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BACKGROUND: The built environment predicts walking in older adults, but the degree to which associations between the objective built environment and walking for different purposes are mediated by environmental perceptions is unknown. PURPOSE: We examined associations between the neighborhood built environment and leisure and utilitarian walking and mediation by the perceived environment among older women. METHODS: Women (N = 2732, M age = 72.8 ± 6.8 years) from Massachusetts, Pennsylvania, and California completed a neighborhood built environment and walking survey. Objective population and intersection density and density of stores and services variables were created within residential buffers. Perceived built environment variables included measures of land use mix, street connectivity, infrastructure for walking, esthetics, traffic safety, and personal safety. Regression and bootstrapping were used to test associations and indirect effects. RESULTS: Objective population, stores/services, and intersection density indirectly predicted leisure and utilitarian walking via perceived land use mix (odds ratios (ORs) = 1.01-1.08, 95 % bias corrected and accelerated confidence intervals do not include 1). Objective density of stores/services directly predicted ≥150 min utilitarian walking (OR = 1.11; 95% CI = 1.02, 1.22). Perceived land use mix (ORs = 1.16-1.44) and esthetics (ORs = 1.24-1.61) significantly predicted leisure and utilitarian walking, CONCLUSIONS: Perceived built environment mediated associations between objective built environment variables and walking for leisure and utilitarian purposes. Interventions for older adults should take into account how objective built environment characteristics may influence environmental perceptions and walking.
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Planejamento Ambiental , Atividades de Lazer , Motivação , Caminhada , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Características de ResidênciaRESUMO
PURPOSE: Despite the health benefits of physical activity (PA), limited research has examined PA interventions in young adult cancer survivors (YACS). This study used a two-group parallel design to examine the effects of a 7-day outdoor adventure camp vs. waitlist control on PA levels among YACS. Secondary aims examined effects on sedentary behavior and PA correlates. METHODS: 50 camp and 66 control participants were assessed at baseline, end of camp, and 3 months. RESULTS: Intent-to-treat analyses indicated that, relative to baseline, camp participants had significantly (p = 0.0001) greater increases in PA than controls during camp (+577 vs. +9 minutes/week) and 3 months post-camp (+133 vs. -75 minutes/week, p = 0.001). Camp participants also reported significantly greater improvements in TV viewing (p = 0.001), hours sitting (p = 0.001), PA variety (p = 0.0001), barriers to PA (p = 0.007), and enjoyment of structured activities (p = 0.04) during camp but not 3 months post-camp. CONCLUSION: A week-long outdoor adventure therapy camp increased PA levels during camp and 3 months after camp termination, although effects were attenuated over time. IMPLICATIONS FOR CANCER SURVIVORS: Outdoor adventure therapy camps may increase PA and its correlates in YACS, but future research should explore methods to promote sustained PA after camp termination.
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Acampamento , Exercício Físico/psicologia , Promoção da Saúde/métodos , Neoplasias/terapia , Sobreviventes/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Autoeficácia , Sobreviventes/estatística & dados numéricos , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Using validated measures of individuals' perceptions of their neighborhood built environment is important for accurately estimating effects on physical activity. However, no studies to date have examined the factorial validity of a measure of perceived neighborhood environment among older adults in the United States. The purpose of this measurement study was to test the factorial validity of a version of the Abbreviated Neighborhood Environment Walkability Scale (NEWS-A) modified for seniors in the Nurses' Health Study (NHS). FINDINGS: A random sample of 2,920 female nurses (mean age = 73 ± 7 years) in the NHS cohort from California, Massachusetts, and Pennsylvania completed a 36-item modified NEWS-A for seniors. Confirmatory factor analyses were conducted to test measurement models for both the modified NEWS-A for seniors and the original NEWS-A. Internal consistency within factors was examined using Cronbach's alpha. The hypothesized 7-factor measurement model was a poor fit for the modified NEWS-A for seniors. Overall, the best-fitting measurement model was the original 6-factor solution to the NEWS-A. Factors were correlated and internally consistent. CONCLUSIONS: This study provided support for the construct validity of the original NEWS-A for assessing perceptions of neighborhood environments in older women in the United States.
