Perceived Neighborhood Environment Research Articles

Unfavorable perceived neighborhood environment associates with less routine healthcare utilization: Data from the Dallas Heart Study.

Neighborhood environment perception (NEP) has been associated with health outcomes. However, little is known about how NEP relates to routine healthcare utilization. This study investigated the relationship between NEP and independent subfactors with healthcare utilization behavior, as measured by self-reported (1) usual source of healthcare and (2) time since last routine healthcare check-up. We used cross-sectional data from the Dallas Heart Study, which features a diverse, probability-based sample of Dallas County residents ages 18 to 65. We used logistic regression modeling to examine the association of self-reported NEP and routine healthcare utilization. NEP was assessed via a questionnaire exploring residents’ neighborhood perceptions, including violence, the physical environment, and social cohesion. Routine healthcare utilization was assessed via self-reported responses regarding usual source of care and time since last routine healthcare check-up. The analytic sample (N = 1706) was 58% black, 27% white, 15% Hispanic, 42% male, and had a mean age of 51 (SD = 10.3). Analysis of NEP by tertile demonstrated that younger age, lower income, and lower education were associated with unfavorable overall NEP (p trend <0.05 for each). After adjustment for potential confounders, including neighborhood deprivation, health insurance, disease burden and psychosocial factors, we found that individuals with more unfavorable perception of their physical environment were more likely to report lack of a usual source of care (p = 0.013). Individuals with more unfavorable perception of the neighborhood physical environment or greater neighborhood violence reported longer time periods since last routine visit (p = 0.001, p = 0.034 respectively). There was no relationship between perceived social cohesion and healthcare utilization. Using a multi-ethnic cohort, we found that NEP significantly associates with report of a usual source of care and time since last routine check-up. Our findings suggest that public health professionals should prioritize improving NEP since it may act as barrier to routine preventive healthcare and ideal health outcomes.

Associations between perceived neighborhood environment and cognitive function among middle-aged and older women and men: Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

To examine cross-sectional associations between perceived neighborhood environment and cognitive function among middle-aged and older Hispanic/Latino women and men. Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) and its Sociocultural Ancillary Study (2009-2010) were used. Participants were Hispanic/Latino women (n = 1812) and men (n = 1034) aged 45-74years. Survey-weighted linear regression models were used to examine associations between self-reported perceived neighborhood environment (i.e., neighborhood social cohesion and problems categorized as quintiles, and neighborhood safety from crime categorized as low, medium, or high) with cognitive function (i.e., global cognition, verbal learning, memory, verbal fluency, and processing speed scores) in women and men. Final model adjusted for age, Hispanic/Latino background, language, field site, household income, education, years lived in neighborhood, and depressive symptoms. Women in the lowest quintile of perceived neighborhood problems (vs. highest quintile) had higher global cognition (β 0.48, 95% CI 0.03, 0.94, p trend 0.229) and memory scores (0.60, 95% CI 0.11, 1.09, p trend: 0.060). Women in the highest quintile of perceived neighborhood social cohesion (vs. lowest quintile) had lower global cognition (β - 0.56, 95% CI - 1.02, - 0.09, p trend0.004), verbal learning(B - 1.01, 95% CI- 2.00,- 0.03,p trend 0.015),verbal fluency (B - 2.00, 95% CI - 3.83, - 0.16, p trend 0.006), and processing speed (B - 2.11, 95% CI - 3.87, - 0.36, p trend 0.009). There was no association between perceived neighborhood safety from crime and cognition among women, or between any perceived neighborhood environment measure and cognition among men. Middle-aged and older Hispanic/Latina women living in neighborhoods with the lowest perceived problems had higher global cognition and memory. Women living in neighborhoods with the highest perceived social cohesion had lower global cognition, verbal learning, verbal fluency, and processing speed.

