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Seguin-Fowler RA, LaCroix AZ, LaMonte MJ, Liu J, Maddock JE, Rethorst CD, Bird CE, Stefanick ML, Manson JE. Association of Neighborhood Walk Score with Accelerometer-Measured Physical Activity Varies by Neighborhood Socioeconomic Status in Older Women. Prev Med Rep 2022; 29:101931. [PMID: 36161128 PMCID: PMC9502671 DOI: 10.1016/j.pmedr.2022.101931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 10/27/2022] Open
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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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3
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Stowe EW, Hughey SM, Hallum SH, Kaczynski AT. Associations between Walkability and Youth Obesity: Differences by Urbanicity. Child Obes 2019; 15:555-559. [PMID: 31448951 DOI: 10.1089/chi.2019.0063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Attributes of the built environment, such as neighborhood walkability, have been linked to increased physical activity and reduced obesity risk. This relationship, however, has primarily been documented in adults; less is known about neighborhood walkability and youth obesity, as limited prior research has produced mixed findings. The purpose of this study was to examine the association between neighborhood walkability and youth obesity, including differences by urbanicity. Methods: Data were collected in 2013 from youth aged 7-14 years (n = 13,469) in a Southeastern county school district. Height and weight were objectively measured and utilized to calculate body mass index (BMI) z-scores. Youth demographic characteristics and addresses were obtained, and a Walk Score® was gathered for each youth's home address. Multilevel linear regression analysis, accounting for nesting within census block groups, was conducted to examine the association between Walk Score and BMI z-score and to test for the moderating effect of urbanicity. Separate multilevel analyses examined Walk Score and BMI z-score among urban, urban-rural mixed, and rural youth subsamples. Results: Overall, as Walk Score increased, youth BMI z-score decreased. Walk Score was positively associated with BMI z-score among urban youth and negatively associated with BMI z-score among rural youth; no relationship was observed between Walk Score and youth in urban-rural mixed areas. Conclusions: Neighborhood walkability may impact youth differently across geographic areas. Further study is warranted about how youth utilize a walkable environment and mechanisms through which walkability influences youth physical activity and obesity risk.
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Affiliation(s)
- Ellen W Stowe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - S Morgan Hughey
- Department of Health and Human Performance, College of Charleston, Charleston, SC
| | - Shirelle H Hallum
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Prevention Research Center, Amold School of Public Health, University of South Carolina, Columbia, SC
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Abstract
Rural residents are less physically active than their urban counterparts and disproportionately affected by chronic diseases and conditions associated with insufficient activity. While the ecological model has been successful in promoting and translating active living research in urban settings, relatively little research has been conducted in rural settings. The resulting research gap prohibits a comprehensive understanding and application of solutions for active living in rural America. Therefore, the purpose of this article was to assess the evidence base for an ecological model of active living for rural populations and outline key scientific gaps that inhibit the development and application of solutions. Specifically, we reexamined the 4 domains conceptualized by the model and suggest that there is a dearth of research specific to rural communities across all areas of the framework. Considering the limited rural-specific efforts, we propose areas that need addressing to mobilize rural active living researchers and practitioners into action.
