Two-year outcomes of Faith in Action/Fe en Acción: a randomized controlled trial of physical activity promotion in Latinas.

BACKGROUND: Latina women are less likely to report engaging in leisure-time physical activity (PA) than non-Latina white women. This study evaluated the 24-month impact of a faith-based PA intervention targeting Latinas. METHODS: The study is a cluster randomized controlled trial of a PA intervention or cancer screening comparison condition, with churches as the randomization unit. A total of 436 Latinas (aged 18-65 years) from 16 churches who engaged in low levels of self-report and accelerometer-based PA were enrolled. The experimental condition was a 24-month PA intervention, with in-person classes, social support, and environmental changes, led by community health workers (i.e., promotoras). At baseline, 12-, and 24 months, we assessed changes in accelerometer-based and self-reported moderate to vigorous physical activity (MVPA; primary outcomes). Secondary outcomes were light intensity activity, sedentary time, body mass index (BMI), and waist circumference. RESULTS: After adjusting for sociodemographic factors, a mixed effects analysis found significant increases in self-reported leisure time MVPA (p < 0.005) and marginal increases in accelerometer-assessed MVPA (p < 0.08) 24 months post-baseline in the intervention compared to the attention-control condition. Data showed significant associations between PA class attendance and engaging in MVPA as assessed by self-report and accelerometry. No significant changes were found for light activity, sedentary time, BMI, or waist circumference. CONCLUSIONS: Participants who attended the PA classes at least once a month engaged in significantly higher MVPA compared to those who did not. Maximizing engagement and maintenance strategies to enhance PA maintenance could contribute to important long-term health benefits. TRIAL REGISTRATION: NCT01776632 , Registered March 18, 2011.

A landscape-scale framework to identify refugia from multiple stressors.

From a conservation perspective, quantifying potential refugial capacity has been predominantly focused on climate refugia, which is critical for maintaining the persistence of species and ecosystems. However, protection from other stressors, such as human-induced changes in fire and hydrology, that cause habitat loss, degradation, and fragmentation is also necessary to ensure that conservation efforts focused on climate are not undermined by other threats. Thus, conceptual and methodological advances for quantifying potential refugia from multiple anthropogenic stressors are important to support conservation efforts. We devised a new conceptual approach, the domains of refugia, for assessing refugial capacity that identifies areas where exposure to multiple stressors is low. In our framework, patterns of environmental variability (e.g., increased frequency of warm summers), thresholds of resilience, and extent and intensity of stressors are used to identify areas of potential refugia from a suite of ongoing anthropogenic stressors (e.g., changes in fire regime). To demonstrate its utility, we applied the framework to a Southern California landscape. Sites with high refugial capacity (super-refugia sites) had on average 30% fewer extremely warm summers, 20% fewer fire events, 10% less exposure to altered river channels and riparian areas, and 50% fewer recreational trails than the surrounding landscape. Our results suggest that super-refugia sites (∼8200 km2 ) for some natural communities are underrepresented in the existing protected area network, a finding that can inform efforts to expand protected areas. Our case study highlights how considering exposure to multiple stressors can inform planning and practice to conserve biodiversity in a changing world.

Marco Conceptual a para Identificar Refugios de Múltiples Amenazas a Escala de Paisaje Resumen Desde la perspectiva de la conservación, la cuantificación de la capacidad potencial de refugio se ha enfocado principalmente en los refugios climáticos, los cuales son críticos para mantener la persistencia de las especies y los ecosistemas. Sin embargo, la protección ante otros factores estresantes, como los cambios inducidos por los humanos en los incendios y la hidrología, que causan la pérdida, degradación y fragmentación del hábitat, también son necesarios para asegurar que los esfuerzos de conservación enfocados en el clima no sean afectados por otras amenazas. Por lo tanto, los avances conceptuales y metodológicos para cuantificar los refugios potenciales ante múltiples factores estresantes causados por el humano son importantes para asegurar que los esfuerzos de conservación logren sus objetivos. Diseñamos una nueva estrategia conceptual, los dominios de los refugios, para evaluar la capacidad de refugio de un paisaje donde la exposición a múltiples factores estresantes es baja. En nuestro marco conceptual usamos los patrones de variabilidad ambiental (p. ej.: incremento en la frecuencia de veranos cálidos), los umbrales de resiliencia y la extensión e intensidad de los factores estresantes para identificar las áreas de refugios potenciales a partir de un conjunto de factores antropogénicos persistentes (p. ej.: cambios en el régimen de incendios). Para demostrar su utilidad, aplicamos el marco conceptual a un paisaje del sur de California. Los sitios con una alta capacidad de refugio (sitios de súper-refugios) tuvieron en promedio un 30% menos veranos extremadamente cálidos, 20% menos eventos de incendios y 50% menos senderos recreativos que el paisaje circundante. Nuestros resultados sugieren que los sitios de súper-refugios (∼ 8,200 km2 ) para algunas comunidades naturales están subrepresentados en la red existente de áreas protegidas, un resultado que puede orientar los esfuerzos por expandir las áreas protegidas. Nuestro estudio de caso resalta que considerar la exposición a múltiples amenazas puede guiar la planificación y la práctica de la conservación de la biodiversidad en un mundo cambiante.

