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1.
N C Med J ; 83(2): 99-102, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35256466

RESUMO

The built environment is a key social determinant of health. Exposure to parks and greenspace can improve physical and mental health and provide other benefits that enhance well-being. Programs and initiatives that capitalize on nature-based opportunities offer health care providers with a cost-effective alternative for upstream health promotion.


Assuntos
Saúde Mental , Parques Recreativos , Ambiente Construído , Pessoal de Saúde , Promoção da Saúde , Humanos
2.
Artigo em Inglês | MEDLINE | ID: mdl-33924490

RESUMO

While many studies suggest evidence for the health benefits of nature, there is currently no standardized method to measure time spent in nature or nature contact, nor agreement on how best to define nature contact in research. The purpose of this review is to summarize how nature contact has been measured in recent health research and provide insight into current metrics of exposure to nature at individual and population scales. The most common methods include surrounding greenness, questionnaires, and global positioning systems (GPS) tracking. Several national-level surveys exist, though these are limited by their cross-sectional design, often measuring only a single component of time spent in nature, and poor links to measures of health. In future research, exposure assessment combining the quantifying (e.g., time spent in nature and frequency of visits to nature) and qualifying (e.g., greenness by the normalized difference of vegetation index (NDVI) and ratings on perception by individuals) aspects of current methods and leveraging innovative methods (e.g., experience sampling methods, ecological momentary assessment) will provide a more comprehensive understanding of the health effects of nature exposure and inform health policy and urban planning.


Assuntos
Planejamento de Cidades , Sistemas de Informação Geográfica , Estudos Transversais , Humanos , Características de Residência , Inquéritos e Questionários
3.
J Phys Act Health ; 18(5): 603-609, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33785658

RESUMO

BACKGROUND: Neighborhood parks are recognized as important spaces for facilitating physical activity (PA); however, it remains unclear how the frequency of park use is associated with PA. The purpose of this study was to examine associations between minutes of moderate to vigorous PA and multiple park use indicators: (1) use of a neighborhood park, (2) unique number of neighborhood parks used, and (3) frequency of neighborhood park use. METHODS: Adults were surveyed from 4 US cities (Brooklyn, NY; Greenville County, SC; Raleigh, NC; and Seattle, WA). Using a map-based survey platform, participants indicated all neighborhood parks they used and the frequency of use in the past 30 days. Participants self-reported their weekly moderate to vigorous PA. Quantile regression was used to examine associations between PA and park use indicators. RESULTS: Of all respondents (N = 360), 60% indicated visiting a neighborhood park in the past 30 days, with an average of about 13 total neighborhood park visits (SD = 17.5). Significant, positive associations were found between moderate to vigorous PA and both unique neighborhood park visits and total number of neighborhood parks visits. CONCLUSIONS: Frequency of park visitation is associated with PA among US adults. Ensuring equitable and safe access to neighborhood parks has the potential for population-level PA health benefits.


Assuntos
Exercício Físico , Características de Residência , Adulto , Cidades , Planejamento Ambiental , Nível de Saúde , Humanos , Parques Recreativos , Recreação , Autorrelato
4.
Ann Epidemiol ; 57: 30-39, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33596444

