Rebecca E. Lee

Resources for physical activity participation: does availability and accessibility differ by neighborhood socioeconomic status?

The purpose of this study was to determine whether the availability and accessibility of physical activity resources differed by neighborhood socioeconomic status (SES) in a small U.S. city (population = 133,046). U.S. census tracts (N = 32) were used to represent neighborhoods and categorized into high, medium, or low SES on the basis of the percentage of unemployed individuals, per capita income, and percentage of the population below the poverty threshold. We developed a geographic information system to generate a comprehensive list of physical activity resources available within each census tract in the city. We identified 112 parks, 33 sport facilities, 15 fitness clubs, 11 community centers, and 5 walking/biking trails. The total number of physical activity resources varied by neighborhood SES (p > .05); low-SES (M = 4.5±2.3) and medium-SES (M = 4.9±2.6) neighborhoods had significantly fewer resources than high-SES (M = 8.4±3.5) neighborhoods. Low-, medium-, and high-SES neighborhoods did not differ on the number of pay-for-use facilities; however, low-SES (M = 3.1±1.5) and medium-SES (M = 3.8±1.6) neighborhoods had significantly fewer free-for-use resources than high- (M = 6.1±2.4) SES neighborhoods (p > .01). Data suggest that individuals from lower SES neighborhoods may have limited ability to control their physical activity in the face of inaccessible environments. Community research and promotion efforts should include assessment and targeting of available and accessible physical activity resources.

Toward a comprehensive model of physical activity.

Background and purpose. Despite the widely acknowledged public health burden and years of individually based intervention approaches, physical inactivity remains a growing concern among industrialized nations. Interventions aimed at changing individual dispositions that increase physical activity generally result in small changes in behavior that dissipate within weeks. Correlational research testing theories and models focusing on these same individual dispositions explain, at best, 20–40% of the variance in physical activity. As a result, recent calls have been made for consideration of broader, multilevel, ecological approaches to physical activity promotion. The purpose of this article is to define a comprehensive model for understanding physical activity and consider future directions for research. Methods. Relevant literature is reviewed within each of the areas being discussed. Results and conclusions. Ecological models incorporate both intra- and extra-individual influences that may impact on individual physical activity. However, the role of extra-individual factors has not been clearly defined in current ecological models of physical activity. We present the theoretical background of ecological models of health behavior, and define an ecological model for physical activity promotion. This model portrays physical activity behavior as being influenced by interplay between environmental settings and biological and psychological factors. Further testing of this and existing ecological models of physical activity is recommended.

Assessing Overweight, Obesity, Diet, and Physical Activity in College Students

Abstract The authors surveyed 738 college students aged 18 to 27 years to assess overweight, obesity, dietary habits, and physical activity. They used BMI (body mass index) > 25 kg/m2 or BMI > 85th percentile and BMI > 30 kg/m1 or BMI > 95th percentile to estimate overweight and obesity in those aged < 19 years. To define overweight and obesity in those > 20 years, they used BMI > 25 kg/m2 and > 30 kg/m2. They found overweight rates of 21.6% using BMI directly and 16.2% using BMI percentile and obesity rates of 4.9% using BMI directly and 4.2% using BMI percentile. More than 69% of the participants reported < 5 servings of fruits and vegetables per day and more than 67% reported < 20 g of fiber per day; participants reported physical activity on fewer than 3 d/wk. Most college students are not meeting dietary and physical activity guidelines, suggesting the need for prevention interventions and increased understanding of overweight in college students.

Neighborhood Context and Youth Cardiovascular Health Behaviors

OBJECTIVES This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. METHODS Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. RESULTS Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. CONCLUSIONS Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors.

The Physical Activity Resource Assessment (PARA) instrument: evaluating features, amenities and incivilities of physical activity resources in urban neighborhoods.

BackgroundNeighborhood environment factors may influence physical activity (PA). The purpose of this study was to develop and test a brief instrument to systematically document and describe the type, features, amenities, quality and incivilities of a variety of PA resources.MethodThe one-page Physical Activity Resource Assessment (PARA) instrument was developed to assess all publicly available PA resources in thirteen urban lower income, high ethnic minority concentration neighborhoods that surrounded public housing developments (HDs) and four higher income, low ethnic minority concentration comparison neighborhoods. Neighborhoods had similar population density and connectivity. Trained field coders rated 97 PA resources (including parks, churches, schools, sports facilities, fitness centers, community centers, and trails) on location, type, cost, features, amenities, quality and incivilities. Assessments typically took about 10 minutes to complete.ResultsHD neighborhoods had a mean of 4.9 PA resources (n = 73) with considerable variability in the type of resources available for each neighborhood. Comparison neighborhoods had a mean of 6 resources (n = 24). Most resources were accessible at no cost (82%). Resources in both types of neighborhoods typically had about 2 to 3 PA features and amenities, and the quality was usually mediocre to good in both types of neighborhoods. Incivilities at PA resources in HD neighborhoods were significantly more common than in comparison neighborhoods.ConclusionAlthough PA resources were similar in number, features and amenities, the overall appearance of the resources in HD neighborhoods was much worse as indicated by substantially worse incivilities ratings in HD neighborhoods. The more comprehensive assessment, including features, amenities and incivilities, provided by the PARA may be important to distinguish between PA resources in lower and higher deprivation areas.

