevention Research Center, Stanford, CA 94305, USA
| |
Collapse
|
21
|
Lanza K, Oluyomi A, Durand C, Gabriel KP, Knell G, Hoelscher DM, Ranjit N, Salvo D, Walker TJ, Kohl HW. Transit environments for physical activity: Relationship between micro-scale built environment features surrounding light rail stations and ridership in Houston, Texas. JOURNAL OF TRANSPORT & HEALTH 2020; 19:100924. [PMID: 32904408 PMCID: PMC7455164 DOI: 10.1016/j.jth.2020.100924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/14/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Health professionals promote transport-related physical activity because travelers oftentimes walk or bike to and from transit stops or stations. Although previous studies have examined the associations between macro-scale built environment features surrounding light rail transit (LRT) stations (e.g., density) and LRT ridership, this study examined the associations between numerous micro-scale features (e.g., street-level noise pollution) and ridership. METHODS This analysis originated from the Houston Travel-Related Activity in Neighborhoods (TRAIN) Study, a project evaluating how an LRT extension impacted adult physical activity in Houston, Texas. In 2014, researchers used the Analytic Audit Tool to quantify 58 micro-scale built environment features within six categories: Land Use Environment, Transportation Environment, Facilities, Aesthetics, Signage, and Social Environment. Feature data were obtained from 590 street segments within 0.25 miles of 22 LRT stations. For each station, separate composite indices were created per category by averaging the computed feature scores (1-7) within each category, with higher scores signifying more physical activity-promoting features. Station-level LRT ridership data were obtained from monthly ridership reports for the 12 months following station opening. Linear mixed models were constructed to examine the associations of the six built environment categories with ridership, adjusting for season, weekday vs. weekend day, and station as a random intercept. RESULTS Holding all other variables constant, every one-unit increase in composite index scores for Transportation Environment and Social Environment was associated with an increase in daily ridership by 425 and 488 riders, respectively (p < 0.05). Every one-unit increase in composite index score for Signage was associated with a decrease of 722 riders daily (p < 0.05). The relations of Land Use Environment, Facilities, and Aesthetics with ridership were statistically null (p > 0.05). CONCLUSIONS Enhancements to the Transportation Environment and Social Environment may slightly increase overall LRT ridership, and consequently, utilitarian physical activity.
Collapse
Affiliation(s)
- Kevin Lanza
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
| | | | - Casey Durand
- Center for Health Promotion and Prevention Research, Department of Health Promotion & Behavioral Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory Knell
- Department of Epidemiology, Human Genetics, And Environmental Sciences, School of Public Health in Dallas, The University of Texas Health Science Center at Houston, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health, Dallas, TX, USA
- Andrew's Institute for Orthopaedics and Sports Medicine, Children's Health, Plano, TX, USA
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
| | - Nalini Ranjit
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Timothy J Walker
- Center for Health Promotion and Prevention Research, Department of Health Promotion & Behavioral Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Harold W Kohl
- Michael and Susan Dell Center for Healthy Living, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
- Department of Epidemiology, Human Genetics, And Environmental Sciences, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX, USA
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
22
|
Li Y, Yatsuya H, Hanibuchi T, Ota A, Naito H, Otsuka R, Murata C, Hirakawa Y, Chiang C, Uemura M, Tamakoshi K, Aoyama A. Positive Association of Physical Activity with Both Objective and Perceived Measures of the Neighborhood Environment among Older Adults: The Aichi Workers' Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217971. [PMID: 33138333 PMCID: PMC7663542 DOI: 10.3390/ijerph17217971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 11/24/2022]
Abstract
We examined the association between objective and perceived neighborhood characteristics and self-reported leisure-time physical activity (PA) in older Japanese residents living in areas ranging from metropolitan to rural in 2016. Objective measures used were walkability and the numbers of parks/green spaces and sports facilities within 500 or 1000 m of subjects’ homes, calculated using geographic information systems. Subjective measures were the subjects’ perceptions of their neighborhoods, assessed using a structured questionnaire. All variables were divided into three groups, and the lowest tertile was used as the reference. We assessed the location and frequency of strolling or brisk walking, moderate-intensity PA, and vigorous-intensity PA (sports) using a self-reported questionnaire and defined as performing a certain type of PA 3–4 times/week as a habit. Living in a neighborhood in the highest tertile for walkability and number of parks/green spaces as well as perception of having good access to recreational facilities, observing others exercising and the presence of walkable sidewalks was associated with walking and sports habits (multivariable odds ratios (ORs): 1.33–2.46, all p < 0.05). Interestingly, objective measures of PA-friendly environmental features were inversely associated with moderate-intensity PA habits, potentially because moderate-intensity PA consisted predominantly of gardening. In conclusion, living in an environment supportive of PA, whether objectively or subjectively measured, is related to leisure-time PA habits among older Japanese adults.
