Practitioners

Urban planners, public health leaders and business owners can all help people be active in their neighborhoods. Teachers, principals and school district directors can help children be active before, during and after school. Relying on evidence-based strategies in your work will help you be as effective as possible. Active Living Research has resources to provide practitioners with guidance on promising approaches for preventing obesity and promoting physical activity.

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Moving targets: Promoting physical activity in public spaces via open streets in the US

Date: 
10/01/2017
Description: 

Hipp JA, Bird A, van Bakergem M, et al. (2017). Moving targets: Promoting physical activity in public spaces via open streets in the US. Prev Med. 103(Suppl), S15-S20.

Abstract: 

Popularity of Open Streets, temporarily opening streets to communities and closing streets to vehicles, in the US has recently surged. As of January 2016, 122 cities have hosted an Open Streets program. Even with this great expansion, the sustainability of Open Streets remains a challenge in many cities and overall Open Streets in the US differ from their successful counterparts in Central and South America.

Between summer 2015 and winter 2016, we reviewed the websites and social media of the 122 identified programs and interviewed 32 unique Open Streets programs. Websites and social media were reviewed for program initiation, number of Open Streets days, length of routes, duration of program, and reported participation. Interview questions focused on barriers and facilitators of expanding Open Streets and specific questioning regarding local evaluation activities. All interviews were transcribed verbatim and analyzed with constant comparative methodology.

Over three-quarters of US Open Streets programs have been initiated since 2010, with median frequency of one time per year, 4 h per date, and 5000–9999 participants. Seventy-seven percent of program routes are under 5 km in length.

Success of programs was measured by enthusiasm, attendance, social media, survey metrics, and sustainability. Thirteen of 32 program organizers expressed interest in expanding their programs to 12 dates per year, but noted consistent barriers to expansion including funding, permitting, and branding.

Though many cities now host Open Streets programs, their ability to effect public health remains limited with few program dates per year. Coordinated efforts, especially around funding, permitting, and branding may assist in expanding program dates.

Authors: 
J. Aaron Hipp, Alyssa Bird, Margaret van Bakergem, Elizabeth Yarnall
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Perceived neighborhood environmental attributes associated with leisure-time and transport physical activity in Mexican adults

Date: 
10/01/2017
Description: 

Jáuregui A, Salvo D, Lamadrid-Figueroa H, et al. (2017). Perceived neighborhood environmental attributes associated with leisure-time and transport physical activity in Mexican adultPrev Med. 103(Suppl), S21-S26.

Abstract: 

Environmental factors have been associated with specific physical activity domains, including leisure-time and transport physical activity, in some high income countries. Few studies have examined the environmental correlates for domain-specific physical activity in low-and middle-income countries, and results are inconsistent. We aimed to estimate the associations between perceived environment and self-reported leisure-time walking, moderate-to-vigorous leisure-time physical activity and transport physical activity among adults living in Cuernavaca, Mexico. A population-based study of adults 20 to 64 years old was conducted in Cuernavaca, Mexico in 2011 (n = 677). Leisure and transport physical activity was measured using the International Physical Activity Questionnaire – Long Form. Perceptions of neighborhood environment were obtained by questionnaire. Hurdle regression models estimated the association between environmental perceptions and participation and time spent in each physical activity domain. High perceived aesthetics were positively correlated with participation and time spent in leisure-time walking and moderate-to-vigorous physical activity. SES differences existed for aesthetics in relation to participation in leisure-time walking. Participation in transport physical activity was positively associated with easy access to large parks, while closer distance to large parks was a negative correlate for participation and time-spent in this physical activity domain. Results suggest that perceived environmental characteristics related with physical activity are domain specific. High perceived aesthetics were an important correlate for leisure-time activities among Mexican adults, suggesting that policy strategies aimed at improving this environmental perception may be warranted. Patterns of associations between environmental correlates and transport physical activity differed from those reported in commonly studied high income countries.

