Home Neighborhood Environment Research Articles

O5-5 Neighbourhood Walkability and Physical Activity: Moderating Role of a Physical Activity Interventions in Overweight and Obese Older Adults with Metabolic Syndrome

BackgroundWhile urban built environments might promote active ageing, an infrequently studied question is how the neighbourhood walkability modulates physical activity changes during a physical activity intervention program in older adults. We assessed the influence of objectively assessed neighbourhood walkability on the change in physical activity during the intervention program used in the ongoing PREvención con DIeta MEDiterránea (PREDIMED)-Plus trial. PREDIMED-Plus is a parallel-group, randomized trial which tested the effect of an intensive lifestyle intervention on cardiovascular disease prevention, in overweight and obese participants with the metabolic syndrome.MethodThe present study involved 228 PREDIMED-Plus senior participants aged between 55 to 75, recruited in Palma de Mallorca (Spain). Overweight/obese older adults with metabolic syndrome were randomized to an intensive weight-loss lifestyle intervention or a control group (106 intervention group and 122 control group). A home neighborhood environment walkability index (residential density, land use mix, intersections density) was calculated using geographic information systems (1km sausage-network buffer). Physical activity was assessed using accelerometer for seven days, and a REGICOR validated physical activity questionnaire, at baseline and 2 follow-up visits (six-months and one-year later). Generalized Additive Mixed Models (GAMMs) were fitted to estimate the association between the neighbourhood walkability index and changes in physical activity during follow-up.ResultsHigher neighbourhood walkability (1 z-score increment) was associated with moderate-to-vigorous accelerometer assessed physical activity duration, (ß = 3,44; 95% CI = 0.52;6.36 minutes per day). When analyses were stratified by intervention arm, the association was only observed in the intervention group (ß = 6.357; 95% CI = 2.07;10.64 minutes per day) (p for interaction = 0.055). There were no statistically significant associations between neighbourhood walkability and self-reported physical activity nor brisk walking duration.ConclusionsThe results indicate that the walkability of the neighbourhood could support a physical activity intervention, helping to maintain or increase older adults' objectively measured physical activity. This research may modify evidence on whether environmental factors modify habits acquisition during physical activity intervention programs.

Abstract P070: Individual And Environmental Correlates Of Objectively Assessed Physical Activity Levels In Rural Residents

Introduction: Rural communities in the US face disproportionately higher rates of physical inactivity as well as coronary heart disease mortality, when compared to their urban and suburban counterparts. As such, increasing physical activity (PA) and reducing barriers to PA is critical in improving population health. Neighborhood characteristics have been shown to influence PA, but are understudied in rural communities. The current analysis: (1) describes PA patterns in rural mid-western communities, and (2) examines the associations of and interactions between individual and environmental correlates of objectively assessed weekly moderate to vigorous physical activity (MVPA) minutes. Hypotheses: Overall, we expected low levels of weekly MVPA in rural residents; with lower levels anticipated in female, older, and low-income participants. We also expected positive associations of favorable perceptions of the neighborhood environment, trail use, and self-efficacy for PA with weekly MVPA. Finally, the test of interactions between intrapersonal and perceived environmental factors in relation to weekly MVPA is exploratory. Methods: Telephone surveys were conducted with 280 adults in 14 rural southeast Missouri communities, who were also asked to wear accelerometer devices for seven days. Participants were recruited via address-based sampling, and at local community events. Participants self-reported demographic information (age, sex, income), individual level behavioral factors (self-efficacy for PA, trail use) and neighborhood environment perceptions (indoor recreational access, safety from traffic, home neighborhood environment). Weekly MVPA minutes were assessed using the accelerometry data. Generalized linear mixed models using a negative binomial distribution were used examining associations of and interactions between individual characteristics and environmental correlates with weekly MVPA (Analyses were conducted using STATA V15). Results: Participants had a weekly average of 97 minutes MVPA, with 21% meeting PA guidelines. Increased age and being female were significantly associated with lower weekly MVPA. Additionally, increased self-efficacy and trail use were significantly associated with higher weekly MVPA. When exploring interaction effects, there was a significant interaction between gender and safety from traffic. For females, increased perceived safety from traffic was associated with lower MVPA. Conclusions: Rural residents have low levels of PA with less than a quarter meeting PA guidelines (75 minutes of vigorous and/or 150 minutes of moderate PA per week). Specifically, female residents face disproportionately lower levels of MVPA, with only 75 weekly minutes compared to 135 weekly minutes in males. Promoting trail use and targeting self efficacy for PA, may be effective strategies for increasing PA in rural residents.

Residential neighborhood features associated with objectively measured walking near home: Revisiting walkability using the Automatic Context Measurement Tool (ACMT).

Many distinct characteristics of the social, natural, and built neighborhood environment have been included in walkability measures, and it is unclear which measures best describe the features of a place that support walking. We developed the Automatic Context Measurement Tool, which measures neighborhood environment characteristics from public data for any point location in the United States. We explored these characteristics in home neighborhood environments in relation to walking identified from integrated GPS, accelerometer, and travel log data from 681 residents of King Country, WA. Of 146 neighborhood characteristics, 92 (63%) were associated with walking bout counts after adjustment for individual characteristics and correction for false discovery. The strongest built environment predictor of walking bout count was housing unit count. Models using data-driven and a priori defined walkability measures exhibited similar fit statistics. Walkability measures consisting of different neighborhood characteristic measurements may capture the same underlying variation in neighborhood conditions.

