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Aznar S, Jimenez-Zazo F, Romero-Blanco C, Gómez SF, Homs C, Wärnberg J, Medrano M, Gusi N, Gonzalez-Gross M, Marín-Cascales E, González-Valeiro MÁ, Serra-Majem L, Terrados N, Tur JA, Segu M, Lassale C, Colom-Fernández A, Labayen I, Sánchez-Gómez J, Alcaraz PE, Sevilla-Sanchez M, Zapico AG, Herrera-Ramos E, Pulgar S, Bibilonii MDM, Sistac C, Schröder H, Molina-García J. Walkability and socio-economic status in relation to walking, playing and sports practice in a representative Spanish sample of youth: The PASOS study. PLoS One 2024; 19:e0296816. [PMID: 38489321 PMCID: PMC10942037 DOI: 10.1371/journal.pone.0296816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/19/2023] [Indexed: 03/17/2024] Open
Abstract
PURPOSE Physical activity (PA) provides multiple health-related benefits in children and adolescents, however, at present, the majority of young people are insufficiently physically active. The aim of this study was to evaluate if neighborhood walkability and/or socio-economic status (SES) could affect the practice of walking, play outdoors and sports practice in a representative sample of Spanish children and adolescents. METHODS A sample of 4092 youth (aged 8-16 years old) from 245 primary and secondary schools in 121 localities from each of the 17 Spanish autonomous communities participated in the study. Walk Score was used to evaluate walkability of the neighborhood and household income was used as an indicator of SES. A 7-item self-reported validated questionnaire, was used to assess PA levels, and in a subsample of 10% of the participants, randomly selected from the entire sample, PA was objectively measured by accelerometers. RESULTS Youth from more walkable areas reported more minutes walking per day compared with those from less walkable neighborhoods (51.4 vs 48.8 minutes, respectively). The lowest average minutes spent in playing outdoors was found among participants from low-SES and low-walkable neighborhoods. Neighborhood SES influenced on the participation in team sports during the weekend, being this participation higher in high SES neighborhoods. CONCLUSION Providing high walkable environments seems a good strategy to promote PA regardless SES levels. It seems that improving the walkability is a key component to partially overcome the SES inequalities, especially in urban areas with low SES. High-SES environments can offer better sports facilities and more organized physical activities than low-SES ones.
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Affiliation(s)
- Susana Aznar
- PAFS Research Group, Department of Physical Activity and Sports Sciences, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Fabio Jimenez-Zazo
- PAFS Research Group, Department of Physical Activity and Sports Sciences, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Cristina Romero-Blanco
- PAFS Research Group, Department of Nursery, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Santiago F. Gómez
- Gasol Foundation, Sant Boi de Llobregat, Barcelona, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain
- Ciber Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Cardiovascular Risk and Nutrition Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Clara Homs
- Gasol Foundation, Sant Boi de Llobregat, Barcelona, Spain
- GRoW, Global Research on Wellbeing, Blanquerna School of Life Sciences, University Ramon Llull, Barcelona, Spain
| | - Julia Wärnberg
- EpiPHAAN Research Group, School of Health Sciences, University of Málaga–Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Maria Medrano
- ELIKOS Group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Navarra, Spain
| | - Narcís Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Marcela Gonzalez-Gross
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Elena Marín-Cascales
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
- Faculty of Sport Sciences, UCAM, Catholic University of Murcia, Murcia, Spain
| | | | - Lluis Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
- Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Nicolás Terrados
- Regional Unit of Sports Medicine, Municipal Sports Foundation of Avilés, Asturias, Spain
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), Palma de Mallorca, Spain
| | | | - Camille Lassale
- Ciber Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Antoni Colom-Fernández
- EpiPHAAN Research Group, School of Health Sciences, University of Málaga–Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Idoia Labayen
- ELIKOS Group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Navarra, Spain
| | - Jesús Sánchez-Gómez
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Pedro Emilio Alcaraz
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
- Faculty of Sport Sciences, UCAM, Catholic University of Murcia, Murcia, Spain
| | - Marta Sevilla-Sanchez
- Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Augusto G. Zapico
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Language, Arts and Physical Education, Universidad Complutense de Madrid, Madrid, Spain
| | - Estefanía Herrera-Ramos
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Susana Pulgar
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Maria del Mar Bibilonii
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
- Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), Palma de Mallorca, Spain
| | | | - Helmut Schröder
- Ciber Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain
- Cardiovascular Risk and Nutrition Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Javier Molina-García
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
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Campos-Garzón P, Stewart T, Palma-Leal X, Molina-García J, Herrador-Colmenero M, Schipperijn J, Chillón P, Barranco-Ruiz Y. Are Spanish adolescents who actively commute to and from school more active in other domains? A spatiotemporal investigation. Health Place 2024; 86:103211. [PMID: 38428065 DOI: 10.1016/j.healthplace.2024.103211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
We examined the association between mode of commuting to/from school (i.e., walking, multimodal, and motorized-vehicle) and movement behaviours in several space-time domains (i.e., total day, home, school, transport, and other locations). Walking to and/or from school was associated with higher MVPA in all space-time domains except home, where no associations were found. After subtracting commuting time to/from school from total day domain, the associations in favour of walking to/from school were maintained compared to those using other commuting modes, and in transport domain these associations dissipated. The study suggests the importance of promoting walking to/from school for increasing MVPA levels.
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Affiliation(s)
- P Campos-Garzón
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - T Stewart
- Auckland University of Technology, New Zealand
| | - X Palma-Leal
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; IRyS Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Viña Del Mar, Chile
| | - J Molina-García
- AFIPS Research Group, Department of Teaching of Physical Education, Arts and Music, University of Valencia, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-UJI-UV, Valencia, Spain.
| | - M Herrador-Colmenero
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; La Inmaculada Teacher Training Centre, University of Granada, Granada, Spain
| | - J Schipperijn
- Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
| | - P Chillón
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Y Barranco-Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
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Lamb KE, Daniel M, Chaix B, Kestens Y, Coffee NT, Thornton LE. Socioeconomic differences in associations between living in a 20-min neighbourhood and diet, physical activity and self-rated health: Cross-sectional findings from ProjectPLAN. Health Place 2023; 84:103119. [PMID: 37742399 DOI: 10.1016/j.healthplace.2023.103119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/28/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
The 20-min neighbourhood (20MN) concept aims to enable residents to meet daily needs using resources within a 20-min trip from home noting that there is no single definition of what services and amenities are required for daily needs nor what modes of transport constitute a 20 min trip. Whether 20MNs promote better health and whether associations differ by socio-economic status (SES) is unknown. Using cross-sectional data from adults randomly sampled in 2018-19 from Melbourne or Adelaide, Australia, we examined whether associations between neighbourhood type (20MN/non-20MN) and diet, physical activity or self-rated health vary according to individual- or area-level SES. We found no consistent patterns of interactions. The results do not consistently support the often assumed belief that 20MNs support more healthful behaviour and that these relationships vary by SES.
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Affiliation(s)
- Karen E Lamb
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Mark Daniel
- Dasman Diabetes Institute, GeoHealth Laboratory, Kuwait City, Kuwait
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Nemesis Research team, F75012, Paris, France
| | - Yan Kestens
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada; Centre de Recherche en Santé Publique (CReSP), Montréal, QC, Canada
| | - Neil T Coffee
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Lukar E Thornton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Department of Marketing, Faculty of Business Economics, University of Antwerp, Antwerp, Belgium
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Aris IM, Perng W, Dabelea D, Padula AM, Alshawabkeh A, Vélez-Vega CM, Aschner JL, Camargo CA, Sussman TJ, Dunlop AL, Elliott AJ, Ferrara A, Joseph CLM, Singh AM, Breton CV, Hartert T, Cacho F, Karagas MR, Lester BM, Kelly NR, Ganiban JM, Chu SH, O’Connor TG, Fry RC, Norman G, Trasande L, Restrepo B, Gold DR, James P, Oken E. Neighborhood Opportunity and Vulnerability and Incident Asthma Among Children. JAMA Pediatr 2023; 177:1055-1064. [PMID: 37639269 PMCID: PMC10463174 DOI: 10.1001/jamapediatrics.2023.3133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 08/29/2023]
Abstract
Background The extent to which physical and social attributes of neighborhoods play a role in childhood asthma remains understudied. Objective To examine associations of neighborhood-level opportunity and social vulnerability measures with childhood asthma incidence. Design, Setting, and Participants This cohort study used data from children in 46 cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program between January 1, 1995, and August 31, 2022. Participant inclusion required at least 1 geocoded residential address from birth and parent or caregiver report of a physician's diagnosis of asthma. Participants were followed up to the date of asthma diagnosis, date of last visit or loss to follow-up, or age 20 years. Exposures Census tract-level Child Opportunity Index (COI) and Social Vulnerability Index (SVI) at birth, infancy, or early childhood, grouped into very low (<20th percentile), low (20th to <40th percentile), moderate (40th to <60th percentile), high (60th to <80th percentile), or very high (≥80th percentile) COI or SVI. Main Outcomes and Measures The main outcome was parent or caregiver report of a physician's diagnosis of childhood asthma (yes or no). Poisson regression models estimated asthma incidence rate ratios (IRRs) associated with COI and SVI scores at each life stage. Results The study included 10 516 children (median age at follow-up, 9.1 years [IQR, 7.0-11.6 years]; 52.2% male), of whom 20.6% lived in neighborhoods with very high COI and very low SVI. The overall asthma incidence rate was 23.3 cases per 1000 child-years (median age at asthma diagnosis, 6.6 years [IQR, 4.1-9.9 years]). High and very high (vs very low) COI at birth, infancy, or early childhood were associated with lower subsequent asthma incidence independent of sociodemographic characteristics, parental asthma history, and parity. For example, compared with very low COI, the adjusted IRR for asthma was 0.87 (95% CI, 0.75-1.00) for high COI at birth and 0.83 (95% CI, 0.71-0.98) for very high COI at birth. These associations appeared to be attributable to the health and environmental and the social and economic domains of the COI. The SVI during early life was not significantly associated with asthma incidence. For example, compared with a very high SVI, the adjusted IRR for asthma was 0.88 (95% CI, 0.75-1.02) for low SVI at birth and 0.89 (95% CI, 0.76-1.03) for very low SVI at birth. Conclusions In this cohort study, high and very high neighborhood opportunity during early life compared with very low neighborhood opportunity were associated with lower childhood asthma incidence. These findings suggest the need for future studies examining whether investing in health and environmental or social and economic resources in early life would promote health equity in pediatric asthma.
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Affiliation(s)
- Izzuddin M. Aris
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts
| | - Carmen M. Vélez-Vega
- University of Puerto Rico (UPR) Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, Puerto Rico
| | - Judy L. Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, New Jersey
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York
| | - Carlos A. Camargo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Tamara J. Sussman
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland
| | | | - Anne Marie Singh
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin–Madison
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Tina Hartert
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ferdinand Cacho
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Barry M. Lester
- Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene
| | - Jody M. Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC
| | - Su H. Chu
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill
| | - Gwendolyn Norman
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Wayne State University, Detroit, Michigan
| | - Leonardo Trasande
- Department of Pediatrics, Grossman School of Medicine, New York University, New York
| | - Bibiana Restrepo
- Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento
| | - Diane R. Gold
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
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Estevan I, García-Massó X, Menescardi C, Ortega-Benavent N, Montalt-García S, Romero-Martínez J, Castillo I, Álvarez O, Queralt A, Molina-García J. A Classroom-Based Intervention to Promote Physical Literacy in Children: ALPHYL Study Protocol. Behav Sci (Basel) 2023; 13:609. [PMID: 37504056 PMCID: PMC10376495 DOI: 10.3390/bs13070609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/24/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
Physical literacy is crucial for children's appropriate development and physical, social and mental health. In a school setting, class-based physical activity (PA) interventions are considered to be appropriate programs to foster PA participation and cognitive development. The purpose of this project, named the Active Learning in PHYsical Literacy (ALPHYL) study, was to describe a multicomponent classroom-based physically-active learning randomised control trial (RCT) in primary school children. The main purpose was to promote children's physical literacy, academic achievement and cognitive function. The ALPHYL study is mainly based on physical literacy, active school models and the Supportive, Active, Autonomous, Fair and Enjoyable principles. The ALPHYL is an 8-10-week RCT to be conducted in six primary schools (12 classes) in Valencia (Spain) and its metropolitan area. Schools will be randomly assigned to the intervention or waiting-list control group. After a 30 h in-person training course for teachers and weekly meetings in the three months of resource preparation, the ALPHYL intervention will be conducted in physical education (PE) and non-PE lessons by teachers. The intervention consists of at least three daily sessions of physically active learning in addition to model-based PE teaching. Its feasibility will be evaluated weekly according to the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. To assess its effectiveness, a pre-test, post-test and retention (8-10 weeks post-intervention) with primary outcomes (i.e., PA level, motor competence, perceived motor competence and PL, motivation, perceived social support, academic achievement and cognitive function), secondary outcomes and covariates will be collected.
