Physical activity among cancer survivors: do neighborhood walkability and metropolitan size play a role?

PURPOSE: To examine associations between walkability, metropolitan size, and physical activity (PA) among cancer survivors and explore if the association between walkability and PA would vary across United States metropolitan sizes. METHODS: This study used data from the 2020 National Health Interview Survey to examine independent associations of walkability and metropolitan size with engaging in moderate-to-vigorous PA (MVPA) and to explore the effect modification of metropolitan size using log-binomial regression. The dependent variable was dichotomized as < vs. ≥ 150 min/week of MVPA. The predictors were perceived walkability, a total score comprising eight neighborhood attributes, and metropolitan size. Covariates included sociodemographic and health characteristics, geographic region, cancer type, and time since cancer diagnosis. RESULTS: Engaging in 150 + min/wk of MVPA significantly increased among cancer survivors (n = 3,405) who perceived their neighborhoods as more walkable (prevalence ratio:1.04; p = 0.004). Engaging in 150 + min/wk of MVPA significantly increased among cancer survivors living in medium and small metropolitan areas vs. those living in large central metropolitan areas (prevalence ratio:1.12; p = 0.044). Perceived walkability levels were similar among cancer survivors in nonmetropolitan areas vs. those living in large central metropolitan areas. Association between walkability and PA did not significantly vary across metropolitan sizes. CONCLUSIONS: Perceived neighborhood walkability is positively associated with MVPA among cancer survivors, regardless of metropolitan size. IMPLICATIONS FOR CANCER SURVIVORS: Findings highlight the importance of investing in the built environment to increase walkability among this population and translating lessons from medium and small metropolitan areas to other metropolitan areas to address the rural-urban disparity in PA among cancer survivors.

Non-use and inadequate use of cervical cancer screening among a representative sample of women in the United States.

Introduction: Women's adherence to the United States (U.S.) Preventive Services Task Force guidelines for cervical cancer screening was determined by examining predisposing, enabling, and needs factors from Andersen's Behavioral Model of Health Services Use conceptual framework. Methods: The outcome was operationalized as cervical cancer screening use, non-use, and inadequate-use. Multinomial logistic regression was conducted on data from the 2019 National Health Interview Survey of 7,331 eligible women aged 21-65. Results: Compared with women who used cervical cancer screening services, women aged 30-65 were less likely to be Non-Users than those aged 21-29. Hispanic, Asian, and American Indian/Alaska Native (AIAN) women were more likely to be Non-Users than White women. More educated women were less likely to be Non-Users. Foreign-born women <10 years in the U.S. were more likely to be Non-Users than U.S.-born women. Women with financial hardship were less likely to be Non-Users. Poorer women and uninsured women were more likely to be Non-Users. Women with children in their household were less likely to be Non-Users than those without children. Women who had a well-visit in the past year were less likely to be Non-Users. Women with a history of human papillomavirus (HPV) vaccination were less likely to be Non-Users. Compared with women who used cervical cancer screening services, women aged 30-65 were less likely to be Inadequate-Users. AIAN women were more likely to be Inadequate-Users. Women of other races were less likely to be Inadequate-Users. Employed women were less likely to be Inadequate-Users. Uninsured women were more likely to be Inadequate-Users. Women who had a well-visit within a year were less likely to be Inadequate-Users. Women with past HPV vaccination were more likely to be Inadequate-Users. Smokers were less likely to be Inadequate-Users. Discussion: Predisposing, enabling, and needs factors are differently associated with non-use and inadequate use of cervical cancer screening. Understanding factors associated with the use, non-use, and inadequate use of cervical cancer screening is crucial to avoid or curb unnecessary tests, increased costs to both society and individuals, and the ill-allocation of limited resources.

Type 2 diabetes and health-related quality of life among older Medicare beneficiaries: The mediating role of sleep.

OBJECTIVE: To examine mediating effects of sleep quality and duration on the association between T2D and QoL among Medicare beneficiaries 65+. METHODS: Data from the Medicare Health Outcome Survey (2015-2020) were used. The outcome was QoL (physical and mental health component-summary scores [PCS and MCS]) measured by the Veterans-Rand-12. The main predictor was diagnosed T2D. Mediators were sleep duration and sleep quality. The effect modifier was race/ethnicity. Structural Equation Modeling was used to estimate moderated-mediating effects of sleep quality and duration across race/ethnicity. RESULTS: Of the 746,400 Medicare beneficiaries, 26.7% had T2D, and mean age was 76 years (SD ± 6.9). Mean PCS score was 40 (SD ± 12.2), and mean MCS score was 54.0 (SD ± 10.2). Associations of T2D with PCS and MCS were negative and significant. For all racial/ethnic groups, those with T2D reported lower PCS. For White, Black, Asian, and Hispanic beneficiaries only, those with T2D reported lower MCS. The negative impact of T2D on PCS and MCS was mediated through sleep quality, especially very bad sleep quality. CONCLUSION: Improving sleep may lead to improvement in QoL in elderly adults with T2D.

