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Which aspects of neighbourhood environment are most associated with meeting physical activity recommendations in American adults: an NHIS study.

ABSTRACT: OBJECTIVES:To investigate which perceived neighbourhood characteristics are most strongly linked with adequate physical activity (PA) in a nationally representative sample of adults in the USA. DESIGN:Cross-sectional. SETTING:USA via 2015 National Health Interview Survey Data. PARTICIPANTS:A group of 28?697 non-institutionalised adults with complete data. PRIMARY OUTCOME MEASURES:Meeting PA was defined as 150?min/week of moderate to vigorous activity. RESULTS:The population had a mean age of 49.6 (±18.3) years and was 51.3% female and 66.2% non-Hispanic white. In adjusted, weighted analysis, places to walk and relax was mostly strongly associated with meeting PA recommendations (OR=1.40 (95% CI 1.27 to 1.54)). Other elements associated with meeting PA were presence of bus or transit stops to walk to and presence of movies, libraries or churches to walk to (OR=1.12 (95% CI 1.03 to 1.23) and OR=1.19 (95% CI 1.08 to 1.31), respectively). CONCLUSIONS:In this analysis, the characteristic most strongly associated with PA was presence of places to walk and relax. Identifying communities that may lack amenities such as this, like a park, may help direct community investment to enhance structures that encourage activity.

SUBMITTER: Gebauer SC

PROVIDER: S-EPMC7526292 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Which aspects of neighbourhood environment are most associated with meeting physical activity recommendations in American adults: an NHIS study.

Gebauer Sarah C SC Salas Joanne J Scherrer Jeffrey J Callahan Leigh F LF

BMJ open 20200929 9

<h4>Objectives</h4>To investigate which perceived neighbourhood characteristics are most strongly linked with adequate physical activity (PA) in a nationally representative sample of adults in the USA.<h4>Design</h4>Cross-sectional.<h4>Setting</h4>USA via 2015 National Health Interview Survey Data.<h4>Participants</h4>A group of 28 697 non-institutionalised adults with complete data.<h4>Primary outcome measures</h4>Meeting PA was defined as 150 min/week of moderate to vigorous activity.<h4>Resul ...[more]

PMID: 32994249

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Project description:Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes-dwelling density, street connectivity, and neighbourhood destination accessibility-using seven different neighbourhood definitions (three administrative unit boundaries, and 500, 800, 1000- and 1500-m road network buffers). The associations between the three built environment measures and five measures of physical activity (mean accelerometer counts per hour, percentage time in moderate-vigorous physical activity, self-reported walking for transport, self-reported walking for recreation and self-reported walking for all purposes) were modelled for each neighbourhood definition. The combination of the choice of neighbourhood definition, built environment measure, and physical activity measure determined whether evidence of an association was detected or not. Results demonstrated that, while there was no single ideal neighbourhood definition, the built environment was most consistently associated with a range of physical activity measures when the 800-m and 1000-m road network buffers were used. For the street connectivity and destination accessibility measures, associations with physical activity were less likely to be detected at smaller scales (less than 800 m). In line with some previous research, this study demonstrated that the choice of neighbourhood definition can influence whether or not an association between the built environment and adults' physical activity is detected or not. This study additionally highlighted the importance of the choice of built environment attribute and physical activity measures. While we identified the 800-m and 1000-m road network buffers as the neighbourhood definitions most consistently associated with a range of physical activity measures, it is important that researchers carefully consider the most appropriate type of neighbourhood definition and scale for the particular aim and participants, especially at smaller scales.

Project description:BackgroundExisting physical activity guidelines predominantly focus on healthy age-stratified target groups. The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18-65?years) with noncommunicable diseases (NCDs).MethodsThe PA recommendations were developed based on existing PA recommendations. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria, and high-quality recommendations were analysed. In phase 3, PA recommendations for seven chronic conditions were deducted and then synthesised to generate generic German PA recommendations for adults with NCDs. In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs.ResultsThe German recommendations for physical activity state that adults with NCDs should, over the course of a week, do at least 150?min of moderate-intensity aerobic PA, or 75?min of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs.ConclusionThe development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.