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Affiliation(s)
- Isaac Estevan
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
| | - Xavier García-Massó
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
| | - Cristina Menescardi
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
| | - Nuria Ortega-Benavent
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
| | - Sergio Montalt-García
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
| | - Jorge Romero-Martínez
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
| | - Isabel Castillo
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
- Department of Social Psychology, Faculty of Psychology and Speech Therapy, University of Valencia, Av. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Octavio Álvarez
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
- Department of Social Psychology, Faculty of Psychology and Speech Therapy, University of Valencia, Av. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Ana Queralt
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, Avda. Menendez Pelayo, s/n, 46010 Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-UJI-UV, 46020 Valencia, Spain
| | - Javier Molina-García
- Department of Teaching of Physical Education, Arts and Music, University of Valencia, Avda. dels Tarongers 4, 46022 Valencia, Spain
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-UJI-UV, 46020 Valencia, Spain
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Yoon J, Sung H, Lee EY, Kim G, Choe H, Jeon J, Kim YS. Physical activity among adolescent-parent dyads: 2017-2019 Korea National Health and Nutrition Examination Surveys of Korean adolescents and that of their parents. J Sports Sci 2023:1-7. [PMID: 37224565 DOI: 10.1080/02640414.2023.2205766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/11/2023] [Indexed: 05/26/2023]
Abstract
This study investigated physical activity (PA) levels among adolescents and their parents in South Korea. Repeated cross-sectional data from 2017-2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used. The KNHANES uses a complex, multi-stage probability sample design. Data included 875 Korean adolescents aged 12 to 18years and their parents. Adolescents were asked how many days during the week they were physically active for at least 60 minutes. Compliance was defined as 4+ days per week. Logistic regressions were used and odds ratios and 95% confidence intervals were provided. The adherence to PA compliance and guideline among adolescents (≥60 min/d for at least 4 d/week) and their parents (≥600MET/min per week) were 11.54% and 23.09%, respectively. Parents who adhered to the PA guideline were more likely to have a child who also adhere to the PA than the parents who did not adhere to the PA guideline (OR=2.48, 95% CI=1.39-4.49). Only mothers (OR=1.31, 95% CI=0.65-2.57) and fathers (OR=1.37, 95% CI=0.74-2.55) were not significant in association to their adolescents' PA when complying with the PA guidelines, respectively. Parental PA appears to be important for PA among adolescents. Therefore, strategies to promote PA among adolescents should target families in South Korea.
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Affiliation(s)
- Jiyeon Yoon
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
| | - Hoyong Sung
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
| | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Geonhui Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
| | - Harim Choe
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
| | - Justin Jeon
- Department of Sport Industry Studies, Yonsei University, Seoul, South Korea
| | - Yeon Soo Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
- Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
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Salvo D, Resendiz E, Stefancic A, Cabassa LJ. Examining Place-Based Neighborhood Factors in a Multisite Peer-Led Healthy Lifestyle Effectiveness Trial for People with Serious Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095679. [PMID: 37174197 PMCID: PMC10178706 DOI: 10.3390/ijerph20095679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/15/2023]
Abstract
People with severe mental illness (SMI) experience significantly higher obesity-related comorbidities and premature mortality rates than healthy populations. The physical and social characteristics of neighborhoods where people with SMI reside can play an important role in promoting or hindering healthy eating and physical activity. However, this is seldom considered when designing and testing health behavior interventions for these populations. This study used baseline data from an obesity control trial for low-income, minority people with SMI to demonstrate the utility of assessing neighborhood- and city-level place-based factors within the context of lifestyle interventions. GIS was used to create a zip-code-level social and built environment geodatabase in New York City and Philadelphia, where the trial occurred. Chi-square and t-tests were used to assess differences in the spatial distribution of health-related built and social environment characteristics between and within cities and diet and physical activity outcomes. All types of neighborhood characteristics showed significant environmental differences between and within cities. Several neighborhood characteristics were associated with participants' baseline healthy eating and physical activity behaviors, emphasizing that place-based factors may moderate lifestyle interventions for SMI patients. Future behavioral interventions targeting place-dependent behaviors should be powered and designed to assess potential moderation by place-based factors.
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Affiliation(s)
- Deborah Salvo
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
| | - Eugen Resendiz
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Ana Stefancic
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Leopoldo J Cabassa
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
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Schwarz A, Winkens LHH, de Vet E, Ossendrijver D, Bouwsema K, Simons M. Design Features Associated With Engagement in Mobile Health Physical Activity Interventions Among Youth: Systematic Review of Qualitative and Quantitative Studies. JMIR Mhealth Uhealth 2023; 11:e40898. [PMID: 36877551 PMCID: PMC10028523 DOI: 10.2196/40898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/02/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Globally, 81% of youth do not meet the physical activity (PA) guidelines. Youth of families with a low socioeconomic position are less likely to meet the recommended PA guidelines. Mobile health (mHealth) interventions are preferred by youth over traditional in-person approaches and are in line with their media preferences. Despite the promise of mHealth interventions in promoting PA, a common challenge is to engage users in the long term or effectively. Earlier reviews highlighted the association of different design features (eg, notifications and rewards) with engagement among adults. However, little is known about which design features are important for increasing engagement among youth. OBJECTIVE To inform the design process of future mHealth tools, it is important to investigate the design features that can yield effective user engagement. This systematic review aimed to identify which design features are associated with engagement in mHealth PA interventions among youth who were aged between 4 and 18 years. METHODS A systematic search was conducted in EBSCOhost (MEDLINE, APA PsycINFO, and Psychology & Behavioral Sciences Collection) and Scopus. Qualitative and quantitative studies were included if they documented design features associated with engagement. Design features and related behavior change techniques and engagement measures were extracted. Study quality was assessed according to the Mixed Method Assessment Tool, and one-third of all screening and data extraction were double coded by a second reviewer. RESULTS Studies (n=21) showed that various features were associated with engagement, such as a clear interface, rewards, multiplayer game mode, social interaction, variety of challenges with personalized difficulty level, self-monitoring, and variety of customization options among others, including self-set goals, personalized feedback, progress, and a narrative. In contrast, various features need to be carefully considered while designing mHealth PA interventions, such as sounds, competition, instructions, notifications, virtual maps, or self-monitoring, facilitated by manual input. In addition, technical functionality can be considered as a prerequisite for engagement. Research addressing youth from low socioeconomic position families is very limited with regard to engagement in mHealth apps. CONCLUSIONS Mismatches between different design features in terms of target group, study design, and content translation from behavior change techniques to design features are highlighted and set up in a design guideline and future research agenda. TRIAL REGISTRATION PROSPERO CRD42021254989; https://tinyurl.com/5n6ppz24.
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Affiliation(s)
- Ayla Schwarz
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Laura H H Winkens
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Dian Ossendrijver
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Kirsten Bouwsema
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
| | - Monique Simons
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
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Dhillon NK, Kufera J, Ghneim M. Emergency General Surgery Procedures in Older Adults: Where You Live Matters! Am Surg 2023:31348231160838. [PMID: 36861456 DOI: 10.1177/00031348231160838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND Neighborhood location and its built environment are important social determinants of health that impact health outcomes. Older adults (OAs) represent the fastest growing population in the United States with many requiring emergency general surgery procedures (EGSPs). The aim of this study was to evaluate whether neighborhood location, represented by zip code, influences mortality and disposition in OAs undergoing EGSPs in Maryland. METHODS A retrospective review was undertaken of hospital encounters in the Maryland Health Services Cost Review Commission from 2014 to 2018 of OAs undergoing EGSPs. Older adults residing in the 50 most affluent (MANs) and 50 least affluent (LANs) neighborhoods based on zip codes were compared. Data collected included demographics, all patient-refined (APR)-severity of illness (SOI), APR-risk of mortality (ROM), Charlson Comorbidity Index, complications, mortality, and discharge to a higher level of care. RESULTS Of the 8661 OAs analyzed, 2362 (27.3%) resided in MANs and 6299 (72.7%) in LANs. Older adults in LANs were more likely to undergo EGSPs, had higher APR-SOI and APR-ROM, and experienced more complications, discharge to higher level of care, and mortality. Living in LANs was independently associated with discharge to higher level of care (OR 1.56, 95% CI: 1.38-1.77, P < .001) and increased mortality (OR 1.35, 95% CI: 1.07-1.71, P = .01). DISCUSSION Mortality and quality of life in OAs undergoing EGSPs are dependent on environmental factors likely determined by neighborhood location. These factors need to be defined and incorporated in predictive models of outcomes. Public health opportunities to improve outcomes for those who are socially disadvantaged are necessary.
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Affiliation(s)
- Navpreet K Dhillon
- Department of Surgery, Program in Trauma, University of Maryland School of Medicine, 137889R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Joseph Kufera
- National Study Center for Trauma and Emergency Medical Systems, Center for Shock, Trauma and Anesthesiology Research, 12264University of Maryland School of Medicine, Baltimore MD, USA
| | - Mira Ghneim
- Department of Surgery, Program in Trauma, University of Maryland School of Medicine, 137889R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
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de Albuquerque FM, Pessoa MC, Filgueiras MDS, do Carmo AS, Vegi ASF, Ribeiro AQ, de Novaes JF. Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index. Am J Hum Biol 2023; 35:e23835. [PMID: 36394453 DOI: 10.1002/ajhb.23835] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). METHODS A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. RESULTS The neighborhood obesogenic environment had a significant total association (Standardized Coefficient = 0.172, p = .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient = 0.066, p = .049). CONCLUSIONS Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.
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Affiliation(s)
- Fernanda Martins de Albuquerque
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Milene Cristine Pessoa
- Programa de Pós Graduação em Nutrição e Saúde, Departamento de Nutrição, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mariana De Santis Filgueiras
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Ariene Silva do Carmo
- Programa de Pós Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Siqueira Fogal Vegi
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Andréia Queiroz Ribeiro
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Juliana Farias de Novaes
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
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11
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Liu Y, Trude ACB, Song S, Jiang N, Wang S, Gittelsohn J, Wen D. Childhood obesity inequality in northeast China: joint effect of social economic status and school neighborhood environment. BMC Public Health 2023; 23:318. [PMID: 36782186 PMCID: PMC9926811 DOI: 10.1186/s12889-023-15194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 02/02/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Obesogenic environment is important in driving obesity epidemic. Children spend large amount of their time in schools. School neighborhood environment, as well as its interaction with socioeconomic status (SES) needs to be explored to provide evidence for children obesity prevention policies. METHODS Objective anthropometric measurement, a household structured questionnaire, and school geospatial analyses were carried out on 3670 children (aged 9-12 years) of 26 schools in northeast China. Interaction between SES inter-categorical intersectionality group and school neighborhood environment was tested for the effect on children's body mass index z scores (z-BMI) and waist-hip ratio z scores (z-WHR), following formulation of SES inter-categorical intersectionality group based on household wealth, parental education, and parental occupation. RESULTS SES groups formed by household wealth, parental education and parental occupation was associated with z-BMI and z-WHR for girls. Those from moderate wealth & self-employed (M&S) families had the highest adjusted z-BMI and z-WHR among all SES groups. School neighborhood environment factors interacted with SES groups in association with WHR for girls. Number of school neighborhood supermarkets and residential sites were negatively associated with z-WHR for girls from M&S families (β= -0.45 (95%CI: -0.76, -0.15) for supermarkets; β= -0.01 (95%CI: -0.03, 0.00) for residential sites). Number of school neighborhood convenience stores and public transport stops were positively associated with z-WHR for girls from M&S families (β = 0.02 (95%CI: 0.00, 0.03) for convenience stores; β = 0.23 (95%CI: 0.15, 0.31) for public transport stops). While non-significant association was found for number of vegetable stores. CONCLUSION Girls from moderate wealth & self-employed families may be the group susceptible to school neighborhood environment. Local policies targeted at improving the school neighborhood environment may be one avenue for reducing socioeconomic disparities in obesity especially for girls.