Fe en Accion/Faith in Action: Design and implementation of a church-based randomized trial to promote physical activity and cancer screening among churchgoing Latinas.

OBJECTIVES: To describe both conditions of a two-group randomized trial, one that promotes physical activity and one that promotes cancer screening, among churchgoing Latinas. The trial involves promotoras (community health workers) targeting multiple levels of the Ecological Model. This trial builds on formative and pilot research findings. DESIGN: Sixteen churches were randomly assigned to either the physical activity intervention or cancer screening comparison condition (approximately 27 women per church). In both conditions, promotoras from each church intervened at the individual- (e.g., beliefs), interpersonal- (e.g., social support), and environmental- (e.g., park features and access to health care) levels to affect change on target behaviors. MEASUREMENTS: The study's primary outcome is min/wk of moderate-to-vigorous physical activity (MVPA) at baseline and 12 and 24 months following implementation of intervention activities. We enrolled 436 Latinas (aged 18-65 years) who engaged in less than 250 min/wk of MVPA at baseline as assessed by accelerometer, attended church at least four times per month, lived near their church, and did not have a health condition that could prevent them from participating in physical activity. Participants were asked to complete measures assessing physical activity and cancer screening as well as their correlates at 12- and 24-months. SUMMARY: Findings from the current study will address gaps in research by showing the long term effectiveness of multi-level faith-based interventions promoting physical activity and cancer screening among Latino communities.

Social media: the key to health information access for 18- to 30-year-old college students.

This work examines where 18- to 30-year-old college students seek health information on the Internet and how they determine site and message credibility. Using a qualitative methodology, five focus groups were conducted with 18- to 30-year-old college students, and transcripts were analyzed with MaxQDA text analysis software. The study revealed that 18- to 30-year-old college students have Internet health information source preferences, reasons for seeking health information on the Internet, and message design factors that improve their perception of site and message credibility. We conclude that the Internet and social media show great promise as effective health communication channels for 18- to 30-year-old college students and confirm that preferred Internet/social media sites can be utilized by health educators to present important risk management/disease prevention information to 18- to 30-year-old college students. In addition, message design factors can lend credibility to both sites and the health information delivered there.

Ciclovía participation and impacts in San Diego, CA: the first CicloSDias.

OBJECTIVE: Ciclovía or Open Streets initiatives support physical activity through cycling/rolling, and walking/running. We evaluated San Diego's first Open Streets event, CicloSDias, to document attendance, reach and marketing, and effects on social cohesion, businesses, and physical activity. METHODS: The comprehensive evaluation consisted of a city-wide survey 1 week before and after the event (n=805), counts of event attendees, and surveys of event attendees (n=713) and businesses (n=26). RESULTS: An estimated 8311 people attended the event. Attendees had an average of 144 min (SD=85) of physical activity, 97% met the 30 min/day guideline, and 39% met the 150 min/week guideline during the event. 27% of attendees would have been inactive without the event. Awareness of the event was 10% before and 26% after the event. When comparing event attendees to San Diego residents, Latinos and non-White race/ethnicities were under-represented. Restaurants/pubs, services, and most retail stores excluding liquor stores and food markets reported positive or neutral impacts on business. CONCLUSION: Open Street initiatives are promising ways to promote physical activity and are desired by the community. Positive effects were observed for physical activity, social cohesion, and businesses, though reach should be expanded to include more underserved community members. Evaluating Open Streets is important for sustaining and improving these efforts.

Designing and implementing a regional active transportation monitoring program through a county-MPO-university collaboration.

PURPOSE: This article describes a unique effort underway in San Diego County to establish a regional nonmotorized data collection system in support of long-range planning for bicycle and pedestrian systems, and physical activity promotion and monitoring. DESIGN: Case study of a novel approach to sitting a regional active travel data collection program. SETTING: San Diego County, California. SUBJECTS: None. INTERVENTION: Installation of 54 automated bicycle and pedestrian counting units at 35 sites across San Diego County. MEASURES: Equipment sitting criteria including population density, employment density, median household income, planned bicycle network, and planned land uses. ANALYSIS: Mapping, stakeholder input, site visits. RESULTS: A comprehensive network of 76 sites identified and proposed for long-range implementation. CONCLUSION: This research establishes a sitting methodology that holds promise for replication in other regions. San Diego's counting program is one of the most comprehensive automated data collection systems of any region in the United States.

