Behavior and weight correlates of weight-control efforts in Australian women living in disadvantage : the READI study

Background
With increasing obesity rates worldwide, more and more people are actively attempting to lose weight or avoid weight gain, but relatively little is known about what specific behaviors comprise these efforts and which, if any, are associated with better weight control over time.

Methods
This paper reports relationships between body weight, weight-control efforts and related behaviors over a three-year period in 1,634 Australian women. The women were purposefully recruited from 80 disadvantaged neighborhoods in Victoria, Australia. Weight loss efforts were categorized as trying to lose weight, trying to prevent weight gain and no weight-control efforts. Behavioral correlates examined included different kinds of physical activity and consumption of a number of specific foods types.

Results and discussion
Self-reported body weight at baseline was higher in women trying to lose weight. Frequency of consumption of low energy density foods was positively associated with reported weight-control efforts, as was frequency of reported total and leisure-time physical activity. Longitudinal associations between changes in weight-control efforts and changes in behaviors were consistent with the cross-sectional findings. At three-year follow up, however, weight-control efforts were not associated with change in body weight. More detailed analyses of specific food choices suggested that part of the explanation of no effect of reported weight-control efforts and weight over time might be that people are not as well-informed as they should be about the energy density of some common foods. In particular, those reporting engagement in weight-control efforts reported reducing consumption of carbohydrate-containing foods such as bread and potatoes more than is justified by their energy content, while they reported increasing consumption of some high energy density foods (e.g., cheese and nuts).

Conclusion
It is tentatively concluded that women living in disadvantaged neighborhoods understand messages about weight-control (more activity and foods with lower fat and lower energy density) but that some foods eaten more by women engaged in weight control may reduce the effectiveness of these efforts.

Sharing good NEWS across the world: developing comparable scores across 12 countries for the neighborhood environment walkability scale (NEWS)

Background: The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally.
Methods: The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen’s d) between them using data from countries that had included items from both standard and alternative versions of the subscales.
Results: Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix – access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version.
Conclusions: We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries.

Advancing science and policy through a coordinated international study of physical activity and built environments: IPEN Adult methods

Background: National and international strategies to increase physical activity emphasize environmental and policy changes that can have widespread and long-lasting impact. Evidence from multiple countries using comparable methods is required to strengthen the evidence base for such initiatives. Because some environment and policy changes could have generalizable effects and others may depend on each country’s context, only international studies using comparable methods can identify the relevant differences. Methods: Currently 12 countries are participating in the International Physical Activity and the Environment Network (IPEN) study. The IPEN Adult study design involves recruiting adult participants from neighborhoods with wide variations in environmental walkability attributes and socioeconomic status (SES). Results: Eleven of twelve countries are providing accelerometer data and 11 are providing GIS data. Current projections indicate that 14,119 participants will provide survey data on built environments and physical activity and 7145 are likely to provide objective data on both the independent and dependent variables. Though studies are highly comparable, some adaptations are required based on the local context. Conclusions: This study was designed to inform evidence-based international and country-specific physical activity policies and interventions to help prevent obesity and other chronic diseases that are high in developed countries and growing rapidly in developing countries.

Perceived neighborhood environmental attributes associated with adults’ transport-related walking and cycling: Findings from the USA, Australia and Belgium

Background : Active transportation has the potential to contribute considerably to overall physical activity levels in adults and is likely to be influenced by neighborhood-related built environment characteristics. Previous studies that examined the associations between built environment attributes and active transportation, focused mainly on transport-related walking and were conducted within single countries, limiting environmental variability. We investigated the direction and shape of relationships of perceived neighborhood attributes with transport-related cycling and walking in three countries; and examined whether these associations differed by country and gender.

Methods Data from the USA (Baltimore and Seattle), Australia (Adelaide) and Belgium (Ghent) were pooled. In total, 6,014 adults (20–65 years, 55.7% women) were recruited in high-/low-walkable and high-/low-income neighborhoods. All participants completed the Neighborhood Environmental Walkability Scale and the International Physical Activity Questionnaire. Generalized additive mixed models were used to estimate the strength and shape of the associations.

Results Proximity to destinations, good walking and cycling facilities, perceiving difficulties in parking near local shopping areas, and perceived aesthetics were included in a ‘cyclability’ index. This index was linearly positively related to transport-related cycling and no gender- or country-differences were observed. The ‘walkability’ index consisted of perceived residential density, land use mix access, proximity of destinations and aesthetics. A non-linear positive relationship with transport-related walking was found. This association was stronger in women than in men, and country-specific associations were identified: the strongest association was observed in Seattle, the weakest in Adelaide. In Ghent, the association weakened at higher levels of walkability.