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Affiliation(s)
- Yang Liu
- grid.412449.e0000 0000 9678 1884Institute of Health Science, China Medical University, Shenyang, China
| | - Angela Cristina Bizzotto Trude
- grid.411024.20000 0001 2175 4264Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, United States
| | - Shenzhi Song
- grid.412449.e0000 0000 9678 1884Institute of Health Science, China Medical University, Shenyang, China
| | - Nan Jiang
- grid.412449.e0000 0000 9678 1884Institute of International Medical Education, China Medical University, Shenyang, China
| | - Shihan Wang
- grid.412449.e0000 0000 9678 1884School of public health, China Medical University, Shenyang, China
| | - Joel Gittelsohn
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, Human Nutrition Center, Baltimore, United States
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang, China.
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12
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DeVille NV, Iyer HS, Holland I, Bhupathiraju SN, Chai B, James P, Kawachi I, Laden F, Hart JE. Neighborhood socioeconomic status and mortality in the nurses' health study (NHS) and the nurses' health study II (NHSII). Environ Epidemiol 2023; 7:e235. [PMID: 36777531 PMCID: PMC9916023 DOI: 10.1097/ee9.0000000000000235] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022] Open
Abstract
Few studies have prospectively examined long-term associations between neighborhood socioeconomic status (nSES) and mortality risk, independent of demographic and lifestyle risk factors. Methods We assessed associations between nSES and all-cause, nonaccidental mortality among women in the Nurses' Health Study (NHS) 1986-2014 (N = 101,701) and Nurses' Health Study II (NHSII) 1989-2015 (N = 101,230). Mortality was ascertained from the National Death Index (NHS: 19,228 deaths; NHSII: 1556 deaths). Time-varying nSES was determined for the Census tract of each residential address. We used principal component analysis (PCA) to identify nSES variable groups. Multivariable Cox proportional hazards models were conditioned on age and calendar period and included time-varying demographic, lifestyle, and individual SES factors. Results For NHS, hazard ratios (HRs) comparing the fifth to first nSES quintiles ranged from 0.89 (95% confidence interval [CI] = 0.84, 0.94) for percent of households receiving interest/dividends, to 1.11 (95% CI = 1.06, 1.17) for percent of households receiving public assistance income. In NHSII, HRs ranged from 0.72 (95% CI: 0.58, 0.88) for the percent of households receiving interest/dividends, to 1.27 (95% CI: 1.07, 1.49) for the proportion of households headed by a single female. PCA revealed three constructs: education/income, poverty/wealth, and racial composition. The racial composition construct was associated with mortality (HRNHS: 1.03; 95% CI = 1.01, 1.04). Conclusion In two cohorts with extensive follow-up, individual nSES variables and PCA component scores were associated with mortality. nSES is an important population-level predictor of mortality, even among a cohort of women with little individual-level variability in SES.
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Affiliation(s)
- Nicole V. DeVille
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas School of Public Health, Las Vegas, Naveda
| | - Hari S. Iyer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Isabel Holland
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shilpa N. Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Boyang Chai
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Johnson AM, Tandon PS, Hafferty KR, Senturia K, Garrett KA, Bollinger BJ, Kroshus E. Barriers and facilitators to comprehensive, school-based physical activity promotion for adolescents prior to and during the COVID-19 pandemic: a qualitative study. HEALTH EDUCATION RESEARCH 2023; 38:69-83. [PMID: 36458631 DOI: 10.1093/her/cyac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to identify barriers and facilitators to comprehensive, school-based physical activity (PA) promotion among adolescents prior to and during the coronavirus disease of 2019 (COVID-19) pandemic, considering the perspectives of students, parents, and school staff. Data were collected from 2020 to 2021 using semi-structured individual interviews with students (n = 15), parents (n = 20), and school staff (n = 8) at a Title I middle school (i.e. high percentage of students from low-income families). Two theoretical frameworks guided analysis: the Comprehensive School Physical Activity Program framework and Bronfenbrenner's ecological systems theory. Using an iteratively developed codebook, data were coded, thematically analyzed, and synthesized. PA barriers and facilitators were present throughout the school day, at home, and in the community. Key determinants included pandemic-induced challenges (e.g. COVID-19 exposure); neighborhood characteristics/weather (e.g. neighborhood safety); school-family communication/collaboration; implementation climate (i.e. school staff's support for programming); time, spatial, and monetary resources (e.g. funding); staffing capacity/continuity and school champions; staffing creativity and adaptability; PA opportunities before, during, and after school; and child's motivation/engagement. Efforts to improve school-based PA programs, irrespective of pandemic conditions, should include strategies that address factors at the community, school, family and individual levels. School-family communication/collaboration, school staff programming support, and PA opportunities throughout the day can help promote comprehensive, school-based PA.
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Affiliation(s)
- Ashleigh M Johnson
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Pooja S Tandon
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
- Department of Pediatrics, University of Washington, Box 356320, Seattle, WA 98115-8160, USA
| | - Kiana R Hafferty
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Kirsten Senturia
- Department of Health Systems and Population Health, University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Kimberly A Garrett
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Beth J Bollinger
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Emily Kroshus
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
- Department of Pediatrics, University of Washington, Box 356320, Seattle, WA 98115-8160, USA
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14
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An analytical model for spatial developing of sports places and spaces. JOURNAL OF FACILITIES MANAGEMENT 2023. [DOI: 10.1108/jfm-03-2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose
In terms of the use of sports places and spaces, per capita is a determining parameter for the status and perspective of the future. Although there are many uses for the per capita indicator in sports places, there are no consistent scientific and methodological methods for calculating it. Therefore, this study aims to provide an analytical model to determine the per capita index of sports places and spaces.
Design/methodology/approach
One of the matters that can be considered as the basic information required to develop and construct sports facilities is determination of per capita, which can be used as the most vital information to plan and develop this type of urban utilities. In the history of contemporary urbanization, the use of the per capita concept is one of Reinhard Laumeister’s innovations, a founder of modern urban engineering in Germany, hence, the use of per capita was triggered in 1876, almost 133 years ago.
Findings
The underlying information of the research in two spatial and descriptive sections was analyzed in the geographic information systems (GIS) software. After the division and network distribution of the boundary by the Thiessen Networks analytic function in the Arc GIS, per capita of each polygon was separately calculated using the presented formula and the population of the related blocks
Originality/value
Finally, with the qualitative per capita achieved in the previous stage, the study area was classified based on the need for the development of indoor pools to three, privileged, semi-privileged and deprived spectrums.
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15
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Whooten R, Horan C, Aguirre A, Dartley AN, Taveras E. Parent and Pediatrician Perspectives on Physical Activity Promotion in Pediatric Primary Care: A Preliminary Mixed Methods Study. Am J Health Promot 2023; 37:65-76. [PMID: 35817761 DOI: 10.1177/08901171221113317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To elicit preliminary pediatrician and parent perspectives on physical activity (PA) counseling and identify opportunities for improvement. DESIGN Mixed methods, including a cross-sectional survey and semi-structured interviews. SETTING AND PARTICIPANTS Primary care pediatricians (N = 73; 40% response rate) within a single large healthcare system and parents of students (N = 20) participating in a local school-based PA program in eastern Massachusetts. METHODS Electronic survey of pediatricians assessing opinions of American Academy of Pediatrics (AAP) PA guidelines and potential PA promotion tools; semi-structured qualitative interviews with parents assessing overall discussion, education, and recommendations relating to PA. ANALYSIS We report descriptive statistics for survey items and bivariate analyses comparing responses by physician characteristics. We performed thematic analysis of qualitative interviews and present results through an implementation science framework. RESULTS In this preliminary study, pediatricians reported adoption, appropriateness, and lower perceived effectiveness of PA counseling. School-based programs and educational materials were most often chosen as PA promotion tools. Responses varied by pediatrician characteristics. While parents reported satisfaction, opportunities for improvement included connections with community resources and continued conversations with the child about PA. CONCLUSIONS Pediatricians and parents highlighted gaps in PA counseling in primary care. While results are preliminary given small sample size, this study provides actionable targets to support PA promotion as a preventive health priority in this setting.
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Affiliation(s)
- Rachel Whooten
- Division of General Academic Pediatrics, Department of Pediatrics, 2348Massachusetts General Hospital for Children, Boston, MA, USA
- Division of Endocrinology, Department of Pediatrics, 2348Massachusetts General Hospital for Children, Boston, MA, USA
| | - Christine Horan
- Division of General Academic Pediatrics, Department of Pediatrics, 2348Massachusetts General Hospital for Children, Boston, MA, USA
| | - Annabelle Aguirre
- Division of General Academic Pediatrics, Department of Pediatrics, 2348Massachusetts General Hospital for Children, Boston, MA, USA
| | - Anna Nicole Dartley
- Division of General Academic Pediatrics, Department of Pediatrics, 2348Massachusetts General Hospital for Children, Boston, MA, USA
| | - Elsie Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, 2348Massachusetts General Hospital for Children, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Kraft Center for Community Health, 2348Massachusetts General Hospital, Boston, MA, USA
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Andersen OK, Gebremariam MK, Kolle E, Tarp J. Socioeconomic position, built environment and physical activity among children and adolescents: a systematic review of mediating and moderating effects. Int J Behav Nutr Phys Act 2022; 19:149. [PMID: 36510203 PMCID: PMC9743748 DOI: 10.1186/s12966-022-01385-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/26/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Physical activity behaviors among children and adolescents are socioeconomically patterned. Understanding if, and how, the built environment contributes to socioeconomic inequalities in physical activity and for whom built environments are most important, can lead to the identification of intervention entry points to reduce inequalities in physical activity. OBJECTIVE To summarize the existing evidence among children and adolescents on (a) whether the built environment mediates the association between socioeconomic position and physical activity and (b) whether socioeconomic position moderates the association between the built environment and physical activity. METHODS A systematic literature search was conducted using PubMed, Embase, PsycINFO and Web of Science. Two independent reviewers screened articles for eligibility, extracted information from included studies and assessed risk of bias with the Quality Assessment Tool for Observational Cohort and Cross-Sectional studies. We performed a narrative evidence synthesis considering the totality of the evidence and by study characteristics such as geographic region, age group, and exposure-outcome assessment methodology. The reporting was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. RESULTS A total of 28 papers were included. In general, the studies were of low methodological quality. There was no evidence to support that the built environment functions as a mediator in the relationship between socioeconomic position and physical activity. We observed inconclusive moderation patterns with five studies reporting stronger associations between features of the built environment and physical activity among high socioeconomic positioned youths. Seven studies reported stronger associations among low socioeconomic positioned youth and fourteen studies reported no difference in associations. We observed different moderation patterns across geographical regions (Europe vs. US) indicating that, in Europe, having a walkable neighborhood is important for low socioeconomic positioned youth only. No differences in moderation patterns were observed for younger vs. older children or activity domains. CONCLUSION Current evidence does not support a strong interplay between built environment and socioeconomic position on physical activity in youth. However, given the low quality of the evidence, firm conclusions cannot be made, and additional high-quality research is likely to have substantial impact on the evidence base.