Collapse
Affiliation(s)
- Yuanying Li
- Department of Public Health, Fujita Health University School of Medicine, Aichi 470-1192, Japan; (H.Y.); (A.O.); (H.N.)
- Correspondence: ; Tel.: +81-562-93-2476
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Aichi 470-1192, Japan; (H.Y.); (A.O.); (H.N.)
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan; (Y.H.); (C.C.); (M.U.); (A.A.)
| | - Tomoya Hanibuchi
- Graduate School of Environmental Studies, Tohoku University, Sendai 980-8572, Japan;
| | - Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Aichi 470-1192, Japan; (H.Y.); (A.O.); (H.N.)
| | - Hisao Naito
- Department of Public Health, Fujita Health University School of Medicine, Aichi 470-1192, Japan; (H.Y.); (A.O.); (H.N.)
| | - Rei Otsuka
- Section of NILS-LSA, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan;
| | - Chiyoe Murata
- Department of Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan;
- Department of Nutrition, Tokai Gakuen University, Aichi 468-8514, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan; (Y.H.); (C.C.); (M.U.); (A.A.)
| | - Chifa Chiang
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan; (Y.H.); (C.C.); (M.U.); (A.A.)
| | - Mayu Uemura
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan; (Y.H.); (C.C.); (M.U.); (A.A.)
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University School of Health Science, Aichi 461-8673, Japan;
| | - Atsuko Aoyama
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan; (Y.H.); (C.C.); (M.U.); (A.A.)
- Nagoya University of Arts and Sciences, Aichi 481-8503, Japan
| |
Collapse
|
23
|
Abstract
The number of elderly people as a proportion of the world’s population is growing significantly. Special attention to the accessibility and mobility requirements of this group is needed. The contribution of this paper is a review of travel patterns, mode preferences, infrastructure solutions, accessibility indices, mode choice models and datasets as they relate to elderly mobility. Key findings highlight the role of residential location characteristics in shaping elderly travel patterns, helping to explain why research on elderly travel has largely relied on case studies to date. The review also summarizes a range of indices that have been developed to measure public transport and walking accessibility among the elderly, including distance and time-based methods. Future research should consider the dominance of private transport in facilitating elderly mobility and its implications for cities experiencing an aging population.
Collapse
|
24
|
Lin JS, Chan FYF, Leung J, Yu B, Lu ZH, Woo J, Kwok T, Lau KKL. Longitudinal Association of Built Environment Pattern with Physical Activity in a Community-Based Cohort of Elderly Hong Kong Chinese: A Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124275. [PMID: 32549289 PMCID: PMC7344458 DOI: 10.3390/ijerph17124275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
A large number of studies have focused on the associations between single built environment (BE) characteristics and physical activity (PA). Combinations of BE characteristics offer a more comprehensive approach to identify the BE–PA associations. We aimed to examine the BE–PA associations in a cohort of elderly Hong Kong Chinese. Between 2001 and 2003, 3944 participants (65–98 years of age) were recruited and followed for a mean of 7.8 years. BE characteristics were assessed via geographic information system. PA levels were obtained using the Physical Activity Scale for the Elderly questionnaire at baseline and three follow-ups. Latent profile analysis was first conducted to classify the BE characteristics, and linear mixed-effects models were then used to explore the longitudinal associations between the BE classes and changes in the PA levels. Three classes of BE were identified. Class 3 (characterized by greater green space and sky view factor) demonstrated a significant decline in household PA (β = −1.26, 95% confidence interval: −2.20, −0.33) during the study period, and a slower decline in walking PA (1.19 (0.42, 1.95)) compared with Class 2 (characterized by a greater proportion of residential land use). Our results indicate that BE patterns characterized by high green space and a sky view factor may help promote the walking PA level.