Higher residential and employment densities are associated with more objectively measured walking in the home neighborhood

IntroductionUnderstanding where people walk and how the built environment influences walking is a priority in active living research. Most previous studies were limited by self-reported data on walking. In the present study, walking bouts were determined by integrating one week of accelerometry, GPS, and a travel log data among 675 adult participants in the baseline sample of the Travel Assessment and Community study at Seattle, Washington in the United State. MethodsHome neighborhood was defined as being within 0.5 mile of each participants’ residence (a 10–min walk), with home neighborhood walking defined as walking bout lines with at least one GPS point within the home neighborhood. Home neighborhood walkability was constructed with seven built environment variables derived from spatially continuous objective values (SmartMaps). Collinearity among neighborhood environment variables was analyzed and variables that were strongly correlated with residential density were excluded in the regression analysis to avoid erroneous estimates. A Zero Inflated Negative Binomial (ZINB) served to estimate associations between home neighborhood environment characteristics and home neighborhood walking frequency. ResultsThe study found that more than half of participants’ walking bouts occurred in their own home neighborhood. Higher residential density and job density were the two neighborhood walkability measures related to higher likelihood and more time walking in the home neighborhood, highest tertile residential density (22.4–62.6 unit/ha) (coefficient = 1.43; 95% CI 1.00–2.05) and highest tertile job density (12.4–272.3 jobs/acre) (coefficient = 1.62; 1.10–2.37). ConclusionsThe large proportion of walking that takes place in the home neighborhood highlights the importance of continuing to examine the impact of the home neighborhood environment on walking. Potential interventions to increase walking behavior may benefit from increasing residential and employment density within residential areas.

Exploring Neighborhood Environments and Active Commuting in Chennai, India.

Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, poor enforcement of traffic rules and regulations, air pollution, and overcrowding. This cross-sectional study investigated associations between home neighborhood environment characteristics and active commuting in Chennai, India. Adults (N = 370, 47.2% female, mean age = 37.9 years) were recruited from 155 wards in the metropolitan area of Chennai in southern India between January and June 2015. Participants self-reported their usual mode of commute to work, with responses recoded into three categories: (1) multi-modal or active commuting (walking and bicycling; n = 56); (2) public transit (n = 52); and (3) private transport (n = 111). Environmental attributes around participants’ homes were assessed using the Neighborhood Environment Walkability Scale for India (NEWS-India). Associations between environmental characteristics and likelihood of active commuting and public transit use were modeled using logistic regression with private transport (driving alone or carpool) as the reference category, adjusting for age, gender, and household car ownership. Consistent with other international studies, participants living in neighborhoods with a mix of land uses and a transit stop within a 10-minute walk from home were more likely to use active commuting (both p < 0.01). Land-use mix was significantly associated with the use of public transit compared to private transport (adjusted odds ratio (aOR) = 5.2, p = 0.002). Contrary to findings in high-income countries, the odds of active commuting were reduced with improved safety from crime (aOR = 0.2, p = 0.003), aesthetics (aOR = 0.2, p = 0.05), and street connectivity (aOR = 0.2, p = 0.003). Different environmental attributes were associated with active commuting, suggesting that these relationships are complex and may distinctly differ from those in high-income countries. Unexpected inverse associations of perceived safety from crime and aesthetics with active commuting emphasize the need for high-quality epidemiologic studies with greater context specificity in the study of physical activity in LMICs. Findings have public health implications for India and suggest that caution should be taken when translating evidence across countries.

Work and Home Neighborhood Design and Physical Activity.

To investigate relations of perceived worksite neighborhood environments to total physical activity and active transportation, over and above home neighborhood built environments. Observational epidemiologic study. Baltimore, Maryland-Washington, DC, and Seattle-King County, Washington metropolitan areas. One thousand eighty-five adults (mean age = 45.0 [10.2]; 46% women) recruited from 32 neighborhoods stratified by high/low neighborhood income and walkability. The Neighborhood Environment Walkability Survey assessed perceptions of worksite and home neighborhood environments. Accelerometers assessed total moderate-to-vigorous physical activity (MVPA). The International Physical Activity Questionnaire assessed total active transportation and active transportation to and around work. Mixed-effects regression tested relations of home and worksite neighborhood environments to each physical activity outcome, adjusted for demographics. Home and worksite mixed land use and street connectivity had the most consistent positive associations with physical activity outcomes. Worksite traffic and pedestrian safety were also associated with multiple physical activity outcomes. The worksite neighborhood explained additional variance in physical activity outcomes than explained by the home neighborhood. Worksite and home neighborhood environments interacted in explaining active transportation to work, with the greatest impacts occurring when both neighborhoods were activity supportive. Both worksite and home neighborhood environments were independently related to total MVPA and active transportation. Community design policies should target improving the physical activity supportiveness of worksite neighborhood environments and integrating commercial and residential development.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain.

