Dori E. Rosenberg

Neighborhood environment and physical activity among youth a review

CONTEXT Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people. EVIDENCE ACQUISITION A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years. EVIDENCE SYNTHESIS Papers were categorized by design features, sample characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated. CONCLUSIONS Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access/proximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan.

Exergames for Subsyndromal Depression in Older Adults: A Pilot Study of a Novel Intervention

OBJECTIVES Subsyndromal depression (SSD) is several times more common than major depression in older adults and is associated with significant negative health outcomes. Physical activity can improve depression, but adherence is often poor. The authors assessed the feasibility, acceptability, and short-term efficacy and safety of a novel intervention using exergames (entertaining video games that combine game play with exercise) for SSD in older adults. METHODS Community-dwelling older adults (N = 19, aged 63-94 years) with SSD participated in a 12-week pilot study (with follow-up at 20-24 weeks) of Nintendos Wii sports, with three 35-minute sessions a week. RESULTS Eight-six percent of enrolled participants completed the 12-week intervention. There was a significant improvement in depressive symptoms, mental health-related quality of life (QoL), and cognitive performance but not physical health-related QoL. There were no major adverse events, and improvement in depression was maintained at follow-up. CONCLUSIONS The findings provide preliminary indication of the benefits of exergames in seniors with SSD. Randomized controlled trials of exergames for late-life SSD are warranted.

Active transportation to school over 2 years in relation to weight status and physical activity

Objective: To prospectively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth.

Neighborhood Environment Walkability Scale for Youth (NEWS-Y): Reliability and Relationship With Physical Activity

OBJECTIVES To examine the psychometric properties of the Neighborhood Environment Walkability Scale-Youth (NEWS-Y) and explore its associations with context-specific and overall physical activity (PA) among youth. METHODS In 2005, parents of children ages 5-11 (n=116), parents of adolescents ages 12-18 (n=171), and adolescents ages 12-18 (n=171) from Boston, Cincinnati, and San Diego, completed NEWS-Y surveys regarding perceived land use mix-diversity, recreation facility availability, pedestrian/automobile traffic safety, crime safety, aesthetics, walking/cycling facilities, street connectivity, land use mix-access, and residential density. A standardized neighborhood environment score was derived. Self-reported activity in the street and in parks, and walking to parks, shops, school, and overall physical activity were assessed. RESULTS The NEWS-Y subscales had acceptable test-retest reliability (ICC range .56-.87). Being active in a park, walking to a park, walking to shops, and walking to school were related to multiple environmental attributes in all three participant groups. Total neighborhood environment, recreation facilities, walking and cycling facilities, and land use mix-access had the most consistent relationships with specific types of activity. CONCLUSIONS The NEWS-Y has acceptable reliability and subscales were significantly correlated with specific types of youth PA. The NEWS-Y can be used to examine neighborhood environment correlates of youth PA.

Physical Activity During Youth Sports Practices

OBJECTIVE To document physical activity (PA) during organized youth soccer and baseball/softball practices. DESIGN Cross-sectional study. SETTING Community sports leagues in San Diego County, California. PARTICIPANTS Two hundred youth aged 7 to 14 years were recruited from 29 teams in 2 youth sports in middle-income cities with an approximately equal distribution across sports, sex, and age groups. MAIN EXPOSURE Youth sports practices. OUTCOME MEASURES A sample of players wore accelerometers during practices. Minutes of PA at multiple intensity levels were calculated using established cutoff points. Participants were categorized as meeting or not meeting guidelines of at least 60 minutes of moderate to vigorous PA (MVPA) during practice. RESULTS The overall mean for MVPA was 45.1 minutes and 46.1% of practice time. Participants on soccer teams (+13.7 minutes, +10.6% of practice time), boys (+10.7 minutes, +7.8% of practice time), and those aged 7 to 10 years (+7.0 minutes, +5.8% of practice time) had significantly more MVPA than their counterparts. Participants on soccer teams spent an average of 17.0 more minutes and 15.9% more of practice time in vigorous-intensity PA than those on baseball/softball teams. Overall, 24% of participants met the 60-minute PA guideline during practice, but fewer than 10% of 11-to 14-year-olds and 2% of girl softball players met the guideline. CONCLUSIONS Participation in organized sports does not ensure that youth meet PA recommendations on practice days. The health effects of youth sports could be improved by adopting policies that ensure participants obtain PA during practices.

The Role of the Built Environment in Healthy Aging: Community Design, Physical Activity, and Health among Older Adults

Older adults are a large but very inactive population group. Physical activity, especially walking, has many important health benefits for older adults. This review describes the relationship between walking and health and reviews studies investigating the relationship between the built environment, walking, and health in older adults. Important features of community design for older adults are identified and suggestion for impacting walking behavior is made.