Collapse
Affiliation(s)
- Jie-Sheng Lin
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong 99077, China;
- Correspondence: (J.-S.L.); (K.K.-L.L.); Tel.: +852-39435399 (J.-S.L.); +852-39435398 (K.K.-L.L.)
| | - Faye Ya-Fen Chan
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong 99077, China;
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong 99077, China; (J.L.); (B.Y.); (T.K.)
| | - Blanche Yu
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong 99077, China; (J.L.); (B.Y.); (T.K.)
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
| | - Zhi-Hui Lu
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong 99077, China
| | - Timothy Kwok
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong 99077, China; (J.L.); (B.Y.); (T.K.)
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 99077, China; (Z.-H.L.); (J.W.)
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong 99077, China;
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong 99077, China
- Correspondence: (J.-S.L.); (K.K.-L.L.); Tel.: +852-39435399 (J.-S.L.); +852-39435398 (K.K.-L.L.)
| |
Collapse
|
25
|
Hino K, Usui H, Hanazato M. Three-Year Longitudinal Association Between Built Environmental Factors and Decline in Older Adults' Step Count: Gaining insights for Age-Friendly Urban Planning and Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4247. [PMID: 32545896 PMCID: PMC7344418 DOI: 10.3390/ijerph17124247] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 01/05/2023]
Abstract
This study examined the longitudinal association between the change in the step count of older adults and the neighborhood-built environment (BE) in Yokohama, Japan. We analyzed pedometer data in March 2016 and March 2019 that were acquired from 21,557 older adults aged 65-79 years at baseline, who lived in 758 neighborhoods in Yokohama City and participated in the Yokohama Walking Point Program (YWPP). Six BE variables were computed, for each of which neighborhoods were classified into quartiles. Using multilevel regression analysis, we examined the association between the BE variables, baseline step count, and change in step count. Higher population density, lower intersection density, and the second shortest quartile of the average distance to the nearest railway station were associated with a higher baseline step count. A lower intersection density and shorter average distance to the nearest railway station were associated with a smaller decline. The lowest quartile of population density was inversely associated with step-count decline. In conclusion, the neighborhood BEs were not only associated with their step count at baseline, but also widened the disparity of the step count over the three years. These findings would contribute to creating age-friendly cities where older adults can maintain and promote their health.
Collapse
Affiliation(s)
- Kimihiro Hino
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan;
| | - Hiroyuki Usui
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan;
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan;
| |
Collapse
|
26
|
Klann A, Vu L, Ewing M, Fenton M, Pojednic R. Translating Urban Walkability Initiatives for Older Adults in Rural and Under-Resourced Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173041. [PMID: 31443359 PMCID: PMC6747272 DOI: 10.3390/ijerph16173041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/29/2019] [Accepted: 08/14/2019] [Indexed: 12/26/2022]
Abstract
The built environment can promote physical activity in older adults by increasing neighborhood walkability. While efforts to increase walkability are common in urban communities, there is limited data related to effective implementation in rural communities. This is problematic, as older adults make up a significant portion of rural inhabitants and exhibit lower levels of physical activity. Translating lessons from urban strategies may be necessary to address this disparity. This review examines best practices from urban initiatives that can be implemented in rural, resource-limited communities. The review of the literature revealed that simple, built environment approaches to increase walkability include microscale and pop-up infrastructure, municipal parks, and community gardens, which can also increase physical activity in neighborhoods for urban older adults. These simple and cost-effective strategies suggest great potential for rural communities.