There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance.

Choice of commuting mode among employees: Do home neighborhood environment, worksite neighborhood environment, and worksite policy and supports matter?

BackgroundPromoting the use of public transit and active transport (walking and cycling) instead of car driving is an appealing strategy to increase overall physical activity. PurposeTo quantify the combined associations between self-reported home and worksite neighborhood environments, worksite support and policies, and employees’ commuting modes. MethodBetween 2012 and 2013, participants residing in four Missouri metropolitan areas were interviewed via telephone (n=1338) and provided information on socio-demographic characteristics, home and worksite neighborhoods, and worksite support and policies. Commuting mode was self-reported and categorized into car driving, public transit, and active commuting. Commuting distance was calculated using geographic information systems. Commuters providing completed data were included in the analysis. Multivariate logistic regression models were used to examine the correlates of using public transit and active commuting. ResultThe majority of participants reported commuting by driving (88.9%); only 4.9% used public transit and 6.2% used active modes. After multivariate adjustment, having transit stops within 10–15min walking distance from home (p=0.05) and using worksite incentive for public transit (p<0.001) were associated with commuting by public transit. Commuting distance (p<0.001) was negatively associated with active commuting. Having free or low cost recreation facilities around the worksite (p=0.04) and using bike facilities to lock bikes at the worksite (p<0.001) were associated with active commuting. ConclusionBoth environment features and worksite supports and policies are associated with the choice of commuting mode. Future studies should use longitudinal designs to investigate the potential of promoting alternative commuting modes through worksite efforts that support sustainable commuting behaviors as well as the potential of built environment improvements.

Parental safety concerns and active school commute: correlates across multiple domains in the home-to-school journey

BackgroundEmpirical evidence of the relationship between safety concerns and walking to school (WTS) is growing. However, current research offers limited understanding of the multiple domains of parental safety concerns and the specific mechanisms through which parents articulate safety concerns about WTS. A more detailed understanding is needed to inform environmental and policy interventions. This study examined the relationships between both traffic safety and personal safety concerns and WTS in the U.S.MethodsThis cross-sectional analysis examined data from the Texas Childhood Obesity Prevention Policy Evaluation (T-COPPE) project, an evaluation of state-wide obesity prevention policy interventions. All study data were from the survey (n = 830) of parents with 4th grade students attending 81 elementary schools across Texas, and living within two miles from their children's schools. Traffic safety and personal safety concerns were captured for the home neighborhood, en-route to school, and school environments. Binary logistic regression analysis was used to assess the odds of WTS controlling for significant covariates.ResultsOverall, 18% of parents reported that their child walked to school on most days of the week. For traffic safety, students were more likely to walk to school if their parent reported favorable perceptions about the following items in the home neighborhood environment: higher sidewalk availability, well maintained sidewalks and safe road crossings. For the route to school, the odds of WTS were higher for those who reported "no problem" with each one of the following: traffic speed, amount of traffic, sidewalks/pathways, intersection/crossing safety, and crossing guards, when compared to those that reported "always a problem". For personal safety in the en-route to school environment, the odds of WTS were lower when parents reported concerns about: stray or dangerous animals and availability of others with whom to walk.ConclusionsFindings offered insights into the specific issues that drive safety concerns for elementary school children’s WTS behaviors. The observed associations between more favorable perceptions of safety and WTS provide further justification for practical intervention strategies to reduce WTS barriers that can potentially bring long-term physical activity and health benefits to school-aged children.

Children’s physical activity and parents’ perception of the neighborhood environment: neighborhood impact on kids study

BackgroundPhysical activity is important to children’s physical health and well-being. Many factors contribute to children’s physical activity, and the built environment has garnered considerable interest recently, as many young children spend much of their time in and around their immediate neighborhood. Few studies have identified correlates of children’s activity in specific locations. This study examined associations between parent report of their home neighborhood environment and children’s overall and location-specific physical activity.MethodsParents and children ages 6 to 11 (n=724), living in neighborhoods identified through objective built environment factors as high or low in physical activity environments, were recruited from Seattle and San Diego metropolitan areas, 2007–2009. Parents completed a survey about their child’s activity and perceptions of home neighborhood environmental attributes. Children wore an accelerometer for 7 days. Multivariate regression models explored perceived environment correlates of parent-reported child’s recreational physical activity in their neighborhood, in parks, and in general, as well as accelerometry-based moderate-to-vigorous activity (MVPA) minutes.ResultsParent-reported proximity to play areas correlated positively with both accelerometery MVPA and parent-reported total child physical activity. Lower street connectivity and higher neighborhood aesthetics correlated with higher reported child activity in the neighborhood, while reported safety from crime and walk and cycle facilities correlated positively with reported child activity in public recreation spaces.ConclusionsDifferent aspects of parent’s perceptions of the neighborhood environment appear to correlate with different aspects of children’s activity. However, prioritizing closer proximity to safe play areas may best improve children’s physical activity and, in turn, reduce their risk of obesity and associated chronic diseases.