Community Food Environment, Home Food Environment, and Fruit and Vegetable Intake of Children and Adolescents

OBJECTIVES To determine (1) reliability of new food environment measures; (2) association between home food environment and fruit and vegetable (FV) intake; and (3) association between community and home food environment. METHODS In 2005, a cross-sectional survey was conducted with readministration to assess test-retest reliability. Adolescents, parents of adolescents, and parents of children (n = 458) were surveyed in San Diego, Boston, and Cincinnati. RESULTS Most subscales had acceptable reliability. Fruit and vegetable intake was positively associated with availability of healthful food (r = 0.15-0.27), FV (r = 0.22-0.34), and ratio of more-healthful/less-healthful food in the home (r = 0.23-0.31) and was negatively associated with less-healthful food in the home (r = -0.17 to -0.18). Home food environment was associated with household income but not with community food environment. CONCLUSIONS AND IMPLICATIONS A more healthful home food environment was related to youth FV intake. Higher income households had more healthful food in the home. The potential influence of neighborhood food outlets warrants further study.

Outdoor Built Environment Barriers and Facilitators to Activity among Midlife and Older Adults with Mobility Disabilities

PURPOSE To gain better understanding of how the built environment impacts neighborhood-based physical activity among midlife and older adults with mobility disabilities. DESIGN AND METHODS We conducted in-depth interviews with 35 adults over age 50, which used an assistive device and lived in King County, Washington, U.S. In addition, participants wore global positioning systems (GPS) devices for 3 days prior to the interview. The GPS maps were used as prompts during the interviews. Open coding of the 35 interviews using latent content analysis resulted in key themes and subthemes that achieved consensus between coders. Two investigators independently coded the text of each interview. RESULTS Participants were on average of 67 years of age (range: 50-86) and predominantly used canes (57%), walkers (57%), or wheelchairs (46%). Key themes pertained to curb ramp availability and condition, sidewalk availability and condition, hills, aesthetics, lighting, ramp availability, weather, presence and features of crosswalks, availability of resting places and shelter on streets, paved or smooth walking paths, safety, and traffic on roads. IMPLICATIONS A variety of built environment barriers and facilitators to neighborhood-based activity exist for midlife and older adults with mobility disabilities. Preparing our neighborhood environments for an aging population that uses assistive devices will be important to foster independence and health.

Physical activity, weight status, and neighborhood characteristics of dog walkers

OBJECTIVE This study examined how demographics, physical activity, weight status, and neighborhood characteristics varied among households with and without dogs. METHOD Participants aged 20 to 65 years (n=2199, 52% male, 75% white, mean age=45) were recruited from 32 neighborhoods in the Seattle, WA and Baltimore, MD regions during 2002-2005. Dog ownership, dog walking, education, height, weight, and family income were self-reported. Minutes of moderate to vigorous physical activity (MVPA) were measured objectively by 7-day accelerometry. RESULTS Dog walking was associated with a higher proportion of participants who met national recommendations for MVPA (53%) when compared to those who had but did not walk their dog (33%) and to non-dog owners (46%). There were significantly fewer obese dog walkers (17%) when compared to both owners who did not walk their dogs (28%) and non-owners (22%). Dog owners who walked their dogs were more likely to live in high-walkable neighborhoods when compared to dog owners who did not walk their dogs. CONCLUSION Dog walking may promote physical activity and contribute to weight control. Dog walking appears to be a mechanism by which residents of high-walkable neighborhoods obtain their physical activity.

Patterns of Technology Use Among Older Adults With and Without Disabilities

PURPOSE OF THE STUDY The purpose of this study was to describe prevalence of technology use among adults ages 65 and older, particularly for those with disability and activity-limiting symptoms and impairments. DESIGN AND METHODS Data from the 2011 National Health and Aging Trends Study, a nationally representative sample of community-dwelling Medicare beneficiaries (N = 7,609), were analyzed. Analysis consisted of technology use (use of e-mail/text messages and the internet) by sociodemographic and health characteristics and prevalence ratios for technology usage by disability status. RESULTS Forty percent of older adults used e-mail or text messaging and 42.7% used the internet. Higher prevalence of technology use was associated with younger age, male sex, white race, higher education level, and being married (all p values <.001). After adjustment for sociodemographic and health characteristics, technology use decreased significantly with greater limitations in physical capacity and greater disability. Vision impairment and memory limitations were also associated with lower likelihood of technology use. IMPLICATIONS Technology usage in U.S. older adults varied significantly by sociodemographic and health status. Prevalence of technology use differed by the type of disability and activity-limiting impairments. The internet, e-mail, and text messaging might be viable mediums for health promotion and communication, particularly for younger cohorts of older adults and those with certain types of impairment and less severe disability.