Collapse
Affiliation(s)
- Alexandra Klann
- Department of Nutrition, Simmons University, Boston, MA 02115, USA
| | - Linh Vu
- Department of Nutrition, Simmons University, Boston, MA 02115, USA
| | - Mollie Ewing
- Children and Family Services Corporation, Vincennes, IN 47951, USA
| | - Mark Fenton
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Rachele Pojednic
- Department of Nutrition, Simmons University, Boston, MA 02115, USA.
- Harvard Medical School, Institute of Lifestyle Medicine, Boston, MA 02115, USA.
| |
Collapse
|
27
|
Landscape Preferences and Distance Decay Analysis for Mapping the Recreational Potential of an Urban Area. SUSTAINABILITY 2019. [DOI: 10.3390/su11133620] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Green infrastructure plays an important role in recreation and human well-being, especially in urban and peri-urban areas. Our study aimed to evaluate and map the recreational potential of an urban area (Brașov, Romania) using two data sets: (a) people’s preferred landscape features and (b) preferred locations where outdoor activities and recreation take place. The latter was gathered through participatory mapping techniques. For each location, we computed explanatory variables, e.g., the distance to 19 landscape elements known to be important for recreation. Based on (b), we determined the recreational activity profiles for each participant and evaluated how well these profiles matched the participant’s preferences for landscape features (dataset a). Finally, recreational potential was mapped by computing a recreational index using dataset b. Two preference profiles (P1: urban, infrastructure-oriented; P2: nature-oriented) were identified based on people’s preferred landscape features, and three recreational activity profiles were identified based on the preferred locations, i.e., an “urban”, a “nature”, and an “ubiquist” type. The importance of green infrastructures for recreation in both preference profiles was striking. Many persons belonging to the urban and infrastructure-oriented group indicated that they recreate in locations with a high amount of green infrastructure and nature. The map of the recreational potential shows hotspots for recreation but also areas lacking recreational provisions, giving useful insight for future urban planning.
Collapse
|
28
|
Environmental Factors Associated with Older Adult’s Walking Behaviors: A Systematic Review of Quantitative Studies. SUSTAINABILITY 2019. [DOI: 10.3390/su11123253] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this study is to systematically review the relationship between neighborhood environments and all types of walking behaviors among older adults. Seventy peer-reviewed journal articles which met the selection criteria were examined. Research designs were summarized by geographical location and the associations of environmental characteristics and walking were calculated. Interactions between moderators and environmental characteristics for all types of walking were also categorized. Results have shown that transport walking is the most supported by neighborhood environmental characteristics. The positively related environmental characteristics are walkability, urbanization, land use mix-diversity and accessibility, walking amenities, and bicycle lanes. Total walking was positively associated with walkability and urbanization. Recreational walking was associated with neighborhood employment/income level, nearness to public transport/bus stops, and social cohesion. The most commonly used moderators were age and gender, but inconsistent moderating effects between neighborhood environments and walking were also found. In densely populated environments such as Hong Kong, older adults walked mostly for both transport and recreation. In contrast, American older adults in low density areas walked less for transport and more for recreation. Findings support a strong relationship between neighborhood environments and older adults’ walking. Future research should focus on longitudinal studies and comparison studies by geographic location.
Collapse
|
29
|
Scerpella DL, Adam A, Marx K, Gitlin LN. Implications of Geographic Information Systems (GIS) for targeted recruitment of older adults with dementia and their caregivers in the community: A retrospective analysis. Contemp Clin Trials Commun 2019; 14:100338. [PMID: 30899836 PMCID: PMC6412022 DOI: 10.1016/j.conctc.2019.100338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
5.5 million Americans are living with Alzheimer's dementia (AD) or related dementias. Developing evidence-based interventions for these people and their caregivers (dyads) is a public health priority, and is highly dependent on recruiting representatives from the community. Precision recruitment methodologies are needed to improve the efficiency of this process. Geographic Information Systems (GIS) offer the potential to determine location trends of an older adult population of people living with dementia in the community and their caregivers. American Community Survey (ACS) 2015 5-year estimates were analyzed at the census tract level in ESRI ArcMap v. 10.5.1. Datasets included summarized estimates of age, gender, income, and education in Maryland. Using a two-step process, geographic regions were identified in ArcMap that contained various combinations of available data variables. These areas were compared to participant locations from a previously completed traditional recruitment effort to determine overlap (Dementia Behavior Study - R01AGO41781). The largest number of existing participants were identified in derived regions defined by combining age, education, gender, and income variables; predicting 184 (79%) of 234 participants regardless of the population density within census tracts. 208 (89%) were identified when matching this variable combination to the highest density census tracts (city/urban), and 66 (28%) in regions with the lowest population density (rural). This study successfully defined specific geographic regions in the state of Maryland that overlapped with a large number of known dementia dyad locations obtained via traditional recruitment efforts. Implications for these findings allow for more targeted recruitment efforts of difficult to recruit populations, and less utilization of resources for doing so.