Income variability and incident cardiovascular disease in diabetes: a population-based cohort study.

BACKGROUND AND AIMS: Longitudinal change in income is crucial in explaining cardiovascular health inequalities. However, there is limited evidence for cardiovascular disease (CVD) risk associated with income dynamics over time among individuals with type 2 diabetes (T2D). METHODS: Using a nationally representative sample from the Korean National Health Insurance Service database, 1 528 108 adults aged 30-64 with T2D and no history of CVD were included from 2009 to 2012 (mean follow-up of 7.3 years). Using monthly health insurance premium information, income levels were assessed annually for the baseline year and the four preceding years. Income variability was defined as the intraindividual standard deviation of the percent change in income over 5 years. The primary outcome was a composite event of incident fatal and nonfatal CVD (myocardial infarction, heart failure, and stroke) using insurance claims. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated after adjusting for potential confounders. RESULTS: High-income variability was associated with increased CVD risk (HRhighest vs. lowest quartile 1.25, 95% CI 1.22-1.27; Ptrend < .001). Individuals who experienced an income decline (4 years ago vs. baseline) had increased CVD risk, which was particularly notable when the income decreased to the lowest level (i.e. Medical Aid beneficiaries), regardless of their initial income status. Sustained low income (i.e. lowest income quartile) over 5 years was associated with increased CVD risk (HRn = 5 years vs. n = 0 years 1.38, 95% CI 1.35-1.41; Ptrend < .0001), whereas sustained high income (i.e. highest income quartile) was associated with decreased CVD risk (HRn = 5 years vs. n = 0 years 0.71, 95% CI 0.70-0.72; Ptrend < .0001). Sensitivity analyses, exploring potential mediators, such as lifestyle-related factors and obesity, supported the main results. CONCLUSIONS: Higher income variability, income declines, and sustained low income were associated with increased CVD risk. Our findings highlight the need to better understand the mechanisms by which income dynamics impact CVD risk among individuals with T2D.

Job Flexibility, Job Security, and Mental Health Among US Working Adults.

Importance: Understanding the association between job characteristics and mental health can inform policies and practices to promote employee well-being. Objective: To investigate associations between job characteristics and mental health, work absenteeism, and mental health care use among US adults. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2021 National Health Interview Survey and included adults aged 18 years or older who reported employment during the past 12 months. Data were analyzed from May 2023 to January 2024. Exposures: Job flexibility was assessed as a summative variable to 3 questions: perceived ease of changing one's work schedule to do things important to oneself or their family, regularity of work schedule changes, and advance notice of work hours. Job security was measured as perceived likelihood of losing one's job. Main Outcomes and Measures: Mental health outcomes included self-reported serious psychological distress and frequency of anxiety. Work absenteeism was assessed using the number of missed workdays due to illness. Mental health care use was examined for both current and past year use. Multivariable logistic and binomial regression analyses were used to examine associations of interest. Results: The analytic sample consisted of 18 144 adults (52.3% [95% CI, 51.5%-53.2%] male; mean age, 42.2 [95% CI, 41.9-42.6] years). Greater job flexibility was associated with decreased odds of serious psychological distress (odds ratio [OR], 0.74 [95% CI, 0.63-0.86]; P < .001) and lower odds of weekly anxiety (OR, 0.89 [95% CI, 0.81-0.97]; P = .008) or daily anxiety (OR, 0.87 [95% CI, 0.79-0.96]; P = .005). Greater job security was associated with decreased odds of serious psychological distress (OR, 0.75 [95% CI, 0.65-0.87]; P < .001) and lower odds of anxiety weekly (OR, 0.79 [95% CI, 0.71-0.88]; P < .001) or daily (OR, 0.73 [95% CI, 0.66-0.81]; P < .001). Greater job flexibility (incidence rate ratio [IRR], 0.84 [95% CI, 0.74-0.96]; P = .008) and job security (IRR, 0.75 [95% CI, 0.65-0.87]; P < .001) were each associated with decreased number of days worked despite feeling ill over the past 3 months. Greater job security was associated with decreased absenteeism in the past year (IRR, 0.89 [95% CI, 0.82-0.98]; P < .014). Conclusions and Relevance: Organizational policies that enhance job flexibility and security may facilitate a healthier work environment, mitigate work-related stress, and ultimately promote better mental health.