RESUMO

PURPOSE: Striking disparities persist in cardiovascular disease risk factors among minority youth. We examined the association between multiple indicators of neighborhood quality and minority youth fitness. METHODS: The primary exposure was the Child Opportunity Index (COI), a measure comprised of indicators that facilitate healthy child development. Outcome data were drawn from the 2018-2019 Fit2Play Study (Miami-Dade County, FL). Hotspot analysis evaluated COI spatial clustering. Generalized linear mixed models examined cross-sectional COI-fitness associations. RESULTS: The sample included 725 youth (53% Black, 43% Hispanic; 5-17 years). Significant neighborhood quality spatial clusters were identified (Gi*z-score = -4.85 to 5.36). Adjusting for sociodemographics, walkability was associated with lower percentiles in body mass index (BMI) and diastolic blood pressure percentiles (DBP) (ß = -5.25, 95% CI: -8.88, -1.62 and ß = -3.95, 95% CI: -7.02, -0.89, respectively) for all, lower skinfold thickness (ß = -4.83, 95% CI: -9.97, 0.31 and higher sit-ups (ß = 1.67, 95% CI: -0.17, 3.50) among girls, and lower systolic blood pressure percentiles (SBP) (ß = -4.75, 95% CI: -8.99, -0.52) among boys. Greenspace was associated with higher BMI (ß = 6.17, 95% CI: 2.47, 9.87), SBP (ß = 3.47, 95% CI: -0.05, 6.99), and DBP (ß = 4.11, 95% CI: 1.08, 7.13). CONCLUSIONS: COI indicators were positively associated with youth fitness. Disparities in youth cardiovascular disease risk may be modifiable through community interventions and built environment initiatives targeting select neighborhood factors.


Assuntos
Doenças Cardiovasculares , Adolescente , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Criança , Estudos Transversais , Feminino , Florida , Humanos , Masculino , Aptidão Física , Fatores de Risco
5.
Prev Med Rep ; 20: 101218, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33354490

RESUMO

Composite metrics integrating park availability, features, and quality for a given address or neighborhood are lacking. The purposes of this study were to describe the validation, application, and demonstration of ParkIndex in four diverse communities. This study occurred in Fall 2018 in 128 census block groups within Seattle(WA), Brooklyn(NY), Raleigh(NC), and Greenville County(SC). All parks within a half-mile buffer were audited to calculate a composite park quality score, and select households provided data about use of proximal parks via an online, map-based survey. For each household, the number of parks, total park acreage, and average park quality score within one half-mile were calculated using GIS. Logistic regression was used to identify a parsimonious model predicting park use. ParkIndex values (representing the probability of park use) were mapped for all study areas and after scenarios involving the addition and renovation/improvement of parks. Out of 360 participants, 23.3% reported visiting a park within the past 30 days. The number of parks (OR = 1.36, 95% CI = 1.15-1.62), total park acreage (OR = 1.13, 95% CI = 1.07-1.19), and average park quality score (OR = 1.04, 95% CI = 1.01-1.06) within one half-mile were all associated with park use. Composite ParkIndex values across the study areas ranged from 0 to 100. Hypothetical additions of or renovations to study area parks resulted in ParkIndex increases of 22.7% and 19.2%, respectively. ParkIndex has substantial value for park and urban planners, citizens, and researchers as a common metric to facilitate awareness, decision-making, and intervention planning related to park access, environmental justice, and community health.

6.
Prev Chronic Dis ; 17: E73, 2020 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-32730200

RESUMO

INTRODUCTION: Crime and the fear of crime can be a barrier to park use, and locations of crimes can have varied effects. Unsafe areas in or around the park, around the residence, or along the route to the park can alter park use behavior. Our study aimed to examine associations between objective measures of types and location of crimes and park use behaviors. METHODS: In 2013 we surveyed a sample (N = 230) of residents in Greensboro, North Carolina, about park use, with responses matched to objective crime and spatial measures. We measured all crimes and violent crimes near home, near the closest park, and along the shortest route between home and park. By using ordered and binary logistic modeling, we examined the relationships between the locations of crime and park use and duration of park visit, park rating, and never visiting parks. Additional models included distance to the closest park. RESULTS: Increased crime in parks and near home was associated with fewer park visits. Greater violent crime in all locations was related to fewer park visits. Park ratings were lower for parks with high violent crime rates. CONCLUSION: Given the importance of parks as settings for outdoor recreation and physical activity, crime may have a detrimental effect on physical activity and, therefore, public health.


