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He S, Yu S, Ai L, Dai J, Chung CKL. The built environment, purpose-specific walking behaviour and overweight: evidence from Wuhan metropolis in central China. Int J Health Geogr 2024; 23:2. [PMID: 38273303 PMCID: PMC10809537 DOI: 10.1186/s12942-024-00361-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Abstract
The impact of objective and subjective environmental factors on health outcomes has been a topic of significant debate, with a growing body of research acknowledging the role of a physically active lifestyle in promoting health. However, consensus regarding their precise influence remains elusive. This study contributes to these discussions by exploring how individual health outcomes correlate with transport and leisure walking behaviours, set against both the objective and subjective aspects of environmental influences in the context of Wuhan, an inland Chinese megacity. Street view images, multi-source geospatial data and a questionnaire survey were employed to characterise the "5D + Greenery" objective and perceived characteristics of the neighbourhood environment. Multi-group structural equation modelling was utilised to unravel the complex relationship and gender heterogeneity among environmental factors, purpose-specific walking, and overweight. Our results suggest that both objective land use diversity and perceived convenience are significantly associated with overweight. The accessibility of local service facilities and visible greenery promote both transport and leisure walking. While perceived neighbourhood safety encourages transport walking, perceived walkability is positively correlated with leisure walking. Notably, leisure walking, usually considered beneficial, presents a positive association with overweight conditions, acting as a mediation. Gender disparities exist in pathways between the environment and purpose-specific walking, as well as weight. The findings lend support to the planning of an activity-supporting built environment as a crucial strategy for obesity prevention.
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Affiliation(s)
- Sanwei He
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China.
| | - Shan Yu
- Department of Land Economy, University of Cambridge, Cambridge, UK
| | - Lina Ai
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China
| | - Jingya Dai
- Department of Community, Culture and Global Studies, University of British Columbia Okanagan, Kelowna, Canada
| | - Calvin King Lam Chung
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong, China
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De Silva Weliange S, Perera M, Gunatilake J. Perceived social and built environment associations of leisure-time physical activity among adults in Sri Lanka. BMC Res Notes 2021; 14:391. [PMID: 34670605 PMCID: PMC8527713 DOI: 10.1186/s13104-021-05810-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Although perceived neighbourhood environment is considered a predictor of leisure-time physical activity (LTPA), evidence for this is limited in South Asia. Thus, the aim was to determine the association between neighbourhood social and built environment features in carrying out LTPA among adults in Colombo District, Sri Lanka. A cross-sectional study among 1320 adults was carried out using validated questionnaires for physical activity (PA) and built environment data collection. Multiple logistic regression analysis was conducted to assess the associations between environment characteristics and LTPA after adjusting for gender, age, employment status, income level and sector of residence. RESULTS A total of 21.7% of adults participated in some LTPA. The commonest type of LTPA was walking; carried out by 14.5%. Moderate and vigorous activity at leisure was carried out by 10.3% and 3.9% respectively. Perceived social acceptance for PA was positively associated with LTPA. Out of the built environment characteristics perceived infrastructure for walking, and recreational facilities for PA were negatively associated with LTPA. Self-efficacy emerged as an important positive correlate of LTPA. The participants were positively influenced by the self-efficacy and perceived social environment which should be addressed when promoting LTPA.
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Affiliation(s)
| | - Madhawa Perera
- Department of Gynaecology and Obstetrics, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Jagath Gunatilake
- Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka.,Department of Geology, University of Peradeniya, Peradeniya, Sri Lanka
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Cheng J, Yu H. The relationship between neighborhood environment and physical activity in Chinese youth: a retrospective cross-sectional study. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01547-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Time Distances to Residential Food Amenities and Daily Walking Duration: A Cross-Sectional Study in Two Low Tier Chinese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020839. [PMID: 33478168 PMCID: PMC7844623 DOI: 10.3390/ijerph18020839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 12/17/2022]
Abstract
Recent studies indicate the accepted concept of using land-use mix (LUM) to promote physical activity is ineffective and even counteractive in the Chinese context. Before considering LUM as a whole, different amenity types need to be respectively analyzed in relation to various functions and demands. This study aims to examine the specific associations between food-related amenities and perceived daily walking duration (WD) in small Chinese cities. Two interviewer-administered questionnaire surveys (n = 354) were conducted in Yuncheng and Suihua between 2017 and 2018. Logistic regression models were used to examine the associations of WD with seven different categories of food outlet at three levels of walking distance. The associations were further explored by food environment diversity and through two age groups. With the exception of café/tea house, the other six food outlets were positively associated with WD. After adjusting for socioeconomic variables, the associations of grocery store and supermarket weakened. Higher levels of food environment diversity were associated with a longer WD. Among the age groups, food outlets were more associated with older adults’ WD. This novel quantitative study suggests that increasing the number and heterogeneity of food-related amenities (including mobile street vendors) within a neighborhood can enhance physical activity in small Chinese cities.