Association Between Physical Activity and Physical Function in a Marshallese Population with Type 2 Diabetes.

Physical activity can delay functional decline in people with type 2 diabetes (T2D), but these associations have not been studied within a sample of Native Hawaiian or Pacific Islander adults with T2D. Using data from a randomized control trial in which 218 Marshallese adults with T2D participated in a 10-week diabetes self-management education intervention, this study tested our hypothesis that physical activity would predict physical function when controlling for time and other variables. Levels of physical activity were positively associated with levels of physical function, even after controlling for time and other covariates. These findings provide a more robust understanding of the relationship between physical activity and physical function in a sample of minority adults with T2D. Future studies should further explore levels of physical activity needed to maintain and improve physical function so that culturally appropriate physical activity interventions can be developed.

Characteristics of nursing homes with high percentages of falls and falls with injuries among residents with obesity.

BACKGROUND: Obesity among United States nursing home (NH) residents is increasing. These residents have special care needs, which increases their risk for falls and falls with injuries. NH are responsible for ensuring the health of their residents, including minimizing falls. However, given the special care needs of residents with obesity, different factors may be important for developing programs to minimize falls among this group. AIM: We aimed to identify NH characteristics associated with falls and falls with injuries among residents with obesity. METHOD: We used resident assessment data and logistic regression analysis. RESULTS: We found that rates of falls and falls with injuries among residents with obesity varied significantly based on for-profit status, size, acuity index, obesity rate among residents, and registered nurse hours per patient day. CONCLUSION: Recommendations are made as to how NH may be able to lower risk for falls and falls with injuries among their residents with obesity.

Factors associated with breast cancer screening services use among women in the United States: An application of the Andersen's Behavioral Model of Health Services Use.

This study applied Andersen's Behavioral Model of Health Services Use to examine predisposing, enabling, and need factors associated with adherence to the United States Preventive Services Task Force (USPSTF) guidelines for breast cancer screening (BCS). Multivariable logistic regression was used to determine factors of BCS services utilization among 5484 women aged 50-74 from the 2019 National Health Interview Survey. Predisposing factors significantly associated with use of BCS services were: being a Black (odds-ratios [OR]:1.49; 95% confidence interval [CI]:1.14-1.95) or a Hispanic woman (OR:2.25; CI:1.62-3.12); being married/partnered (OR:1.32, CI:1.12-1.55); having more than a bachelor's degree (OR: 1.62; CI:1.14-2.30); and living in rural areas (OR:0.72; CI:0.59-0.92). Enabling factors were: poverty level [≤138% federal poverty level (FPL) (OR:0.74; CI:0.56-0.97), >138-250% FPL (OR:0.77; CI:0.61-0.97), and > 250-400% FPL (OR:0.77; CI:0.63-0.94)]; being uninsured (OR:0.29; CI:0.21-0.40); having a usual source of care at a physician office (OR:7.27; CI:4.99-10.57) or other healthcare facilities (OR:4.12; CI:2.68-6.33); and previous breast examination by a healthcare professional (OR:2.10; CI:1.68-2.64). Need factors were: having fair/poor health (OR:0.76; CI:0.59-0.97) and being underweight (OR:0.46; CI:0.30-0.71). Disparities in BCS services utilization by Black and Hispanic women have been reduced. Disparities still exist for uninsured and financially restrained women living in rural areas. Addressing disparities in BCS uptake and improving adherence to USPSTF guidelines may require revamping policies that address disparities in enabling resources, such as health insurance, income, and health care access.

Medical Financial Hardship and Food Security among Cancer Survivors in the United States.