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Affiliation(s)
- Oddbjørn Klomsten Andersen
- grid.412285.80000 0000 8567 2092Department of Sports Sciences, Norwegian School of Sport Sciences, PO Box 4014, Ullevaal stadion, 0806 Oslo, Norway
| | - Mekdes Kebede Gebremariam
- grid.5510.10000 0004 1936 8921Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elin Kolle
- grid.412285.80000 0000 8567 2092Department of Sports Sciences, Norwegian School of Sport Sciences, PO Box 4014, Ullevaal stadion, 0806 Oslo, Norway
| | - Jakob Tarp
- grid.7048.b0000 0001 1956 2722Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
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17
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Howell NA, Booth GL. The Weight of Place: Built Environment Correlates of Obesity and Diabetes. Endocr Rev 2022; 43:966-983. [PMID: 35201344 PMCID: PMC9695105 DOI: 10.1210/endrev/bnac005] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Indexed: 11/19/2022]
Abstract
In recent decades, the prevalence of obesity and diabetes has risen substantially in North America and worldwide. To address these dual epidemics, researchers and policymakers alike have been searching for effective means to promote healthy lifestyles at a population level. As a consequence, there has been a proliferation of research examining how the "built" environment in which we live influences physical activity levels, by promoting active forms of transportation, such as walking and cycling, over passive ones, such as car use. Shifting the transportation choices of local residents may mean that more members of the population can participate in physical activity during their daily routine without structured exercise programs. Increasingly, this line of research has considered the downstream metabolic consequences of the environment in which we live, raising the possibility that "healthier" community designs could help mitigate the rise in obesity and diabetes prevalence. This review discusses the evidence examining the relationship between the built environment, physical activity, and obesity-related diseases. We also consider how other environmental factors may interact with the built environment to influence metabolic health, highlighting challenges in understanding causal relationships in this area of research.
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Affiliation(s)
| | - Gillian L Booth
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
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18
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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.
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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
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19
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Parental Education Moderates the Relation between Physical Activity, Dietary Patterns and Atopic Diseases in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050686. [PMID: 35626863 PMCID: PMC9139783 DOI: 10.3390/children9050686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Background: Atopic diseases, particularly asthma, eczema, and rhinitis, are among the most common chronic diseases in childhood, with several factors implicated in their pathogenesis. Our study examined the role of parental education in the association between diet, physical activity, and atopy in adolescents. Methods: 1934 adolescents (47.5% boys) aged 13−14 years old reported information about their diet and physical activity and their parents reported their highest educational level. The moderating role of parental education level (primary/secondary vs. tertiary) in the relation between lifestyle patterns and atopic diseases was examined with logistic regression analyses. Results: High consumption of dairy products was inversely associated to adolescents’ asthma and rhinitis symptoms overall, but this relation was almost 50% stronger for the adolescents with high parental education level background. The same pattern of reduction of the odds was noticed also regarding the association among the high intake of fruits, vegetables, pulses, with all three atopic diseases and the adherence to a physically active lifestyle only with current asthma and eczema (all p < 0.05). Conclusion: Adolescents who are physically active and consume a higher intake of fruits, vegetables, and pulses and a lower intake of fast-food and sweets, and their parents/guardians having higher education, are less likely to have any current symptoms of asthma, eczema, and rhinitis than the ones who have low educated parents.
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20
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Public Rental Housing and Obesogenic Behaviors among Adults in Hong Kong: Mediator Role of Food and Physical Activity Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052960. [PMID: 35270652 PMCID: PMC8910218 DOI: 10.3390/ijerph19052960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/05/2022]
Abstract
Public rental housing (PRH) for low-income families has been shown in several studies to be associated with poor health status and obesity. However, the causes of this health disparity are controversial, and the associations and pathways between PRH and obesogenic behaviors remain unknown. Using cross-sectional survey data of 1977 adults living in Hong Kong (aged or over 18) together with multi-source GIS-based environmental data, we examined the associations between PRH and obesogenic behaviors and the extent to which those associations can be explained by neighborhood food and physical environment. The unhealthy food environment, which relates with infrequent fruit and vegetables consumption, was calculated based on the relative density of fast food restaurants and convenience stores to grocery stores. The physical activity environment, which relates to physical inactivity and prolonged sitting, was assessed in terms of density of sports facilities and street greenery, separately. Regressions and mediation analyses show that PRH was negatively associated with physical inactivity directly and also indirectly via higher sports facilities density; however, PRH was positively associated with unhealthy diet largely directly and positively associated with prolonged sitting indirectly via less street greenery. We advanced the international literature of PRH health impact assessment and its environmental health pathways by providing evidence from the least housing-affordable city in the world. The findings provide planning implications in formulating a healthier PRH community for these low-income PRH households and mitigating health disparities induced by housing type.
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21
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Malacarne D, Handakas E, Robinson O, Pineda E, Saez M, Chatzi L, Fecht D. The built environment as determinant of childhood obesity: A systematic literature review. Obes Rev 2022; 23 Suppl 1:e13385. [PMID: 34859950 DOI: 10.1111/obr.13385] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 01/19/2023]
Abstract
We evaluated the epidemiological evidence on the built environment and its link to childhood obesity, focusing on environmental factors such as traffic noise and air pollution, as well as physical factors potentially driving obesity-related behaviors, such as neighborhood walkability and availability and accessibility of parks and playgrounds. Eligible studies were (i) conducted on human children below the age of 18 years, (ii) focused on body size measurements in childhood, (iii) examined at least one built environment characteristic, (iv) reported effect sizes and associated confidence intervals, and (v) were published in English language. A z test, as alternative to the meta-analysis, was used to quantify associations due to heterogeneity in exposure and outcome definition. We found strong evidence for an association of traffic-related air pollution (nitrogen dioxide and nitrogen oxides exposure, p < 0.001) and built environment characteristics supportive of walking (street intersection density, p < 0.01 and access to parks, p < 0.001) with childhood obesity. We identified a lack of studies that account for interactions between different built environment exposures or verify the role and mechanism of important effect modifiers such as age.
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Affiliation(s)
- Diego Malacarne
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Evangelos Handakas
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Elisa Pineda
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, and School of Public Health, Imperial College London, London, UK
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Leda Chatzi
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
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22
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Molina-García J, Menescardi C, Estevan I, Queralt A. Associations between Park and Playground Availability and Proximity and Children's Physical Activity and Body Mass Index: The BEACH Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010250. [PMID: 35010510 PMCID: PMC8750605 DOI: 10.3390/ijerph19010250] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 05/06/2023]
Abstract
A cross-sectional study was designed to evaluate the relationship between the availability and proximity to parks and playgrounds and physical activity (PA). Moreover, the accessibility to parks and playgrounds and its association with active commuting to/from school (ACS) and body mass index (BMI) were analyzed. The sample was composed of children aged 6-12 years old from the BEACH (Built Environment and Active CHildren) study in Valencia, Spain. The availability and proximity to parks and playgrounds were calculated at different buffer sizes (250, 500, 1000 and 1250 m) using geographical information system data. PA out of school was assessed using accelerometers. Sociodemographics and ACS were measured with a parent questionnaire. Objectively measured weight and height were used to calculate BMI. Mixed linear regression analyses were conducted for each exposure variable, adjusting for sociodemographics, neighborhood walkability level, and participant clustering. The number of parks and playgrounds were positively associated with moderate to vigorous PA (MVPA) and total PA (TPA); including light PA and MVPA, during weekdays, in different buffer sizes. A negative relationship between distance to the nearest playground and TPA during weekdays was found. In addition, the number of playgrounds was positively related to ACS in different buffer sizes, whereas park land area was negatively related to the BMI percentile. This study highlights the importance of assessing the availability and proximity to parks and playgrounds in children's neighborhoods when PA behavior and weight status are analyzed. Study findings may help policymakers when targeting interventions to promote health-enhancing behaviors in children.
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Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain; (C.M.); (I.E.)
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain;
- Correspondence: ; Tel.: +34-961-625-170
| | - Cristina Menescardi
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain; (C.M.); (I.E.)
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain;
| | - Isaac Estevan
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022 Valencia, Spain; (C.M.); (I.E.)
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain;
| | - Ana Queralt
- AFIPS Research Group, University of Valencia, 46010 Valencia, Spain;
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010 Valencia, Spain
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23
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On successfully avoiding communication inequalities and instilling positive impacts: The experience of the 2012–2016 WIXX campaign in Québec. Prev Med Rep 2021; 24:101582. [PMID: 34976643 PMCID: PMC8683878 DOI: 10.1016/j.pmedr.2021.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/23/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
Communication campaigns can contribute to promoting physical activity (PA) among children. However, health inequalities can ensue from this type of public health intervention. Using a pre-test posttest design, we examined the effects of social disadvantage on the large-scale WIXX communication campaign and whether or not social disadvantage moderated WIXX’s impact on PA. Parents of youths were identified using random digit dialing procedures and asked permission for their child to participate in a telephone survey. Surveys were conducted each year between 2012 and 2016. Moderating effects of individual-level and area-based indicators of social disadvantage on campaign effectiveness were examined. Self-reported levels of PA and trying new PAs were the outcomes. Exposure was defined as a function of ads recall and brand awareness. Logistic regression analyses controlling for survey periods, screen time, language, school grade, and attitudes toward PA were performed in 2020. Among girls, no significant interaction effects were observed for household income, parental education, and material deprivation. A significant interaction effect was observed for minority group status on PA (OR = 2.4; 95%CIs: 1.2, 4.9) and trying of new activities (OR = 2.5; 95%CIs: 1.2, 5.1). A significant interaction effect between social deprivation and exposure was observed for trying new activities among girls (OR = 1.8; 95%CIs: 1.0, 3.2). Among boys, no significant interaction effects were observed for any indicators. Results suggest no clear evidence of communication inequalities as a result of the WIXX campaign but reveal positive impacts of the campaign among more socially disadvantaged girls.
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24
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Jacobs J, Strugnell C, Allender S, Orellana L, Backholer K, Bolton KA, Fraser P, Le H, Brown AD, Nichols M. The impact of a community-based intervention on weight, weight-related behaviours and health-related quality of life in primary school children in Victoria, Australia, according to socio-economic position. BMC Public Health 2021; 21:2179. [PMID: 34837974 PMCID: PMC8627608 DOI: 10.1186/s12889-021-12150-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/19/2021] [Indexed: 01/22/2023] Open
Abstract
Background Approximately a quarter of Australian children are classified as overweight or obese. In high-income countries, childhood obesity follows a socio-economic gradient, with greater prevalence amongst the most socio-economically disadvantaged children. Community-based interventions (CBI), particularly those using a systems approach, have been shown to be effective on weight and weight-related behaviours. They are also thought to have an equitable impacts, however there is limited evidence of their effectiveness in achieving this goal. Methods Secondary analysis was conducted on data collected from primary school children (aged 6–13 years) residing in ten communities (five intervention, five control) involved in the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) cluster randomised trial in Victoria, Australia. Outcomes included Body Mass Index z-score (BMI-z) derived from measured height and weight, self-reported physical activity and dietary behaviours and health related quality of life (HRQoL). Repeat cross-sectional data from 2015 (n = 1790) and 2019 (n = 2137) were analysed, stratified by high or low socio-economic position (SEP). Multilevel linear models and generalised estimating equations were fitted to assess whether SEP modified the intervention effect on the outcomes. Results There were no overall changes in BMI-z for either SEP strata. For behavioural outcomes, the intervention resulted in a 22.5% (95% CI 5.1, 39.9) point greater improvement in high-SEP compared to low-SEP intervention schools for meeting physical activity guidelines. There were also positive dietary intervention effects for high SEP students, reducing takeaway and packaged snack consumption, although there was no significant difference in effect between high and low SEP students. There were positive intervention effects for HRQoL, whereby scores declined in control communities with no change in intervention communities, and this did not differ by SEP. Conclusion The WHO STOPS intervention had differential effects on several weight-related behaviours according to SEP, including physical activity. Similar impacts on HRQoL outcomes were found between high and low SEP groups. Importantly, the trial evaluation was not powered to detect subgroup differences. Future evaluations of CBIs should be designed with an equity lens, to understand if and how these types of interventions can benefit all community members, regardless of their social and economic resources. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12150-4.