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Seinsche J, Zijlstra W, Giannouli E. Motility in Frail Older Adults: Operationalization of a New Framework and First Insights into Its Relationship with Physical Activity and Life-Space Mobility: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8814. [PMID: 33260952 PMCID: PMC7730834 DOI: 10.3390/ijerph17238814] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/06/2023]
Abstract
In order to design effective interventions to prevent age-related mobility loss, it is important to identify influencing factors. The concept of "motility" by Kaufmann et al. subdivides such factors into three categories: "access", "skills", and "appropriation". The aim of this study was to assemble appropriate quantitative assessment tools for the assessment of these factors in frail older adults and to get first insights into their relative contribution for life-space and physical activity-related mobility. This is an exploratory cross-sectional study conducted with twenty-eight at least prefrail, retired participants aged 61-94. Life-space mobility was assessed using the "University of Alabama at Birmingham Life-space Assessment" (LSA) and physical activity using the "German Physical Activity Questionnaire" (PAQ50+). Factors from the category "appropriation", followed by factors from the category "skills" showed the strongest associations with the LSA. Factors from the category "access" best explained the variance for PAQ50+. This study's findings indicate the importance of accounting for and examining comprehensive models of mobility. The proposed assessment tools need to be explored in more depth in longitudinal studies with larger sample sizes in order to yield more conclusive results about the appropriateness of the motility concept for such purposes.
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Affiliation(s)
| | | | - Eleftheria Giannouli
- Institute of Movement & Sport Gerontology, German Sport University Cologne, 50933 Cologne, Germany; (J.S.); (W.Z.)
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Pedestrian Walkways for Health in Shiraz, Iran, the Contribution of Attitudes, and Perceived Environmental Attributes. SUSTAINABILITY 2020. [DOI: 10.3390/su12187263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Walking is important for improving physical activity and public health. The pedestrian walkways called Walkways for Health in Shiraz, Iran, present a high standard of aesthetic and design features which attract many people for the purpose of recreation. In addition, a significant percentage of Iranians suffer from mental disorders. The contribution of aesthetic and design features toward walking for recreation as well as mental health has been demonstrated in previous studies, which have focused on either one or the other of these aspects. This interdisciplinary research study aims to evaluate both of these aspects simultaneously. A quantitative approach including a survey questionnaire and multiple regression analysis was used to examine the objectives. The contributions of walking attitudes and several perceived environmental attributes to the attractiveness for walking and to general/mental health were determined, which suggested the need for new arrangements of the visual sequences and social setting along these walkways. In addition, the observation that younger people suffer are more affected by mental health disorders was one of the most challenging findings. The policy makers of this city could apply the findings of this study to these pedestrian walkways in order to improve the attractiveness for walking as well as general and mental health.
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Zheng Y, Chen Z, Pearson T, Zhao J, Hu H, Prosperi M. Design and methodology challenges of environment-wide association studies: A systematic review. ENVIRONMENTAL RESEARCH 2020; 183:109275. [PMID: 32105887 PMCID: PMC7346707 DOI: 10.1016/j.envres.2020.109275] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 05/09/2023]
Abstract
Environment-wide association studies (EWAS) are an untargeted, agnostic, and hypothesis-generating approach to exploring environmental factors associated with health outcomes, akin to genome-wide association studies (GWAS). While design, methodology, and replicability standards for GWAS are established, EWAS pose many challenges. We systematically reviewed published literature on EWAS to categorize scope, impact, types of analytical approaches, and open challenges in designs and methodologies. The Web of Science and PubMed databases were searched through multiple queries to identify EWAS articles between January 2010 and December 2018, and a systematic review was conducted following the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) reporting standard. Twenty-three articles met our inclusion criteria and were included. For each study, we categorized the data sources, the definitions of study outcomes, the sets of environmental variables, and the data engineering/analytical approaches, e.g. neighborhood definition, variable standardization, handling of multiple hypothesis testing, model selection, and validation. We identified limited exploitation of data sources, high heterogeneity in analytical approaches, and lack of replication. Despite of the promising utility of EWAS, further development of EWAS will require improved data sources, standardization of study designs, and rigorous testing of methodologies.