BACKGROUND: Some cancer survivors experience medical financial hardship, which may reduce their food security. The purpose of this study was to explore whether medical financial hardship is related to food security among cancer survivors. METHODS: The study was based on cross-sectional data from the 2020 National Health Interview Survey. We used ordinal logistic regression to examine the relationship between material, psychological, and behavioral medical financial hardships and household food security (i.e., high, marginal, low, or very low) among individuals ages ≥18 years who reported a cancer diagnosis from a health professional (N = 4,130). RESULTS: The majority of the sample reported high household food security (88.5%), with 4.8% reporting marginal, 3.6% reporting low, and 3.1% reporting very low household food security. In the adjusted model, the odds of being in a lower food security category were higher for cancer survivors who had problems paying or were unable to pay their medical bills compared with those who did not [OR, 1.73; 95% confidence interval (CI), 1.06-2.82, P = 0.027], who were very worried about paying their medical bills compared with those who were not at all worried (OR, 2.88; 95% CI, 1.64-5.07; P < 0.001), and who delayed medical care due to cost compared with those who did not (OR, 2.56; 95% CI, 1.29-5.09; P = 0.007). CONCLUSIONS: Food insecurity is rare among cancer survivors. However, medical financial hardship is associated with an increased risk of lower household food security among cancer survivors. IMPACT: A minority of cancer survivors experience medical financial hardship and food insecurity; social needs screenings should be conducted.

Prevalence and associations between food insecurity and overweight/obesity among native Hawaiian and Pacific Islander adolescents.

OBJECTIVE: This study estimates the prevalence of, and associations between, family food insecurity and overweight/obesity among Native Hawaiian and Pacific Islander (NHPI) adolescents and explores socio-demographic factors which might have a moderation effect on the association. DESIGN: Cross-sectional study using 2014 NHPI-National Health Interview Survey data reported by a parent or guardian. Family-level food security was assessed by the US Department of Agriculture 10-item questionnaire. BMI for age and sex ≥ 85th and 95th percentiles defined overweight and obesity, respectively, according to US Centers for Disease Control and Prevention criteria. SETTING: The USA, including all 50 states and the District of Columbia. PARTICIPANTS: 383 NHPI adolescents aged 12-17 in the USA. RESULTS: A third (33·5 %) of NHPI adolescents aged 12-17 were overweight (19·1 %) or obese (14·4 %); 8·1 % had low food security; and 8·5 % had very low food security. Mean family food security score was 1·06, which corresponds to marginal food security. We found no association between family food insecurity and adolescent overweight/obesity or between any other covariates and overweight/obesity, except for family Supplemental Nutrition Assistance Program (SNAP) participation. Odds of being overweight/obese were 77 % lower for adolescents in families participating in SNAP (OR: 0·23, 95 % CI: 0·08, 0·64, P = 0·007). The association between SNAP participation and lower odds of overweight/obesity was particularly pronounced for adolescent girls in food-insecure families. CONCLUSIONS: The association between SNAP participation and lower odds of overweight/obesity suggests potential benefit of research to determine whether interventions to increase SNAP enrollment would improve NHPI adolescents' health outcomes.

Higher walkability associated with increased physical activity and reduced obesity among United States adults.

OBJECTIVE: This study examined associations among perceived neighborhood walkability, physical activity (PA), and obesity among United States adults. METHODS: Data from the 2020 National Health Interview Survey were analyzed. Walkability was assessed using a summative scale and was categorized as low, medium, or high. PA was categorized as insufficient (0-149 min/wk) or sufficient (150+ min/wk). Multivariable regressions estimated an association between obesity and BMI and PA/walkability. Mediation analysis was used to partition contribution of PA as a mediator. Effect modification by race and ethnicity in the association between walkability and BMI was explored. RESULTS: The sample included N = 31,568 adults. Compared with those in low-walkability neighborhoods, participants in high-walkability neighborhoods had increased odds of sufficient PA (odds ratio [OR] = 1.48; 95% CI: 1.30-1.69) and decreased obesity odds (OR = 0.76; 95% CI: 0.66-0.87). PA partially mediated the association between walkability and BMI (23.4%; 95% CI: 14.6%-62.7%). The association between walkability and BMI was modified by race and ethnicity (F[5,567]  = 2.75; p = 0.018). Among White, Black, Hispanic, and Asian adults, BMI decreased with increasing walkability; among American Indian/Alaska Native and multiracial/other adults, BMI increased with increasing walkability. CONCLUSIONS: The findings highlight the importance of investing in the built environment to improve perceptions of walkability and promote PA and healthy weight, as well as developing interventions to target racial and ethnic disparities in these outcomes.

Characteristics of United States nursing homes with high percentages of stage 2-4 pressure injuries among high-risk nursing home residents with obesity.