Changes in perceptions of neighborhood environment and Cardiometabolic outcomes in two predominantly African American neighborhoods

BackgroundPerceived neighborhood characteristics, including satisfaction with one’s neighborhood as a place to live, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. Yet, few studies have evaluated whether changes in perceived neighborhood characteristics over time may be associated with cardiometabolic health indicators.MethodsChanges in perception of one’s neighborhood (2013–2016) were determined from a cohort of residents who lived in one of two low-income urban neighborhoods. Changes were categorized into the following: improvement vs. no change or worsening over the three-year time-period. Multivariable linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, DBP, HbA1c, HDL-c) that were assessed in 2016, and compared with those who perceived no change or worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, and years spent in neighborhood. To examine potential sex differences, follow-up models were conducted and stratified by sex.ResultsAmong the 622 individuals who remained in the same neighborhood during the time period, 93% were African American, 80% were female, and the mean age was 58 years. In covariate-adjusted models, those who perceived improvement in their neighborhood safety over the time period had a significantly higher BMI (kg/m2) than those who perceived no improvement or worsening (β = 1.5, p = 0.0162); however, perceived improvement in safety was also significantly associated with lower SBP (mmHg) (β = − 3.8, p = 0.0361). When results were stratified by sex, the relationship between improved perceived neighborhood safety and BMI was only evident in females.ConclusionsThese findings suggest that perceived neighborhood characteristics may impact cardiometabolic outcomes (BMI, SBP), but through differing pathways. This highlights the complexity of the associations between neighborhood characteristics and underscores the need for more longitudinal studies to confirm the associations with cardiometabolic health in African American populations.

Pregnant African American Women's Perceptions of Neighborhood, Racial Discrimination, and Psychological Distress as Influences on Birth Outcomes.

African American women are more likely to experience preterm birth compared with White women. Social factors such as neighborhood disorder and experiences of racial discrimination, which disproportionately affect African American women, may partially explain these disparities. The purpose of this study was to examine pregnant African American women's perceptions of neighborhood disorder, racial discrimination, and psychological distress and whether these concepts were viewed as influences on birth outcomes. Using a mixed-methods approach, seven pregnant African American women completed questionnaires including scales for neighborhood disorder (Ross Neighborhood Disorder Scale), racial discrimination (Experiences of Discrimination), and psychological distress (Center for Epidemiological Studies Depression Scale; Psychological General Well-Being Index). All constructs were also assessed by semistructured interviews. Within- and across-case analyses were conducted to compare agreement and discordance between the data sources for each construct and to note patterns in the data. The qualitative interviews provided data about women's experiences that were not captured by questionnaires alone. All of the women disclosed concerns about neighborhood conditions, experiences of discrimination, and psychological distress either reported on the questionnaires, during the qualitative interviews, or both. The mixed-methods approach provided a rich source of data that brought into focus the depth of the perceptions around these constructs. Maternal-child nurses should assess perceptions of neighborhood environment, racial discrimination, and psychological distress, as these factors may increase the risk for adverse pregnancy and birth outcomes.

Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study

ABSTRACT Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015–2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11–17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

Development and validation of the neighborhood environment walkability scale for youth across six continents

BackgroundThe IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents’ physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability.MethodsAdolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status.ResultsFinal country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity.ConclusionsA robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.

Multiple Linear Regression-Structural Equation Modeling Based Development of the Integrated Model of Perceived Neighborhood Environment and Quality of Life of Community-Dwelling Older Adults: A Cross-Sectional Study in Nanjing, China.

Due to the poor functioning in daily living activities, community-dwelling older adults spend more time in their neighborhood environment. The perceived neighborhood environment is crucial to their quality of life (QoL). To explore the complex influences of perceived neighborhood environment on QoL, a questionnaire was designed to measure their perception of each factor of neighborhood environment and each domain of QoL. Based on collected data, the reliability test was applied to revise the questionnaire. Multiple linear regression (MLR) and structural equation modeling (SEM) were adopted to hypothesize and test the integrated model for community-dwelling older adults. The results show that community-dwelling older adults’ perceptions of neighbor support, facilities related to physical exercise and recreation, and accessibility to facilities impact their overall QoL with diverse coefficients of 0.437, 0.312, and 0.295, respectively; neighbor support (0.207) on physical health; sidewalk condition (0.134), natural environment (0.260), and facilities related to daily life (0.165) on psychological health; and neighbor support (0.298), facilities related to daily life (0.206), and design-related safety (0.225) on social relationship. This revealed that perceptions of neighborhood environment have diverse impacts on their QoL. This study can provide targeted retrofit strategies for communities to enhance QoL of community-dwelling older adults efficiently.