Assuntos
Crime/estatística & dados numéricos , Parques Recreativos/estatística & dados numéricos , Adulto , Idoso , Exercício Físico , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Recreação , Características de Residência/estatística & dados numéricos , Inquéritos e Questionários
7.
Artigo em Inglês | MEDLINE | ID: mdl-32545651

RESUMO

Nature prescription programs have emerged to address the high burden of chronic disease and increasingly sedentary and screen-based lifestyles. This study examines the base of evidence regarding such programs. We conducted a narrative review of published literature using four electronic databases. We included case studies, research design articles, and empirical studies that discussed any type of outdoor exposure or activities initiated by a health-care provider from an outpatient clinic. We examined articles for information on target populations, health outcomes, and structural and procedural elements. We also summarized evidence of the effectiveness of nature prescription programs, and discussed needs and challenges for both practice and research. Eleven studies, including eight empirical studies, have evaluated nature prescription programs with either structured or unstructured formats, referring patients either to nearby parks or to formal outdoor activity programs. Empirical studies evaluate a wide variety of health behaviors and outcomes among the most at-risk children and families. Research is too sparse to draw patterns in health outcome responses. Studies largely tested program structures to increase adherence, or patient follow-through, however findings were mixed. Three published studies explore providers' perspectives. More research is necessary to understand how to measure and increase patient adherence, short and long-term health outcomes for patients and their families, and determinants of provider participation and participation impacts on providers' own health.


Assuntos
Pessoal de Saúde , Doença Crônica , Atenção à Saúde , Humanos , Projetos Piloto , Estudos Prospectivos
8.
Med Sci Sports Exerc ; 52(9): 2029-2036, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32175976

RESUMO

PURPOSE: To test the validity of the Ecological Video Identification of Physical Activity (EVIP) computer vision algorithms for automated video-based ecological assessment of physical activity in settings such as parks and schoolyards. METHODS: Twenty-seven hours of video were collected from stationary overhead video cameras across 22 visits in nine sites capturing organized activities. Each person in the setting wore an accelerometer, and each second was classified as moderate-to-vigorous physical activity or sedentary/light activity. Data with 57,987 s were used to train and test computer vision algorithms for estimating the total number of people in the video and number of people active (in moderate-to-vigorous physical activity) each second. In the testing data set (38,658 s), video-based System for Observing Play and Recreation in Communities (SOPARC) observations were conducted every 5 min (130 observations). Concordance correlation coefficients (CCC) and mean absolute errors (MAE) assessed agreement between (1) EVIP and ground truth (people counts+accelerometry) and (2) SOPARC observation and ground truth. Site and scene-level correlates of error were investigated. RESULTS: Agreement between EVIP and ground truth was high for number of people in the scene (CCC = 0.88; MAE = 2.70) and moderate for number of people active (CCC = 0.55; MAE = 2.57). The EVIP error was uncorrelated with camera placement, presence of obstructions or shadows, and setting type. For both number in scene and number active, EVIP outperformed SOPARC observations in estimating ground truth values (CCC were larger by 0.11-0.12 and MAE smaller by 41%-48%). CONCLUSIONS: Computer vision algorithms are promising for automated assessment of setting-based physical activity. Such tools would require less manpower than human observation, produce more and potentially more accurate data, and allow for ongoing monitoring and feedback to inform interventions.


Assuntos
Algoritmos , Computadores , Exercício Físico , Gravação em Vídeo , Acelerometria , Ambiente Construído , Humanos , Observação/métodos , Parques Recreativos , Instituições Acadêmicas
9.
Prev Med ; 131: 105948, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31836479