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Affiliation(s)
- Jane Jacobs
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Claudia Strugnell
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Steven Allender
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kristy A Bolton
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Penny Fraser
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Ha Le
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.,Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Australia
| | - Andrew Dwight Brown
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Melanie Nichols
- Global Obesity Centre (GLOBE)Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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25
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Bridger Staatz C, Kelly Y, Lacey RE, Blodgett JM, George A, Arnot M, Walker E, Hardy R. Socioeconomic position and body composition in childhood in high- and middle-income countries: a systematic review and narrative synthesis. Int J Obes (Lond) 2021; 45:2316-2334. [PMID: 34315999 PMCID: PMC8528703 DOI: 10.1038/s41366-021-00899-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The relation between socioeconomic position (SEP) and obesity measured by body mass index (BMI), a measure of weight for height, has been extensively reviewed in children, showing consistent associations between disadvantaged SEP and higher BMI in high-income countries (HICs) and lower BMI in middle-income countries (MICs). Fat mass (FM), a more accurate measure of adiposity, and fat-free mass (FFM) are not captured by BMI, but have been shown to track from childhood to adulthood, and be important for cardiovascular health and functional outcomes in later life. It is not clear whether body composition is associated with SEP. We systematically reviewed the association between SEP and body composition in childhood. METHODS A systematic review was carried out following PRISMA guidelines. The protocol was pre-registered with PROSPERO (CRD42019119937). Original studies in the English language, which examined the association between SEP and body composition in childhood, were included. An electronic search of three databases was conducted. Two independent reviewers carried out screening, data extraction and quality assessment. Due to heterogeneity in results, a narrative synthesis was conducted. Heterogeneity in findings according to SEP, sex, body composition measure and country income level was investigated. RESULTS 50 papers were included, the majority from HICs. No papers were from low-income countries. Disadvantage in childhood was associated with greater FM and lower FFM in HICs, but with lower FM and lower FFM in MICs. When measures of FFM indexed to height were used there was no evidence of associations with SEP. In HICs, more studies reported associations between disadvantaged SEP and higher FM among girls comparative to boys. CONCLUSIONS Inequalities in FM are evident in HICs and, in the opposite direction, in MICs and follow similar trends to inequalities for BMI. Inequalities in height are likely important in understanding inequalities in FFM.
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Affiliation(s)
- Charis Bridger Staatz
- Social Research Institute, Institute of Education, University College London, London, UK.
| | - Yvonne Kelly
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca E Lacey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Joanna M Blodgett
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Anitha George
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Megan Arnot
- Department of Anthropology, University College London, London, UK
| | - Emma Walker
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca Hardy
- Social Research Institute, Institute of Education, University College London, London, UK
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26
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Measuring the Built Environment in Studies of Child Health-A Meta-Narrative Review of Associations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010741. [PMID: 34682484 PMCID: PMC8535212 DOI: 10.3390/ijerph182010741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 12/23/2022]
Abstract
Although the built environment (BE) is important for children’s health, there is little consensus about which features are most important due to differences in measurement and outcomes across disciplines. This meta-narrative review was undertaken by a multi-disciplinary team of researchers to summarise ways in which the BE is measured, and how this links to children’s health. A structured search of four databases across the relevant disciplines retrieved 108 relevant references. The most commonly addressed health-related outcomes were active travel, physical activity and play, and obesity. Many studies used objective (GIS and street audits) or standardised subjective (perceived) measurements of the BE. However, there was a wide variety, and sometimes inconsistency, in their definition and use. There were clear associations between the BE and children’s health. Objective physical activity and self-reported active travel, or obesity, were positively associated with higher street connectivity or walkability measures, while self-reported physical activity and play had the strongest association with reduced street connectivity, indicated by quieter, one-way streets. Despite the high heterogeneity found in BE measures and health outcomes, the meta-narrative approach enabled us to identify ten BE categories that are likely to support children’s health and be protective against some non-communicable disease risk factors. Future research should implement consistent BE measures to ensure key features are explored. A systems approach will be particularly relevant for addressing place-based health inequalities, given potential unintended health consequences of making changes to the BE.
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27
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Kuhn AW, Grusky AZ, Cash CR, Churchwell AL, Diamond AB. Disparities and Inequities in Youth Sports. Curr Sports Med Rep 2021; 20:494-498. [PMID: 34524194 DOI: 10.1249/jsr.0000000000000881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Participation in youth sports can have a positive, lasting impact on a child's general health and physical well-being. Unfortunately, some youth populations are unable to participate and/or reap the benefits of sports because of existing inequities. Youth from lower socioeconomic status and ethnic minority children have been found to participate in sports less. These disparities are unfortunately pervasive and likely the result of multiple barriers, including financial and time constraints, limited resources and the inability to access facilities both in and out of school, and lack of familial support. There also exist inequities with regard to sports injury management, including knowledge, access to athletic trainers, and care. This article provides a review of the numerous disparities and inequities in youth sports. Compiling and understanding these data may help develop a framework to make youth sports more equitable and beneficial for all.
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Affiliation(s)
- Andrew W Kuhn
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO
| | - Alan Z Grusky
- Vanderbilt University School of Medicine, Nashville, TN
| | - Carsen R Cash
- Vanderbilt University School of Medicine, Nashville, TN
| | | | - Alex B Diamond
- Department of Orthopaedic Surgery and Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
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28
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Olsen JR, Leung KY, Nicholls N, Loo BP. Do neighbourhood characteristics matter in understanding school children’s active lifestyles? A cross-region multi-city comparison of Glasgow, Edinburgh and Hong Kong. CHILDREN'S GEOGRAPHIES 2021; 19:488-504. [PMID: 34790065 PMCID: PMC7611993 DOI: 10.1080/14733285.2020.1828826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many studies have explored the influence of individual and neighbourhood factors on active school travel (AST), this novel study is the first to examine how AST and formal extracurricular activities are associated with children’s active lifestyles. The aims of this study were to (a) create an active lifestyle variable (ALIFE) measured in terms of total weekly minutes of AST and extracurricular activities, and (b) explore how ALIFE is associated with different attributes at the individual, household and neighbourhood levels, and how these relationships differ for children aged 10 and 11 years old across the three cities: Glasgow, Edinburgh and Hong Kong. We found environmental factors to be important indicators of lower AST, for example greater parking facility density. The most substantial contribution to children’s overall ALIFE was household income, those from the lowest household group having almost 2 h less ALIFE per-week than those from the highest income.
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Affiliation(s)
- Jonathan R. Olsen
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kevin Y.K. Leung
- Department of Geography, University of Hong Kong, Hong Kong, Hong Kong
| | - Natalie Nicholls
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Becky P.Y. Loo
- Department of Geography, University of Hong Kong, Hong Kong, Hong Kong
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Fox EH, Chapman JE, Moland AM, Alfonsin NE, Frank LD, Sallis JF, Conway TL, Cain KL, Geremia C, Cerin E, Vanwolleghem G, Van Dyck D, Queralt A, Molina-García J, Hino AAF, Lopes AADS, Salmon J, Timperio A, Kershaw SE. International evaluation of the Microscale Audit of Pedestrian Streetscapes (MAPS) Global instrument: comparative assessment between local and remote online observers. Int J Behav Nutr Phys Act 2021; 18:84. [PMID: 34193160 PMCID: PMC8247070 DOI: 10.1186/s12966-021-01146-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The use of online imagery by non-local observers to conduct remote, centralized collection of streetscape audit data in international studies has the potential to enhance efficiency of collection and comparability of such data for research on built environments and health. The objectives of the study were to measure (1) the consistency in responses between local in-field observers and non-local remote online observers and (2) the reliability between in-country online observers and non-local remote online observers using the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features along streets in five countries. METHODS Consistency and inter-rater reliability were analyzed between local and non-local observers on a pooled database of 200 routes in five study regions (Melbourne, Australia; Ghent, Belgium; Curitiba, Brazil; Hong Kong, China; and Valencia, Spain) for microscale environmental feature subscales and item-level variables using the intraclass correlation coefficient (ICC). RESULTS A local in-field versus remote online comparison had an ICC of 0.75 (95 % CI: 0.68-0.80) for the grand total score. An ICC of 0.91 (95 % CI: 0.88-0.93) was found for the local online versus remote online comparison. Positive subscales yielded stronger results in comparison to negative subscales, except for the similarly poor-performing positive aesthetics/social characteristics. CONCLUSIONS This study demonstrated remote audits of microscale built environments using online imagery had good reliability with local in-field audits and excellent reliability with local online audits. Results generally supported remote online environmental audits as comparable to local online audits. This identification of low-cost and efficient data acquisition methods is important for expanding research on microscale built environments and physical activity globally.
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Affiliation(s)
- Eric H. Fox
- Urban Design 4 Health, Inc., Rochester, NY USA
| | | | | | | | - Lawrence D. Frank
- Urban Design 4 Health, Inc., Rochester, NY USA
- Department of Urban Studies and Planning, University of California San Diego, San Diego, CA USA
| | - James F. Sallis
- Department of Family Medicine and Public Health (now Herbert Wertheim School of Public Health and Human Longevity Science), University of California San Diego, San Diego, CA USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Terry L. Conway
- Department of Family Medicine and Public Health (now Herbert Wertheim School of Public Health and Human Longevity Science), University of California San Diego, San Diego, CA USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Kelli L. Cain
- Department of Family Medicine and Public Health (now Herbert Wertheim School of Public Health and Human Longevity Science), University of California San Diego, San Diego, CA USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Carrie Geremia
- Department of Family Medicine and Public Health (now Herbert Wertheim School of Public Health and Human Longevity Science), University of California San Diego, San Diego, CA USA
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Griet Vanwolleghem
- Faculty of Medicine and Health Sciences, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Faculty of Medicine and Health Sciences, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Ana Queralt
- Department of Nursing, University of Valencia, Valencia, Spain
| | - Javier Molina-García
- Department of Teaching of Musical, Visual, and Corporal Expression, University of Valencia, Valencia, Spain
| | | | | | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise & Nutrition Science, Deakin University, Geelong, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, School of Exercise & Nutrition Science, Deakin University, Geelong, Australia
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Socioeconomic Inequities in Youth Participation in Physical Activity and Sports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136946. [PMID: 34209544 PMCID: PMC8297079 DOI: 10.3390/ijerph18136946] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022]
Abstract
Access to opportunities for physical activity and sports, and therefore potential benefits of participation, are distributed inequitably. The aims of this study were to describe and compare youth experiences related to sport and physical activity by socioeconomic factors. A cross-sectional survey was conducted of students in 5–12th grades in King County, Washington, USA. Students were asked about physical activity and sports experiences and about demographic factors including family affluence, which was categorized as low, medium, and high. Participants were 1038 youth (50% girls, 58% non-White, and 32% from homes where languages other than English are spoken). Children from low-affluence families reported fewer days/week of physical activity, fewer sports sampled, and lower rates of ever playing sports. Greater proportions of children from low-affluence families reported these barriers to sports: (1) don’t want to get hurt, (2) don’t feel welcome on teams, (3) too expensive, and (4) transportation. Middle school children from high-affluence families had three times higher odds of meeting physical activity recommendations, and high-affluence high schoolers had three times higher odds of ever participating in sports compared to peers from low-affluence families. Socioeconomic status was inversely associated with outcomes related to youth physical activity and sports participation. The disproportionately reported barriers to sports participation are modifiable, and cross-sector solutions can help promote play equity.