Conclusions For cycling, consistent correlates were found in the three countries, but associations were less straightforward for transport-related walking. Moreover, the identified neighborhood environmental correlates were different for walking compared to cycling. In order to further clarify the shape of these associations and reach more specific international guidelines for developing walkable and bikeable neighborhoods, future studies should include even more countries to maximize environmental variability.

Correlates of change in adults’ television viewing time : a four-year follow-up study

Purpose: Adults tend to increase their television (TV) viewing time as they age, but little is known about attributes associated with change in TV viewing over time. This study examined individual, social, and environmental correlates of change in TV viewing time for 4 yr.

Methods: Adult participants (n = 897) from a longitudinal epidemiological study in Adelaide, Australia, reported TV viewing time at baseline (2003–2004) and at follow- up (2007–2008). Generalized linear modeling was used to examine correlates of change in TV viewing time.

Results: The mean TV viewing time increased from 112 to 116 min·d-1 from baseline to follow-up. Adjusted for TV viewing time at baseline, having a tertiary education was associated with a 13% lower TV time at follow-up (P = 0.007). Each additional hour of occupational and transport physical activity at baseline was associated with a 2% and 7% lower TV viewing at follow-up (P = 0.031 and P = 0.023, respectively). For men, an additional hour of domestic physical activity was associated with a 7% higher TV viewing time at follow-up (P = 0.006). A significant neighborhood walkability × working status interaction (P = 0.035) indicated that, for those who were not working, living in a highly walkable neighborhood was associated with a 23% lower TV viewing time at follow-up (P = 0.003).

Conclusions: Adults with lower educational attainment, adults with lower occupational and transport physical activity, men with higher domestic physical activity, and nonworking adults living in lowly walkable neighborhoods were at higher risk of increase in TV viewing time. Interventions should target multiple variables at the individual, social, and environmental levels to address age-related increases in TV viewing time.

Impact of an active video game on healthy children’s physical activity

OBJECTIVE: This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether the effect would be greater among children in unsafe neighborhoods, who might not be allowed to play outside.

METHODS: Participants were children 9 to 12 years of age, with a BMI >50th percentile, but <99th percentile; none of these children a medical condition that would preclude physical activity or playing video games. A randomized clinical trial assigned children to receiving 2 active or 2 inactive video games, the peripherals necessary to run the games, and a Wii console. Physical activity was monitored by using accelerometers for 5 weeks over the course of a 13-week experiment. Neighborhood safety was assessed with a 12 item validated questionnaire.

RESULTS: There was no evidence that children receiving the active video games were more active in general, or at anytime, than children receiving the inactive video games. The outcomes were not moderated by parent perceived neighborhood safety, child BMI z score, or other demographic characteristics.

CONCLUSIONS: These results provide no reason to believe that simply acquiring an active video game under naturalistic circumstances provides a public health benefit to children.

Measuring walking within and outside the neighborhood in Chinese elders : reliability and validity

Background : Walking is a preferred, prevalent and recommended activity for aging populations and is influenced by the neighborhood built environment. To study this influence it is necessary to differentiate whether walking occurs within or outside of the neighborhood. The Neighborhood Physical Activity Questionnaire (NPAQ) collects information on setting-specific physical activity, including walking, inside and outside one's neighborhood. While the NPAQ has shown to be a reliable measure in adults, its reliability in older adults is unknown. Additionally its validity and the influence of type of neighborhood on reliability and validity have yet to be explored. Methods : The NPAQ walking component was adapted for Chinese speaking elders (NWQ-CS). Ninety-six Chinese elders, stratified by social economic status and neighborhood walkability, wore an accelerometer and completed a log of walks for 7 days. Following the collection of valid data the NWQ-CS was interviewer-administered. Fourteen to 20 days (average of 17 days) later the NWQ-CS was re-administered. Test-retest reliability and validity of the NWQ-CS were assessed. Results : Reliability and validity estimates did not differ with type of neighborhood. NWQ-CS measures of walking showed moderate to excellent reliability. Reliability was generally higher for estimates of weekly frequency than minutes of walking. Total weekly minutes of walking were moderately related to all accelerometry measures. Moderate-to-strong associations were found between the NWQ-CS and log-of-walks variables. The NWQ-CS yielded statistically significantly lower mean values of total walking, weekly minutes of walking for transportation and weekly frequency of walking for transportation outside the neighborhood than the log-of-walks. Conclusions : The NWQ-CS showed measurement invariance across types of neighborhoods. It is a valid measure of walking for recreation and frequency of walking for transport. However, it may systematically underestimate the duration of walking for transport in samples that engage in high levels of this type of walking.