Relative importance of perceived physical and social neighborhood characteristics for depression: a machine learning approach

PurposeThe physical and social neighborhood environments are increasingly recognized as determinants for depression. There is little evidence on combined effects of multiple neighborhood characteristics and their importance. Our aim was (1) to examine associations between depression severity and multiple perceived neighborhood environments; and (2) to assess their relative importance.MethodsCross-sectional data were drawn from a population-representative sample (N = 9435) from the Netherlands. Depression severity was screened with the Patient Health Questionnaire (PHQ-9) and neighborhood perceptions were surveyed. Supervised machine learning models were employed to assess depression severity-perceived neighborhood environment associations.ResultsWe found indications that neighborhood social cohesion, pleasantness, and safety inversely correlate with PHQ-9 scores, while increasing perceived distance to green space and traffic were correlated positively. Perceived distance to blue space and urbanicity seemed uncorrelated. Young adults, low-income earners, low-educated, unemployed, and divorced persons were more likely to have higher PHQ-9 scores. Neighborhood characteristics appeared to be less important than personal attributes (e.g., age, marital and employment status). Results were robust across different ML models.ConclusionsThis study suggested that the perceived social environment plays, independent of socio-demographics, a role in depression severity. Contrasted with person-level and social neighborhood characteristics, the prominence of the physical neighborhood environment should not be overstated.

Citizens’ perceptions of the health-related neighbourhood environment in Limassol, Cyprus

Abstract Background “Place” can impact on health and quality of life. There is a growing interest in neighbourhood audits. In the context of developing the CyNOTes audit tool, a residents’ perception of the neighbourhood environment survey was performed. Methods A systematic random sample of ten adult residents (N = 150) across a stratified sample of fifteen neighbourhoods according to educational attainment as per census data responded to the “Place Standard” tool which assesses 14 aspects of the physical, built and social neighbourhood environment. Neighbourhoods were also audited using the 126-item CyNOTes. Results Three in four participants were home owners and lived in the neighbourhood for over 10 years. With the exception of “identity and sense of belonging” (M = 5.8, SD = 2.0) and “opportunities for social interaction” (M = 5.3, SD = 2.1), physical and built aspects of the environment were rated close to the middle point on a scale 1: large to 7: little room for improvement. “Parks, playgrounds and green space” and “garbage, animal droppings and other physical disorder” were the most commonly mentioned priorities for action in the free text by one in three participants. The lowest score was recorded for “influence and sense of control” (M = 3.4, SD = 2.4). While on a 1-10 subjective perception of neighbourhood position, residents in lower education neighbourhoods gave a rating of 6.6 on average compared to 8.1 in the higher group, they tended to rate aspects of their neighbourhood more favourably. Even though the audit revealed a systematic pattern of less favourable conditions along the socio-economic continuum, the perception survey revealed a U-pattern with residents in the middle category more likely to give less favourable ratings. Conclusions The extent to which perceptions surveys may be affected by differential expectations across social groups is not clear. Neighborhood audits provide supplementary profiles of “place” independent of the perceptions of residents. Key messages Based on the Place Standard tool, Limassol residents’ rate social aspects of their neighbourhood environment more favourably than aspects of the built and physical environment. Neighbourhood observed-based audits, independent of residents’ perceptions surveys can supplement each other in city health profiling.

“Is anyone walking in our neighborhoods?”: Citizens’ experience of the neighbourhood environment