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Affiliation(s)
- Yi Zheng
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Zhaoyi Chen
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Thomas Pearson
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
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Elshahat S, O’Rorke M, Adlakha D. Built environment correlates of physical activity in low- and middle-income countries: A systematic review. PLoS One 2020; 15:e0230454. [PMID: 32182278 PMCID: PMC7077823 DOI: 10.1371/journal.pone.0230454] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/01/2020] [Indexed: 01/07/2023] Open
Abstract
Insufficient physical activity (PA) is the fourth major risk factor for many non-communicable diseases and premature mortality worldwide. Features of the built environment (BE) play a considerable role in determining population PA behaviors. The majority of evidence for PA-BE relationships comes from high-income countries and may not be generalizable to low- and middle-income countries (LMICs). We aim to systematically review the literature and assess the associations between perceived and/or objective BE characteristics and PA domains in LMICs. This review adopted a systematic search strategy for English language articles published between January 2000 and June 2019 from four electronic databases-Medline, Embase, Web of Science and PubMed-adhering to the PRISMA guidelines. Studies addressing the associations between self-reported and/or objective BE and PA were only included if they were conducted in LMICs, according to the World Bank classification list. Articles investigating PA-BE relationships across any age groups were included, and all study designs were eligible, except for qualitative studies and reviews. Thirty-three studies were included for evidence synthesis. Cross-sectional studies were the most prevailing study design (97%), revealing a notable gap in longitudinal PA-BE research in LMICs. A majority of the BE factors were not associated with different PA domains while others (e.g., density, proximity to services, aesthetics) exhibited an inconsistent association. Land-use mix diversity was positively associated with transport PA and the presence of recreation facilities resulted in an increase in PA during leisure-time. Increased safety from crime at night consistently increased total PA and walking levels. Research exploring the associations between BE attributes and PA behaviors in LMICs appears to be limited and is primarily cross-sectional. Longitudinal research studies with objective measures are needed for inferring well-grounded PA-BE causal relationships and informing the design of evidence-based environmental interventions for increasing PA levels in LMICs.
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Affiliation(s)
- Sarah Elshahat
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Michael O’Rorke
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
| | - Deepti Adlakha
- School of Natural and Built Environment, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
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Why Some Walk and Others Don't: Neighborhood Safety and the Sociodemographic Variation Effect on Walking for Leisure and Transportation. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 26:E24-E32. [PMID: 30969276 DOI: 10.1097/phh.0000000000000992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The study was aimed at assessing the association of all components of safety (crime, traffic, social, and physical) and general safety with walking for leisure and transportation among Iranian adults. In this regard, sociodemographic factors as potential effect modifiers on walking behavior and the association of neighborhood safety with the level of walking were explored. METHOD A total of 1300 questionnaires were distributed among respondents residing in 8 neighborhoods in Bandar Abbas city, among which 1132 qualified for use in further analysis. Using a binary logistic regression method, differences in walking behavior and perceived safety to walk were evaluated across sociodemographic characteristics. RESULTS The results showed that the walking rate is higher among older adults, married people, and adults with lower education and a higher length of residency. An increase in neighborhood safety from crime, traffic, social disorders, and overall safety associates with increased leisure walking among all populations. Further, overall neighborhood safety and safety from crime and traffic positively correlate with the level of transportation walking among all respondents. For both types of walking, this association varies in sociodemographic groups. CONCLUSION The study suggests that an increase in the safety of a neighborhood contributes to a higher level of leisure and transportation walking; however, it varies in different subgroups. This study provides the knowledge needed to consider all aspects of neighborhood safety to measure walking behavior level.
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Stener-Victorin E, Zhang H, Li R, Friden C, Li D, Wang W, Wang H, Chang C, Li S, Huo Z, Zhang H, Ji X, Linden-Hirschberg A, Qiao J. Acupuncture or metformin to improve insulin resistance in women with polycystic ovary syndrome: study protocol of a combined multinational cross sectional case-control study and a randomised controlled trial. BMJ Open 2019; 9:e024733. [PMID: 30612112 PMCID: PMC6326273 DOI: 10.1136/bmjopen-2018-024733] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is linked to hyperinsulinemia and insulin resistance with dysfunctional glucose metabolism. Pilot studies suggests that acupuncture treatment with combined manual and low-frequency electrical stimulation (electroacupuncture (EA)) of the needles decrease circulating glycated haemoglobulin (HbA1c) and homeostatic model assessment-insulin resistance. Therefore, we here aim to investigate if acupuncture treatment or metformin together with lifestyle or lifestyle management alone improves insulin sensitivity and related symptoms in overweight/obese women with PCOS. METHODS AND ANALYSIS This is a two-centre multinational (Sweden and China), cross-sectional case-control study combined with an open-labelled randomised controlled trial (RCT). Participants are randomised to one of three groups: (1) EA 2-3 times/week during 4 months+lifestyle management; (2) metformin, 500 mg, three/day during 4 months+lifestyle management; or (3) lifestyle management alone. The primary outcome measure in the RCT is changes in HbA1C. A total of 123 obese overweight women with PCOS will be enrolled and randomised into one of the three groups with a target power of at least 80% and 5% significance level based on two-sided tests. ETHICS AND DISSEMINATION The study has been approved by the Regional Ethical Review Board of Stockholm and of Peking University Third Hospital, China. Primary outcome data of the RCT will be published in a relevant journal together with supporting secondary outcome measurements. Further, outcome measurements will be published in separate papers as well as case-control data. EXPECTED RESULTS We anticipate that EA and metformin, both with lifestyle management, are equally effective and superior to lifestyle management alone for improvement of glycaemic control. TRIAL REGISTRATION NUMBERS NCT02647827 and EudraCT2015-004250-18.
