Improving Physical Activity among Residents of Affordable Housing: Is Active Design Enough?

Abstract

Physical inactivity increases risk of chronic disease. Few studies examine how built environment interventions increase physical activity (PA). Active design (AD) utilizes strategies in affordable housing to improve resident health. We assessed how AD housing affects PA among low-income families in Brooklyn, New York. Participants were recruited at lease signings in 2016 from a new AD apartment complex and two recently renovated comparison buildings without AD features. Eligibility included age ≥18 years with no contraindications to exercise. Anthropometric data were collected. PA was self-reported using the Recent and Global Physical Activity Questionnaires. Smartphone users shared their tracked step. Data collection was repeated one year after move-in. All data were analyzed using SPSS. Eighty-eight eligible participants completed the initial questionnaire (36 AD and 52 from 2 comparison buildings) at baseline (T0). There were no differences between AD and comparison cohorts in: stair use, PA, sitting time or, mean waist-to-hip ratio (WHR) at T0. However, the AD cohort had a lower baseline BMI (27.6 vs. 31.0, p = 0.019). At one-year follow-up (T1), 75 participants completed our survey including a 64% retention rate among those who previously completed the T0 questionnaire. Among T0 questionnaire respondents, mean daily steps increased at T1 among AD participants who moved from an elevator building (∆6782, p = 0.051) and in the comparison group (∆2960, p = 0.023). Aggregate moderate work-related activity was higher at T1 in the AD building (746 vs. 401, p = 0.031). AD building women reported more work-related PA overall but AD men engaged in more moderate recreational PA. Living in an AD building can enhance low-income residents’ PA. More research with objective measures is needed to identify strategies to sustain higher PA levels and overall health.