RESUMO

Urban parks provide spaces and facilities for children's physical activity (PA) and can be a free resource in low-income communities. This study examined whether neighborhood characteristics were associated with children's park use and park-based moderate-to-vigorous PA (MVPA) in low-income diverse communities and how associations differed between ethnic groups. Data on park visits and MVPA came from 16,402 children 5-10-years old directly observed using the System for Observing Play and Recreation in Communities in 20 parks in low-income neighborhoods with majority Latino or Asian populations in New York City. Neighborhood characteristics included land use mix (LUM), street audits, crime rates, and an area deprivation index. We employed Poisson and negative binomial models to estimate effects of neighborhood-level variables on the number of children observed in parks and engaging in MVPA, overall and by ethnicity. Results for Asian, Latino, and African American children indicated that higher levels of LUM and pedestrian-friendly streets were associated with greater numbers of children in parks and higher MVPA across all three groups. For Asian and Latino children only, quality of environment was positively associated with MVPA, whereas level of deprivation and crime rates in the surrounding neighborhood were negatively associated with children's park-based MVPA. In contrast, a park's access to public transportation was negatively associated with number of all children observed and engaging in MVPA. Study findings suggest that park-based MVPA interventions can be informed by understanding how neighborhood characteristics facilitate and constrain park use and park-based MVPA.


Assuntos
Planejamento Ambiental , Exercício Físico/fisiologia , Parques Recreativos/estatística & dados numéricos , Pobreza , Características de Residência , Criança , Pré-Escolar , Crime , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Recreação
10.
BMC Public Health ; 19(1): 1730, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870351

RESUMO

BACKGROUND: Since its introduction in 2006, SOPARC (Systematic Observation of Play and Recreation in Communities) has become a fundamental tool to quantify park visitor behaviors and characteristics. We tested SOPARC reliability when assessing race/ethnicity, physical activity, contextual conditions at the time of observation, and settings of target areas to understand its utility when trying to account for individual characteristics of users. METHODS: We used 4725 SOPARC observations completed simultaneously by two independent observers to evaluate intraclass correlation and agreement rate between the two observers when trying to assess sex, age group, race/ethnicity, and level of physical activity of urban park users in different park settings. Observations were in 20 New York City parks during Spring and Summer 2017 within the PARC3 project. RESULTS: Observers counted 25,765 park users with high interobserver reliability (ICC = .94; %Agreement.75). Reliability scores were negatively affected by the population being observed, the intensity of physical activity, and the contextual conditions and settings of the target area at the time of observation. Specific challenges emerged when assessing the combination of physical activity and race/ethnicity. CONCLUSIONS: SOPARC training should aim to improve reliability when assessing concurrent measures such as physical activity, race/ethnicity, age, and sex. Similarly, observing crowded park areas with many active users areas may require more observation practice hours.


Assuntos
Exercício Físico , Observação , Parques Recreativos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Reprodutibilidade dos Testes , Estações do Ano , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-31692932

RESUMO

The relationship between park availability, physical activity, and positive health outcomes has been documented across the globe. However, studying how people access parks and why they use the parks is difficult due to a lack of consensus with respect to measurement approaches and assessment of park environments. Establishing a parsimonious method and tool for quantifying both park availability and park quality represents a major step that could advance park and physical activity research and practice. This paper describes phase one of the effort to develop such a measurement tool, known as ParkIndex. ParkIndex is a two-year National Institutes of Health (NIH)-funded study to create an evidence-based tool that will assist citizens and professionals in understanding and using information regarding community park access and use. Phase one consisted of key informant interviews conducted with research and practice leaders to inform development and provide insight on the essential foundations of ParkIndex. Twelve professionals from practice and academia, including parks and recreation, landscape design, and public health sectors, were interviewed in fall 2016. Key informants were interviewed on four topics concerning the content, value, feasibility, and dissemination of ParkIndex. Trained research assistants employed double, emergent, open, and axial coding methods to develop key themes and concepts to guide phase 2 and further development of ParkIndex. Key themes throughout the interviews included measures for park use, including distance, safety, neighborhood characteristics, route and travel mode to park, and overall park characteristics. Park elements discussed included quality of, and availability of, amenities, activity spaces, programming, and park management, as well as the context of the park and the engagement of the local community. Respondents determined that ParkIndex could benefit park planning and community development and provide for a standardized method for evaluating park access. Interviews and themes offer parks and public health practitioners and researchers-and this specific ParkIndex development team-the opportunity to refine and evaluate measures to be included in a comprehensive park access and use tool. Key informants repeatedly referenced the need, especially within parks and recreation management, for consistent, reliable, and valid measures of park access and use, such as ParkIndex seeks to provide. We believe a well-conceived, integrated index will at the very least allow for greater comparison between parks and park systems and at best will facilitate the many park stakeholders to best design, maintain, program, research, and advocate for their local parks.