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Affiliation(s)
| | - Haolin Zhang
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Rong Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Cecilia Friden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Dong Li
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Wei Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Haining Wang
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, China
| | - Cuiqing Chang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Shi Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
| | - ZeJun Huo
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, Beijing, China
| | - Xiaolan Ji
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | | | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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Sawyer ADM, Jones R, Ucci M, Smith L, Kearns A, Fisher A. Cross-sectional interactions between quality of the physical and social environment and self-reported physical activity in adults living in income-deprived communities. PLoS One 2017; 12:e0188962. [PMID: 29240791 PMCID: PMC5730220 DOI: 10.1371/journal.pone.0188962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/16/2017] [Indexed: 11/18/2022] Open
Abstract
Background Understanding the environmental determinants of physical activity in populations at high risk of inactivity could contribute to the development of effective interventions. Socioecological models of activity propose that environmental factors have independent and interactive effects of physical activity but there is a lack of research into interactive effects. Objectives This study aimed to explore independent and interactive effects of social and physical environmental factors on self-reported physical activity in income-deprived communities. Methods Participants were 5,923 adults in Glasgow, United Kingdom. Features of the social environment were self-reported. Quality of the physical environment was objectively-measured. Neighbourhood walking and participation in moderate physical activity [MPA] on ≥5 days/week was self-reported. Multilevel multivariate logistic regression models tested independent and interactive effects of environmental factors on activity. Results ‘Social support’ (walking: OR:1.22,95%CI = 1.06–1.41,p<0.01; MPA: OR:0.79,95%CI = 0.67–0.94,p<0.01), ‘social interaction’ (walking: OR:1.25,95%CI = 1.10–1.42,p<0.01; MPA: OR:6.16,95%CI = 5.14–7.37,p<0.001) and ‘cohesion and safety’ (walking: OR:1.78,95%CI = 1.56–2.03,p<0.001; MPA: OR:1.93,95%CI = 1.65–2.27,p<0.001), but not ‘trust and empowerment’, had independent effects on physical activity. ‘Aesthetics of built form’ (OR:1.47,95%CI = 1.22–1.77,p<0.001) and ‘aesthetics and maintenance of open space’ (OR:1.32, 95%CI = 1.13–1.54,p<0.01) were related to walking. ‘Physical disorder’ (OR:1.63,95%CI = 1.31–2.03,p<0.001) had an independent effect on MPA. Interactive effects of social and physical factors on walking and MPA were revealed. Conclusions Findings suggest that intervening to create activity-supportive environments in deprived communities may be most effective when simultaneously targeting the social and physical neighbourhood environment.
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Affiliation(s)
- Alexia D. M. Sawyer
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- * E-mail:
| | - Russell Jones
- Glasgow Centre for Population Health, Third Floor, Olympia Building, Bridgeton Cross, Glasgow, United Kingdom
| | - Marcella Ucci
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London, Central House, London, United Kingdom
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ade Kearns
- Urban Studies, University of Glasgow, Glasgow, United Kingdom
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Yeh CY, Chang CK, Yang FA. Applying a Treatment Effects Model to Investigate Public Amenity Effect on Physical Activity of the Elderly. J Aging Soc Policy 2017; 30:72-86. [PMID: 28885131 DOI: 10.1080/08959420.2017.1376844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The increasing elderly population puts significant health, economic, and social burdens on society. Physical activity is one of the most cost-effective ways to maintain the health of the elderly. This study adopts a treatment effects model to investigate the causal relationship between environment attributes and physical activity among the elderly, while taking endogeneity into account. The data were collected from 274 participants by face-to-face interviews in Taichung, Taiwan. Performing physical activity regularly in parks is the most important measure of the amount of physical activity by the elderly. Providing sufficient and accessible parks in metropolitan residential neighborhoods could be one of the most cost-effective ways to promote physical activity for the elderly living in midsize Asian cities.