Reliability and validity of the IPAQ-L in a sample of Hong Kong urban older adults : does neighborhood of residence matter?

This study examined reliability and validity of the Chinese version of the International Physical Activity Questionnaire–Long Form (IPAQ-LC) in Chinese seniors, including moderating effects of neighborhood walkability and socioeconomic status (SES) on reliability and validity. The IPAQ-LC was interviewer-administered (n = 96), accelerometer and 7-day walk-diary data were collected (n = 94), and the IPAC-LC was readministered (N = 92). Acceptable reliability was found for all measures of physical activity (PA) overall and across different types of neighborhood. Participants from highly walkable neighborhoods were more reliable at estimating walking for transport. Participants from low-SES areas were less reliable at estimating leisure-time PA and sitting but more reliable at estimating transport-related walking. IPAQ-LC walking was significantly related to light- but not moderate-intensity accelerometry-based PA. It was moderately to strongly related to a 7-day diary of walking. The data imply slow-paced walking, probably due to age, climate, and terrain. The findings suggest that the IPAQ-LC’s reliability and validity are acceptable in Chinese seniors.

Cross-validation of the factorial structure of the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A)

Background : The Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A) assess perceived environmental attributes believed to influence physical activity. A multilevel confirmatory factor analysis (MCFA) conducted on a sample from Seattle, WA showed that, at the respondent level, the factor-analyzable items of the NEWS and NEWS-A measured 11 and 10 constructs of perceived neighborhood environment, respectively. At the census blockgroup (used by the US Census Bureau as a subunit of census tracts) level, the MCFA yielded five factors for both NEWS and NEWS-A. The aim of this study was to cross-validate the individual- and blockgroup-level measurement models of the NEWS and NEWS-A in a geographical location and population different from those used in the original validation study.

Methods : A sample of 912 adults was recruited from 16 selected neighborhoods (116 census blockgroups) in the Baltimore, MD region. Neighborhoods were stratified according to their socio-economic status and transport-related walkability level measured using Geographic Information Systems. Participants self-completed the NEWS. MCFA was used to cross-validate the individual- and blockgroup-level measurement models of the NEWS and NEWS-A.

Results : The data provided sufficient support for the factorial validity of the original individual-level measurement models, which consisted of 11 (NEWS) and 10 (NEWS-A) correlated factors. The original blockgroup-level measurement model of the NEWS and NEWS-A showed poor fit to the data and required substantial modifications. These included the combining of aspects of building aesthetics with safety from crime into one factor; the separation of natural aesthetics and building aesthetics into two factors; and for the NEWS-A, the separation of presence of sidewalks/walking routes from other infrastructure for walking.

Conclusion : This study provided support for the generalizability of the individual-level measurement models of the NEWS and NEWS-A to different urban geographical locations in the USA. It is recommended that the NEWS and NEWS-A be scored according to their individual-level measurement models, which are relatively stable and correspond to constructs commonly used in the urban planning and transportation fields. However, prior to using these instruments in international and multi-cultural studies, further validation work across diverse non-English speaking countries and populations is needed.

Neighborhood environment walkability scale : validity and development of a short form

Purpose : The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated version (NEWS-A).

Methods : A stratified two-stage cluster sample design was used to recruit 1286 adults. The sample was drawn from residential addresses within eight high- and eight low-walkable neighborhoods matched for socioeconomic status. Subjects completed the NEWS and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire.

Results : Multilevel confirmatory factor analysis was used to develop measurement models of the NEWS and NEWS-A. Six individual-level and five blockgroup-level factors were identified. Factors/scales gauging presence of diversity of destinations, residential density, walking infrastructure, aesthetics, traffic safety, and crime were positively related to walking for transport. Aesthetics, mixed destinations, and residential density were associated with walking for recreation.

Conclusions : The NEWS and NEWS-A possess adequate levels of factorial and criterion validity. Alternative methods of scoring for different purposes are presented.

Neighborhood and individual socio-economic variations in the contribution of occupational physical activity to total physical activity

Background: There is an inverse relationship between individual socio-economic status (SES) and amount of occupational physical activity. The role of the socio-economic environment is, however, less clear. This study examined the independent influences of neighborhood and individual SES on absolute and relative amount of occupational physical activity. It also examined the moderating effects of neighborhood SES on the relationship between individual SES and occupational physical activity.

Methods: Employees (n = 1236) resident in high or low SES neighborhoods were assessed on socio-demographic factors, including educational attainment and household income, and physical activity.