Contribution of neighbourhood socioeconomic status and physical activity resources to physical activity among women

Introduction: Residence in a deprived neighbourhood is associated with lower rates of physical activity. Little is known about the manifestation of deprivation that mediates this relationship. This study aimed to investigate whether access to physical activity resources mediated the relationship between neighbourhood socioeconomic status and physical activity among women. Method: Individual data from women participating in the Stanford Heart Disease Prevention Program (1979–90) were linked to census and archival data from existing records. Multilevel regression models were examined for energy expenditure and moderate and vigorous physical activity as reported in physical activity recalls. Results: After accounting for individual-level socioeconomic status, women who lived in lower-socioeconomic status neighbourhoods reported greater energy expenditure, but undertook less moderate physical activity, than women in moderate-socioeconomic status neighbourhoods. In contrast, women living in higher-socioeconomic status neighbourhoods reported more vigorous physical activity than women in moderate-socioeconomic status neighbourhoods. Although availability of physical activity resources did not appear to mediate any neighbourhood socioeconomic status associations, several significant interactions emerged, suggesting that women with low income or who live in lower-socioeconomic status neighbourhoods may differentially benefit from greater physical activity resource availability. Discussion: Although we found expected relationships between residence in a lower-socioeconomic status neighbourhood and undertaking less moderate or vigorous physical activity among women, we also found that these same women reported greater overall energy expenditure, perhaps as a result of greater work or travel demands. Greater availability of physical activity resources nearby appears to differentially benefit women living in lower-socioeconomic status neighbourhoods and low-income women, having implications for policy-making and planning.

How Does the Built Environment Relate to Body Mass Index and Obesity Prevalence Among Public Housing Residents

Purpose. This study examined associations of environmental variables with obesity prevalence and individual body mass index (BMI) among impoverished residents of public housing developments. Design. Cross-sectional data were drawn from two studies in the same Midwestern metropolitan area of participants within neighborhoods. Setting. Pathways to Health interviewed housing development residents and Understanding Neighborhood Determinants of Obesity assessed built environment factors in the surrounding neighborhoods (i.e., 800–m radius from center of housing development). Subjects. Four hundred twenty-one residents participated (mean age = 43.8 years; 72.0% women, 59.6% high school degree, 79.6% African-American). Fifty-five physical activity resources were identified and assessed. Measures. Demographics and measured weights and heights were obtained for participants. The Physical Activity Resource Assessment measured the type, accessibility, features, amenities, qualities, and incivilities of neighborhood physical activity resources. Neighborhood street connectivity was also measured. Results. Average age-adjusted BMI was 31.4 (SD = 1.3), with 45% of residents obese. High negative correlations were found between BMI and street connectivity (p = .05) and between obesity prevalence and resource accessibility (p = .09), number of amenities (p = .04), and amenity quality (p = .04). Higher resource accessibility, feature quality, number of amenities, and fewer incivilities per resource accounted for 71% of obesity variance (p < .05). Male gender and higher feature quality, F(11, 407)37.19 and 12.66, p < .001, predicted lower BMI among residents. Conclusion. Supportive neighborhood environments were related to lower obesity prevalence and lower BMI among residents.

Associations between the built environment and physical activity in public housing residents

BackgroundEnvironmental factors may influence the particularly low rates of physical activity in African American and low-income adults. This cross-sectional study investigated how measured environmental factors were related to self-reported walking and vigorous physical activity for residents of low-income public housing developments.MethodsPhysical activity data from 452 adult residents residing in 12 low-income housing developments were combined with measured environmental data that examined the neighborhood (800 m radius buffer) around each housing development. Aggregated ecological and multilevel regression models were used for analysis.ResultsParticipants were predominately female (72.8%), African American (79.6%) and had a high school education or more (59.0%). Overall, physical activity rates were low, with only 21% of participants meeting moderate physical activity guidelines. Ecological models showed that fewer incivilities and greater street connectivity predicted 83% of the variance in days walked per week, p < 0.001, with both gender and connectivity predicting days walked per week in the multi-level analysis, p < 0.05. Greater connectivity and fewer physical activity resources predicted 90% of the variance in meeting moderate physical activity guidelines, p < 0.001, and gender and connectivity were the multi-level predictors, p < 0.05 and 0.01, respectively. Greater resource accessibility predicted 34% of the variance in days per week of vigorous physical activity in the ecological model, p < 0.05, but the multi-level analysis found no significant predictors.ConclusionThese results indicate that the physical activity of low-income residents of public housing is related to modifiable aspects of the built environment. Individuals with greater access to more physical activity resources with fewincivilities, as well as, greater street connectivity, are more likely to be physically active.

Ready to be Physically Active? The Effects of a Course Preparing Low-Income Multiethnic Women to be more Physically Active:

The purpose of this study is to evaluate the effect of a preintervention physical activity preparatory course on physical activity, and social, cognitive, and transtheoretical constructs. The sample included 82 low-income, multiethnic women (75% Latina) who completed an 8-week course designed to prepare them to become more active prior to randomization into a 10-month physical activity intervention. Participants completed precourse and postcourse measures. Paired-comparison t tests showed increases in knowledge, perceived social support for exercise, minutes of walking per week, and total cognitive and behavioral processes following the preparatory course. Perceived barriers and self-efficacy for exercise did not change from precourse to postcourse. Preintervention preparatory courses may be an effective way to increase social and cognitive constructs associated with physical activity behavior, potentially yielding a greater effect from subsequent interventions.

Striding Toward Social Justice: The Ecologic Milieuof Physical Activity

Disparities in physical activity should be investigated in light of social justice principles. This article critically evaluates evidence and trends in disparities research within an ecologic framework, focusing on multilevel factors such as neighborhood and racial discrimination that influence physical activity. Discussion focuses on strategies for integrating social justice into physical activity promotion and intervention programming within an ecologic framework.