Collapse
Affiliation(s)
- Danny L. Scerpella
- Johns Hopkins School of Nursing, Center for Innovative Care in Aging, 901 N. Broadway, Baltimore, MD, 21205, USA
- Corresponding author.
| | - Atif Adam
- Johns Hopkins Bloomberg School of Public Health, Center on Aging and Health, 624 N. Broadway, Room 390, Baltimore, MD, 21205, USA
| | - Katherine Marx
- Johns Hopkins School of Nursing, Center for Innovative Care in Aging, 901 N. Broadway, Baltimore, MD, 21205, USA
| | - Laura N. Gitlin
- Drexel University, 1601 Cherry Street, 10th Floor, Room 1092, Philadelphia, PA, 19102, USA
| |
Collapse
|
30
|
Okuyama K, Abe T, Hamano T, Takeda M, Sundquist K, Sundquist J, Nabika T. Hilly neighborhoods are associated with increased risk of weight gain among older adults in rural Japan: a 3-years follow-up study. Int J Health Geogr 2019; 18:10. [PMID: 31077213 PMCID: PMC6509780 DOI: 10.1186/s12942-019-0174-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/03/2019] [Indexed: 12/27/2022] Open
Abstract
Background Neighborhood environments have been regularly associated with the weight status. Although the evidence is mostly limited to adults residing in western urban settings, the weight status of older adults living in rural areas is also assumed to be significantly affected by their neighborhood environments. This study aimed to identify environmental attributes specific to rural areas that could affect the risk of longitudinal weight gain among older adults (≥ 65 years) in Japan. Methods We examined five environmental attributes, i.e., land slope, public transportation accessibility, residential density, intersection density, and the availability of parks and recreational centers, measured by the geographic information system. Our analysis was based on 714 subjects participated in Shimane Community-based Healthcare Research and Education study in 2012 and 2015. Multinomial logistic regression model was conducted to examine the association between each neighborhood environmental attribute and weight change status (gain, loss and unchanged). Results We observed a significant increase in the risk of weight gain as the steepness of the neighborhood land slope increased. There was no significant association between other environmental attributes and risk of weight gain as well as weight loss among older adults. Conclusion Living in hilly neighborhoods was associated with increased risk of weight gain among rural Japanese older adults. Future research should consider region-specific environmental attributes when investigating their effect on older adults’ weight status.
Collapse
Affiliation(s)
- Kenta Okuyama
- Center for Community-based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan.
| | - Takafumi Abe
- Center for Community-based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
| | - Tsuyoshi Hamano
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Motoyama, Kamigamo Kita-ku, Kyoto, 603-8555, Japan
| | - Miwako Takeda
- Center for Community-based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms Gata 35, 205 02, Malmö, Sweden
| | - Toru Nabika
- Department of Functional Pathology, Faculty of Medicine, Shimane University, 89-1, Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
| |
Collapse
|
31
|
Resnick B, Galik E, Boltz M, Vigne E, Holmes S, Fix S, Zhu S, Lewis R. Testing of the Function Focused Environment Assessment and the Function Focused Policy Assessment in Assisted Living. JOURNAL OF HOUSING FOR THE ELDERLY 2019; 33:153-172. [PMID: 32038064 PMCID: PMC7006224 DOI: 10.1080/02763893.2018.1534180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study tested two new instruments, the Function Focused Environment Assessment (FF-EA) and the Function Focused Policy Assessment (FF-PA). The measures were developed for clinical evaluation of AL settings to help optimize function and physical activity among residents. A total of 106 AL settings and 242 residents were included. There was evidence of item reliability (0.92) and interrater reliability (kappa=0.40, p=.015; percent agreement 85%) of FF-EA and item reliability (0.89) and interrater reliability (kappa=0.48, p=.001, percent agreement 82%) of the FF-PA, and support for validity of both measures based on INFIT and OUTFIT statistics and hypothesis testing.