Authors: 
Alejandra Jáuregui, Deborah Salvo, Héctor Lamadrid-Figueroa, Bernardo Hernández, Juan A. Rivera, Michael Pratt
Location by State: 
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Where Latin Americans are physically active, and why does it matter? Findings from the IPEN-adult study in Bogota, Colombia; Cuernavaca, Mexico; and Curitiba, Brazil

Date: 
10/01/2017
Description: 

Salvo D, Sarmiento OL, Reis RS, et al. (2017). Where Latin Americans are physically active, and why does it matter? Findings from the IPEN-adult study in Bogota, Colombia; Cuernavaca, Mexico; and Curitiba, Brazil. Prev Med. 103(Suppl), S27-S33.

Abstract: 

Latin America (LA) has a unique structural, political, cultural and social environment. This study aimed to identify the places where Latin American adults are physically active; and to determine the association of using public- and restricted-access places with physical activity (PA). We used data from the International PA Environment Network study in Bogota, Colombia (n = 1000, accelerometry = 249); Cuernavaca, Mexico (n = 677, accelerometry = 652); and Curitiba, Brazil (n = 697, accelerometry = 331) (2010 − 2011). Walking and moderate-to-vigorous PA for leisure were measured with the International Physical Activity Questionnaire. Overall PA and PA within 10-minute bouts were measured with accelerometers. Participants reported use of public- and restricted-access places for PA. Mixed-effects regression models were used to determine the association of using public- and restricted-access places with PA. The streets were the most frequently-reported place for PA, and walking was the most common PA in the studied places. ‘Informal’, non-exercise-or-sports places (e.g., shopping malls) ranked high for use for PA in Bogota and Cuernavaca. In Curitiba, use of ‘formal’ places for sports/exercise (e.g., gyms) was more prevalent. Using public-access places was directly related to walking for leisure in all cities, and to additional PA outcomes in Bogota and Cuernavaca. In Cuernavaca and Curitiba, using restricted-access places was also associated with PA. Our study highlights the importance of public-access places for PA in LA. In some contexts, places for social interaction may be as important for PA as places for exercise/sport. Strategies increasing the availability, accessibility and quality of these places may effectively promote PA in LA.

Authors: 
Deborah Salvo, Olga L. Sarmiento, Rodrigo S. Reis, Adriano A.F. Hino, Manuel A. Bolivar, Pablo D. Lemoine, Priscilla B. Gonçalves, Michael Pratt
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Reclaiming the streets for people: Insights from Ciclovías Recreativas in Latin America

Date: 
10/01/2017
Description: 

Sarmiento OL, Díaz del Castillo A, Triana CA, et al. (2017). Reclaiming the streets for people: Insights from Ciclovías Recreativas in Latin America. Prev Med. 103(Suppl), S34-S40.

Abstract: 

The Ciclovías comprise worldwide programs in which streets are closed to motor-vehicles and open to individuals for leisure activities. Currently, 93% of the regular programs are in Latin American countries (LAC). The aims of this study were to describe the characteristics of regular Ciclovías in 7 LAC and to analyze the factors that influence the sustainability and scaling-up of five case studies. We conducted a survey of 67 Ciclovías in 2014–2015. In addition, we conducted semi-structured interviews with current and former program coordinators and reviewed policy documents from Ciclovías in 5 LAC. The greatest expansion of Ciclovías has occurred since 2000. The number of participants per event ranged from 40 to 1,500,000 (mean 41,399 ± 193,330; median 1600), and the length ranged from 1 to 113.6 km (mean 9.1 ± 16.4; median 3). Ciclovía routes connect low-middle and high income neighborhoods (89.3%), and include the participation of minority populations (61.2%). The main complementary activity offered was physical activity (PA) classes (94.0%), and 80.0% of the programs included strategies to promote biking. All five case studies met definitions for sustainability and scaling-up. All programs shared some level of government support, alliances, community appropriation, champions, compatibility with the mission of the host organization, organizational capacity, flexibility, perceived benefits, and funding stability. However, they differed in operational conditions, political favorability, sources of funding, and number of alliances. The Ciclovías of LAC showed heterogeneity within their design and sustainability factors. Both their heterogeneity and flexibility to adjust to changes make them promising examples of socially inclusive programs to promote PA.