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Shirtcliff B, Manzo R, Scudder R. Crosscutting environmental risk with design: A multi-site, multi-city socioecological approach for Iowa's diversifying small towns. PLoS One 2021; 16:e0252127. [PMID: 34161328 PMCID: PMC8221475 DOI: 10.1371/journal.pone.0252127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/11/2021] [Indexed: 11/18/2022] Open
Abstract
Globally, the influx of refugee, migrant, and immigrant populations into small centers of industrialized agriculture has called attention to a looming public health crisis. As small towns shift from remote villages into rural, agri-industrial centers, they offer limited access to amenities needed to support human well-being. Our study focused on three Iowa towns that continue to experience an increase in under-represented minority populations and decline of majority populations as a proxy for studying shifting populations in an era of industrialized agriculture and global capital. We aimed to understand the socioecological impact of built environments-outdoor locations where people live and work-and likelihood of environmental exposures to impact vulnerable populations. Urban socioecological measures tend to present contradictory results in small towns due to their reliance on density and proximity. To compensate, we used post-occupancy evaluations (POE) to examine built environments for evidence of access to environmental design criteria to support healthy behaviors. The study systematically identified 44 locations on transects across three small towns to employ a 62 item POE and assess multiple environmental criteria to crosscut design with environmental health disparities. Principal-components factor analysis identified two distinct significant components for environmental risk and population vulnerability, supporting similar studies on parallel communities. Multilevel modeling found a divergence between supportive environmental design coupled with an increase environmental risk due to location. The combined effect likely contributes to environmental health disparities. The study provides a strategy for auditing small town built environments as well as insight into achieving equity.
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Affiliation(s)
- Benjamin Shirtcliff
- Landscape Architecture, Iowa State University, Ames, Iowa, United States of America
| | - Rosie Manzo
- Landscape Architecture, Iowa State University, Ames, Iowa, United States of America
| | - Rachel Scudder
- Community and Regional Planning, Iowa State University, Ames, Iowa, United States of America
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Apetoh E, Roquet F, Palstra F, Baxerres C, Le Hesran JY. Household sampling through geocoded points and satellite view: A step-by-step approach to implement a spatial sampling method for demographic and health surveys in areas without population sampling frame and with limited resource settings. Rev Epidemiol Sante Publique 2021; 69:173-182. [PMID: 34148761 DOI: 10.1016/j.respe.2021.04.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Spatial sampling is increasingly used in health surveys as it provides a simple way to randomly select target populations on sites where reliable and complete data on the general population are not available. However, the previously implemented protocols have been poorly detailed, making replication difficult or even impossible. To our knowledge, ours is the first document describing step-by-step an efficient spatial sampling method for health surveys. Our objective is to facilitate the rapid acquisition of the technical skills and know-how necessary for its deployment. METHODS The spatial sampling design is based on the random generation of geocoded points in the study area. Afterwards, these points were projected on the satellite view of Google Earth Pro™ software and the identified buildings were selected for field visits. A detailed formula of the number of points required, considering non-responses, is proposed. Density of buildings was determined by drawing circles around points and by using a replacement strategy when interviewing was unachievable. The method was implemented for a cross-sectional study during the April-May 2016 period in Cotonou (Bénin). The accuracy of the collected data was assessed by comparing them to those of the Cotonou national census. RESULT This approach does not require prior displacement in the study area and only 1% of identified buildings with Google Earth Pro™ were no longer extant. Most of the measurements resulting from the general census were within the confidence intervals of those calculated with the sample data. Furthermore, the range of measurements resulting from the general census was similar to those calculated with the sample data. These include, for example, the proportion of the foreign population (unweighted 8.9%/weighted 9% versus 8.5% in census data), the proportion of adults over 17 years of age (56.7% versus 57% in census data), the proportion of households whose head is not educated (unweighted 21.9%/weighted 22.8% versus 21.1% in census data). CONCLUSION This article illustrates how an epidemiological field survey based on spatial sampling can be successfully implemented at low cost, quickly and with little technical and theoretical knowledge. While statistically similar to simple random sampling, this survey method greatly simplifies its implementation.
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Affiliation(s)
- E Apetoh
- Institut de recherche pour le développement/Development research institute, Unité mixte de recherche 216/Mixed research unit 216: Mères et enfants face aux infections tropicale/Mother and child face to tropical infection, Faculté de pharmacie Paris-Descartes, 4, avenue de l'observatoire, 75006 Paris, France; École doctorale Pierre Louis de santé publique/Pierre-Louis doctoral public health school, ED 393 Épidémiologie et Sciences de l'Information Biomédicale/Epidemiology and biomedical information sciences, Paris, France.
| | - F Roquet
- Hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; ECSTRRA, CRESS-Unité mixte de recherche 1153, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010, Paris, France.
| | - F Palstra
- Centre Norbert Elias EHESS-Campus Marseille La Vieille Charité, 2, rue de la Charité, 13002 Marseille, France.
| | - C Baxerres
- Institut de recherche pour le développement/Development research institute, Unité mixte de recherche 216/Mixed research unit 216: Mères et enfants face aux infections tropicale/Mother and child face to tropical infection, Faculté de pharmacie Paris-Descartes, 4, avenue de l'observatoire, 75006 Paris, France; Centre Norbert Elias EHESS-Campus Marseille La Vieille Charité, 2, rue de la Charité, 13002 Marseille, France.
| | - J-Y Le Hesran
- Institut de recherche pour le développement/Development research institute, Unité mixte de recherche 216/Mixed research unit 216: Mères et enfants face aux infections tropicale/Mother and child face to tropical infection, Faculté de pharmacie Paris-Descartes, 4, avenue de l'observatoire, 75006 Paris, France.
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Influence of the COVID-19 Pandemic on the Lifestyles of Health Sciences University Students in Spain: A Longitudinal Study. Nutrients 2021; 13:nu13061958. [PMID: 34200390 PMCID: PMC8229467 DOI: 10.3390/nu13061958] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic has significantly impacted daily activities worldwide. University students may have experienced substantial changes in daily living as a result of restrictions on university attendance. The return to normalcy may take a long time, and understanding the influence that shifts in daily routines have had on the lifestyles of university students may inform approaches to support overall well-being. We analyzed changes in the lifestyles of students enrolled at a health sciences university during the COVID-19 pandemic. This longitudinal study took place at the Faculty of Medicine and Nursing in the University of the Basque Country in Spain, and the final sample consisted of 113 nursing students, 109 medical students, and 45 physiotherapy students. Our results demonstrate changes in lifestyles of university students during the pandemic. MedDiet adherence scores and the percentage of students with high adherence increased during the pandemic. This increase was due to the increased consumption of vegetables and nuts. In terms of physical activity, the practice of moderate and intense physical activity was maintained. These results provide important information for both public health authorities and educational institutions to guide strategies to maintain the well-being of students and enhance opportunities for young adults to lead a healthy lifestyle.
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34
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Relationship Between the Physical Environment and Physical Activity Levels in Preschool Children: A Systematic Review. Curr Environ Health Rep 2021; 8:177-195. [PMID: 33934294 DOI: 10.1007/s40572-021-00318-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to understand the influence of the physical environment on the physical activity (PA) behavior of preschool children (aged 2 to 6 years), in order to provide an overview of these influences from the perspective of the ecological model. RECENT FINDINGS PA is of great importance for the prevention of obesity and cardiovascular diseases since childhood. The physical environment has a direct relationship with the different domains, where people can spend their time being physically active. Nonetheless, despite the importance of the physical environment to engagement in PA, very few reviews have focused on this relationship in the context of the growing problem of physical inactivity among preschool children. Studies that had analyzed the school domain had found that greater availability of a wider variety of portable play equipment, presence of certain fixed playground equipment, and presence of open spaces had favored PA levels. Furthermore, different studies had shown that the natural environment and the presence of hills were important for children's PA. Thus, despite the associations with PA we were able to identify in this review, new studies will still be needed to link the physical environment with PA levels, especially regarding transportation and leisure time. In conclusion, promoting studies on this subject from an early age will allow us to obtain information that could allow the adaptation, design, and construction of healthier homes, neighborhoods, and schools that promote children's health.
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Ferris EB, Wyka K, Evenson KR, Dorn JM, Thorpe L, Catellier D, Huang TTK. Recruitment and Retention Strategies for Community-Based Longitudinal Studies in Diverse Urban Neighborhoods. JMIR Form Res 2021; 5:e18591. [PMID: 33759799 PMCID: PMC8294636 DOI: 10.2196/18591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/30/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
Longitudinal, natural experiments provide an ideal evaluation approach to better understand the impact of built environment interventions on community health outcomes, particularly health disparities. As there are many participant engagement challenges inherent in the design of large-scale community-based studies, adaptive and iterative participant engagement strategies are critical. This paper shares practical lessons learned from the Physical Activity and Redesigned Community Spaces (PARCS) study, which is an evaluation of the impact of a citywide park renovation initiative on physical activity, psychosocial health, and community well-being. The PARCS study, although ongoing, has developed several approaches to improve participant engagement: building trust with communities, adapting the study protocol to meet participants' needs and to reflect their capacity for participation, operational flexibility, and developing tracking systems. These strategies may help researchers anticipate and respond to participant engagement challenges in community-based studies, particularly in low-income communities of color.
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Affiliation(s)
- Emily B Ferris
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Katarzyna Wyka
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Joan M Dorn
- Sophie Davis Biomedical Education Program, City University of New York School of Medicine, New York, NY, United States
| | - Lorna Thorpe
- Department of Population Health, School of Medicine, New York University, New York, NY, United States
| | - Diane Catellier
- Research Triangle Institute, Research Triangle Park, Durham, NC, United States
| | - Terry T-K Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
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A national examination of neighborhood socio-economic disparities in built environment correlates of youth physical activity. Prev Med Rep 2021; 22:101358. [PMID: 33854906 PMCID: PMC8024702 DOI: 10.1016/j.pmedr.2021.101358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 11/23/2022] Open
Abstract
Most U.S. adolescents do not meet current physical activity guidelines. Built environments and neighborhood socioeconomic status may impact activity. Examined neighborhood walkability using geocoded home addresses and Census data. Living in areas with walkable attributes was associated with more physical activity. Walkability and activity associations varied by neighborhood socioeconomic status.
Adolescents in the U.S. do not meet current physical activity guidelines. Ecological models of physical activity posit that factors across multiple levels may support physical activity by promoting walkability, such as the neighborhood built environment and neighborhood socioeconomic status (nSES). We examined associations between neighborhood built environment factors and adolescent moderate-to-vigorous physical activity (MVPA), and whether nSES moderated associations. Data were drawn from a national sample of adolescents (12–17 years, N = 1295) surveyed in 2014. MVPA (minutes/week) were estimated from self-report validated by accelerometer data. Adolescents’ home addresses were geocoded and linked to Census data from which a nSES Index and home neighborhood factors were derived using factor analysis (high density, older homes, short auto commutes). Multiple linear regression models examined associations between neighborhood factors and MVPA, and tested interactions between quintiles of nSES and each neighborhood factor, adjusting for socio-demographics. Living in higher density neighborhoods (B(SE): 9.22 (2.78), p = 0.001) and neighborhoods with more older homes (4.42 (1.85), p = 0.02) were positively associated with adolescent MVPA. Living in neighborhoods with shorter commute times was negatively associated with MVPA (−5.11 (2.34), p = 0.03). Positive associations were found between MVPA and the high density and older homes neighborhood factors, though associations were not consistent across quintiles. In conclusion, living in neighborhoods with walkable attributes was associated with greater adolescent MVPA, though the effects were not distributed equally across nSES. Adolescents living in lower SES neighborhoods may benefit more from physical activity interventions and environmental supports that provide opportunities to be active beyond neighborhood walkability.
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Key Words
- Adolescents
- BMI, body mass index
- Built environment
- FLASHE Study, Family Life, Activity, Sun, Health, and Eating Study
- GED, General Educational Development
- MVPA, moderate to vigorous physical activity
- NCES, National Center for Education Statistics
- NCI, National Cancer Institute
- Neighborhood factors
- Neighborhood socioeconomic status
- PCA, principal component analysis
- Physical activity
- SE, standard error
- SES, socioeconomic status
- TEAN, Teen Environment and Neighborhood
- Walkability
- YAP, Youth Activity Profile
- nSES, neighborhood socioeconomic status
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A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042066. [PMID: 33672550 PMCID: PMC7923771 DOI: 10.3390/ijerph18042066] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 12/20/2022]
Abstract
This manuscript describes the rationale and protocol of a school-based randomized controlled trial called “Cycling and Walk to School” (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1–2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.