12.
Prev Med ; 129: 105767, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31739908

RESUMO

This guest editorial introduces the rationale and goals of the Physical Activity Research Center. It provides an overview of the five papers in this Special Section plus six commissioned studies intended to inform advocacy efforts.


Assuntos
Exercício Físico/fisiologia , Disparidades nos Níveis de Saúde , Obesidade/prevenção & controle , Adolescente , Humanos
13.
JAMA Netw Open ; 2(10): e1912443, 2019 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-31584678

RESUMO

Importance: Both indoor tanning and skin cancer are more common among sexual-minority men, defined as gay and bisexual men, than among heterosexual men. Convenient access to indoor tanning salons may influence use patterns. Objective: To investigate whether indoor tanning salons are disproportionately located in areas with higher concentrations of gay men. Design, Setting, and Participants: This cross-sectional study used geographic information systems to integrate census data and business location data obtained from ArcGIS and Google Maps for the 10 US cities with the largest lesbian, gay, bisexual, and transgender populations in 2010, ie, Los Angeles, California; Chicago, Illinois; San Francisco, California; Seattle, Washington; San Diego, California; Dallas, Texas; Phoenix, Arizona; Washington, DC; Portland, Oregon; and Denver, Colorado. The association of indoor tanning salon locations with proportions of gay men, using the concentration of male-male partnered households as a proxy measure for the latter, was examined. Data analysis was performed in October 2018. Exposures: Census tracts with at least 1%, 5%, or 10% male-male partnered households, adjusting for median household income, percentage young women, and percentage non-Hispanic white residents. Main Outcomes and Measures: Presence of 1 or more indoor tanning salons within census tracts. Results: Across the 10 cities and 4091 census tracts in this study, there were 482 823 unmarried partnered households, of which 35 164 (7.3%) were male-male. The median (interquartile range) percentage of male-male partnered households per census tract was 0% (0%-10.6%). Odds of indoor tanning salon presence in areas with at least 10% male-male households were more than twice those of areas with less than 10% male-male households (odds ratio, 2.17; 95% CI, 1.59-2.97). When sensitivity analyses using a 1-mile euclidian buffer around each tanning salon were conducted, this association remained significant (odds ratio, 2.48; 95% CI, 2.14-2.88). After adjusting for median household income, percentage young women, and percentage non-Hispanic white residents, the odds of an indoor tanning salon being within 1 mile of a census tract with at least 10% male-male households remained twice that of census tracts with less than 10% male-male households (odds ratio, 2.00; 95% CI, 1.71-2.35). Conclusions and Relevance: In this study, indoor tanning salons were more likely to be located near neighborhoods with higher concentrations of male-male partnered households, possibly contributing to the disproportionate use of indoor tanning by sexual-minority men.