A latent profile analysis of neighborhood recreation environments in relation to adolescent physical activity, sedentary time, and obesity.

UNLABELLED: OBJECTIVEV: This study examined whether multivariate profiles of the neighborhood recreation environment were associated with adolescent physical activity, sedentary time, and obesity. DESIGN: Residential addresses of 871 adolescents in San Diego County (53% female, mean age = 12.8 years) were geocoded to create 1-mile network buffers. MEASURES: Geographic information systems calculated neighborhood environmental variables. Accelerometers (worn 3-7 days) estimated daily moderate to vigorous physical activity (MVPA) and sedentary time. Height and weight were directly measured. RESULTS: Latent profile analysis, using 7 environmental variables, resulted in 3 neighborhood profiles characterized as "open space" (OS), "residential with cul-de-sacs" (RWC), and "housing & facility dense" (HFD). These were named Adolescent Recreation Environment Accessibility (AREA) profiles. Multiple regression models stratified by gender tested associations between the AREA profiles and outcomes. Boys were less sedentary in the OS and RWC neighborhoods (7 hours per day) compared with the HFD neighborhoods (8 hours per day) (P < .01), and boys were more likely to be obese in the HFD neighborhoods (55%) compared with the OS group (24%) (P < .05). Girls in the RWC neighborhoods had lower MVPA levels (70 minutes per day) and were more likely to be obese (31%) than those in the OS neighborhoods (79 minutes per day MVPA, 21% obese) (Ps < .05). No differences were found for boys' MVPA or girls' sedentary time by the AREA profiles. CONCLUSIONS: These findings highlight the complex relationships among environmental factors, activity levels, and obesity.nn.

Do neighborhood environments moderate the effect of physical activity lifestyle interventions in adults?

This study builds upon the current literature investigating the relationship between individuals' physical activity and the built environment. This prospective study of two lifestyle interventions in adults explores the moderating effect of the built environment measured both objectively and by self-report. Results show that overweight men in an intervention group increased their walking significantly more if they lived in less walkable neighborhoods. Overweight women were more likely to increase their physical activity over time if they perceived better safety from traffic. This study suggests that psychosocial interventions can help men overcome environmental barriers to walking.

Developer and realtor perspectives on factors that influence development, sale, and perceived demand for activity-friendly communities.

BACKGROUND: Although public support for physical activity-friendly Traditional Neighborhood Developments (TNDs) appears to be growing, information is lacking on private sector perspectives and how economic factors (eg, fuel prices) might influence the development and sale of TNDs. METHODS: A sample of realtors from the National Association of Realtors (n = 4950) and developers from the National Association of Home Builders (n = 162) were surveyed in early 2009 to assess factors influencing homebuyers' decisions; incentives and barriers to developing TNDs; effects of depressed housing market conditions and financing on sales; trends in buying; and energy considerations (eg, green building). RESULTS: Realtors believed that homebuyers continue to rank affordability, safety and school quality higher than TND amenities. Developers reported numerous barriers to TNDs, including the inability to overcome governmental/political hurdles, lack of cooperation between government agencies, and lack of market demand. Yet, realtors believed clients are increasingly influenced by gas and oil prices, and developers reported that clients are looking for energy efficient homes, reduced commute time, and walkable neighborhoods. Respondents reported consumers are more interested in living in a TND than 5 years ago. CONCLUSIONS: Activity-friendly TNDs appear to be increasing in demand, but developers and realtors reported significant barriers to creating these communities.

Does proximity to retailers influence alcohol and tobacco use among Latino adolescents?

Despite decades of research surrounding determinants of alcohol and tobacco (A&T) use among adolescents, built environment influences have only recently been explored. This study used ordinal regression on 205 Latino adolescents to explore the influence of the built environment (proximity to A&T retailers) on A&T use, while controlling for recognized social predictors. The sample was 45% foreign-born. A&T use was associated with distance from respondents' home to the nearest A&T retailer (-), acculturation (+), parents' consistent use of contingency management (-), peer use of A&T (+), skipping school (+), attending school in immediate proximity to the US/Mexico border (+), and the interaction between the distance to the nearest retailer and parents' consistent use of contingency management (+). The association between decreasing distance to the nearest A&T retailer and increased A&T use in Latino adolescents reveals an additional risk behavior determinant in the US-Mexico border region.

Validation of the Neighborhood Environment Walkability Scale (NEWS) items using geographic information systems.