Abstract Background Several generic or feature-specific neighbourhood audit tools have been developed in recent years. In the context of developing the Cyprus Neighbourhood Observation Tool for auditing urban environments (CyNOTes), a virtual ethnographic study of citizens’ perceptions of their neighbourhood environment was performed. Methods The municipality and mayor’s Facebook were reviewed for posts related to neighbourhood environment over a 12-month period (e.g. regeneration projects). Comments were content analysed using a deductive as well as an inductive approach to gain an in-depth understanding of citizens’ perceptions of neighbourhood environment. Results 348 comments to 27 relevant posts were identified. The unit of analysis was sentences or short phrases and 289 CMU were identified. The central theme was “Citizens’ voice”. Six themes and several sub-themes emerged. “Comparisons” to contrast the differing conditions between high-profile locations versus “left out” residential neighbourhoods (“Yes, the city centre, the waterfront is a jewel, what about the neighborhoods?”) or to compare their experience to “another place-another time”. They express “Mixed feelings” ranging from “hope” to “disbelief” about proposed actions. Citizens are referring to “Consequences” of neighbourhood adverse environment on “Quality of Life” or “Local ecomomy and housing” and identify “Causes” in “Money and Power” or “Lack of vision and planning”. They are placing “Responsibility” in both “Authorities’ inaction” as well as “Everyone’s role”. “Suggestions” included measures related to “Law and Order” as well as “Citizens’ participation”. Conclusions Citizens voice their experiences of the neighbourhood environment lack of influence and control and demand for more involvement in decision-making. They blame authorities for neighbourhood problems but also recognize the lack of individual responsibility, suggesting policing and punitive measures and stronger collective action. Key messages A virtual ethnographic study of citizens’ comments on social media offers an in-depth understanding of the neighbourhood experience. Citizens want to have a “voice” to express their concerns about neighbourhood problems as well as to participate in decision-making.

The association of perceived neighborhood walkability and environmental pollution with frailty among community-dwelling older adults in rural areas

OPS 31: Health effects of multiple environmental stressors, Room 412, Floor 4, August 27, 2019, 1:30 PM - 3:00 PM Background/Aim: Frailty is one of the most problematic expression of population ageing. Older adults are often targeted for interventions to prevent frailty, especially interventions that focus on physical activity and socialization. However, the role of neighborhood environments in influencing old people’s physical activity levels, social participation and accessibility has not been fully investigated. The aim of this study was to evaluate the association of perceived neighborhood walkability and environmental pollution with frailty among community-dwelling older adults in rural areas. Methods: Participants were 807 community-dwelling men and women aged 65 years and older in two rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environments (walkability and environmental pollution), and frailty, was collected using face-to-face interviews in June 2018 to August 2018. Walkability was measured using 20 items selected and revised from the Neighborhood Environment Walkability Scales (NEWS), the Physical Activity Neighborhood Environment Survey (PANES), and the Neighborhood Walkability Checklist from National Heart Foundation in Australia. The Kaigo-Yobo Checklist was used to assess participants’ frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.6%. Compare to the non-frail participants, the frail individuals were female, older, living alone, having lower education level, unemployed, having poor grip strength, taking more than three medicines. Frailty was associated with lower perceived neighborhood walkability (odds ratio [OR] = 0.881, 95% confidence interval [CI] = 0.834-0.932, p < 0.001) and worse perceived neighborhood environmental pollution (OR = 1.051, 95% CI = 1.017-1.087, p = 0.003) after adjustment for sex, age, solitariness, education level, employment status, monthly income, grip strength, and polypharmacy. Conclusions: It is needed to improve local environments as well as personal physical, mental, and social health to prevent or reverse frailty in rural areas where population ageing is more severe and built environment is worse than urban areas.

Neighborhood Environment Perceptions among Latinos in the U.S.

In the U.S., immigrants and racial/ethnic minorities (e.g., Latinos) often report unfavorable neighborhood environments, which may hinder physical activity (PA). Among Latinos, PA levels are disproportionately lower in foreign-born, female, older, and low-education individuals. It is unclear whether these subgroups, including those from multiple disadvantaged backgrounds (e.g., low education, foreign-born), perceive worse neighborhood environments for PA. This cross-sectional study aimed to examine differences in neighborhood environment perceptions among Latinos in the 2015 National Health Interview Survey (N = 4643; 59% foreign-born). Logistic regression models examined nativity—and its interactions with age, gender, and education—in relation to the perceived presence of transportation infrastructure (two items) and destinations (four items), controlling for self-reported walking. Models used sample weights and accounted for the complex survey design. Nativity was not significantly associated with neighborhood environment perceptions. However, nativity interactions with age and education showed the greatest inequities (lowest perceptions) of neighborhood infrastructure (e.g., fewer sidewalks) or destinations (e.g., fewer places to relax) among disadvantaged U.S.-born (older or low education) and advantaged foreign-born (higher education) Latinos. Findings suggest neighborhood perceptions are shaped by complex interactions of nativity with structural (education) and contextual (age) factors. Additional research is needed to complement our findings and inform environmental interventions targeting Latinos.