Collapse
Affiliation(s)
- Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Elizabeth Galik
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Marie Boltz
- Pennsylvania State University, College of Nursing, 201 Nursing Sciences Building, University Park, PA 16802
| | - Erin Vigne
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Sarah Holmes
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Steven Fix
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Shijun Zhu
- University of Maryland School of Nursing, 655 West Lombard St, Baltimore MD 21218
| | - Regina Lewis
- The Pennsylvania State University, College of Nursing, 303 B Nursing Sciences Building, University Park, PA 16802
| |
Collapse
|
32
|
Walkability Assessment in a Rapidly Urbanizing City and Its Relationship with Residential Estate Value. SUSTAINABILITY 2019. [DOI: 10.3390/su11082205] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Walkability has increasingly been recognized as an important factor for sustainable urban development that, however, has seldom been investigated in rapid urbanizing cities, especially in the Asian context. This paper assessed walkability in Futian District in the central area of Shenzhen, which has undergone very rapid urbanization within a short period of time. Walkability was assessed for 2013 and 2018 using a walkability index adapted from Walk Score. It was compared with housing prices of 215 randomly selected residential buildings, to further explore the relationships between walkability and residential estate value, provided as one practical application of the assessment of walkability in urban management. Our results show that Futian District has low walkability level, although walkability has been generally improved from 2013 to 2018. A high spatial variation of walkability level within this area was observed in both years. Overall, there was a negative relationship between walkability and housing prices (significant only in 2018), which is inconsistent with studies elsewhere. The results suggest that the housing prices in Futian District are more strongly influenced by other factors rather than by walkability. In addition, the ability of the walkability model to explicitly delineate spatial variation of walkability level makes it a powerful tool to be applied in urban planning and management. Results of this study also have practical applications, which can be used as a reference for residents’ home selection and enable them to make informed decisions in selecting walkable neighborhoods with acceptable prices.
Collapse
|
33
|
MacLeod KE, Sanders RL, Griffin A, Cooper JF, Ragland DR. Latent analysis of Complete Streets and traffic safety along an urban corridor. JOURNAL OF TRANSPORT & HEALTH 2018; 8:15-29. [PMID: 36578816 PMCID: PMC9794175 DOI: 10.1016/j.jth.2017.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND To evaluate Complete Street implementations that covary, the present paper aims to: 1) explore the development of typologies of intersections; and 2) examine how these typologies relate to traffic safety. METHODS The study site is a five-mile segment in Los Angeles County, California. Multiple indicators of environmental features were collected in 2012 and were included in a latent analysis. Latent classes were then analyzed as a predictor of the number of pedestrian injuries/fatalities and injuries/fatalities for all modes in separate models using negative binomial regression and controlling for exposures. Injuries/fatalities represent the most recent 3 years of crash data available surrounding the environmental data collection (2009-2014). We also examined the role of alcohol. RESULTS For a relatively short segment of an urban corridor, we identified two distinct classes of intersections. One class was more complete with respect to pedestrian features but was also associated with indicators of increased potential conflict and was predictive of higher overall injuries/fatalities for all modes. This class also had higher pedestrian volumes but was not predictive of higher pedestrian injuries/fatalities in the final models. The alcohol involvement in crash injuries at these locations did not differ by intersection class but was positively associated with injuries/fatalities for all modes and with severe/fatal injuries for pedestrians in the final models. CONCLUSIONS Identifying typologies can be used to understand the combination of features and prioritize locations for treatment. While Complete Streets may help counter pedestrian injury trends, the efforts captured in this data are insufficient for municipalities aiming for Vision Zero. Ideally, future research can examine these intersections after the implementation of additional improvements in order to isolate treatment effects. These findings suggest additional intersection countermeasures are needed, in addition to efforts to address social problems such as alcohol use and traffic safety.
