Genevieve F. Dunton

A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning

Smart growth is an approach to urban planning that provides a framework for making community development decisions. Despite its growing use, it is not known whether smart growth can impact physical activity. This review utilizes existing built environment research on factors that have been used in smart growth planning to determine whether they are associated with physical activity or body mass. Searching the MEDLINE, Psycinfo and Web‐of‐Knowledge databases, 204 articles were identified for descriptive review, and 44 for a more in‐depth review of studies that evaluated four or more smart growth planning principles. Five smart growth factors (diverse housing types, mixed land use, housing density, compact development patterns and levels of open space) were associated with increased levels of physical activity, primarily walking. Associations with other forms of physical activity were less common. Results varied by gender and method of environmental assessment. Body mass was largely unaffected. This review suggests that several features of the built environment associated with smart growth planning may promote important forms of physical activity. Future smart growth community planning could focus more directly on health, and future research should explore whether combinations or a critical mass of smart growth features is associated with better population health outcomes.

Physical environmental correlates of childhood obesity: a systematic review

Increasing rates of childhood obesity in the USA and other Western countries are a cause for serious public health concern. Neighborhood and community environments are thought to play a contributing role in the development of obesity among youth, but it is not well understood which types of physical environmental characteristics have the most potential to influence obesity outcomes. This paper reports the results of a systematic review of quantitative research examining built and biophysical environmental variables associated with obesity in children and adolescents through physical activity. Literature searches in PubMed, PsychInfo and Geobase were conducted. Fifteen quantitative studies met the inclusion criteria for this systematic review. The majority of studies were cross‐sectional and published after 2005. Overall, few consistent findings emerged. For children, associations between physical environmental variables and obesity differed by gender, age, socioeconomic status, population density and whether reports were made by the parent or child. Access to equipment and facilities, neighborhood pattern (e.g. rural, exurban, suburban) and urban sprawl were associated with obesity outcomes in adolescents. For most environmental variables considered, strong empirical evidence is not yet available. Conceptual gaps, methodological limitations and future research directions are discussed.

A study of community design, greenness and physical activity in children using satellite, GPS and accelerometer data

This study examined relationships between greenness exposure and free-living physical activity behavior of children in smart growth and conventionally designed communities. Normalized Difference Vegetation Index (NDVI) was used to quantify childrens (n=208) greenness exposure at 30-s epoch accelerometer and GPS data points. A generalized linear mixed model with a kernel density smoothing term for addressing spatial autocorrelation was fit to analyze residential neighborhood activity data. Excluding activity at home and during school-hours, an epoch-level analysis found momentary greenness exposure was positively associated with the likelihood of contemporaneous moderate-to-vigorous physical activity (MVPA). This association was stronger for smart growth residents who experienced a 39% increase in odds of MVPA for a 10th to 90th percentile increase in exposure to greenness (OR=1.39, 95% CI 1.36-1.44). An individual-level analysis found children who experienced >20 min of daily exposure to greener spaces (>90th percentile) engaged in nearly 5 times the daily rate of MVPA of children with nearly zero daily exposure to greener spaces (95% CI 3.09-7.20).

Investigating children's physical activity and sedentary behavior using Ecological Momentary Assessment with mobile phones.

The risk of obesity during childhood can be significantly reduced through increased physical activity and decreased sedentary behavior. Recent technological advances have created opportunities for the real‐time measurement of these behaviors. Mobile phones are ubiquitous and easy to use, and thus have the capacity to collect data from large numbers of people. The present study tested the feasibility, acceptability, and validity of an electronic Ecological Momentary Assessment (EMA) protocol using electronic surveys administered on the display screen of mobile phones to assess childrens physical activity and sedentary behaviors. A total of 121 children (ages 9–13, 51% male, 38% at risk for overweight/overweight) participated in EMA monitoring from Friday afternoon to Monday evening during childrens nonschool time, with 3–7 surveys/day. Items assessed current activity (e.g., watching TV/movies, playing video games, active play/sports/exercising). Children simultaneously wore an Actigraph GT2M accelerometer. EMA survey responses were time‐matched to total step counts and minutes of moderate‐to‐vigorous physical activity (MVPA) occurring in the 30 min before each EMA survey prompt. No significant differences between answered and unanswered EMA surveys were found for total steps or MVPA. Step counts and the likelihood of 5+ min of MVPA were significantly higher during EMA‐reported physical activity (active play/sports/exercising) vs. sedentary behaviors (reading/computer/homework, watching TV/movies, playing video games, riding in a car) (P < 0.001). Findings generally support the acceptability and validity of a 4‐day EMA protocol using mobile phones to measure physical activity and sedentary behavior in children during leisure time.