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Affiliation(s)
- Chia-Yu Yeh
- a Associate Professor, Department of Economics , National Chi Nan University , Nantou , Taiwan
| | - Chen-Kang Chang
- b Professor, Sport Science Research Center , National Taiwan University of Sport , Taichung , Taiwan
| | - Feng-An Yang
- c PhD Student, Department of Agricultural , Environmental and Development Economics, The Ohio State University , Columbus , Ohio , USA
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Sawyer A, Ucci M, Jones R, Smith L, Fisher A. Simultaneous evaluation of physical and social environmental correlates of physical activity in adults: A systematic review. SSM Popul Health 2017; 3:506-515. [PMID: 29349241 PMCID: PMC5769071 DOI: 10.1016/j.ssmph.2017.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 04/05/2017] [Accepted: 05/12/2017] [Indexed: 11/27/2022] Open
Abstract
Background Ecological models of physical activity posit that social and physical environmental features exert independent and interactive influences on physical activity, but previous research has focussed on independent influences. This systematic review aimed to synthesise the literature investigating how features of neighbourhood physical and social environments are associated with physical activity when both levels of influence are simultaneously considered, and to assess progress in the exploration of interactive effects of social and physical environmental correlates on physical activity. Methods A systematic literature search was conducted in February 2016. Articles were included if they used an adult (≥15 years) sample, simultaneously considered at least one physical and one social environmental characteristic in a single statistical model, used self-reported or objectively-measured physical activity as a primary outcome, reported findings from quantitative, observational analyses and were published in a peer-reviewed journal. Combined measures including social and physical environment items were excluded as they didn’t permit investigation of independent and interactive social and physical effects. Forty-six studies were identified. Results An inconsistent evidence base for independent environmental correlates of physical activity was revealed, with some support for specific physical and social environment correlates. Most studies found significant associations between physical activity and both physical and social environmental variables. There was preliminary evidence that physical and social environmental variables had interactive effects on activity, although only 4 studies examined interactive effects. Conclusions Inconsistent evidence of independent associations between environmental variables and physical activity could be partly due to unmeasured effect modification (e.g. interactive effects) creating unaccounted variance in relationships between the environment and activity. Results supported multiple levels of environmental influence on physical activity. It is recommended that further research uses simultaneous or interaction analyses to gain insight into complex relationships between neighbourhood social and physical environments and physical activity, as there is currently limited research in this area.
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Affiliation(s)
- Alexia Sawyer
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Marcella Ucci
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, Central House, University College London, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Russell Jones
- Glasgow Centre for Population Health, The Olympia Building, University of Glasgow, Glasgow G12 8QQ, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Dept. of Life Sciences, Anglia Ruskin University, UK
| | - Abi Fisher
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
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Malambo P, Kengne AP, Lambert EV, De Villers A, Puoane T. Association between perceived built environmental attributes and physical activity among adults in South Africa. BMC Public Health 2017; 17:213. [PMID: 28219427 PMCID: PMC5319054 DOI: 10.1186/s12889-017-4128-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 02/13/2017] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND To investigate the association between perceived environmental attributes and leisure-time and transport-related physical activity. METHODS This was a cross-sectional survey involving 671 South Africans aged ≥35 years from urban and rural settings. International Physical Activity Questionnaire and Neighbourhood Walkability Scale were used to collect data. Multivariable logistic regressions were used to investigate the associations. RESULTS Significant urban vs. rural differences were apparent in the distribution of most attributes of neighborhood environment. After adjusting for gender, age, setting and relevant interaction terms, proximity to local stores was significantly associated with leisure-time physical activity (OR: 4.26; 95% CI, 1.00-18.08); while proximity to transit stops (2.44; 1.48-4.02), pleasant scenery (1.93; 1.07-3.46), sidewalks (2.36; 1.25-4.44), shade from trees (2.14; 1.19-3.85), traffic (2.17; 91.21-3.91) and well-lit streets (2.01; 1.04-3.89) were significantly associated with walking for leisure. Four-way intersections (4.54; 1.54-13.43), pleasant scenery (3.84; 1.35-10.99), traffic (0.28; 0.09-0.89), sidewalks (3.75; 1.06-13.27) and crosswalks were associated with transport related physical activity. Proximity to transit stops (2.12; 1.17-3.84) and well maintained sidewalks (2.69; 2.20-10.02) were significantly associated with total physical activity. Significant interactions by setting were apparent in some of the associations. CONCLUSION Some, but not all attributes of a neighborhood environment were significantly associated in expected directions with the three physical activity domains in this mixed urban and rural population. This study highlights the need for policy strategies aimed at improving or maintaining these perceived environmental attributes to promote physical activity.