Correlates of Children's Independent Mobility in Canada: A Multi-Site Study.

Globally, physical inactivity is a concern, and children’s independent mobility (CIM) may be an important target behavior for addressing the physical inactivity crisis. The aim of this study was to examine correlates of CIM (8–12 years old) in the Canadian context to inform future interventions. CIM was measured via parent surveys. Individual, social, and environmental correlates of CIM were examined using a social–ecological framework. 1699 participants’ data were analyzed using descriptive statistics and gender-stratified linear mixed-effects models while controlling for site, area-level socioeconomic status, and type of urbanization. Individual correlates including child grade (β = 0.612, p < 0.001), language spoken at home (β = −0.503, p < 0.001), car ownership (β = −0.374, p < 0.05), and phone ownership (β = 0.593, p < 0.001) were associated with CIM. For boys, parental gender (β = −0.387, p < 0.01) was negatively associated with CIM. Parents’ perceptions of safety and environment were significantly associated with CIM. Location (i.e., site) was significantly associated with CIM (ref: Trois-Rivières; Ottawa (β = −1.188, p < 0.001); Vancouver (β = −1.216, p < 0.001)). Suburban environments were negatively associated with boys’ independent mobility (β = −0.536, p < 0.05), while walkability (400 m β = 0.064, p < 0.05; 1600 m β = −0.059, p < 0.05) was significantly associated with girls’ independent mobility only. Future research and interventions should consider targeting “modifiable factors” like children’s and parents’ perceptions of neighborhood safety and environment.

The linkage between the perception of neighbourhood and physical activity in Guangzhou, China: using street view imagery with deep learning techniques

BackgroundNeighbourhood environment characteristics have been found to be associated with residents’ willingness to conduct physical activity (PA). Traditional methods to assess perceived neighbourhood environment characteristics are often subjective, costly, and time-consuming, and can be applied only on a small scale. Recent developments in deep learning algorithms and the recent availability of street view images enable researchers to assess multiple aspects of neighbourhood environment perceptions more efficiently on a large scale. This study aims to examine the relationship between each of six neighbourhood environment perceptual indicators—namely, wealthy, safe, lively, depressing, boring and beautiful—and residents’ time spent on PA in Guangzhou, China.MethodsA human–machine adversarial scoring system was developed to predict perceptions of neighbourhood environments based on Tencent Street View imagery and deep learning techniques. Image segmentation was conducted using a fully convolutional neural network (FCN-8s) and annotated ADE20k data. A human–machine adversarial scoring system was constructed based on a random forest model and image ratings by 30 volunteers. Multilevel linear regressions were used to examine the association between each of the six indicators and time spent on PA among 808 residents living in 35 neighbourhoods.ResultsTotal PA time was positively associated with the scores for “safe” [Coef. = 1.495, SE = 0.558], “lively” [1.635, 0.789] and “beautiful” [1.009, 0.404]. It was negatively associated with the scores for “depressing” [− 1.232, 0.588] and “boring” [− 1.227, 0.603]. No significant linkage was found between total PA time and the “wealthy” score. PA was further categorised into three intensity levels. More neighbourhood perceptual indicators were associated with higher intensity PA. The scores for “safe” and “depressing” were significantly related to all three intensity levels of PA.ConclusionsPeople living in perceived safe, lively and beautiful neighbourhoods were more likely to engage in PA, and people living in perceived boring and depressing neighbourhoods were less likely to engage in PA. Additionally, the relationship between neighbourhood perception and PA varies across different PA intensity levels. A combination of Tencent Street View imagery and deep learning techniques provides an accurate tool to automatically assess neighbourhood environment exposure for Chinese large cities.

Development and validation of a tool to assess the rural neighborhood environment for obesity in Korean adults.