Mapping the Social and Physical Contexts of Physical Activity Across Adolescence Using Ecological Momentary Assessment

Background: Research has sought to understand how environmental factors influence adolescent physical activity, yet little is known about where and with whom adolescents are physically active.Purpose: This study used electronic ecological momentary assessment (e.EMA) to map the social and physical contexts of exercise and walking across adolescence. Differences in physical activity contexts by gender, grade in school, day of the week, and season were examined.Methods: Twice a year between 9th and 12th grade, 502 adolescents (51% female) of mixed ethnicity (55% White) participated in 4-day e.EMA intervals (Thursday-Sunday) where their primary activity (e.g., exercise, TV, homework), social company (e.g., friends, family, class), and physical location (e.g., home, school, outdoors) were assessed every 30 (±10) min during waking hours.Results: Overall, greater proportions of exercise and walking were reported with friends, outdoors, and at school. However, boys were more likely to report exercising and walking in outdoor locations than girls. Exercising with classmates, family, and at school decreased across high school. Walking with family, friends, and outdoors also decreased. On weekdays compared to weekends, students reported a greater proportion of their exercise and walking at school. Students were more likely to report exercising and walking outdoors in the fall and the spring than in the winter.Conclusion: e.EMA showed that the social and physical contexts of adolescent exercise and walking vary as a function of gender, grade in school, day of the week, and season. Understanding the contexts of physical activity during the high school years can be helpful in designing interventions during adolescence.

Joint associations of physical activity and sedentary behaviors with body mass index: results from a time use survey of US adults

Objective:Obesity risk is negatively associated with physical activity and positively associated with time spent in sedentary behaviors. Yet, it is not known how different combinations of sedentary and active behavior are associated with body mass index (BMI). This study examined the interaction between time spent in physical activity and sedentary behavior on BMI in US adults.Design:Cross-sectional, data from the 2006 American Time Use Survey.Subjects:10 984 non-underweight adults (aged 21 + years).Measurement:A phone interview assessed all activities performed in the past 24 h, height, weight, health status, and other sociodemographic characteristics. Time spent in (1) moderate-to-vigorous leisure-time physical activity (MVPA), (2) active transportation (walking, biking), (3) sedentary leisure activities (TV/movie watching, computer use, playing games, reading), and (4) sedentary transportation (motorized vehicles) was determined from activity coding. BMI was calculated.Results:After adjusting for age, gender, education level, race/ethnicity, and health status, sample-weighted linear regressions found significant interactions for leisure MVPA × TV/movies, leisure MVPA × playing games, active transportation × sedentary transportation, and active transportation × reading (Ps<0.0001). For example, the group of adults watching <60 min per day of TV/movies and engaging in ⩾60 min per day of leisure MVPA had lower average BMI compared to the group watching <60 min per day of TV/movies and reporting <60 min per day of leisure MVPA (P<0.0001). In contrast, for adults watching ⩾189 min per day of TV/movies, there was not a significant difference in BMI by time spent in leisure MVPA.Conclusion:Data from a US time use survey indicate that the strength of the association between certain types of sedentary behavior and BMI varies according to time spent in certain types of physical activity and vice versa.