Results: Neighborhood SES and individual SES were independently inversely related to absolute and relative amount of occupational physical activity. Significant interactions between neighborhood SES and level of educational attainment in the contribution of total and vigorous occupational physical activity to total physical activity were found.

Conclusions: Neighborhood SES can function as a moderator in the relationship between individual SES and occupational physical activity.

A new urban planning code's impact on walking: The residential environments project

Objectives. We examined whether people moving into a housing development designed according to a state government livable neighborhoods subdivision code engage in more walking than do people who move to other types of developments.

Methods. In a natural experiment of 1813 people building homes in 73 new housing developments in Perth, Western Australia, we surveyed participants before and then 12 and 36 months after moving. We measured self-reported walking using the Neighborhood Physical Activity Questionnaire and collected perceptions of the environment and self-selection factors. We calculated objective measures of the built environment using a Geographic Information System.

Results. After relocation, participants in livable versus conventional developments had greater street connectivity, residential density, land use mix, and access to destinations and more positive perceptions of their neighborhood (all P < .05). However, there were no significant differences in walking over time by type of development (P > .05).

Conclusions. Implementation of the Livable Neighborhoods Guidelines produced more supportive environments; however, the level of intervention was insufficient to encourage more walking. Evaluations of new urban planning policies need to incorporate longer term follow-up to allow time for new neighborhoods to develop.

Neighborhood perceptions moderate the association between the family environment and children's objectively assessed physical activity

This study aimed to investigate whether parents' perceptions of the neighborhood environment moderate associations between the family environment and children's moderate- to vigorous-intensity physical activity (MVPA) outside of school hours. In total, 929 parents of 10-12 year-old children completed a questionnaire concerning the family environment, MVPA levels, and the neighborhood environment. Children wore an Actigraph (AM7164-2.2C) accelerometer. Compared with neighborhood environment factors, the family environment was more frequently associated with children's MVPA. Parental MVPA was positively associated with children's MVPA, but only among children whose parents reported a high presence of sporting venues. Having more restrictive physical activity rules was negatively associated with children's weekday MVPA in neighborhoods with high perceived stranger danger.

Where do Children Travel to and What Local Opportunities Are Available? The Relationship Between Neighborhood Destinations and Children’s Independent Mobility

Associations between access to local destinations and children’s independent mobility (IM) were examined. In 2007, 10- to 12-year-olds (n = 1,480) and their parents (n = 1,314) completed a survey. Children marked on a map the destinations they walked or cycled to (n = 1,132), and the availability of local destinations was assessed using Geographic Information Systems. More independently mobile children traveled to local destinations than other children. The odds of IM more than halved in both boys and girls whose parents reported living on a busy road (boys, OR = 0.48; girls, OR = 0.36) and in boys who lived near shopping centers (OR = 0.18) or community services (OR = 0.25). Conversely, the odds of IM more than doubled in girls living in neighborhoods with well-connected low-traffic streets (OR = 2.32) and increased in boys with access to local recreational (OR = 1.67) and retail (OR = 1.42) destinations. Creating safe and accessible places and routes may facilitate children’s IM, partly by shaping parent’s and children’s feelings of safety while enhancing their confidence in the child’s ability to use active modes without an adult.

Mediators of the relationship between sedentary behavior and depressive symptoms amongst disadvantaged women

Statement of problem
Associations between sedentary behavior (e.g. time spent sitting watching TV/using the computer) and physical health have been well documented, however, studies are increasingly reporting a positive relationship between certain sedentary behaviors and poor mental health (e.g. depression). Little is known about the underlying factors that may explain the link between sedentary behavior and likelihood of depression. The purpose of this study was to investigate the contribution of selected intra-personal and social factors as potential mediators of the relationship between sedentary behavior and depressive symptoms among women from disadvantaged neighborhoods.
Method
Cross-sectional survey data were provided by 4065 women (aged 18–45) living in disadvantaged neighborhoods. Women self-reported their sedentary behavior (total sitting time and screen time), depressive symptoms (CES-D 10), as well as a number of intra-personal (leisure-time physical activity, diet quality, weight status) and social (social cohesion, interpersonal trust, club membership) factors.
Results
Mediating analyses, controlling for confounders, showed that women's leisure-time physical activity partly mediated the relationship between total sitting time and increased likelihood of depressive symptoms. Women's diet quality, and social cohesion partly mediated the relationship between screen time and increased likelihood of depressive symptoms.
Conclusions
Acknowledging the cross-sectional study design, findings suggest that there may be several factors that explain the increased likelihood of depressive symptoms associated with greater sedentary time. Although future studies should test the mediating relationships longitudinally, these findings may help inform interventions aimed at reducing the likelihood of depression in disadvantaged women with high sitting time.