Lee-Ann M. Wilson

Neighborhood Disadvantage and Physical Activity: Baseline Results from the HABITAT Multilevel Longitudinal Study

PURPOSE To examine the association between neighborhood disadvantage and physical activity (PA). METHODS We use data from the HABITAT multilevel longitudinal study of PA among middle-aged (40-65 years) men and women (N = 11,037, 68.5% response rate) living in 200 neighborhoods in Brisbane, Australia. PA was measured using three questions from the Active Australia Survey (general walking, moderate, and vigorous activity), one indicator of total activity, and two questions about walking and cycling for transport. The PA measures were operationalized by using multiple categories based on time and estimated energy expenditure that were interpretable with reference to the latest PA recommendations. The association between neighborhood disadvantage and PA was examined with the use of multilevel multinomial logistic regression and Markov chain Monte Carlo simulation. The contribution of neighborhood disadvantage to between-neighborhood variation in PA was assessed using the 80% interval odds ratio. RESULTS After adjustment for sex, age, living arrangement, education, occupation, and household income, reported participation in all measures and levels of PA varied significantly across Brisbanes neighborhoods, and neighborhood disadvantage accounted for some of this variation. Residents of advantaged neighborhoods reported significantly higher levels of total activity, general walking, moderate, and vigorous activity; however, they were less likely to walk for transport. There was no statistically significant association between neighborhood disadvantage and cycling for transport. In terms of total PA, residents of advantaged neighborhoods were more likely to exceed PA recommendations. CONCLUSIONS Neighborhoods may exert a contextual effect on the likelihood of residents participating in PA. The greater propensity of residents in advantaged neighborhoods to do high levels of total PA may contribute to lower rates of cardiovascular disease and obesity in these areas.

The Association Between Objectively Measured Neighborhood Features and Walking in Middle- Aged Adults

Purpose. Explore the role of the neighborhood environment in supporting walking. Design. Cross-sectional study of 10,286 residents of 200 neighborhoods. Participants were selected using a stratified two-stage cluster design. Data were collected by mail survey (68.5% response rate). Setting. Brisbane City Local Government Area, Australia, 2007. Subjects. Brisbane residents aged 40 to 65 years. Measures. Environmental: street connectivity, residential density, hilliness, tree coverage, bikeways, and streetlights within a 1-km circular buffer from each residents home; and network distance to nearest river or coast, public transport, shop, and park. Walking: minutes walked in the previous week: <30 minutes, ≥30 to <90 minutes, ≥90 to <150 minutes, ≥150 to <300 minutes, and ≥300 minutes. Analysis. The association between each neighborhood characteristic and walking was examined using multilevel multinomial logistic regression, and the model parameters were estimated using Markov chain Monte Carlo simulation. Results. After adjustment for individual factors, the likelihood of walking for more than 300 minutes (relative to <30 minutes) was highest in areas with the most connectivity (odds ratio [OR] = 1.93; 99% confidence intervals [CI], 1.32–2.80), greatest residential density (OR = 1.47; 99% CI, 1.02–2.12), least tree coverage (OR = 1.69; 99% CI, 1.13–2.51), most bikeways (OR = 1.60; 99% CI, 1.16–2.21), and most streetlights (OR = 1.50; 99% CI, 1.07–2.11). The likelihood of walking for more than 300 minutes was also higher among those who lived closest to a river or the coast (OR = 2.06; 99% CI, 1.41–3.02). Conclusion. The likelihood of meeting (and exceeding) physical activity recommendations on the basis of walking was higher in neighborhoods with greater street connectivity and residential density, more streetlights and bikeways, closer proximity to waterways, and less tree coverage. Interventions targeting these neighborhood characteristics may lead to improved environmental quality as well as lower rates of overweight and obesity and associated chromic disease. (Am J Health Promot 2011;25[4]:e12–e21.)PURPOSE To identify worksite practices that show promise for promoting employee weight loss. DATA SOURCE The following electronic databases were searched from January 1, 1966, through December 31, 2005: CARL Uncover (via Ingenta), CDP, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Library, CRISP, Dissertation Abstracts, EMBASE, ERIC, Health Canada, INFORM (part of ABI/INFORM Proquest), LocatorPlus, New York Academy of Medicine, Ovid MEDLINE, SPORTDiscus, PapersFirst, PsycINFO, PubMed, and TRIP. STUDY INCLUSION AND EXCLUSION CRITERIA Included studies were published in English, conducted at a worksite, designed for adults (aged ≥ 18 years), and reported weight-related outcomes. DATA EXTRACTION Data were extracted using an online abstraction form. DATA SYNTHESIS Studies were evaluated on the basis of study design suitability quality of execution, sample size, and effect size. Changes in weight-related outcomes were used to assess effectiveness. RESULTS The following six promising practices were identified: enhanced access to opportunities for physical activity combined with health education, exercise prescriptions alone, multicomponent educational practices, weight loss competitions and incentives, behavioral practices with incentives, and behavioral practices without incentives. CONCLUSIONS These practices will help employers and employees select programs that show promise for controlling and preventing obesity.

