Communities

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The way communities are designed has a great influence on how active we are. When communities are safe, well-maintained and have appealing scenery, children and families are more likely to be active. Unfortunately, many people—especially those at high risk for obesity—live in communities that lack parks and have high crime rates, dangerous traffic patterns and unsafe sidewalks.  Such communities discourage residents from walking, bicycling and playing outside. Increasingly, local governments are considering how community design will impact residents’ physical activity. Our research documents effective strategies for creating communities that support active living and promote health.

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Urban density, diversity and design: Is more always better for walking? A study from Hong Kong

Date: 
10/01/2017
Description: 

Lu Y, Xiao Y, & Ye Y. (20107). Urban density, diversity and design: Is more always better for walking? A study from Hong Kong. Prev Med. 103(Suppl), S99-S103.

Abstract: 

Many cities in China have undergone rapid urbanization and are experiencing a decline in residents' physical activity levels. Previous studies have reported inconsistent findings on the association between 3D's (density, diversity, design) and walking behavior, and few studies have been conducted in China. The aim of this study was to identify the association between objectively measured 3D's and different domains of walking (transport vs. leisure) in Hong Kong, China. A survey was conducted in 2014 to collect walking data and relevant individual data from 1078 participants aged 18–65. The participants were randomly selected from 36 Hong Kong housing estates with different built environment and neighborhood socioeconomic status (SES). Built environment factors—population design, land-use mix and street intersection density—were assessed using a geographic information system. Multi-level regression was used to explore the associations between walking behavior and built environment factors, while adjusting for covariates. Two out the three D's—land-use mix and street connectivity—are not significantly related to any domains of walking. Furthermore, the third D, population density, is only positively related to walking for transport and walking for leisure in the lower range of density, while is negatively related to walking for leisure in the higher range of density. The findings suggest that the association between original 3D's and walking may vary in different urban contexts. The policy or planning strategy—using three D's to promote physical activity—may be ineffective or even counterproductive in large and already dense cities in China.

Authors: 
Yi Lu, Yang Xiao, Yu Ye
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Equity in Active Living for People with Disabilities: Less Talk and More Action

Date: 
02/01/2017
Description: 

Rimmer, J.H. (2017). Equity in Active Living for People with Disabilities: Less Talk and More Action. Prev Med. 95(Suppl), S154-S156.

Authors: 
JH Rimmer
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Physical Activity in Indian Country

Date: 
02/01/2017
Description: 

Roanhorse, O. (2017). Physical Activity in Indian Country. Prev Med. 95(Suppl), S151-S153.

Abstract: 

This article shares promising efforts, strategies and approaches in effectively and culturally supporting Native communities in promoting the health of their children through movement, the connection to their land, language, culture and traditional knowledge.

Authors: 
O Roanhorse
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A Comprehensive Scoring System to Measure Healthy Community Design in Land Use Plans and Regulations

Description: 

Maiden, K.M., Kaplan, M., Walling, L.A., Miller, P.P., & Crist, G. (2017). A Comprehensive Scoring System to Measure Healthy Community Design in Land Use Plans and Regulations. Prev Med. 95(Suppl), S141-S147.

Date: 
02/01/2017
Abstract: 

Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January–April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations.

Authors: 
KM Maiden, M Kaplan, LA Walling, PP Miller, & G Crist
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Pedestrian-Oriented Zoning is Associated with Reduced Income and Poverty Disparities in Adult Active Travel to Work, United States

Description: 

Chriqui, J.F., Leider, J., Thrun, E., Nicholson, L.M., & Slater, S.J. (2017). Pedestrian-Oriented Zoning is Associated with Reduced Income and Poverty Disparities in Adult Active Travel to Work, United States. Prev Med. 95(Suppl), S126-S133.

Date: 
02/01/2017
Abstract: 