Authors: 
Olga L. Sarmiento, Adriana Díaz del Castillo, Camilo A. Triana, María José Acevedo, Silvia A. Gonzalez, Michael Pratt
Location by State: 
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Start small, dream big: Experiences of physical activity in public spaces in Colombia

Date: 
10/01/2017
Description: 

Díaz del Castillo A, González SA, Ríos AP, et al. (2017). Start small, dream big: Experiences of physical activity in public spaces in Colombia. Prev Med. 103(Suppl), S41-S50.

Abstract: 

Multi-sectoral strategies to promote active recreation and physical activity in public spaces are crucial to building a “culture of health”. However, studies on the sustainability and scalability of these strategies are limited. This paper identifies the factors related to the sustainability and scaling up of two community-based programs offering physical activity classes in public spaces in Colombia: Bogotá's Recreovía and Colombia's “Healthy Habits and Lifestyles Program-HEVS”. Both programs have been sustained for more than 10 years, and have benefited 1455 communities. We used a mixed-methods approach including semi-structured interviews, document review and an analysis of data regarding the programs' history, characteristics, funding, capacity building and challenges. Interviews were conducted between May–October 2015. Based on the sustainability frameworks of Shediac-Rizkallah and Bone and Scheirer, we developed categories to independently code each interview. All information was independently analyzed by four of the authors and cross-compared between programs. Findings showed that these programs underwent adaptation processes to address the challenges that threatened their continuation and growth. The primary strategies included flexibility/adaptability, investing in the working conditions and training of instructors, allocating public funds and requesting accountability, diversifying resources, having community support and champions at different levels and positions, and carrying out continuous advocacy to include physical activity in public policies. Recreovía and HEVS illustrate sustainability as an incremental, multi-level process at different levels. Lessons learned for similar initiatives include the importance of individual actions and small events, a willingness to start small while dreaming big, being flexible, and prioritizing the human factor.

Authors: 
Adriana Díaz del Castillo, Silvia Alejandra González, Ana Paola Ríos, Diana C. Páez, Andrea Torres, María Paula Díaz, Michael Pratt, Olga L. Sarmiento
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Assessing the effect of physical activity classes in public spaces on leisure-time physical activity: “Al Ritmo de las Comunidades” A natural experiment in Bogota, Colombia

Date: 
10/01/2017
Description: 

Torres A, Díaz MP, Hayat MJ, et al. Assessing the effect of physical activity classes in public spaces on leisure-time physical activity: “Al Ritmo de las Comunidades” A natural experiment in Bogota, Colombia. Prev Med. 103(Suppl), S51-S58.

Abstract: 

The Recreovia program provides free physical activity (PA) classes in public spaces in Bogota, Colombia. The purpose of this study was to assess the effectiveness of the Recreovia program in increasing PA among users of nine parks in Bogota. This study was a natural experiment conducted between 2013 and 2015 in Bogota. Community members and park users living nearby three groups of parks were compared: Group 1 were parks implementing new Recreovias (n = 3), Group 2 were control parks (n = 3) without Recreovias, and Group 3 were parks with existing Recreovías. Individuals in the “intervention” group were exposed to newly implemented Recreovia programs in parks near their homes. Measurements were collected at baseline and 6–8 months after the intervention started. A total of 1533 participants were enrolled in the study: 501 for the existing Recreovias (included in a cross-sectional assessment) and 1032 participants (from the new Recreovias and control parks) included in the cross-sectional and pre-post study. Most participants were low income females. Twenty-three percent of the intervention group started participating in the program. Users of existing Recreovias were significantly more active and less likely to be overweight/obese compared to new Recreovia users at baseline. No changes on PA were found when comparing the intervention and control groups. Recreovias may have potential for increasing PA at the population level in urban areas given their rapid scalability, the higher levels of PA observed among program users, and its potential to reach women, low-income, less educated populations, and the overweight and obese.