Obesity rates in nursing homes (NHs) are increasing. Residents with obesity are at risk for poor outcomes such as pressure injuries (PIs) due to special care needs such as bariatric medical equipment and special protocols for skin care. PIs among resident populations is a sign of poor quality NH care. The purpose of this retrospective observational study was to identify characteristics of NHs with high rates of stage 2-4 PIs among their high-risk residents with obesity. Resident assessment data were aggregated to the NH level. NH structure and process of care and antecedent conditions of the residents and environment measures were used in bivariate comparisons and multivariate logistic regression models to identify associations with NHs having high rates of stage 2-4 PIs among high-risk residents with obesity. We identified three characteristics for which the effect on the odds was at least 10% for clinical significance - for-profit status, large facilities, and the hours of certified nursing assistants (CNAs) per patient day (HRPPD). This study identified several NH characteristics that are associated with higher risk for PIs, which can be targeted with evidence-based interventions to reduce the risk of these adverse safety events occurring.

Characteristics of Nursing Homes with High Rates of Urinary Tract Infections among Their Residents with Obesity.

Nursing home residents with obesity are at high risk for contracting urinary tract infections. In this research study, we found nursing homes in multi-facility chain organizations, for-profit status, nursing home size, obesity rate of resident population, and market competition were significantly associated with rates of urinary tract infections among residents with obesity.

Assessment of Colorectal Cancer Screening Disparities in U.S. Men and Women Using a Demographically Representative Sample.

Timely receipt of colorectal cancer (CRC) screening can reduce morbidity and mortality. This is the first known study to adopt Andersen's model of health services use to identify factors associated with CRC screening among US adults. The data from National Health Interview Survey from 2019 was utilized to conduct the analyses. Multivariable logistic regression was used to separately analyze data from 7,503 age-eligible women and 6,486 age-eligible men. We found similar CRC screening levels among men (57.7%) and women (57.6%). Factors associated with higher screening odds in women were older age, married/cohabitating with a partner, Black race, >bachelor's degree, having a usual source of care, and personal cancer history. Factors associated with lower odds for women were American Indian/Alaska Native race, living in the US for ≤10 years, ≤138% federal poverty level (FPL), uninsured or having Medicare, and in fair/poor health. For men, factors associated with higher screening odds were older age, homosexuality, married/cohabitating with a partner, Black race, >high school/general educational development education, having military insurance, having a usual source of care, and personal cancer history. Factors associated with lower odds for men were being a foreign-born US resident, living in the South or Midwest, ≤138% FPL, and being uninsured or having other insurance. Despite lower screening rates in the past, Black adults show a significantly higher likelihood of CRC screening than White adults; yet, screening disparities remain in certain other groups. CRC screening efforts should continue to target groups with lower screening rates to eliminate screening disparities.

Nursing home directors of nursing experiences regarding safety among residents with obesity.

The prevalence of nursing home (NH) residents with obesity is rising. Perspectives of NH Directors of Nursing (DONs) who oversee care trajectories for residents with obesity is lacking. This study aimed to describe the experiences of NH DONs regarding care and safety for NH residents with obesity. An adapted version of Donabedian's structure-process-outcome model guided this qualitative descriptive study. Semi-structured interviews were conducted with 15 DONs. Data were analyzed using directed content analysis, and findings are presented under the model's constructs. We learned that admission decisions for NH referrals of patients with obesity are complex due to reimbursement issues, available space and resources, and resident characteristics. DONs described the need to coach and mentor Certified Nursing Assistants to provide safe quality care and that more staff education is needed. We identified novel findings regarding the challenges of short-term residents' experience transitioning out of care due to limited resources.

Food Pantry Usage Patterns are Associated with Client Sociodemographics and Health.

Characterizing food pantry (FP) clients' FP usage patterns may provide opportunities to tailor health-related interventions. Respondents (n=245) at seven FPs reported their frequency and reliance on FPs and their sociodemographics, health status, and health-related trade-offs. Clients were categorized via latent class analysis. Higher FP usage was associated with being older, having a household member with heart disease, and putting off buying medicine to buy food. Lower FP usage was associated with higher levels of education and having a household member with cancer. Findings highlight the potential importance of measuring FP clients' degree of FP use.

Factors associated with telehealth use among adults in the United States: Findings from the 2020 National Health Interview Survey.