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Affiliation(s)
- Pasmore Malambo
- Faculty of Community and Health Sciences School of Public Health, University of Western Cape, Cape Town, South Africa
| | - Andre P. Kengne
- Non-communicable Diseases Unit, South African Medical Research Council, Cape Town, South Africa
| | - Estelle V. Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Anniza De Villers
- Non-communicable Diseases Unit, South African Medical Research Council, Cape Town, South Africa
| | - Thandi Puoane
- Faculty of Community and Health Sciences School of Public Health, University of Western Cape, Cape Town, South Africa
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Yi X, Pope Z, Gao Z, Wang S, Pan F, Yan J, Liu M, Wu P, Xu J, Wang R. Associations between individual and environmental factors and habitual physical activity among older Chinese adults: A social-ecological perspective. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:315-321. [PMID: 30356490 PMCID: PMC6188579 DOI: 10.1016/j.jshs.2016.06.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 06/04/2016] [Accepted: 06/14/2016] [Indexed: 05/27/2023]
Abstract
PURPOSE To examine, within a social-ecological framework, associations between multifaceted individual and environmental factors and habitual physical activity (HPA) among older Chinese adults. METHODS Through a mix of qualitative and quantitative methods, a survey instrument assessing various factors underlying 3 social-ecological dimensions of intrapersonal, interpersonal, and community and environmental resources was developed. Using a cross-sectional design, older adults (n = 1580, aged 67 ± 7 years) recruited from 10 communities in Shandong province completed the social-ecological survey of HPA. Data were analyzed using Partial Least Squares Path Modeling. RESULTS Factors related to intrapersonal (medical knowledge, motivation, physical function, sport skills, socioeconomic status, and education), interpersonal (social support, social activity, and social norms), and community and physical environmental resources (safety, capacity, availability of and access to physical activity facilities) were found to be significantly associated with older adults' participation in HPA. CONCLUSION The findings provide an initial validation of a social-ecological approach to the study of HPA in China, suggesting that strategies aimed at promoting physical activity in older adults should address multiple levels of factors that may contribute to the likelihood of older Chinese adults being physically active.
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Affiliation(s)
- Xiangren Yi
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Zachary Pope
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, MN 55455, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota Twin Cities, Minneapolis, MN 55455, USA
| | - Shumei Wang
- School of Public School, Shandong University, Jinan 250061, China
| | - Fang Pan
- School of Medicine, Shandong University, Jinan 250061, China
| | - Jingpeng Yan
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Meng Liu
- School of Public School, Shandong University, Jinan 250061, China
| | - Peipei Wu
- School of Public School, Shandong University, Jinan 250061, China
| | - Jingjing Xu
- School of Medicine, Shandong University, Jinan 250061, China
| | - Rui Wang
- School of Medicine, Shandong University, Jinan 250061, China
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Li F. Physical activity and health in the presence of China's economic growth: Meeting the public health challenges of the aging population. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:258-269. [PMID: 30356539 PMCID: PMC6188738 DOI: 10.1016/j.jshs.2016.06.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/19/2016] [Accepted: 05/05/2016] [Indexed: 05/18/2023]
Abstract
Three decades of rapid economic development in China have not only benefited millions of Chinese by improving their living standards but have also dramatically increased the number of people who are part of the country's aging population. However, economic growth has not been accompanied by sufficient attention given to important public health issues, including an increase in the incidence of chronic diseases and a decline in physical activity (PA) that comes with an aging population. The rapid growth in China's older population will soon exert an impact on the nation's economy, population health status, and health behaviors, and will increase stress on its healthcare system. This review article provides a broad perspective on the impact of rapid economic development, industrialization, and urbanization on health-related behaviors, with a specific focus on PA among older adults. Specifically, the article offers an overview of the demographic context, significant public health challenges, evidence on PA and exercise interventions, and knowledge gaps and future directions for research.