Assuntos
Indústria da Beleza/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Banho de Sol/normas , Bissexualidade/estatística & dados numéricos , Censos , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Transexualidade , Estados Unidos
14.
J Urban Health ; 96(5): 692-702, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31493183

RESUMO

Physical activity typically declines between childhood and adolescence. Despite urban parks being a great venue for physical activity, children change both the frequency of park use and their park use habits as they age into adolescence. However, little is known about how these differences vary by gender and how distinct race/ethnicity groups differentially change their park habits. This study analyzed the differences in park use and per capita energy expenditure between children and teenagers of different gender and race/ethnicity backgrounds. Using the System for Observing Play and Recreation in Communities (SOPARC), systematic observations were conducted in 20 New York City parks in 2017, located in low-income areas with high presence of Latino or Asian residents. A total of 9963 scans in 167 distinct target areas counted 16,602 children (5-10 years old) and 11,269 teenagers (11 or older). Using adjusted marginal means, we estimated the number of park users of each age range, gender, and race/ethnicity expected to be found in each park activity setting. Teenagers of both genders and most race/ethnicity groups were less likely to be in a park and had lower per capita energy expenditure, compared with children. The difference in park attendance was greater than the difference in per capita energy expenditure. Dissimilarities were clearly gendered and race/ethnicity dependent. Asian and Latino females showed the greatest divergence between childhood and adolescence. African American boys were the only group to show a positive age contrast in park attendance and per capita energy expenditure.


Assuntos
/estatística & dados numéricos , Exercício Físico , Parques Recreativos/estatística & dados numéricos , /estatística & dados numéricos , Adolescente , Afro-Americanos , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Áreas de Pobreza , Fatores Sexuais , Adulto Jovem
15.
Prev Med ; 126: 105735, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31150738

RESUMO

Crime and safety perceptions are commonly cited barriers to park use and physical activity (PA). Given the importance of parks as settings for outdoor recreation and physical activity, the presence of crime may have a detrimental effect on public health. This study uses objective police crime reports and observational park use data to assess type of crime and the time when the crime was committed effects on park user behaviors in 20 parks located in low-income neighborhoods in New York City. The System for Observing Play and Recreation in Communities (SOPARC) was used to assess the number of park users and their physical activity during 78 park visits in Spring 2017. The association between crime rates and park use was assessed using two types of crimes (violent and property crimes). The timing of the crime was assessed using the crimes committed within periods of one week, one month, and three months prior to the visit to the park. By including objective measures of crime together with the exact time on which they were committed, we were able to analyze the short and long term effects of crime on park behavior. Overall, there was a consistent negative association between crime and park use. This relationship was stronger at the 1 month and 3 months' period and weaker at the 1-week period. Violent crimes were strongly associated with lower park use, and crimes proved to be associated with child park use to a greater degree. Girls were more affected by crime than boys.


Assuntos
Crime/estatística & dados numéricos , Exercício Físico , Parques Recreativos , Pobreza , Características de Residência , Adulto , Criança , Pré-Escolar , Planejamento Ambiental , Feminino , Humanos , Masculino , Cidade de Nova Iorque , Recreação
16.
J Phys Act Health ; 16(6): 447-454, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31023140

RESUMO

Background: Socioeconomic characteristics of locations where physical activity equipment is installed may affect the activity level of users. The purpose of this study was to verify patterns of use and physical activity levels in fitness zones installed in low- and high-income neighborhoods in the city of Curitiba, Brazil. Methods: Over 1200 observations were conducted in 20 fitness zones in the city of Curitiba, Brazil. Data were collected during the months of November and December 2012, in 4 periods of the day (8 AM, 11 AM, 2 PM, and 5 PM), on 2 weekdays and 2 weekend days. Results: A total of 2232 people were observed in the fitness zones. Age group, level of physical activity in the area, use of fitness zones during weekend days, and occupation of spaces were significantly associated with neighborhood income. Moreover, users of fitness zones located in high-income neighborhoods showed higher odds ratio (OR = 1.74; 95% confidence interval, 1.46-2.07) of moderate to vigorous physical activity than light or sedentary activities, regardless of gender or day of the week. Conclusions: The sole presence of equipment does not seem to favor the use of fitness zones in low-income neighborhoods. Future studies should investigate intrinsic factors for the use of fitness zones for physical activity.