INTRODUCTION: During the COVID-19 pandemic, health care shifted to virtual interactions with health professionals. The aim of this study was to examine the determinants of telehealth use in a nationally representative sample of the United States adult population. METHODS: The study used data from the 2020 National Health Interview Survey of 17,582 respondents aged ≥18. Andersen's model of health services utilization was employed to examine predisposing, enabling, and needs factors associated with past-year telehealth use. Multivariable logistic regression was conducted to examine statistical associations. RESULTS: 32.5% of adults (n = 6402; mean age 51.6, SE = 0.4) reported telehealth use. Predisposing factors: Women and married/partnered adults and those with higher levels of education had greater odds of using telehealth. Adults living in Midwest and South and adults living in medium-small and non-metropolitan areas had decreased odds of using telehealth. Enabling factors: Income and having a usual source of care were positively associated with telehealth use. A negative association was found for those with no insurance and telehealth use, whereas a positive association was found for military insurance. Needs factors: Odds of using telehealth were increased for adults who had well-visits and ER visits in the past 12 months. Mental health services quadrupled the odds of telehealth use. Odds of using telehealth increased with each additional chronic disease, including COVID-19. CONCLUSION: There are disparities in telehealth use according to sex, education, rurality, access to care, and health needs. Tackling these disparities is pivotal to ensure barriers to telehealth use are not exacerbated post-pandemic.

Food insecurity and chronic diseases among Native Hawaiians and Pacific Islanders in the US: results of a population-based survey.

Data from the 2014 Native Hawaiian and Pacific Islander (NHPI) National Health Interview Survey were used to examine associations between food security and individual chronic diseases, total number of chronic diseases, and general health status among 637 NHPI adults with income below 200 percent federal poverty level. Very low food security was associated with hypertension, diabetes, and asthma. Very low food security and marginal food security were associated with having any chronic disease and with having a higher number of chronic diseases. Risk for food insecurity increased as health status decreased. These associations had not previously been documented for NHPI.

Associations between physical activity and functional limitations in Native Hawaiian and Pacific Islander middle-aged and older adults in the United States.

OBJECTIVES: Physical activity (PA) can help individuals maintain physical function and independence. The association between PA and functional limitations (FL) has not been explored in the Native Hawaiian and Pacific Islander (NHPI) population. The purpose of this study was to examine relationships between PA and FL among NHPI adults (age ≥ 45 years) living in the United States. DESIGN: Cross-sectional data from the 2014 NHPI-National Health Interview Survey (N = 628) was used to create three constructs of FL based on responses from the Functioning and Disability Survey Module: needing equipment/assistance, having difficulty walking, and having difficulty with performing self-care and other fine motor activities. We used 2-stage least squares regression to examine the relationship between PA and FL of NHPI adults while accounting for the potential endogeneity of PA to FL. RESULTS: Compared to NHPI adults who met the guideline for recommended levels of aerobic and strengthening PA, those who met only the strengthening guideline experienced less difficulty in two FL constructs (use of medical equipment/assistance and difficulty walking). Those who met the aerobic guideline reported even less difficulties in all three FL constructs. NHPI adults who met both the aerobic and strengthening guidelines experienced the least difficulties in all three FL constructs compared to those who met neither PA guidelines. CONCLUSIONS: PA is associated with function in this adult NHPI population. Aerobic guidelines alone may be more beneficial than meeting the strengthening guideline alone; however, meeting both the aerobic and strengthening guidelines is most protective against FL.

Neighborhood social cohesion and physical activity and obesity outcomes among Native Hawaiian and Pacific Islander individuals.

OBJECTIVE: Native Hawaiian and Pacific Islander (NHPI) individuals report high obesity rates and low physical activity (PA) levels. This study examined associations between neighborhood social cohesion, obesity, and PA among NHPI adults. METHODS: Cross-sectional data from the 2014 NHPI National Health Interview Survey were analyzed. Social cohesion was assessed using a summative scale and categorized as low, medium, and high. PA was measured via self-report and categorized as insufficiently active (0-149 min/wk) or sufficiently active (150+ min/wk). Obesity status was based on self-reported height and weight measures converted into standard BMI categories. Multivariable logistic regression models estimated odds of obesity and sufficient PA associated with social cohesion level. RESULTS: The study sample included n = 2,590 NHPI adults. Compared with those in low social cohesion neighborhoods, participants in high social cohesion neighborhoods had increased sufficient PA odds (odds ratio [OR] = 1.59, 95% CI: 1.19-2.12; p = 0.003) and decreased obesity odds (OR = 0.57, 95% CI: 0.40-0.83; p = 0.005). No associations were observed between social cohesion and obesity and PA outcomes comparing individuals in medium versus low social cohesion neighborhoods. CONCLUSIONS: High social cohesion was associated with reduced obesity odds and increased sufficient PA odds. Findings highlight the importance of enhancing social connectivity as a potential strategy to promote PA and healthy weight among NHPI individuals.