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Méline J, Chaix B, Pannier B, Ogedegbe G, Trasande L, Athens J, Duncan DT. Neighborhood walk score and selected Cardiometabolic factors in the French RECORD cohort study. BMC Public Health 2017; 17:960. [PMID: 29258476 PMCID: PMC5735827 DOI: 10.1186/s12889-017-4962-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022] Open
Abstract
Background Walkable neighborhoods are purported to impact a range of cardiometabolic outcomes through increased walking, but there is limited research that examines multiple cardiometabolic outcomes. Additionally, few Walk Score (a novel measure of neighborhood walkability) studies have been conducted in a European context. We evaluated associations between neighborhood Walk Score and selected cardiometabolic outcomes, including obesity, hypertension and heart rate, among adults in the Paris metropolitan area. Methods and results We used data from the second wave of the RECORD Study on 5993 participants recruited in 2011–2014, aged 34–84 years, and residing in Paris (France). To this existing dataset, we added Walk Score values for participants’ residential address. We used multilevel linear models for the continuous outcomes and modified Poisson models were used for our categorical outcomes to estimate associations between the neighborhood Walk Score (both as a continuous and categorical variable) (0–100 score) and body mass index (BMI) (weight/height2 in kg/m2), obesity (kg/m2), waist circumference (cm), systolic blood pressure (SBP) (mmHg), diastolic blood pressure (DBP) (mmHg), hypertension (mmHg), resting heart rate (RHR) (beats per minute), and neighborhood recreational walking (minutes per week). Most participants lived in Walker’s Paradise (48.3%). In multivariate models (adjusted for individual variables, neighborhood variables, and risk factors for cardiometabolic outcomes), we found that neighborhood Walk Score was associated with decreased BMI (β: -0.010, 95% CI: -0.019 to −0.002 per unit increase), decreased waist circumference (β: -0.031, 95% CI: -0.054 to −0.008), increased neighborhood recreational walking (β: +0.73, 95% CI: +0.37 to +1.10), decreased SBP (β: -0.030, 95% CI: -0.063 to −0.0004), decreased DBP (β: -0.028, 95% CI: -0.047 to −0.008), and decreased resting heart rate (β: -0.026 95% CI: -0.046 to −0.005). Conclusions In this large population-based study, we found that, even in a European context, living in a highly walkable neighborhood was associated with improved cardiometabolic health. Designing walkable neighborhoods may be a viable strategy in reducing cardiovascular disease prevalence at the population level.
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Affiliation(s)
- Julie Méline
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 1 rue Victor Cousin, 75230, 05, Paris cedex, France.,Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 56, boulevard Vincent Auriol CS 81393, 75646, Paris Cedex 13, France
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 1 rue Victor Cousin, 75230, 05, Paris cedex, France.,Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 56, boulevard Vincent Auriol CS 81393, 75646, Paris Cedex 13, France
| | - Bruno Pannier
- IPC Medical Center, 6 Rue la Pérouse, 75016, Paris, France
| | - Gbenga Ogedegbe
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Leonardo Trasande
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.,Departments of Pediatrics and Environmental Medicine, New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA
| | - Jessica Athens
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA. .,Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, Room 621, New York, NY, 10016, USA.
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6
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Geographic variation in the relationship between body mass index and the built environment. Prev Med 2017; 100:33-40. [PMID: 28344118 PMCID: PMC5559354 DOI: 10.1016/j.ypmed.2017.03.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/15/2017] [Accepted: 03/19/2017] [Indexed: 11/22/2022]
Abstract
Studies examining associations between weight status and neighborhood built environment (BE) have shown inconsistent results and have generally focused on urban settings. However, many Americans do not live in metropolitan areas and BE impacts may be different outside of metropolitan areas. We sought to examine whether the relationship between body mass index (BMI) and neighborhood BE exists and varies by geographic region across small towns in the United States. We conducted telephone surveys with 2156 adults and geographic information systems data in nine towns located within three geographic regions (Northeast, Texas, Washington) in 2011 and 2012. Multiple regression models examined the relationship between individual BMI and BE measures. Most physical activity variables were significantly associated with lower BMI in all geographic regions. We saw variation across geographic region in the relationship between characteristics of the BE variables and BMI. Some perceived and objectively-measured characteristics of the BE were significantly associated with adult BMI, but significant relationships varied by geographic region. For example, in the Northeast, perceived attractiveness of the neighborhood as a reason for why they chose to live there was associated with lower BMI; in Texas, the perceived presence of a fast food restaurant was negatively associated with BMI; in Washington, perceived presence of trees along the streets was associated with lower BMI. Our findings suggest that regional variation plays a role in the relationship between adult BMI and BE characteristics in small towns. Regardless of geographic location, interventions should encourage utilitarian walking and other forms of physical activity.