This study aimed to develop and validate a tool that assesses the perceived neighborhood environments influencing obesity development among rural adults in Korea. Qualitative and quantitative methods were used. Twenty-one adults participated in focus group interviews. Subsequently, two independent surveys were conducted with rural adults aged 19-65. Literature review and focus group interviews were used to generate initial items. An expert's panel evaluation established content validity for these items and pilot testing of the draft tool was performed. Explanatory (n=328) and confirmatory factor analyses (n=1,070) were used to establish construct validity, and internal consistency and test-retest reliability were calculated (n=88). The new tool consisting of 37 items was developed and validated. Confirmatory factor analysis revealed an eight-subscale structure (χ2 =3,738.1, GFI=0.831, SRMR=0.060, RMSEA=0.070). The tool showed moderate test-retest reliability (ICC=0.519-0.775) and good internal consistency except for Social Influence on Healthy Eating (Cronbach's α=0.612). The Rural Neighborhood Environment Assessment for Obesity tool might be a valid and reliable instrument for public health practitioners to assess complex social and physical environmental factors related to obesity.

The perceived neighborhood environment is associated with health-enhancing physical activity among adults: a cross-sectional survey of 13 townships in Taiwan

BackgroundMany environmental factors have been associated with physical activity. The environment is considered a key factor in terms of the rate of engagement in physical activity. This study examined the perceived effect of environmental factors on different levels of health-enhancing physical activity among Taiwanese adults.MethodsData were collected from 549 adults aged at least 18 years from the northern, central, southern and eastern regions of Taiwan. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) showcard version, and participants were divided into three categories: those who performed low-, moderate-, or high-levels of physical activity, as suggested by the IPAQ scoring protocol. The perceived neighborhood environment in relation to physical activity was adapted from the Physical Activity Neighborhood Environment Scale. A multinomial logistic regression was conducted to ascertain associations between individual perceptions of the neighborhood environment and different physical activity levels.ResultsRespondents who perceived their neighborhood environment as having easy access to services and stores, and higher traffic safety were more likely to be moderate level of physical activity (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.07–3.37; OR: 1.77, 95% CI: 1.12–2.80). The perception of having easy access to services and stores and seeing many physically active people in the neighborhood were both positively associated with a high level of physical activity (OR: 2.25, 95% CI: 1.01–5.01; OR: 2.40, 95% CI: 1.11–5.23).ConclusionsDifferent perceived neighborhood environmental factors were associated with moderate and high levels of physical activity, respectively. These findings highlight the importance of an activity-friendly neighborhood environment to stimulate engagement in physical activity among adults in Taiwan. Therefore, policies and programs should focus on improving friendliness and diversity in neighborhoods to facilitate individuals’ transitions from inactive to active lifestyles.

Perceived Neighborhood Environment and Its Association with Health Screening and Exercise Participation amongst Low-Income Public Rental Flat Residents in Singapore

Background: In Singapore, an Asian city-state, more than 80% live in public housing. While the majority (90%) own their homes, a needy minority lives in rental flats. Public rental flats are built in the same location as owner-occupied blocks. We evaluated factors associated with perceptions of the neighborhood environment and its association with exercise and health screening participation. Methods: Logistic regression was used to identify associations between perceptions of the neighborhood environment (overall perceived neighborhood disadvantage, safety, and convenience) and sociodemographic factors, as well as exercise and screening participation, amongst residents aged ≥60 years in two Singaporean public housing precincts in 2016. Results: Our response rate was 62.1% (528/800). Staying in a rental flat independently was associated with increased neighborhood disadvantage (adjusted odds ratio, aOR = 1.58, 95%CI = 1.06–2.35). Staying in a stand-alone block (as opposed to staying in a mixed block comprised of both rental and owner-occupied units) was associated with perceptions of a poorer physical environment (aOR = 1.81, 95%CI = 1.22–2.68) and lower perceived proximity to recreational areas (aOR = 1.14, 95%CI = 1.04–1.25). Perceptions of neighborhood disadvantage were independently associated with reduced exercise participation (aOR = 0.67, 95%CI = 0.45–0.98) and reduced participation in diabetes screening (aOR = 0.63, 95%CI = 0.41–0.95). Conclusion: Despite sharing the same built environment, differences in the perception of the neighborhood environment between low-socioeconomic status (SES) and high-SES communities persist. Perceived neighborhood disadvantage is associated with lower participation in regular exercise and diabetes screening.