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Planejamento Ambiental , Características de Residência , Caminhada , Idoso , Idoso de 80 Anos ou mais , California , Estudos de Coortes , Feminino , Humanos , Massachusetts , Pessoa de Meia-Idade , Atividade Motora , Pennsylvania , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Identifying spatial clusters of chronic diseases has been conducted over the past several decades. More recently these approaches have been applied to physical activity and obesity. However, few studies have investigated built environment characteristics in relation to these spatial clusters. This study's aims were to detect spatial clusters of physical activity and obesity, examine whether the geographic distribution of covariates affects clusters, and compare built environment characteristics inside and outside clusters. METHODS: In 2004, Nurses' Health Study participants from California, Massachusetts, and Pennsylvania completed survey items on physical activity (N = 22,599) and weight-status (N = 19,448). The spatial scan statistic was utilized to detect spatial clustering of higher and lower likelihood of obesity and meeting physical activity recommendations via walking. Clustering analyses and tests that adjusted for socio-demographic and health-related variables were conducted. Neighborhood built environment characteristics for participants inside and outside spatial clusters were compared. RESULTS: Seven clusters of physical activity were identified in California and Massachusetts. Two clusters of obesity were identified in Pennsylvania. Overall, adjusting for socio-demographic and health-related covariates had little effect on the size or location of clusters in the three states with a few exceptions. For instance, adjusting for husband's education fully accounted for physical activity clusters in California. In California and Massachusetts, population density, intersection density, and diversity and density of facilities in two higher physical activity clusters were significantly greater than in neighborhoods outside of clusters. In contrast, in two other higher physical activity clusters in California and Massachusetts, population density, diversity of facilities, and density of facilities were significantly lower than in areas outside of clusters. In Pennsylvania, population density, intersection density, diversity of facilities, and certain types of facility density inside obesity clusters were significantly lower compared to areas outside the clusters. CONCLUSIONS: Spatial clustering techniques can identify high and low risk areas for physical activity and obesity. Although covariates significantly differed inside and outside the clusters, patterns of differences were mostly inconsistent. The findings from these spatial analyses could eventually facilitate the design and implementation of more resource-efficient, geographically targeted interventions for both physical activity and obesity.
Assuntos
Planejamento Ambiental/estatística & dados numéricos , Atividade Motora , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Idoso , Peso Corporal , California/epidemiologia , Análise por Conglomerados , Coleta de Dados , Meio Ambiente , Feminino , Humanos , Funções Verossimilhança , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Pennsylvania/epidemiologia , Densidade Demográfica , Análise Espacial , CaminhadaRESUMO
There are few studies of built environment associations with physical activity and weight status among older women in large geographic areas that use individual residential buffers to define environmental exposures. Among 23,434 women (70.0 ± 6.9 yr; range = 57-85) in 3 states, relationships between objective built environment variables and meeting physical activity recommendations via walking and weight status were examined. Differences in associations by population density and state were explored in stratified models. Population density (odds ratio [OR] =1.04 [1.02, 1.07]), intersection density (ORs = 1.18-1.28), and facility density (ORs = 1.01-1.53) were positively associated with walking. Density of physical activity facilities was inversely associated with overweight/obesity (OR = 0.69 [0.49, 0.96]). The strongest associations between facility density variables and both outcomes were found among women from higher population density areas. There was no clear pattern of differences in associations across states. Among older women, relationships between accessible facilities and walking may be most important in more densely populated settings.
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Acessibilidade Arquitetônica , Planejamento Ambiental , Obesidade , Densidade Demográfica , Caminhada , Idoso , Acessibilidade Arquitetônica/métodos , Acessibilidade Arquitetônica/normas , Acessibilidade Arquitetônica/estatística & dados numéricos , Índice de Massa Corporal , California , Planejamento Ambiental/normas , Planejamento Ambiental/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Massachusetts , Atividade Motora , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/psicologia , Razão de Chances , Pennsylvania , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Caminhada/fisiologia , Caminhada/psicologiaRESUMO
The purpose of this study was to examine the factorial invariance of the Abbreviated Neighborhood Environment Walkability Scale (NEWS-A) across subgroups based on demographic, health-related, behavioral, and environmental characteristics among Nurses' Health Study participants (N = 2,919; age M = 73.0, SD = 6.9 years) living in California, Massachusetts, and Pennsylvania. A series of multi-group confirmatory factor analyses were conducted to evaluate increasingly restrictive hypotheses of factorial invariance. Factorial invariance was supported across age, walking limitations, and neighborhood walking. Only partial scalar invariance was supported across state residence and neighborhood population density. This evidence provides support for using the NEWS-A with older women of different ages, who have different degrees of walking limitations, and who engage in different amounts of neighborhood walking. Partial scalar invariance suggests that researchers should be cautious when using the NEWS-A to compare older adults living in different states and neighborhoods with different levels of population density.
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PURPOSE: To provide a synthesis of research on trails and physical activity from the public health, leisure sciences, urban planning, and transportation literatures. METHODS: A search of databases was conducted to identify studies published between 1980 and 2008. RESULTS: 52 studies were identified. The majority were cross-sectional (92%) and published after 1999 (77%). The evidence for the effects of trails on physical activity was mixed among 3 intervention and 5 correlational studies. Correlates of trail use were examined in 13 studies. Several demographic (eg, race, education, income) and environmental factors (eg, land-use mix and distance to trail) were related to trail use. Evidence from 31 descriptive studies identified several facilitators and barriers to trail use. Economic studies (n = 5) examining trails in terms of health or recreational outcomes found trails are cost-effective and produce significant economic benefits. CONCLUSION: There is a growing body of evidence demonstrating important factors that should be considered in promoting trail use, yet the evidence for positive effects of trails on physical activity is limited. Further research is needed to evaluate the effects of trails on physical activity. In addition, trail studies that include children and youth, older adults, and racial and ethnic minorities are a research priority.