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Kahan D, McKenzie TL. School and Neighborhood Predictors of Physical Fitness in Elementary School Students. THE JOURNAL OF SCHOOL HEALTH 2017; 87:448-456. [PMID: 28463449 DOI: 10.1111/josh.12516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/26/2016] [Accepted: 11/01/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND We assessed the associations of 5 school and 7 neighborhood variables with fifth-grade students achieving Healthy Fitness Zone (HFZ) or Needs Improvement-Health Risk (NI-HR) on aerobic capacity (AC) and body composition (BC) physical fitness components of the state-mandated FITNESSGRAM® physical fitness test. METHODS Data for outcome (physical fitness) and predictor (school and neighborhood) variables were extracted from various databases (eg, Data Quest, Walk Score® ) for 160 schools located in San Diego, California. Predictor variables that were at least moderately correlated (|r| ≥ .30) with ≥1 outcome variables in univariate analyses were retained for ordinary least squares regression analyses. RESULTS The mean percentages of students achieving HFZ AC (65.7%) and BC (63.5%) were similar (t = 1.13, p = .26), while those for NI-HR zones were significantly different (AC = 6.0% vs BC = 18.6%; t = 12.60, p < .001). Correlations were greater in magnitude for school than neighborhood demographics and stronger for BC than AC. The school variables free/reduced-price lunch (negative) and math achievement (positive) predicted fitness scores. Among neighborhood variables, percent Hispanic predicted failure of meeting the HFZ BC criterion. CONCLUSIONS Creating school and neighborhood environments conducive to promoting physical activity and improving fitness is warranted.
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Affiliation(s)
- David Kahan
- San Diego State University, School of Exercise and Nutritional Sciences, 5500 Campanile Drive, ENS Building 315, San Diego, CA 92182-7251
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Bezold CP, Stark JH, Rundle A, Konty K, Day SE, Quinn J, Neckerman K, Roux AVD. Relationship between Recreational Resources in the School Neighborhood and Changes in Fitness in New York City Public School Students. J Urban Health 2017; 94:20-29. [PMID: 28116590 PMCID: PMC5359172 DOI: 10.1007/s11524-016-0114-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Physical fitness in children has many beneficial effects, including the maintenance of a healthy weight. The built environment may influence youths' physical fitness by encouraging physical activity. This paper assessed whether higher density of parks, playgrounds, and sports facilities around a school is related to improvements in fitness in middle school boys and girls. Fitness scores and other student covariates collected as part of NYC FITNESSGRAM between the 2006-2007 and 2010-2011 school years were linked with school neighborhood data on characteristics of the built environment for NYC public school students in grades 6-8. Data were analyzed in 2015. Medium, but not high, density of recreational resources in the area surrounding a school was associated with greater annual improvements in fitness for both boys and girls. This association appeared to be driven mainly by the presence of parks. Findings for sports facilities and playgrounds were inconsistent. Overall, few associations were observed between recreational resources near a school and changes in student fitness. Future studies of school influences on student fitness should consider the influence of school resources and the home neighborhood.
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Affiliation(s)
- Carla P Bezold
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA, 02115, USA.
| | - James H Stark
- Worldwide Safety and Regulatory, Pfizer Inc., New York, NY, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Kevin Konty
- Office of School Health, NYC Department of Health and Mental Hygiene, New York, NY, USA
| | - Sophia E Day
- Office of School Health, NYC Department of Health and Mental Hygiene, New York, NY, USA
| | - James Quinn
- Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | | | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA
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Duncan DT, Méline J, Kestens Y, Day K, Elbel B, Trasande L, Chaix B. Walk Score, Transportation Mode Choice, and Walking Among French Adults: A GPS, Accelerometer, and Mobility Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13060611. [PMID: 27331818 PMCID: PMC4924068 DOI: 10.3390/ijerph13060611] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 11/22/2022]
Abstract
Background: Few studies have used GPS data to analyze the relationship between Walk Score, transportation choice and walking. Additionally, the influence of Walk Score is understudied using trips rather than individuals as statistical units. The purpose of this study is to examine associations at the trip level between Walk Score, transportation mode choice, and walking among Paris adults who were tracked with GPS receivers and accelerometers in the RECORD GPS Study. Methods: In the RECORD GPS Study, 227 participants were tracked during seven days with GPS receivers and accelerometers. Participants were also surveyed with a GPS-based web mapping application on their activities and transportation modes for all trips (6969 trips). Walk Score, which calculates neighborhood walkability, was assessed for each origin and destination of every trip. Multilevel logistic and linear regression analyses were conducted to estimate associations between Walk Score and walking in the trip or accelerometry-assessed number of steps for each trip, after adjustment for individual/neighborhood characteristics. Results: The mean overall Walk Scores for trip origins were 87.1 (SD = 14.4) and for trip destinations 87.1 (SD = 14.5). In adjusted trip-level associations between Walk Score and walking only in the trip, we found that a walkable neighborhood in the trip origin and trip destination was associated with increased odds of walking in the trip assessed in the survey. The odds of only walking in the trip were 3.48 (95% CI: 2.73 to 4.44) times higher when the Walk Score for the trip origin was “Walker’s Paradise” compared to less walkable neighborhoods (Very/Car-Dependent or Somewhat Walkable), with an identical independent effect of trip destination Walk Score on walking. The number of steps per 10 min (as assessed with accelerometry) was cumulatively higher for trips both originating and ending in walkable neighborhoods (i.e., “Very Walkable”). Conclusions: Walkable neighborhoods were associated with increases in walking among adults in Paris, as documented at the trip level. Creating walkable neighborhoods (through neighborhood design increased commercial activity) may increase walking trips and, therefore, could be a relevant health promotion strategy to increase physical activity.