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Yang S, Chen X, Wang L, Wu T, Fei T, Xiao Q, Zhang G, Ning Y, Jia P. Walkability indices and childhood obesity: A review of epidemiologic evidence. Obes Rev 2021; 22 Suppl 1:e13096. [PMID: 33185012 PMCID: PMC7988583 DOI: 10.1111/obr.13096] [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: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022]
Abstract
The lack of an active neighbourhood living environment can impact community health to a great extent. One such impact manifests in walkability, a measure of urban design in connecting places and facilitating physical activity. Although a low level of walkability is generally considered to be a risk factor for childhood obesity, this association has not been established in obesity research. To further examine this association, we conducted a literature search on PubMed, Web of Science and Scopus for articles published until 31 December 2018. The included literature examined the association between measures of walkability (e.g., walkability score and walkability index) and weight-related behaviours and/or outcomes among children aged under 18 years. A total of 13 studies conducted in seven countries were identified, including 12 cross-sectional studies and one longitudinal study. The sample size ranged from 98 to 37 460, with a mean of 4971 ± 10 618, and the age of samples ranged from 2 to 18. Eight studies reported that a higher level of walkability was associated with active lifestyles and healthy weight status, which was not supported by five studies. In addition to reviewing the state-of-the-art of applications of walkability indices in childhood obesity studies, this study also provides guidance on when and how to use walkability indices in future obesity-related research.
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Affiliation(s)
- Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Xiang Chen
- Department of Geography, University of Connecticut, Storrs, Connecticut, USA
| | - Lei Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tong Wu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Teng Fei
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,School of Resources and Environmental Science, Wuhan University, Wuhan, China
| | - Qian Xiao
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Gang Zhang
- Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children's Hospital of Chengdu Medical College), Chengdu, China
| | - Yi Ning
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Peking University Health Science Center Meinian Public Health Research Institute, Beijing, China.,Meinian Institute of Health, Beijing, China
| | - Peng Jia
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
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Mei K, Huang H, Xia F, Hong A, Chen X, Zhang C, Qiu G, Chen G, Wang Z, Wang C, Yang B, Xiao Q, Jia P. State-of-the-art of measures of the obesogenic environment for children. Obes Rev 2021; 22 Suppl 1:e13093. [PMID: 32725754 PMCID: PMC7988549 DOI: 10.1111/obr.13093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 11/27/2022]
Abstract
Various measures of the obesogenic environment have been proposed and used in childhood obesity research. The variety of measures poses methodological challenges to designing new research because methodological characteristics integral to developing the measures vary across studies. A systematic review has been conducted to examine the associations between different levels of obesogenic environmental measures (objective or perceived) and childhood obesity. The review includes all articles published in the Cochrane Library, PubMed, Web of Science and Scopus by 31 December 2018. A total of 339 associations in 101 studies have been identified from 18 countries, of which 78 are cross-sectional. Overall, null associations are predominant. Among studies with non-null associations, negative relationships between healthy food outlets in residential neighbourhoods and childhood obesity is found in seven studies; positive associations between unhealthy food outlets and childhood obesity are found in eight studies, whereas negative associations are found in three studies. Measures of recreational or physical activity facilities around the participants' home are also negatively correlated to childhood obesity in nine out of 15 studies. Results differ by the types of measurement, environmental indicators and geographic units used to characterize obesogenic environments in residential and school neighbourhoods. To improve the study quality and compare reported findings, a reporting standard for spatial epidemiological research should be adopted.
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Affiliation(s)
- Kun Mei
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Hong Huang
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Fang Xia
- School of Life Science, Shaoxing University, Shaoxing, China
| | - Andy Hong
- The George Institute for Global Health, University of Oxford, Oxford, UK.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Xiang Chen
- Department of Geography, University of Connecticut, Storrs, Connecticut, USA
| | - Chi Zhang
- Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Ge Qiu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Gang Chen
- Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Zhenfeng Wang
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bo Yang
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China.,School of Public Health, Wenzhou Medical University, Wenzhou, China
| | - Qian Xiao
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Peng Jia
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
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Cain KL, Salmon J, Conway TL, Cerin E, Hinckson E, Mitáš J, Schipperijn J, Frank LD, Anjana RM, Barnett A, Dygrýn J, Islam MZ, Molina-García J, Moran M, Wan Muda WAM, Oyeyemi AL, Reis R, Santos MP, Schmidt T, Schofield GM, Timperio A, Van Dyck D, Sallis JF. International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures. BMJ Open 2021; 11:e046636. [PMID: 33462102 PMCID: PMC7813342 DOI: 10.1136/bmjopen-2020-046636] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese). METHODS AND ANALYSIS The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status. ETHICS AND DISSEMINATION Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.
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Affiliation(s)
- Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jo Salmon
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Terry L Conway
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong
| | - Erica Hinckson
- School of Sport & Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Josef Mitáš
- Institute of Active Lifestyle, Palacky University Olomouc, Olomouc, Olomoucký, Czech Republic
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lawrence D Frank
- Urban Design 4 Health, Seattle, Washington, USA
- Department of Urban Studies and Planning, University of California San Diego, La Jolla, California, USA
| | | | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jan Dygrýn
- Institute of Active Lifestyle, Palacky University Olomouc, Olomouc, Olomoucký, Czech Republic
| | - Mohammed Zakiul Islam
- Department of Architecture, Bangladesh University of Engineering and Technology, Dhaka, Dhaka District, Bangladesh
| | - Javier Molina-García
- AFIPS research group, Department of Musical, Visual and Corporal Expression Teaching, University of Valencia, Valencia, Spain
| | - Mika Moran
- Institute of Urban and Regional Development, University of California Berkeley, Berkeley, California, USA
- School of Public Health, University of Haifa, Haifa, Israel
| | | | - Adewale L Oyeyemi
- Department of Physiotherapy, University of Maiduguri, Maiduguri, Borno, Nigeria
| | - Rodrigo Reis
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri, USA
- Graduate Program in Urban Management, Pontifical Catholic University of Parana, Curitiba, Paraná, Brazil
| | - Maria Paula Santos
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Tanja Schmidt
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Grant M Schofield
- School of Sport & Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Anna Timperio
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
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Adherence to the Mediterranean diet and academic performance in adolescents: Does BMI status moderate this association? Clin Nutr 2021; 40:4465-4472. [PMID: 33495088 DOI: 10.1016/j.clnu.2020.12.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/17/2020] [Accepted: 12/29/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adolescence is a critical period for neurodevelopment, it is characterised by the establishment of behavioural patterns that can affect children's physical, mental and cognitive health, both immediately and later in life. OBJECTIVE The aim of the present research was to examine the association between adherence to the Mediterranean diet (MeD) and academic performance, as well as to analyze the moderating role of body mass index (BMI) status in this relationship. METHODS This cross-sectional study had a total 1290 adolescents (13.07 ± 0.82 years old, 714 boys and 576 girls) aged 12-14 years were included in this study. Adherence to the MeD was assessed using the Mediterranean Diet Quality Index. Academic performance was assessed through school records using four subjects: language, mathematics, English and grade point average (GPA). RESULTS Results showed a positive association between adherence to the MeD and all academic indicators after adjusting for potential confounders (β ranging from 0.165 to 0.213, all p < 0.001). The group of good adherence to the MeD had significantly higher scores in all the academic indicators compared with the poor/average group (p < 0.01). No interaction was found between BMI status and adherence to MeD in relation to academic indicators (all p > 0.340). These differences remained significant for both normal weight and overweight/obesity groups (p < 0.01). CONCLUSIONS Our results suggest that adherence to the MeD may be positively associated academic performance on adolescents regardless, of BMI status.
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Xie B, Lu Y, Wu L, An Z. Dose-response effect of a large-scale greenway intervention on physical activities: The first natural experimental study in China. Health Place 2021; 67:102502. [DOI: 10.1016/j.healthplace.2020.102502] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 12/19/2022]
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Bachner J, Sturm DJ, García-Massó X, Molina-García J, Demetriou Y. Physical Activity-Related Profiles of Female Sixth-Graders Regarding Motivational Psychosocial Variables: A Cluster Analysis Within the CReActivity Project. Front Psychol 2020; 11:580563. [PMID: 33262728 PMCID: PMC7686241 DOI: 10.3389/fpsyg.2020.580563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Adolescents' physical activity (PA) behavior can be driven by several psychosocial determinants at the same time. Most analyses use a variable-based approach that examines relations between PA-related determinants and PA behavior on the between-person level. Using this approach, possible coexistences of different psychosocial determinants within one person cannot be examined. Therefore, by applying a person-oriented approach, this study examined (a) which profiles regarding PA-related psychosocial variables typically occur in female sixth-graders, (b) if these profiles deliver a self-consistent picture according to theoretical assumptions, and (c) if the profiles contribute to the explanation of PA. Materials and Methods The sample comprised 475 female sixth-graders. Seventeen PA-related variables were assessed: support for autonomy, competence and relatedness in PE as well as their satisfaction in PE and leisure-time; behavioral regulation of exercise (five subscales); self-efficacy and social support from friends and family (two subscales). Moderate-to-vigorous PA was measured using accelerometers. Data were analyzed using the self-organizing maps (SOM) analysis, a cluster analysis including an unsupervised algorithm for non-linear models. Results According to the respective level of psychosocial resources, a positive, a medium and a negative cluster were identified. This superordinate cluster solution represented a self-consistent picture that was in line with theoretical assumptions. The three-cluster solution contributed to the explanation of PA behavior, with the positive cluster accumulating an average of 6 min more moderate-to-vigorous PA per day than the medium cluster and 10 min more than the negative cluster. Additionally, SOM detected a subgroup within the positive cluster that benefited from a specific combination of intrinsic and external regulations with regard to PA. Discussion The results underline the relevance of the assessed psychosocial determinants of PA behavior in female sixth-graders. The results further indicate that the different psychosocial resources within a given person do not develop independently of one another, which supports the use of a person-oriented approach. In addition, the SOM analysis identified subgroups with specific characteristics, which would have remained undetected using variable-based approaches. Thus, this approach offers the possibility to reduce data complexity without overlooking subgroups with special demands that go beyond the superordinate cluster solution.
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Affiliation(s)
- Joachim Bachner
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - David J Sturm
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain.,AFIPS Research Group, University of Valencia, Valencia, Spain
| | - Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Valencia, Spain.,AFIPS Research Group, University of Valencia, Valencia, Spain
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Malchrowicz-Mośko E, León-Guereño P, Tapia-Serrano MA, Sánchez-Miguel PA, Waśkiewicz Z. What Encourages Physically Inactive People to Start Running? An Analysis of Motivations to Participate in Parkrun and City Trail in Poland. Front Public Health 2020; 8:581017. [PMID: 33313036 PMCID: PMC7707109 DOI: 10.3389/fpubh.2020.581017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to investigate the motivations for beginner runners to take part in Parkrun Poznań and City Trail Poznań, Poland, taking into account their socio-demographical variables. A total of 165 (age: 36.33 ± 10.38) inexperienced runners participated in the diagnostic survey and completed the MOMS (Motivations of Marathoner Scale) questionnaire. The sample consisted of 82 men (49.7%) and 83 women (50.3%). The results showed that men were more likely to start running due to competition-related motivations, while the motivations of women were more often related to affiliation, psychological coping, life meaning, and self-esteem. As age increased, the level of motivation due to personal goal achievement, competition, and recognition scales decreased. The Affiliation Scale was especially important for singles who started running, in comparison with runners who were married or in a relationship. These factors should be taken into consideration by event managers and public health specialists. Promoting safe running among people who have no experience with this sport is as important as encouraging them to run. All runners stated that they would like to run a marathon in the future. Moreover, thanks to initiatives such as City Trail and Parkrun, Polish respondents feel motivated to lead an active lifestyle, with an average score of 4.98 on a 7-point Likert scale.