Abstract P397: Neighborhood Environment Perceptions Associate With Depression Levels and Cardiometabolic Risk: Data From the Washington, DC Cardiovascular Health and Needs Assessment

Background: Little is understood about associations between perceived neighborhood characteristics and depression, a known cardiovascular (CV) disease risk factor, in diverse populations. We examined the relationship between neighborhood environment perception (NEP), depression, and CV disease markers within an urban, predominantly African-American (AA) cohort. Methods: We conducted the DC CV Health and Needs Assessment, a health evaluation among adults (n=100) in resource-limited DC communities. We measured overall NEP and factor analysis identified three NEP sub-scores: 1) neighborhood violence; 2) physical environment; and 3) social cohesion (higher score=more favorable NEP). Depression was defined by the revised Center for Epidemiologic Studies Depression Scale (CESD-R, higher score=higher depression likelihood). We leveraged linear regression modeling to examine NEP and depression associations adjusting for race, income, Framingham risk score, and neighborhood deprivation index (NDI). A population subset (n=42) provided blood samples which were tested for levels of IL-1β, IL-18, and CRP by ELISA (Mesoscale Diagnostics, USA). Results: Participants (n= 100; mean age = 59; 99% AA) had a mean CESD-R score=5.8 (SD=8.9) and mean NEP score=56.1 (SD=12.6). In fully adjusted models, more favorable NEP, specifically physical environment and social cohesion, was associated with significantly lower CESD-R scores (Figure). Higher CESD-R scores were positively associated with increasing IL-1β (β= 20.3 p&lt;.01) and IL-18 (β=0.006 p&lt;.01). Conclusions: More favorable perceptions of one’s neighborhood are related to lower depression symptoms in a predominantly AA cohort from Washington, DC resource-limited communities. Additionally, increasing CESD-R score was related to higher pro-inflammatory markers. These results suggest that improving individuals’ neighborhood perceptions may be beneficial in improving the psychological well-being and, ultimately, CV health of urban minority residents.

Neighborhood built environment associations with adolescents' location-specific sedentary and screen time

Less is known about how neighborhood environments relate to sedentary time as compared to physical activity. This study examined relations of perceived and objective neighborhood environments with TV time, total screen time, total sedentary time, sedentary time at home, sedentary time in the home neighborhood, and time spent at home, in 524 12-16 year olds. Better perceived aesthetics and a perceived neighborhood environment index were related to less TV and screen time, and greater cul-de-sac density was related to less total and home sedentary time. Greater street connectivity, mixed land use, and an objective neighborhood environmental index were related to more total sedentary time. Findings suggest that some neighborhood environment attributes may not have the same potential influences on limiting sedentary time as they do for supporting physical activity.

Environmental correlates of total and domain-specific sedentary behaviour in young people. The UP&DOWN study

This study investigated the associations between the characteristics of the nearby physical environment with the total and domain-specific leisure-time sedentary behaviour (SB) in young people. The study included 1578 youth (9–18 years) from the UP&DOWN study. Total leisure-time SB was objectively-assessed by accelerometers. Participants self-reported the time spent during leisure-time in different domains of SB (i.e. screen-based, educational-based, social-based, and other-based SB). Information regarding the basic characteristics of the house, the perceived neighbourhood environment, the amount of physical activity facilities, equipment and materials attainable at home, and the media equipment available at home and in the own bedroom was collected. Linear mixed models were performed, including school and city as random effects. The availability of yard was related to lower total SB and time spent surfing the Internet in boys, but not in girls. More favourable perceived neighbourhood environment was associated with lower total SB and time spent playing video games in girls, but not in boys. The amount of physical activity materials at home was negatively associated with screen-based SB, while the availability of a computer in the own bedroom was positively related to the time spent surfing the Internet in boys and girls. The number of televisions at home and having a computer in the own bedroom was associated with lower time in educational-based SB in boys and girls, respectively. Increasing the number of PA materials at home and decreasing the number of TVs at home and the availability of a computer in the bedroom could improve SB profiles of youth.