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Affiliation(s)
- Dustin T Duncan
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA.
- College of Global Public Health, New York University, New York, NY 10016, USA.
- Population Center, New York University, New York, NY 10016, USA.
- Center for Data Science, New York University, New York, NY 10016, USA.
| | - Julie Méline
- Inserm, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Nemesis Team, Paris 75012, France.
- Sorbonne Universités, UPMC Unv Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Nemesis Team, Paris 75012, France.
| | - Yan Kestens
- Department of Social and Preventive Medicine, École de Santé Publique de l'Université de Montréal, Montreal, Montréal, QC H3N 1X9, Canada.
| | - Kristen Day
- Department of Technology, Culture and Society, New York University Tandon School of Engineering, New York, NY 11201, USA.
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA.
- Wagner School of Public Service, New York University, New York, NY 10012, USA.
| | - Leonardo Trasande
- Department of Population Health, New York University School of Medicine, New York, NY 10016, USA.
- College of Global Public Health, New York University, New York, NY 10016, USA.
- Departments of Pediatrics and Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA.
| | - Basile Chaix
- Inserm, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Nemesis Team, Paris 75012, France.
- Sorbonne Universités, UPMC Unv Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Nemesis Team, Paris 75012, France.
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Moore JB, Beets MW, Morris SF, Kolbe MB. Comparison of objectively measured physical activity levels of rural, suburban, and urban youth. Am J Prev Med 2014; 46:289-92. [PMID: 24512868 DOI: 10.1016/j.amepre.2013.11.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 10/28/2013] [Accepted: 11/14/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nationally, youth are generally not achieving 60 minutes of daily moderate-to-vigorous physical activity (MVPA). Studies suggest that rural adults are less active than their urban counterparts, although studies of children are equivocal. PURPOSE To compare objectively measured physical activity across the rural-urban continuum in a sample of fourth- to eighth-grade youth. METHODS In fall 2010, youth from 20 North Carolina counties wore an accelerometer a minimum of 4 monitored days (n=804, 54% female, 25% African American, 54% urban). In spring 2013, two random-effects regression models were estimated separately for boys and girls. Comparisons among minutes of MVPA/day continuous and binary (≥60 minutes vs <60 minutes MVPA/day) among rural, suburban, and urban children were made, controlling for race, monitor wear time, and grade. RESULTS For boys, there were no differences in MVPA/day among urbanicity categories. However, a 4.2 minutes/day decrease in MVPA occurred with each increase in grade. For girls, rural girls accumulated 9.3 minutes MVPA/day and 8.0 minutes MVPA/day more than suburban and urban girls, respectively. A 3 minutes/day decrease in MVPA occurred with each increase in grade. Rural girls were 4.6 times and 2.8 times more likely to accumulate ≥60 minutes MVPA/day compared to suburban and urban girls, respectively. No interactions across all models were significant for boys or girls. CONCLUSIONS The relationship between urbanicity and MVPA in youth appears to be more complex than previously envisioned. Rural residence appears to be supportive of MVPA in girls but not boys. Future research should consider urbanicity when investigating correlates/determinants of MVPA in youth.
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Affiliation(s)
- Justin B Moore
- Department of Health Promotion, Education, and Behavior and Office of Public Health Practice, Columbia, South Carolina.
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Sara F Morris
- Durham Epidemiologic Research and Information Center, Durham Veterans Affairs Medical Center, Durham
| | - Mary Bea Kolbe
- Chronic Disease and Injury Section, North Carolina Division of Public Health, DHHS, Raleigh, North Carolina
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