Authors: 
Andrea Torres, María Paula Díaz, Matthew J. Hayat, Rodney Lyn, Michael Pratt, Deborah Salvo, Olga L. Sarmiento
Location by State: 
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Use of global positioning system for physical activity research in youth: ESPAÇOS Adolescentes, Brazil

Date: 
10/01/2017
Description: 

Oliveira Alberico C, Schipperijn J, & Reis RS. (2017). Use of global positioning system for physical activity research in youth: ESPAÇOS Adolescentes, Brazil. Prev Med. 103(Suppl), S59-S65.

Abstract: 

The built environment is an important factor associated with physical activity and sedentary behavior (SB) during adolescence. This study presents the methods for objective assessment of context-specific moderate to vigorous physical activity (MVPA) and SB, as well as describes results from the first project using such methodology in adolescents from a developing country. An initial sample of 381 adolescents was recruited from 32 census tracts in Curitiba, Brazil (2013); 80 had their homes geocoded and wore accelerometer and GPS devices for seven days. Four domains were defined as important contexts: home, school, transport and leisure. The majority of participants (n = 80) were boys (46; 57.5%), with a normal BMI (52; 65.0%) and a mean age (SD) of 14.5 (5.5) years. Adolescents spent most of their time at home, engaging in SB. Overall, the largest proportion of MVPA was while in transport (17.1% of time spent in this context) and SB while in leisure (188.6 min per day). Participants engaged in MVPA for a median of 28.7 (IQR 18.2–43.2) and 17.9 (IQR 9.2–32.1) minutes during week and weekend days, respectively. Participants spent most of their day in the leisure and home domains. The use of Geographic Information System (GIS), Global Positioning System (GPS) and accelerometer data allowed objective identification of the amount of time spent in MVPA and SB in four different domains. Though the combination of objective measures is still an emerging methodology, this is a promising and feasible approach to understanding interactions between people and their environments in developing countries.

Authors: 
Claudia Oliveira Alberico, Jasper Schipperijn, Rodrigo S Reis
Location by State: 
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Effectiveness of a scaled up physical activity intervention in Brazil: A natural experiment

Date: 
10/01/2017
Description: 

Simões EJ, Hallal PC, Siqueira FV, et al. (2017). Effectiveness of a scaled up physical activity intervention in Brazil: A natural experiment. Prev Med. 103(Suppl), S66-S72.

Abstract: 

Physical inactivity causes 5.3 million deaths annually worldwide. We evaluated the impact on population leisure-time physical activity (LTPA) of scaling up an intervention in Brazil, Academia das Cidades program (AC-P). AC-P is a health promotion program classified as physical activity classes in community settings which started in the state of Pernambuco state in 2008.

We surveyed households from 80 cities of Pernambuco state in 2011, 2012 and 2013, using monitoring data to classify city-level exposure to AC-P. We targeted 2370 individuals in 2011; 3824 individuals in 2012; and 3835 individuals in 2013. We measured participation in AC-P and whether respondents had seen an AC-P activity or heard about AC-P. We measured LTPA using the International Physical Activity Questionnaire. We estimated the odds of reaching recommended LTPA by levels of exposure to the three AC-P measures.

For women, the odds of reaching recommended LTPA were 1.10 for those living in cities with AC-P activity for less than three years, and 1.46 for those living in cities with AC-P activity for more than three years compared to those living in cities that had not adopted AC-P. The odds of reaching recommended LTPA increased with AC-P participation and knowledge about AC-P.