Active travel to work can provide additional minutes of daily physical activity. While the literature points to the relationship between zoning, equity and socioeconomic status, and physical activity, no study has quantitatively explored these connections. This study examined whether zoning may help to moderate any income and poverty inequities in active travel and taking public transit to work. Research was conducted between May 2012 and June 2015. Zoning data were compiled for 3914 jurisdictions covering 45.45% of the U.S. population located in 471 of the most populous U.S. counties and 2 consolidated cities located in 48 states and the District of Columbia. (Sensitivity analyses also captured unincorporated areas which, with the municipalities, collectively covered ~72% of the U.S. population.) Zoning codes were obtained and evaluated to assess the pedestrian-orientation of the zoning codes. Public transit use, active travel to work, median household income, and poverty data were obtained for all study jurisdictions from the 2010–2014 American Community Survey estimates. Associations were examined through multivariate regression models, controlling for community sociodemographics, clustered on county, with robust standard errors. We found that certain pedestrian-oriented zoning provisions (e.g., crosswalks, bike-pedestrian connectivity, street connectivity, bike lanes, bike parking, and more zoning provisions) were associated with reduced income and/or poverty disparities in rates of public transit use and active travel to work. Findings from this study can help to inform cross-sectoral collaborations between the public health, planning, and transportation fields regarding zoning for pedestrian-orientation and active travel.

Authors: 
JF Chriqui, J Leider, E Thrun, LM Nicholson, & SJ Slater
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Associations Between Active Living-Oriented Zoning and No Adult Leisure-Time Physical Activity in the U.S.

Date: 
02/01/2017
Description: 

Leider, J., Chriqui, J.F., & Thrun, E. (2017). Associations Between Active Living-Oriented Zoning and No Adult Leisure-Time Physical Activity in the U.S.. Prev Med. 95(Suppl), S120-S125.

Abstract: 

Nearly one-third of adults report no leisure-time physical activity (LTPA). Governmental and authoritative bodies recognize the role that community design through zoning code changes can play in enabling LTPA. This study examined the association between zoning and no adult LTPA in the U.S. This study was conducted between 2012 and 2016, with analyses occurring in 2015–2016. Zoning codes effective as of 2010 were compiled for jurisdictions located in the 495 most populous U.S. counties and were evaluated for pedestrian-oriented code reform zoning, 11 active living-oriented provisions (e.g., sidewalks, bike-pedestrian connectivity, mixed use, bike lanes) and a summated zoning scale (max = 12). Individual-level LTPA data were obtained from the 2012 CDC Behavioral Risk Factor Surveillance System (BRFSS). County-aggregated, population-weighted zoning variables were constructed for linking to BRFSS. Log-log multivariate regressions (N = 147,517 adults), controlling for individual and county characteristics and with robust standard errors clustered on county, were conducted to examine associations between zoning and no LTPA. Relative risks (RR) compared predicted lack of LTPA at 0% and 100% county-level population exposure to each zoning predictor. Zoning code reforms were associated with a 13% lower probability of no LTPA (RR: 0.87, 95% CI: 0.82–0.92). Except for crosswalks, all zoning provisions were associated with an 11–16% lower probability of no LTPA. Having all 12 zoning provisions was associated with a 22% lower probability of no LTPA (RR: 0.78, 95% CI: 0.72–0.83). The results suggest that active living-oriented zoning is a policy lever available to communities seeking to reduce rates of no LTPA.

Authors: 
J Leider, JF Chriqui, & E Thrun
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Measuring Policy and Related Effects of a Health Impact Assessment Related to Connectivity

Description: 

Bias, T.K. & Abildso, C.G. (2017). Measuring Policy and Related Effects of a Health Impact Assessment Related to Connectivity. Prev Med. 95(Suppl), S92-S94.

Date: 
02/01/2017
Abstract: 

Health Impact Assessments are an important tool to help policymakers perceive the potential positive and negative contributions of decisions to public health. While they have been increasingly used in the United States, studies have not examined intermediate effects. Using key stakeholder interviews, this manuscript examines policy outcomes and other related effects of the HIA 21 months after completing a Health Impact Assessment Report around connectivity policy. Further, it reflects on the measurement of these effects as part of the monitoring and evaluation stage of the Health Impact Assessment process.

Authors: 
TK Bias & CG Abildso
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The Physical Environment of Positive Places: Exploring Differences Between Age Groups

Date: 
02/01/2017
Description: 

Laatikainen, T.E., Broberg, A., & Kyttä, M. (2017). The Physical Environment of Positive Places: Exploring Differences Between Age Groups. Prev Med. 95(Suppl), S85-S91.