Assuntos
Exercício Físico/fisiologia , Parques Recreativos/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Brasil , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos
17.
J Phys Act Health ; 16(3): 214-221, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30798690

RESUMO

BACKGROUND: This study tested if the timing of meals, physical activity, light exposure, and sleep cluster within individuals and are associated with body mass index (BMI) in a sample of free-living adults (N = 125). METHODS: Data were collected between November 2015 and March 2016 at the University of California, San Diego, Children's Hospital of Philadelphia, and Washington University in St Louis. Height and weight were measured, and BMI (kg/m2) was calculated. Sleep timing was estimated using actigraphy, and timing of meals, physical activity, and light exposure were self-reported using a smartphone application. General linear models estimated the mean BMI across time categories of behaviors, adjusting for covariates. A latent class analysis was used to identify patterns of timing variables that clustered within individuals and test for associations between identified patterns and BMI. RESULTS: Later exposure to outdoor light was associated with a lower BMI (P trend < .01). The timing of other behaviors was not independently associated with BMI. The latent class analysis identified 2 distinct groups related to behavioral timing, reflecting an "early bird" and "night owl" phenotype. These phenotypes were not associated with BMI (P > .05). CONCLUSION: Timing of exposures to light, meals, sleep, and physical activity were not strongly associated with BMI in this sample.


Assuntos
Actigrafia/métodos , Índice de Massa Corporal , Exercício Físico/psicologia , Luz , Refeições/psicologia , Sono/fisiologia , Adulto , Feminino , Humanos , Masculino , Projetos Piloto
18.
Chronobiol Int ; 36(2): 203-213, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30365354

RESUMO

Zeitgebers such as light, eating and physical activity provide input to the circadian clock. Chronic circadian misalignment is associated with significant adverse health effects. An improved understanding of the impact of the timing of zeitgebers on the stability of 24-hour rest-activity rhythm in free-living settings may identify behavioural and environmental intervention targets. A total of 133 healthy adults, aged 21-60 years, wore a wrist actigraph for 7 consecutive days. We applied a non-parametric analysis to activity counts to derive rest-activity patterns. We administered a questionnaire through a smartphone app to collect self-reported timing of light exposure, eating episodes and physical activity. To assess the relationship between timing exposures (first and last exposure to outdoor light, first exposure to indoor light, last eating episode, first eating episode, morning physical activity proportion, evening physical activity proportion) and rest-activity or sleep outcomes (bedtimes, total sleep time, inter-daily stability, intra-daily variability, L5 and M10 midpoint), we first calculated Spearman correlations, using the false discovery rate method to control for multiple comparisons. From those significant associations, we then fit regression models adjusting for age, sex, race, household income, education level, study site, body mass index, as well as physical activity. Finally, we tested for interaction between chronotype and each timing-related exposure and stratified the analysis by morning type. All zeitgebers, except for evening physical activity proportion, were correlated with at least four of the seven sleep and rest-activity outcomes. In adjusted analysis, later timing of first (after 6:30 to 7:45 AM versus earlier) and last exposure to indoor light (after 11:00 PM versus earlier) and first (after 7:45-9:45 AM versus earlier) and last eating episode (after 8:00-09:00 PM versus earlier) were associated with a shift of 0.60-1.39 hours to later bedtimes, M10 and L5 midpoints (i.e. timing of peak activities or inactivities). Later timing of first exposure to outdoor light (after 09:30 AM versus earlier) was also associated with 0.51 (95% CI: 0.19 to 0.83) hours longer total sleep time. Higher morning physical activity proportion (> 33%) was associated with 0.95 (95% CI: -1.38 to -0.53) hours earlier in-bed time and 0.69 (95% CI: -1.14 to -0.24) hours earlier out-of-bed time, 0.92 (95% CI: -1.41 to -0.42) hours earlier M10 and 0.96 (95% CI: -1.42 to -0.49) min earlier L5 midpoint. The results did not change substantially with further adjustment for total activity. There was a significant interaction between morning chronotype and first eating episode with rest-activity patterns (p < 0.05), with first eating episode associating with timing of activities only in non-morning type adults. Timing of zeitgebers was associated with sleep and rest-activity patterns, including bedtimes, L5 and M10 midpoint. Future research should evaluate the impact of manipulating zeitgebers on both circadian rhythms and health outcomes.