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Affiliation(s)
- Fuzhong Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
- Oregon Research Institute, Eugene, OR 97403, USA
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Liao Y, Lin CY, Huang JH, Park JH. Gender differences in the associations between perceived environment and walking for recreation in Taiwanese adults. Women Health 2016; 57:551-565. [PMID: 27105304 DOI: 10.1080/03630242.2016.1181138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined gender differences in the associations between perceived environmental factors and walking for recreation in Taiwanese adults. In 2014, a telephone-based, cross-sectional survey targeting Taiwanese adults (20-64 years) was conducted. Data on nine items about environmental perception, time spent in walking for recreation, and socio-demographic variables were obtained from 1,065 adults using the International Physical Activity Questionnaire-long version and its environmental module. Adults who perceived good aesthetics (adjusted odds ratio [AOR] = 1.74; 95% confidence interval [CI]: 1.36-2.23) and reported seeing people being active (AOR = 1.58; 95% CI: 1.21-2.06) were more likely to perform 150 minutes of recreational walking per week. Furthermore, significant interactions regarding walking for recreation were observed between gender and five environmental correlates: access to shops (p = .046), the presence of sidewalks (p < .001), access to recreational facilities (p = .02), seeing people being active (p = .001), and aesthetics (p < .001). These five perceived environmental factors were positively associated with recreational walking in women but not in men. Gender is a potential modifier between perceived environment and walking for recreation in adults. Perceived environmental factors appear to be more critical for women in performing health-enhancing levels of recreational walking than they are for men.
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Affiliation(s)
- Yung Liao
- a Department of Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan , China
| | - Cheng-Yi Lin
- a Department of Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan , China
| | - Jing-Huei Huang
- b School of Tourism and Hospitality Management , Temple University , Philadelphia , Pennsylvania , USA
| | - Jong-Hwan Park
- c Institute of Convergence Bio-Health , Dong-A University , Busan , South Korea
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Gao J, Fu H, Li J, Jia Y. Association between social and built environments and leisure-time physical activity among Chinese older adults--a multilevel analysis. BMC Public Health 2015; 15:1317. [PMID: 26715531 PMCID: PMC4696285 DOI: 10.1186/s12889-015-2684-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022] Open
Abstract
Background Social and physical environments are not only hypothesized to influence physical activity (PA), they are also interrelated and influence each other. However, few studies have examined the relationships of PA with social and physical environments simultaneously. Accordingly, the current study aims to examine the association between physical and social attributes of neighborhood with leisure-time physical activity (LTPA) among the Chinese elders. Methods By employing a two-stage stratified random sampling procedure, 2783 elders were identified from 47 neighborhoods in Shanghai during July and September in 2014. Social and physical attributes of neighborhood were assessed using a validated and psychometrically tested measures, and the Chinese version of the International Physical Activity Questionnaire—Long Form was used to assess LTPA. Control variables included sex, age, marital status, education level, self-rated health and chronic conditions. Multilevel logistic regression analysis was conducted to explore whether individual- and neighborhood-level social and physical attributes were associated with LTPA. Results The overall prevalence of leisure-time active (LTA) was 46.6 %. After controlling for individual covariates, 1) compared to participants with the first quartile of social participation, the odds ratios of LTA for participants with the second, third and fourth quartile of social participation were 1.86 (95 % CI: 1.44–2.41), 2.37 (95 % CI: 1.82–3.08) and 4.27 (95 % CI: 3.27–5.58); 2) compared to participants with the first quartile of social cohesion, the odds ratios of LTA for participants with the second, third and fourth quartile of social cohesion were 1.09 (95 % CI: 1.07–1.20), 1.14 (95 % CI: 1.08–3.50) and 1.31 (95 % CI: 1.11–1.58); 3) compared to participants living in neighborhoods with the first quartile of walkability, the odds ratios of LTA for participants living in neighborhoods with the second, third and fourth quartile of walkability were 1.13 (95 % CI: 1.03–2.02), 1.73 (95 % CI: 1.12–3.21) and 1.85 (95 % CI: 1.19–3.35). Conclusions Both social and physical attribute of neighborhood associate with LTPA among Chinese older adults. It may promote LTPA among Chinese older adults to encourage them to participate in social activities, meanwhile, building walkable and cohesive neighborhoods.