AC-P exposure is associated with increased population LTPA. Extending AC-P to all cities could potentially impact non-communicable diseases in Brazil.

Authors: 
Eduardo J Simões, Pedro C Hallal, Fernando V Siqueira, Chester Schmaltz, Danielle Menor, Deborah C Malta, Hebe Duarte, Adriano Akira Hino, Gregore I Mielke, Michael Pratt, Rodrigo S Reis
Location by State: 
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Are children living on dead-end streets more active? Near-home street patterns and school-going children's time spent outdoors in Dhaka, Bangladesh

Date: 
10/01/2017
Description: 

Monsur M, Mansur M, & Zakiul Islam M. (2017). Are children living on dead-end streets more active? Near-home street patterns and school-going children's time spent outdoors in Dhaka, Bangladesh. Prev Med. 103(Suppl), S73-S80.

Abstract: 

This study aimed to investigate relationships between near-home street patterns and children's time spent outdoors (TSO). Participants were 60 (n = 60) school-age Dhaka children, 7–11 years old (16 girls and 44 boys) selected by a two-phase cluster sampling method. Data were collected from September 2010 to June 2011 by visiting each of 60 children's homes. Children's mean TSOs (in minutes) were reported by parents' face-to-face interviews, and near-home street pattern data were collected by systematic direct observations. The researchers also collected data on seven socio-demographic variables and three neighborhood built-environment variables. A backward selection based multiple linear regression was used to examine association between children's TSO and near-home street patterns. Results (adjusted R2 = 0.66 for weekdays and 0.68 for weekend) suggested that children's TSO were significantly associated with near-home street type: dead-end instead of through streets (28 min on weekdays, p < 0.01 and 66 min on weekend, p < 0.01). The width of the street, level of its branching and availability of an open space or playground near the house are also positively associated with TSO. Near-home street features significantly contribute to TSO in school-going children of Dhaka.

Authors: 
Muntazar Monsur, Mohaimen Mansur, Mohammed Zakiul Islam
Location by State: 
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“Can we walk?” Environmental supports for physical activity in India

Date: 
10/01/2017
Description: 

Adlakha D, Hipp JA, Brownson RC, et al. (2017). “Can we walk?” Environmental supports for physical activity in India. Prev Med. 103(Suppl), S81-S89.

Abstract: 

India is currently facing a non-communicable disease epidemic. Physical activity (PA) is a preventative factor for non-communicable diseases. Understanding the role of the built environment (BE) to facilitate or constrain PA is essential for public health interventions to increase population PA. The objective of this study was to understand BEs associations with PA occurring in two major life domains or life areas—travel and leisure—in urban India. Between December 2014 and April 2015, in-person surveys were conducted with participants (N = 370; female = 47.2%) in Chennai, India. Perceived BE characteristics regarding residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking and bicycling, aesthetics, traffic safety, and safety from crime were measured using the adapted Neighborhood Environment Walkability Scale-India (NEWS-India). Self-reported PA was measured the International Physical Activity Questionnaire. High residential density was associated with greater odds of travel PA (aOR = 1.9, 95% CI = 1.2, 3.2). Land use mix-diversity was positively related to travel PA (aOR = 2.1, 95%CI = 1.2, 3.6), but not associated with leisure or total PA. The aggregate NEWS-India score predicted a two-fold increase in odds of travel PA (aOR = 1.9, 95% CI = 1.1, 3.1) and a 40% decrease in odds of leisure PA (aOR = 0.6, 95% CI = 0.4, 1.0). However, the association of the aggregated score with leisure PA was not significant. Results suggest that relationships between BE and PA in low-and-middle income countries may be context-specific, and may differ markedly from higher income countries. Findings have public health implications for India suggesting that caution should be taken when translating evidence across countries.

Authors: 
Deepti Adlakha, J. Aaron Hipp, Ross C. Brownson, Amy A. Eyler, Carolyn K. Lesorogol, Ramesh Raghavan
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