Media use and obesity in adolescent females

Objective: In the context of growing public health concern with the obesity rates among children and adolescents, much attention has focused on the role of television as a contributor to the problem. Less attention has been devoted to interactive media (internet surfing and video games), despite the fact that these forms of entertainment are fast gaining in popularity among youth. This study investigated the relative associations of TV viewing and interactive media use with body fat and BMI, controlling for both physical activity participation and cardiovascular fitness.

Momentary Assessment of Affect, Physical Feeling States, and Physical Activity in Children

OBJECTIVE Most research on the interplay of affective and physical feelings states with physical activity in children has been conducted under laboratory conditions and fails to capture intraindividual covariation. The current study used Ecological Momentary Assessment (EMA) to bidirectionally examine how affective and physical feeling states are related to objectively measured physical activity taking place in naturalistic settings during the course of childrens everyday lives. METHODS Children (N = 119, ages 9-13 years, 52% male, 32% Hispanic) completed 8 days of EMA monitoring, which measured positive affect (PA), negative affect (NA), feeling tired, and feeling energetic up to 7 times per day. EMA responses were time-matched to accelerometer assessed moderate-to-vigorous physical activity (MVPA) in the 30 min before and after each EMA survey. RESULTS Higher ratings of feeling energetic and lower ratings of feeling tired were associated with more MVPA in the 30 min after the EMA prompt. More MVPA in the 30 min before the EMA prompt was associated with higher ratings of PA and feeling energetic and lower ratings of NA. Between-subjects analyses indicated that mean hourly leisure-time MVPA was associated with less intraindividual variability in PA and NA. CONCLUSIONS Physical feeling states predict subsequent physical activity levels, which in turn, predict subsequent affective states in children. Active children demonstrated higher positive and negative emotional stability. Although the strength of these associations were of modest magnitude and their clinical relevance is unclear, understanding the antecedents to and consequences of physical activity may have theoretical and practical implications for the maintenance and promotion of physical activity and psychological well-being in children.

Using Ecological Momentary Assessment to Examine Antecedents and Correlates of Physical Activity Bouts in Adults Age 50+ Years: A Pilot Study

BackgroundNational recommendations supporting the promotion of multiple short (10+ minute) physical activity bouts each day to increase overall physical activity levels in middle-aged and older adults underscore the need to identify antecedents and correlates of such daily physical activity episodes.PurposeThis pilot study used Ecological Momentary Assessment to examine the time-lagged and concurrent effects of empirically supported social, cognitive, affective, and physiological factors on physical activity among adults age 50+ years.MethodsParticipants (N = 23) responded to diary prompts on a handheld computer four times per day across a 2-week period. Moderate-to-vigorous physical activity (MVPA), self-efficacy, positive and negative affect, control, demand, fatigue, energy, social interactions, and stressful events were assessed during each sequence.ResultsMultivariate results showed that greater self-efficacy and control predicted greater MVPA at each subsequent assessment throughout the day (p < 0.05). Also, having a positive social interaction was concurrently related to higher levels of MVPA (p = 0.052).ConclusionTime-varying multidimensional individual processes predict within daily physical activity levels.

An investigation of psychosocial factors related to changes in physical activity and fitness among female adolescents

Research examined the effects of a supervised physical activity program on potential psychosocial mediators and determined whether changes in these psychosocial variables predicted changes in physical activity and fitness. Sedentary adolescent females were assigned to an intervention (n = 79) or comparison (n = 67) group. Cardiovascular fitness (cycle ergometer), physical activity (3-Day Physical Activity Recall), and psychosocial variables related to physical activity (i.e., self-efficacy, perceived barriers, social support, enjoyment) were assessed at three time points over the 9-month study. An intention-to-treat analysis showed that the intervention did not impact any of the psychosocial variables, with the exception of perceived barriers, which increased in the intervention group. Longitudinal analyses showed that improvements in fitness were associated with positive changes in global self-efficacy and exercise enjoyment. Psychosocial variables did not mediate the programs effects on fitness or activity. However, individual level changes in psychosocial variables were related to changes in cardiovascular fitness.