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Affiliation(s)
- Junling Gao
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
| | - Hua Fu
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
| | - Jiang Li
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
| | - Yingnan Jia
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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Tu H, Liao X, Schuller K, Cook A, Fan S, Lan G, Lu Y, Yuan Z, Moore JB, Maddock JE. Insights from an observational assessment of park-based physical activity in Nanchang, China. Prev Med Rep 2015; 2:930-4. [PMID: 26844171 PMCID: PMC4721293 DOI: 10.1016/j.pmedr.2015.08.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Internationally, parks have been shown to be an important community asset for physical activity (PA), but little is known about the relationship between park usage and physical activity in China. The purpose of this study was to determine the association between park user characteristics and PA in Nanchang, China. In June 2014, 75,678 people were observed in eight parks over 12 days using SOPARC, a validated systematic observation tool. A logistic regression analysis was used to determine the association between PA and park user characteristics. Most park users were older adults (53.5%) or adults (34.6%). Overall, 55% of park users engaged in moderate-to-vigorous physical activity (MVPA). Fewer women were observed in parks than men, but were 66% more likely to be engaged in MVPA than men. Park users were more likely to be observed in MVPA between 6–9 am and when the temperature was below 30 °C. Chinese park users were more active (55%) than US studies in Tampa (30%), Chicago (49%), and Los Angeles (34%). More research is necessary to identify features of parks that are associated with greater PA so that effective interventions can be developed to promote active park use in Chinese citizens. Park use and physical activity were assessed in 8 parks in Nanchang, China. Children and teenagers were seldom observed in parks. About half of park users were physically active. Temperature but not air quality was related to park use.
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Affiliation(s)
- Hong Tu
- School of Public Health, Nanchang University, China
| | - Xiong Liao
- School of Public Health, Nanchang University, China
| | - Kristyn Schuller
- Department of Public Health Sciences, University of Hawaii at Manoa, United States
| | - Angelie Cook
- Department of Public Health Sciences, University of Hawaii at Manoa, United States
| | - Si Fan
- School of Public Health, Nanchang University, China
| | - Guilian Lan
- School of Public Health, Nanchang University, China
| | - Yuanan Lu
- School of Public Health, Nanchang University, China
- Department of Public Health Sciences, University of Hawaii at Manoa, United States
| | | | - Justin B. Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States
| | - Jay E. Maddock
- School of Public Health, Nanchang University, China
- School of Public Health, Texas A&M University, United States
- Corresponding author at: School of Public Health, Texas A&M Health Science Center, MS 1266, 282 SPH Administration Building, College Station, TX 77843-1266, United States. Fax: + 1 979 436 9599.School of Public HealthTexas A&M Health Science Center, MS 1266282 SPH Administration BuildingCollege StationTX77843-1266United States
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Lien WC, Chang JH, Guo NW, Lin YC, Hsieh PC, Kuan TS. Determinants of Perceived Physical Environment Barriers among Community-Dwelling Elderly in Taiwan. J Nutr Health Aging 2015; 19:575-82. [PMID: 25923489 DOI: 10.1007/s12603-015-0473-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test the hypothesis that mobility, activities of daily living, and the interaction between them can play a key role in determining perceived physical environment barriers among community-dwelling elderly. DESIGN Cross-sectional. SETTING Community. PARTICIPANTS One hundred and ninety-seven community-dwelling elderly with more than 7 points on the Short Portable Mental State Questionnaire and less than 7 points on the Geriatric Depression Scale (15 items). INTERVENTION None. MEASUREMENTS Time Get-up and Go test (TUG), the subscales of basic activity of daily living (BADL)/instrumental activities of daily living (IADL) of the Hierarchy of Care Required (HCR), and the physical/structural subscale of the Craig Hospital Inventory of Environmental Factors in Community-dwelling Elderly in Taiwan were used to measure mobility, activities of daily living and perceived physical environment barriers, respectively. Hierarchical linear regression analyses were used to test the study hypothesis. RESULTS Significant and positive relations were found to exist between perceived physical environment barriers and (1) the TUG time (β=.300, p<.05), and (2) the IADL score for the HCR (β=.322, p<.05), respectively. A significant and negative relation existed between perceived physical environment barriers and the interaction term (the TUG time and the IADL score for the HCR) (β=-.211, p<.05). CONCLUSION Mobility, IADL and the interaction between them are found to be significant determinants of perceived physical environment barriers in the community-dwelling elderly under consideration. Strategies targeting the enhancement of mobility among community-dwelling elderly are suggested to lead to improvements in the degree to which physical environment barriers are perceived. This beneficial effect could be greater in the case of elderly individuals with better IADL function.
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Affiliation(s)
- W-C Lien
- T.S. Kuan, Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng-Kung University. No.138, Sheng-Li Road, Tainan 704, Taiwan
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Herrador-Colmenero M, Ruiz JR, Ortega FB, Segura-Jiménez V, Álvarez-Gallardo IC, Camiletti-Moirón D, Estévez-López F, Delgado-Fernández M, Chillón P. Reliability of the ALPHA environmental questionnaire and its association with physical activity in female fibromyalgia patients: the al-Ándalus project. J Sports Sci 2014; 33:850-62. [DOI: 10.1080/02640414.2014.968190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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