BACKGROUND: Concurrent validity of Neighborhood Environment Walkability Scale (NEWS) items was evaluated with objective measures of the built environment using geographic information systems (GIS). METHODS: A sample of 878 parents of children 10 to 16 years old (mean age 43.5 years, SD = 6.8, 34.8% non-White, 63.8% overweight) completed NEWS and the International Physical Activity Questionnaire. GIS was used to develop 1-mile street network buffers around participants' residences. GIS measures of the built environment within participants' buffers included percent of commercial and institutional land uses; number of schools and colleges, recreational facilities, parks, transit stops, and trees; land topography; and traffic congestion. RESULTS: Except for trees and traffic, concordance between the NEWS and GIS measures were significant, with weak to moderate effect sizes (r = -0.09 to -0.36, all P < or = 01). After participants were stratified by physical activity level, stronger concordance was observed among active participants for some measures. A sensitivity analysis of self-reported distance to 15 neighborhood destinations found a 20-minute (compared with 10- or 30-minute) walking threshold generally had the strongest correlations with GIS measures. CONCLUSIONS: These findings provide evidence of the concurrent validity of self-reported built environment items with objective measures. Physically active adults may be more knowledgeable about their neighborhood characteristics.

Latent growth curve modeling of adolescent physical activity: testing parallel process and mediation models.

Data from a randomized clinical trial were used to examine the extent to which a health promotion intervention affected changes in psychosocial constructs and if so whether these in turn explained changes in physical activity (PA). PA and psychosocial data on 878 adolescents (ages 11-15) recruited through primary care providers (age M = 12.7 years, SD = 1.3; 58% white non-Hispanic) were measured at baseline, six and 12 months. Parallel process latent growth curve analyses found positive relationships between the growth trajectories of behavior change strategies, self-efficacy, family support, peer support and the growth trajectory of PA. However, mediation analyses did not reveal statistically significant intervention-mediated effects.

College students use cell phones while driving more frequently than found in government study.

OBJECTIVE: Cell phone use while driving is hazardous; it quadruples the risk of a collision and multiplies the risk of a fatality nine-fold. The National Highway Traffic Safety Administration estimates that 8% of young drivers and 5% of all drivers use cell phones while driving. PARTICIPANTS AND METHODS: The authors trained graduate student volunteers to observe the daytime cell phone use of 3,650 drivers leaving the student exits of college parking structures at a large university. RESULTS: The student observers recorded a cell phone usage rate of 11.1%, which was significantly higher than that seen in the National Occupant Protection Use Survey (p<.00001). Female drivers were 1.51 times more likely to be using a cell phone while driving than were men (12.9% vs 8.6%, p<.001), and drivers with passengers were 0.15 times more likely to drive while telephoning than were solo drivers (1.8% vs 12.1%, p<.001). CONCLUSIONS: The authors offer suggestions for possible interventions to reduce this hazardous behavior.

Association of neighborhood design and recreation environment variables with physical activity and body mass index in adolescents.

PURPOSE: To examine associations of neighborhood walkability and recreation environment variables with physical activity in adolescents. METHODS: The cross-sectional study was conducted with 98 white or Mexican-American adolescents (mean age = 16.2 years). Physical activity was measured with 7 days of accelerometer monitoring. Height and weight were measured to compute body mass index (BMI). Environmental measures were created using geographic information systems. A neighborhood walkability index was based on land use mix, retail density, street connectivity, and residential density. Proximity to public and private recreation facilities was assessed. RESULTS: In a linear regression, the walkability index within 0.5 mile of homes was related to minutes of moderate to vigorous physical activity, explaining approximately 4% of variance. Recreation variables were not related to physical activity, and BMI was not explained by environmental variables. CONCLUSION: Neighborhood walkability was related to adolescents'physical activity, similar to findings for adults.

Community Design and Access to Recreational Facilities as Correlates of Adolescent Physical Activity and Body-Mass Index.

BACKGROUND: Neighborhood-level environmental features have been associated with adult physical activity and weight status, but this link has not been established for adolescents. METHODS: Community design and access to recreational facilities variables were derived using geographic information systems (GIS) for 799 adolescents (age 11 to 15 y, mean = 12.8 y, 53% girls, 43% ethnic minority). Environment variables were calculated for a 1-mile buffer around each participant's residence. Accelerometers measured min/d of physical activity. RESULTS: Number of nearby recreation facilities and number of nearby parks correlated positively with girls' physical activity, and intersection density inversely related to girls' physical activity. Retail floor area ratio correlated positively with boys' physical activity. No community design or access to recreation variables were related to BMI-percentile. CONCLUSIONS: There was limited evidence that both community design and access to recreation facilities variables were associated with adolescent physical activity, but additional built environment variables need to be studied that have particular relevance for youth.