Collapse
|
34
|
Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, McKenna J. Associations between the combined physical activity environment, socioeconomic status, and obesity: a cross-sectional study. Perspect Public Health 2017; 138:169-172. [PMID: 29281499 DOI: 10.1177/1757913917748353] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS This study investigates associations between the combined physical activity environment and obesity and explores any sub-group effects by individual-level socioeconomic status. METHODS In a large cross-sectional cohort ( n = 22,889) from the Yorkshire Health Study, body mass index was calculated using self-reported height and weight and obesity was defined as a body mass index ≥ 30. The physical activity environment was split into 'unfavourable physical activity', 'moderately favourable physical activity' and 'favourable physical activity' environments. This was based on the count of parks and physical activity facilities within a 2 km radial buffer centred on home addresses. A favourable physical activity environment was defined as having ≥1 physical activity facility and ≥1 park, unfavourable as having no physical activity facility and park and any other combinations defined as moderately favourable. Logistic regression (odds ratios) identified associations with obesity. RESULTS Relative to 'unfavourable physical activity environments', individuals within favourable physical activity environments were less likely to be obese (odds ratio = 0.90; 95% confidence interval = 0.82-0.97), and there was no effect for moderately favourable environment. Furthermore, once stratified by education level, this relationship was only present for those of higher education. CONCLUSION Our findings provide novel UK evidence and is one of the first papers internationally that highlights the importance of considering the interplay of individual-level socioeconomic factors when investigating associations between the physical activity environment and obesity.
Collapse
Affiliation(s)
- M Hobbs
- School of Social and Health Sciences, Leeds Trinity University, Leeds LS18 5HD, UK.,Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - C Griffiths
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,Public Health Team, Rotherham Metropolitan Borough Council, Rotherham, UK
| | - J McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| |
Collapse
|
35
|
Wasfi R, Steinmetz-Wood M, Kestens Y. Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada. PLoS One 2017; 12:e0189472. [PMID: 29261706 PMCID: PMC5736224 DOI: 10.1371/journal.pone.0189472] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022] Open
Abstract
This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20-1.67) and older adults (OR: 2.09; 95%CI: 1.51-2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15-2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking.
Collapse
Affiliation(s)
- Rania Wasfi
- Department of Social and Preventive Medicine, École de Santé Publique de l’Université de Montréal (ESPUM), Universite de Montreal, Montreal, Canada
- University of Montreal Hospital Research Centre (CRCHUM), Universite de Montreal, Montreal, Canada
| | - Madeleine Steinmetz-Wood
- University of Montreal Hospital Research Centre (CRCHUM), Universite de Montreal, Montreal, Canada
| | - Yan Kestens
- Department of Social and Preventive Medicine, École de Santé Publique de l’Université de Montréal (ESPUM), Universite de Montreal, Montreal, Canada
- University of Montreal Hospital Research Centre (CRCHUM), Universite de Montreal, Montreal, Canada
| |
Collapse
|
36
|
Patterns of food and physical activity environments related to children's food and activity behaviors: A latent class analysis. Health Place 2017; 49:19-29. [PMID: 29156415 DOI: 10.1016/j.healthplace.2017.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 11/20/2022]
Abstract
Relationships between food and physical activity (PA) environments and children's related behaviors are complex. Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections. Regression analyses examined whether derived classes were related to food consumption, PA, and overweight among 404 low-income children. Compared to children living in Low PA-Low Food environments, children in High Intersection&Parks-Moderate Density&Food, and High Density-Low Parks-High Food environments, had significantly greater sugar-sweetened beverage consumption (ps<0.01) and overweight/obesity (ps<0.001). Children in the High Density-Low Parks-High Food environments were more likely to walk to destinations (p = 0.01) Recognizing and leveraging beneficial aspects of neighborhood patterns may be more effective at positively influencing children's eating and PA behaviors compared to isolating individual aspects of the built environment.
Collapse
|