Abstract: 

Features of the physical environment have an impact on the human behaviour. Thus, planners and policymakers around the world should aim at providing environments that are perceived as being of good quality, in which the residents enjoy spending time and moving around in. It is widely acknowledged that urban environmental quality associates with well-being, but there is currently very little research examining which features of urban environments people of different ages perceive as appealing in their living environments. Individuals experience different age-related developmental environments throughout their life course. Thus, the usage and perceptions of different spaces can also differ between various age groups. Public Participation GIS datasets collected in 2009 and 2011 in Helsinki Metropolitan Area were used to study places perceived as being positive by adults (n = 3119) and children (n = 672). Participants marked points on a map that were overlaid with GIS data to study whether the physical environment of positive places of different age groups differed. The results demonstrated that the physical environment differs significantly in the positive places of different age groups. The places of adult age groups were characterized by green, blue and commercial spaces, whereas sports, residential and commercial spaces characterize children's and adolescents' places. Older adults' places were found to be closest to home, while adolescents' places were the most distant. Providing appealing environments for all age groups in one setting remains problematic but should nevertheless be strived for, especially in the urban context where a constant competition over different usages of space occurs.

Authors: 
TE Laatikainen, A Broberg, & M Kyttä
Location by State: 
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Does the Built Environment Moderate the Relationship Between Having a Disability and Lower Levels of Physical Activity? A Systematic Review

Date: 
02/01/2017
Description: 

Eisenberg, Y., Vanderbom, K.A., & Vasudevan, V. (2017). Does the Built Environment Moderate the Relationship Between Having a Disability and Lower Levels of Physical Activity? A Systematic Review. Prev Med. 95(Suppl), S75-S84.

Abstract: 

The relationship between the built environment and physical activity has been well documented. However, little is known about how the built environment affects physical activity among people with disabilities, who have disproportionately higher rates of physical inactivity and obesity. This study is the first systematic review to examine the role of the built environment as a moderator of the relationship between having a disability (physical, sensory or cognitive) and lower levels of physical activity. After conducting an extensive search of the literature published between 1990 and 2015, 2039 articles were screened, 126 were evaluated by abstract and 66 by full text for eligibility in the review. Data were abstracted using a predefined coding guide and synthesized from both qualitative and quantitative studies to examine evidence of moderation. Nine quantitative and six qualitative articles met the inclusion criteria. Results showed that most research to date has been on older adults with physical disabilities. People with disabilities described how aspects of the built environment affect neighborhood walking, suggesting a positive moderating role of features related to safety and aesthetic qualities, such as benches, lighting and stop light timing. There were mixed results among studies that examined the relationship quantitatively. Most of the studies were not designed to appropriately examine moderation. Future research should utilize valid and reliable built environment measures that are more specific to disability and should include people with and without disabilities to allow for testing of moderation of the built environment.

Authors: 
Y Eisenberg, KA Vanderbom, & V Vasudevan
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Objective Reports Versus Subjective Perceptions of Crime and their Relationships to Accelerometer-Measured Physical Activity in Hispanic Caretaker-Child Dyads

Date: 
02/01/2017
Description: 

van Bakergem, M., Sommer, E.C., Heerman, W.J., Hipp, J.A., & Barkin, S.L. (2017). Objective Reports Versus Subjective Perceptions of Crime and their Relationships to Accelerometer-Measured Physical Activity in Hispanic Caretaker-Child Dyads. Prev Med. 95(Suppl), S68-S74.

Abstract: 

Crime and safety are commonly cited barriers to physical activity (PA). We had three objectives, 1) describe the association between objective crime measures and perceptions of crime, 2) analyze the relationships between each type of crime and accelerometer-measured physical activity in caretakers and young children (ages 3–5 years), and 3) explore for early gender differences in the relationship between crime and physical activity in young children. Data are from the cross-sectional baseline data of an ongoing randomized controlled trial in Nashville, Tennessee spanning September 2012 through May 2014. Data was analyzed from 480 Hispanic dyads (adult caretaker and 3–5 year old child). Objective crime rate was assessed in ArcGIS and perception of crime was measured by caretaker agreement with the statement “The crime rate in my neighborhood makes it unsafe to go on walks.” The primary outcome was accelerometer-measured physical activity over seven consecutive days. Objective and perceived crime were significantly positively correlated. Caretaker vigorous PA was significantly related to perceptions of crime; however, its relationship to objective crime was not significant. Child PA was not significantly related to caretaker perceptions of crime. However, interactions suggested that the relationship between crime rate and PA was significantly more negative for girls than for boys. Objective and subjective measures of crime rate are expected to be important correlates of PA, but they appear to have complex relationships that are different for adults than they are for young children, as well as for young girls compared to boys, and research has produced conflicting findings.

Authors: 
M van Bakergem, EC Sommer, WJ Heerman, JA Hipp, & SL Barkin
Location by State: 
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