Abstract 12776: Neighborhood Walkability is Not Associated With Attaining Recommended Physical Activity in a Behavioral Weight Loss Trial Testing Remotely Delivered Feedback Messages

Abstract

Background: Adding feedback messages (FB) to self-monitoring (SM) can help reinforce behavior change. However, socio-environmental barriers such as limited access to parks and sidewalks (i.e., low walkability) may limit one’s ability to respond to FB focused on physical activity (PA). Hypothesis: Residents of high walkability neighborhoods receiving FB will have higher PA levels than those not receiving FB. Methods: Secondary analysis of a 12-month behavioral weight loss intervention (SMARTER trial) in which participants were randomized to either SM+FB (n=251) or SM alone (n=251) groups. The SM+FB group received a smartphone pop-up message every other day that was tailored to their PA patterns. Neighborhood walkability was assessed via Walk Score (0-100), PA via Fitbit Charge 2 tracker, and weight via Tanita scale. Key study variables included the walkability of neighborhoods (Walk Score: low [<50] vs. high [≥50]), and recommended PA (moderate-to-vigorous PA (MVPA) ≥150 min/week or step count ≥7500/day). Generalized linear mixed model results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results: The sample with complete PA data (n=297) was white (87.9%), female (78.1%), well educated (82% with ≥4 years of college), and on average 48.9±13.7 years of age. Compared to high walkability neighborhoods, low walkability neighborhoods had a higher proportion of the sample who were non-white (18.1% vs 8.3%, p=.011), <45 years of age (45.7% vs 31.5%, p=.013), and with household income <$60,000 (p<.0001) at baseline. After adjusting for these baseline differences and exercise self-efficacy, on average neighborhood walkability did not moderate the effect of FB on the attainment of the recommended MVPA (AOR=1.48, 95% CI: 0.72 - 3.06) or step count (AOR=1.05, 95% CI: 0.48 - 2.29) goal at 12 months. Furthermore, there were no significant treatment or time main effects or interactions observed (p≥0.05), suggesting that there was no significant change in PA over 12 months for both treatment groups. Conclusion: Our findings suggest that FB and neighborhood walkability did not have significant impact on attaining PA goals in the SMARTER weight loss trial. More studies are needed to replicate our work in a more diverse sample.