Assuntos
Ingestão de Alimentos , Exercício Físico , Luz , Descanso , Actigrafia , Adulto , Relógios Biológicos , Ritmo Circadiano , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sono , Inquéritos e Questionários , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-30149686

RESUMO

Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, poor enforcement of traffic rules and regulations, air pollution, and overcrowding. This cross-sectional study investigated associations between home neighborhood environment characteristics and active commuting in Chennai, India. Adults (N = 370, 47.2% female, mean age =37.9 years) were recruited from 155 wards in the metropolitan area of Chennai in southern India between January and June 2015. Participants self-reported their usual mode of commute to work, with responses recoded into three categories: (1) multi-modal or active commuting (walking and bicycling; n = 56); (2) public transit (n = 52); and (3) private transport (n = 111). Environmental attributes around participants' homes were assessed using the Neighborhood Environment Walkability Scale for India (NEWS-India). Associations between environmental characteristics and likelihood of active commuting and public transit use were modeled using logistic regression with private transport (driving alone or carpool) as the reference category, adjusting for age, gender, and household car ownership. Consistent with other international studies, participants living in neighborhoods with a mix of land uses and a transit stop within a 10-minute walk from home were more likely to use active commuting (both p < 0.01). Land-use mix was significantly associated with the use of public transit compared to private transport (adjusted odds ratio (aOR) =5.2, p = 0.002). Contrary to findings in high-income countries, the odds of active commuting were reduced with improved safety from crime (aOR =0.2, p = 0.003), aesthetics (aOR =0.2, p = 0.05), and street connectivity (aOR =0.2, p = 0.003). Different environmental attributes were associated with active commuting, suggesting that these relationships are complex and may distinctly differ from those in high-income countries. Unexpected inverse associations of perceived safety from crime and aesthetics with active commuting emphasize the need for high-quality epidemiologic studies with greater context specificity in the study of physical activity in LMICs. Findings have public health implications for India and suggest that caution should be taken when translating evidence across countries.


Assuntos
Ambiente Construído/estatística & dados numéricos , Planejamento Ambiental , Transportes/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Características de Residência , Transportes/métodos , Adulto Jovem
20.
J Phys Act Health ; 15(8): 626-634, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29882688

RESUMO

BACKGROUND: The Physical Activity Research Center developed a research agenda that addresses youth physical activity (PA) and healthy weight, and aligns with the Robert Wood Johnson Foundation's Culture of Health. This paper summarizes prioritized research studies with a focus on youth at higher risk for inactive lifestyles and childhood obesity in urban and rural communities. METHODS: Systematic literature reviews, a survey, and discussions with practitioners and researchers provided guidance on research questions to build evidence and inform effective strategies to promote healthy weight and PA in youth across race, cultural, and economic groups. RESULTS: The research team developed a matrix of potential research questions, identified priority questions, and designed targeted studies to address some of the priority questions and inform advocacy efforts. The studies selected examine strategies advocating for activity-friendly communities, Play Streets, park use, and PA of youth in the summer. A broader set of research priorities for youth PA is proposed. CONCLUSION: Establishing the Physical Activity Research Center research agenda identified important initial and future research studies to promote and ensure healthy weight and healthy levels of PA for at-risk youth. Results will be disseminated with the goal of promoting equitable access to PA for youth.


Assuntos
Exercício Físico/fisiologia , Obesidade Pediátrica/patologia , População Rural/estatística & dados numéricos , Comportamento Sedentário , Adolescente , Peso Corporal/fisiologia , Criança , Humanos , Masculino , Motivação , Políticas , Estados Unidos
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