Project description:ObjectivesThis population-based observational study explores the associations between individual-level and neighbourhood-level indices of active living with inpatient mental healthcare use among adults with an underlying chronic cardiometabolic condition.Design and settingData from the 2013-2014 Canadian Community Health Survey were linked longitudinally to hospital records from the 2013/2014‒2017/2018 Discharge Abstract Database and to a geocoded measure of active living environments (ALE). Relationships between individuals' leisure-time physical activity and neighbourhood ALE with risk of hospital admission for mental health disorders were assessed using multivariable Cox regressions.ParticipantsA national cohort was identified from the survey data of 24 960 respondents aged 35 years and above reporting having been diagnosed with diabetes, hypertension and/or heart disease.Outcome measurePotentially avoidable hospitalisation for a mood, anxiety or substance use disorder over a 5-year period.ResultsMore than half (52%) of adults aged 35 years and above with a cardiometabolic disease were physically inactive in their daily lives, and one-third (34%) resided in the least activity-friendly neighbourhoods. The rate of being hospitalised at least once for a comorbid mental disorder averaged 8.1 (95% CI: 7.0 to 9.3) per 1000 person-years of exposure. Individuals who were at least moderately active were half as likely to be hospitalised for a comorbid mental health problem compared with those who were inactive (HR: 0.50 (95% CI: 0.38 to 0.65)). No statistically discernible associations between neighbourhood ALE and hospitalisation risks were found after controlling for individuals' behaviours and characteristics, including in separate models stratified by age group and by sex.ConclusionsThe evidence base to support prioritisation of interventions focusing on the built environment favouring mental health-promoting physical activity among higher-risk adults at the population level, independently of individual-level behaviours and characteristics, remains limited.

Project description:The up-to-date scientific evidence suggests that adequate levels of physical activity provide essential health benefits for children and adolescents and help to maintain a healthy body weight. In this sense, children and adolescents should at least accumulate 60 min of moderate-to-vigorous physical activity in a daily basis to achieve these benefits and be considered active. Likewise, some lifestyle-related elements may interact with each other in an antagonistic or synergistic way to modify physical activity status. Thus, a better understanding of how meeting physical activity recommendations influences these potentially modifiable lifestyle factors (obesity-related parameters, physical fitness, dietary habits, or sedentary behaviour) would significantly reinforce the importance of complying with those recommendations from a health perspective and support the establishment of strategies for the promotion of diminishing the lower trends of physical activity among the young population. This study seeks to verify the association of meeting physical activity international recommendations with obesity-related parameters, global physical fitness, screen time, and Mediterranean diet in Spanish schoolchildren aged 8 to 13. A cross-sectional study was performed including 250 schoolchildren (41.2% girls) aged 8-13 (9.7 ± 1.2) from six primary schools in the Region of Murcia (Spain). Results: A higher proportion of children who complying with physical activity recommendations shows normal weight, no abdominal obesity, and low adiposity in comparison to other with different obesity-related parameters categories. Higher values in global physical fitness score were found in those who meet the physical activity international recommendations in both sexes. These higher values were also shown for adherence to the Mediterranean diet in both sexes; not being so in the case of screen time. Notwithstanding, none of these mean differences were statistically significant. To conclude, the proportion of schoolchildren meeting the physical activity recommendations in our study is low. A higher proportion of children who meet with physical activity recommendations present normal weight, no abdominal obesity and low adiposity in comparison to other obesity-related parameters categories in both sexes. Likewise, those considered as active children seem to have higher global physical fitness score and adherence to the Mediterranean diet than children who do not meet the recommendations.

Project description:BACKGROUND:Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. METHODS:This study examined data from 8185 adults (aged 18-65?years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix-diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. RESULTS:Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10?min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10?min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. CONCLUSIONS:Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. TRIAL REGISTRATION:ClinicalTrials. Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Project description:BackgroundIntensity and duration of physical activity are associated with the achievement of health benefits. Our aim was to characterize physical activity behavior in terms of intensity, duration pattern, and adherence to the WHO physical activity recommendations in a population-based sample of adults from southern Germany. Further, we investigated associations between physical activity and sex, age, and body mass index (BMI), considering also common chronic diseases.MethodsWe analyzed 475 subjects (47% males, mean age 58 years, range 48-68 years) who wore ActiGraph accelerometers for up to seven days. Measured accelerations per minute obtained from the vertical axis (uniaxial) and the vector magnitude of all three axes (triaxial) were classified as sedentary, light or moderate-to-vigorous physical activity (MVPA) according to predefined acceleration count cut-offs. The average minutes/day spent in each activity level per subject served as outcome. Associations of sex, age, BMI, and seven chronic diseases or health limitations, with the activity levels were analyzed by negative binomial regression.ResultsMost of the wear time was spent in sedentarism (median 61%/day), whereas the median time spent in MVPA was only 3%, with men achieving more MVPA than women (35 vs. 28 minutes/day, p<0.05). Almost two thirds of MVPA was achieved in short bouts of less than 5 minutes, and 35% of the subjects did not achieve a single 10-minute bout. Hence, only 14% adhered to the WHO recommendation of 2.5 hours of MVPA/week in at least 10-minute bouts. Females, older subjects and obese subjects spent less time in MVPA (p<0.05), but no clear association with hypertension, asthma, diabetes, chronic obstructive pulmonary disease, anxiety/depression, pain or walking difficulties was observed in regression analyses with MVPA as outcome.ConclusionsActivity behavior among middle-aged German adults was highly insufficient, indicating a further need for physical activity promotion in order to gain health benefits.

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Which aspects of neighbourhood environment are most associated with meeting physical activity recommendations in American adults: an NHIS study.

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Which aspects of neighbourhood environment are most associated with meeting physical activity recommendations in American adults: an NHIS study.

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