Increased traffic exposure and negative birth outcomes: a prospective cohort in Australia

BackgroundPregnant women exposed to traffic pollution have an increased risk of negative birth outcomes. We aimed to investigate the size of this risk using a prospective cohort of 970 mothers and newborns in Logan, Queensland.MethodsWe examined two measures of traffic: distance to nearest road and number of roads around the home. To examine the effect of distance we used the number of roads around the home in radii from 50 to 500 metres. We examined three road types: freeways, highways and main roads.ResultsThere were no associations with distance to road. A greater number of freeways and main roads around the home were associated with a shorter gestation time. There were no negative impacts on birth weight, birth length or head circumference after adjusting for gestation. The negative effects on gestation were largely due to main roads within 400 metres of the home. For every 10 extra main roads within 400 metres of the home, gestation time was reduced by 1.1% (95% CI: -1.7, -0.5; p-value = 0.001).ConclusionsOur results add weight to the association between exposure to traffic and reduced gestation time. This effect may be due to the chemical toxins in traffic pollutants, or because of disturbed sleep due to traffic noise.

Development of an Attitudes towards Complementary Therapies Scale for Psychologists.

This study designed and tested a scale to measure psychologists’ attitudes towards complementary and alternative therapies. The scale, derived from existing measures for medical professionals, was tested on a sample of psychology students (N = 163) using an online survey. The data were factor analysed and three correlated subscales were identified, assessing the perceived importance of knowledge about available therapies, attitudes towards integration with psychological practice, and concerns about associated risks of use. It is anticipated that this newly developed scale with be useful in gauging changes in attitudes towards psychology practice over time, as well as in planning educational initiatives within the field of psychology.

Students' Beliefs about Willingness to Access Complementary and Alternative Therapies (CAT) Training for Future Integration into Psychology Practice

It is suggested that all psychologists gain basic training in the types of complementary and alternative therapies (CAT) their clients may be using. As psychology students are the next cohort of health professionals who will inform future initiatives in the field, it is important to first understand the factors which influence their decisions about CAT integration. Drawing on the Theory of Planned Behavior, we investigated the beliefs that differentiate between psychology students who are high or low on willingness to access training in CAT for future practice use. Psychology students (N = 106) completed a questionnaire assessing the likelihood of both positive and negative consequences of accessing training and utilizing CAT within a psychological practice, important others approval, and barriers preventing them from this integration behavior. Those students high compared to low on willingness more likely to endorse positive outcomes (e.g., offering a more holistic approach to therapy) of accessing CAT training for future practice use and to believe that important others (e.g., clients) would support this behavior. We identified important beliefs of student psychologists related to decisions about undertaking CAT training for future professional use and can inform educators and policy-makers about CAT training and integration in psychology practice.