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Affiliation(s)
- Ewa Malchrowicz-Mośko
- Institute of Sport Sciences, Eugeniusz Piasecki Academy of Physical Education, Poznań, Poland
| | - Patxi León-Guereño
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Miguel Angel Tapia-Serrano
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Teaching Training, University of Extremadura, Badajoz, Spain
| | - Pedro Antonio Sánchez-Miguel
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Teaching Training, University of Extremadura, Badajoz, Spain
| | - Zbigniew Waśkiewicz
- Department of Sports Medicine and Medical Rehabilitation of I.M, Sechenov First Moscow State Medical University, Moscow, Russia.,Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Reed JA, Ballard RM, Hill M, Berrigan D. Identification of Effective Programs to Improve Access to and Use of Trails among Youth from Under-Resourced Communities: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7707. [PMID: 33105592 PMCID: PMC7659949 DOI: 10.3390/ijerph17217707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
Abstract
The primary purpose of this paper is to identify and review studies evaluating the effectiveness of programs to increase access to trails and trails use (physical activity) among youth from under-resourced communities. Three additional goals include identifying: (1) Correlates of physical activity/trail use and features of transportation systems and/or built environment and land use destinations, that may inform and support the planning and implementation of programs to promote trail use among youth, (2) benefits associated with trail use, and (3) barriers to trail use. Under-resourced communities are defined as those lacking sufficient resources (i.e., under-funded). METHODS A review of the literature was conducted to identify, abstract, and evaluate studies related to programs to promote trail use among youth and youth from under-resourced communities. In anticipation of very few studies being published about this topic, studies were also reviewed to identify correlates of transportation systems and built environment and land use destinations related to increases in physical activity, and benefits of, and barriers to trail use. PUBMED, MEDLINE, PsycINFO, Sportdiscus, Annual Reviews, American Trails, and Google Scholar databases were searched using terms including trails, built environment, physical activity, exercise, walking, children, adolescents, and youth to identify studies that potentially related to the purposes for conducting this review. Review methods identified, 5278 studies based on our search terms. A review of study titles, abstracts, and select full article screens determined that 5049 studies did not meet the study inclusion criteria, leaving 221 studies included in this review. RESULTS No studies were located that evaluated programs designed to promote and increase trail use among youth, including youth from under-resourced communities. Eight studies used longitudinal or quasi-experimental designs to evaluate physical activity and neighborhood characteristics prospectively among adolescent girls (n = 1), the effects of the path or trail development on physical activity behaviors of children, youth, and adults (n = 4), marketing or media campaigns (n = 2), and wayfinding and incremental distance signage (n = 1) to promote increased trail use. Correlates of transportation systems (e.g., trail access, road traffic congestion related to safe active travel, lack of sidewalks, closer proximity to trails, access to transportation), destinations (e.g., park availability and access, park improvements, greenspaces), or both routes and destinations (e.g., perceptions of safety, lighting), were identified. These correlates may support the planning and implementation of programs to increase trail use among youth, or may facilitate the connection of trails or routes to destinations in communities. Barriers to trail use included costs, crime, lack of transportation, lack of role models using trails, and institutional discrimination. CONCLUSIONS Scientific evidence in support of addressing the underrepresentation of trail use by youth from under-resourced communities is lacking. However, there is a related body of evidence that may inform how to develop programs that support trail use by youth from under-resourced areas. Dedicated, deliberate, and systematic efforts will be required to address research and knowledge gaps, and to evaluate programs and practice related to trail use among youth from low income, often racially or ethnically diverse under-resourced neighborhoods or communities.
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Affiliation(s)
- Julian A. Reed
- Health Sciences, Furman University, Greenville, SC 29613, USA
| | - Rachel M. Ballard
- Prevention Research Coordination, Office of Disease Prevention, NIH, Bethesda, MD 20892, USA;
| | - Michael Hill
- Landscape Architect, Enterprise Program, U.S. Forest Service, Washington, DC 20250, USA;
| | - David Berrigan
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, 9609 Medical Center Drive MSC 7344, Bethesda, MD 20892-7344, USA;
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Molina-García J, Campos S, García-Massó X, Herrador-Colmenero M, Gálvez-Fernández P, Molina-Soberanes D, Queralt A, Chillón P. Different neighborhood walkability indexes for active commuting to school are necessary for urban and rural children and adolescents. Int J Behav Nutr Phys Act 2020; 17:124. [PMID: 32993682 PMCID: PMC7526424 DOI: 10.1186/s12966-020-01028-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/21/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Literature focusing on youth has reported limited evidence and non-conclusive associations between neighborhood walkability measures and active commuting to and from school (ACS). Moreover, there is a lack of studies evaluating both macro- and micro-scale environmental factors of the neighborhood when ACS is analyzed. Likewise, most studies on built environment attributes and ACS focus on urban areas, whereas there is a lack of studies analyzing rural residential locations. Moreover, the relationship between built environment attributes and ACS may differ in children and adolescents. Hence, this study aimed to develop walkability indexes in relation to ACS for urban and rural children and adolescents, including both macro- and micro-scale school-neighborhood factors. METHODS A cross-sectional study of 4593 participants from Spain with a mean age of 12.2 (SD 3.6) years was carried out. Macro-scale environmental factors were evaluated using geographic information system data, and micro-scale factors were measured using observational procedures. Socio-demographic characteristics and ACS were assessed with a questionnaire. Several linear regression models were conducted, including all the possible combinations of six or less built environment factors in order to find the best walkability index. RESULTS Analyses showed that intersection density, number of four-way intersections, and residential density were positively related to ACS in urban participants, but negatively in rural participants. In rural children, positive streetscape characteristics, number of regulated crossings, traffic calming features, traffic lanes, and parking street buffers were also negatively related to ACS. In urban participants, other different factors were positively related to ACS: number of regulated crossings, positive streetscape characteristics, or crossing quality. Land use mix acted as a positive predictor only in urban adolescents. Distance to the school was a negative predictor on all the walkability indexes. However, aesthetic and social characteristics were not included in any of the indexes. CONCLUSIONS Interventions focusing on improving built environments to increase ACS behavior need to have a better understanding of the walkability components that are specifically relevant to urban or rural samples.
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Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022, Valencia, Spain.
- AFIPS research group, University of Valencia, Valencia, Spain.
| | - Sergio Campos
- Department of Urban and Spatial Planning, University of Granada, C/ Severo Ochoa, s/n, 18071, Granada, Spain
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022, Valencia, Spain
- AFIPS research group, University of Valencia, Valencia, Spain
| | - Manuel Herrador-Colmenero
- "La Inmaculada" Teacher Training Centre, University of Granada, C/ Joaquina Eguaras, 114, 18013, Granada, Spain
| | - Patricia Gálvez-Fernández
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, PROFITH "Promoting FITness and Health through physical activity" research group, Ctra. Alfacar, s/n, 18011, Granada, Spain
| | - Daniel Molina-Soberanes
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain
| | - Ana Queralt
- AFIPS research group, University of Valencia, Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010, Valencia, Spain
| | - Palma Chillón
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, PROFITH "Promoting FITness and Health through physical activity" research group, Ctra. Alfacar, s/n, 18011, Granada, Spain
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Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186860. [PMID: 32961819 PMCID: PMC7559571 DOI: 10.3390/ijerph17186860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 12/31/2022]
Abstract
Physical activity improves peoples’ well-being and can help in preventing weight gain, obesity, and related non-communicable diseases. Promoting healthy behaviors in the daily travels and transport choices of adolescents is very important in early establishing healthy habits that imply routine physical activity. For designing and developing effective strategies, it is relevant to study adolescents’ preferences for physical activity and what factors in the social and environmental contexts affect their preferences. The paper investigates these aspects by means of a discrete choice experiment, using data from more than 4300 16–17 year-old adolescents in Italy. The results show that adolescents generally prefer walking for long time alone. However, females prefer cycling, while adolescents from lower educated families prefer motorized means of transport. Environmental factors affect the adolescents’ preferences: living nearby a green area is associated with more active and healthier choices in their short daily travels. Conversely, adolescents living closer to an industrial or high traffic area prefer to use motorized vehicles. Such findings have been discussed and policy implications presented, in order to support policymakers in designing cross-sectoral policies to promote healthy choices related to physical activity in adolescence.
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Using citizen science to understand the prerequisites for physical activity among adolescents in low socioeconomic status neighborhoods - The NESLA study. Health Place 2020; 65:102387. [DOI: 10.1016/j.healthplace.2020.102387] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/28/2020] [Accepted: 06/23/2020] [Indexed: 11/19/2022]
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Chalikavada R, Broder JC, O'Hara RL, Xue W, Gasevic D. The association between neighbourhood walkability and after-school physical activity in Australian schoolchildren. Health Promot J Austr 2020; 32:182-188. [PMID: 32337755 DOI: 10.1002/hpja.356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 03/03/2020] [Accepted: 04/16/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Physical inactivity is a risk factor for many noncommunicable diseases. As reported by the World Health Organisation, 81% of children worldwide are physically inactive. Environmental factors, such as neighbourhood walkability, can shape people's physical activity (PA) behaviour. This study explored the association between neighbourhood walkability and after-school PA among Australian schoolchildren. METHODS The Department for Education and Child Development (DECD) distributed the survey to 189 schools across South Australia to assess the health and well-being of schoolchildren aged between 8 and 14 years. Neighbourhood was defined as an area corresponding to a four digit postcode, and its walkability was measured using Walk Score® . The association between neighbourhood walkability and after-school PA was analysed using multinomial logistic regression adjusted for age, gender, SEIFA score, number of days of TV watching, number of times of eating junk food, neighbourhood safety and children's weight status. RESULTS Children residing in highly walkable areas (walker's paradise) compared to car-dependent areas had higher odds (OR(95%CI)) of engaging in after-school PA three (1.216 (1.029, 1.436), P = .021), four (1.287 (1.064, 1.557), P = .009) and five times a week (1.230 (1.030, 1.133), P = .022) compared to children never participating in PA. CONCLUSION Living in highly walkable areas (walker's paradise), compared to living in car-dependent areas was associated with higher levels of after-school PA. So what? Creating walkable neighbourhoods with greater access to amenities, services and public transportation may help increase after-school PA among schoolchildren.
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Affiliation(s)
| | | | - Rebecca L O'Hara
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - Wenyue Xue
- University of Melbourne, Melbourne, Vic., Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Usher Institute, Edinburgh, UK
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50
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A GIS-Based Method for Analysing the Association Between School-Built Environment and Home-School Route Measures with Active Commuting to School in Urban Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072295. [PMID: 32235341 PMCID: PMC7177458 DOI: 10.3390/ijerph17072295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 11/17/2022]
Abstract
In the current call for a greater human health and well-being as a sustainable development goal, to encourage active commuting to and from school (ACS) seems to be a key factor. Research focusing on the analysis of the association between environmental factors and ACS in children and adolescents has reported limited and inconclusive evidence, so more knowledge is needed about it. The main aim of this study is to examine the association between different built environmental factors of both school neighbourhood and home-school route with ACS of children and adolescents belonging to urban areas. The ACS level was evaluated using a self-reported questionnaire. Built environment variables (i.e., density of residents, street connectivity and mixed land use) within a school catchment area and home-school route characteristics (i.e., distance and pedestrian route directness—PRD) were measured using a geographic information system (GIS) and examined together with ACS levels. Subsequently, the association between environmental factors and ACS was analysed by binary logistic regression. Several cut-off points of the route measures were explored using receiver operating characteristic (ROC) curves. In addition, the PRD was further studied regarding different thresholds. The results showed that 70.5% of the participants were active and there were significant associations between most environmental factors and ACS. Most participants walked to school when routes were short (distance variable in children: OR = 0.980; p = 0.038; and adolescents: OR = 0.866; p < 0.001) and partially direct (PRD variable in children: OR = 11.334; p < 0.001; and adolescents: OR = 3.513; p < 0.001), the latter specially for children. Mixed land uses (OR = 2.037; p < 0.001) and a high density of street intersections (OR = 1.640; p < 0.001) clearly encouraged adolescents walking and slightly discouraged children walking (OR = 0.657, p = 0.010; and OR = 0.692, p = 0.025, respectively). The assessment of ACS together with the environmental factors using GIS separately for children and adolescents can inform future friendly and sustainable communities.
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