ACHPER Healthy Lifestyles Journal – 1



James F. Sallis, Ph.D., Director

alr@projects.sdsu.edu

Carmen L. Cutter, MPH, Deputy Director

ccutter@projects.sdsu.edu

Introduction to the Active Living Research Reference List Aug.-Dec. 2009

The following pages are citations of studies of the relationships between the environment, physical activity, and obesity published during the second half of 2009.  We have organized the publications into 8 categories to make them easier to review. The categories are:

1. Built Environment – Child Physical Activity/Obesity,

2. Built Environment – Adult Physical Activity/Obesity,

3. Policy – Physical Activity/Obesity,

4. Social, Cultural & Family Environments – Child Physical Activity/Obesity,

5. Social, Cultural & Family Environments – Adult Physical Activity/Obesity,

6. Measurement,

7. Community Based Interventions – Physical Activity and Obesity,

8. Childhood Obesity & Miscellaneous

The searches were conducted using several databases and were designed to represent the multiple disciplines in the active living research field. The number of citations continues to grow, especially as there is an extraordinary amount of literature on built environment and policy related to physical activity and obesity. Some citations do not include a journal issue or page numbers; these are articles that are available online ahead of print publication.

We have improved upon our search terms and hope that this list is inclusive. Please send us relevant citations we have missed. Studies that focus on food environments will be covered by the RWJF Healthy Eating Research program.

We will continue to publish twice yearly literature updates as the literature is expanding so rapidly. The abstracts for the current 2009 update and the 2004-2007 abstracts can be found at: .

Papers that specifically report environmental correlates of physical activity behavior or obesity will be included in the online ALR literature database ().

If you have questions or comments please contact Chad Spoon at cspoon@projects.sdsu.edu.

We would like acknowledgement the hard work of Ding Ding (Melody) and the Active Living Research staff for searching several databases and compiling the 2009 reference list.

2009 Search Terms

|Physical Activity/Obesity terms (abstract only) |Environment terms (title or abstract) |

|non motorized OR NMT OR multimodal transportation OR active |environment OR environments OR environmental OR sprawl OR neighbourhood*|

|transport* OR driving OR active living OR inactivity OR inactive |OR neighborhood* OR recreation* OR metropolitan OR rural OR urban* OR |

|OR fit OR fitness OR body mass index OR BMI OR car OR cars OR |pedestrian OR pedestrians OR equipment OR geograph* OR aesthet* OR |

|automobile OR leisure OR television OR TV OR obese OR obesity OR |convenient OR convenience OR urban form OR destination* OR trail OR |

|weight OR overweight OR journey OR travel* OR walk OR walking OR |trails OR park OR parks OR path OR paths OR distance* OR density OR |

|cycle OR cycling OR bike OR bikers OR biking OR bicycle OR |access* OR planning OR location* OR feature* OR polic* OR facility OR |

|bicycling OR sedentary OR commuter* OR commuting OR exercise OR |facilities OR crime OR architecture OR building* OR transit OR street* |

|exercising OR exerciser* OR physical activity OR physically |OR stair* OR playground OR playgrounds OR urban design OR neighborhood |

|active OR play OR playground* OR playing OR vehicle OR obesogenic|development OR neighbourhood development OR smart growth OR outdoor OR |

| |indoor OR connectivity OR new urbanism OR healthy places OR healthy |

| |communities OR greenway OR greenways OR rail-trail OR home OR school OR |

| |schools OR land use OR safe OR safety OR route OR routes OR workplace OR|

| |community OR communities OR attractive* OR green space* OR public space*|

| |OR open space* OR place OR places OR site OR sites OR siting OR greenery|

| |OR amenity OR amenities OR attribute* OR walkable OR walkability OR |

| |residential OR residence OR sidewalks OR availability |

Databases used in the literature searches included Pub Med, ISI Web of Science, Leisure and Recreation Journals and other non-indexed journals.

For more specific information please contact Chad Spoon at cspoon@projects.sdsu.edu.

Journal Counts:

These may indicate journals more interested in built environment research where you could send your manuscripts. Note that only journals with more than one count were included.

American Journal of Health Promotion- 6

American Journal of Preventive Medicine- 6

American Journal of Public health -4

BMC Public Health- 3

British Journal of Sports Medicine- 2

Health Education & Behavior--2

Health and Place- 10

International Journal of Pediatric Obesity- 2

Journal of Adolescent Health- 2

Journal of Nutrition Education and Behavior –3

Journal of Park and Recreation Administration – 4

Journal of Physical Activity and Health --10

Journal of School Health-5

Leisure Sciences –2

Medicine and Science in Sports and Exercise- 2

Pediatric Exercise Science- 2

Pediatrics –2

Pediatric Exercise Science –2

Preventing Chronic Diseases-2

Preventive Medicine- 2

Social Science and Medicine--2

Built Environment and Youth Physical Activity/Obesity

Chaloupka, F. J. and L. M. Powell (2009). "Price, availability, and youth obesity: evidence from Bridging the Gap." Prev Chronic Dis 6(3): A93.

After a decade of analyzing environmental influences on substance use and its consequences among youth in the United States, the Robert Wood Johnson Foundation's Bridging the Gap program has begun studying the effect of environmental factors on youth physical activity, diet, and weight outcomes. Much of this research has focused on access to food, as reflected by availability and price. Program researchers have documented disparities in access to healthy foods and opportunities for physical activity; healthier food outlets and opportunities for physical activity are relatively less available in communities with lower income and larger proportions of racial/ethnic minority populations. They also have found that healthier environments are associated with more fruit and vegetable consumption, more physical activity, lower body mass index, and reduced likelihood of obesity among youth.

Cradock, A. L., S. J. Melly, et al. (2009). "Youth Destinations Associated with Objective Measures of Physical Activity in Adolescents." Journal of Adolescent Health 45(3): S91-S98.

Purpose: Limited availability of desirable destinations within walkable distances and unsuitable weather may adversely affect physical activity among adolescents on weekends. This study examines evidence for associations between objective measures of local environment and physical activity levels of adolescents. Methods: Students (n = 152, 59% male; mean age, 13.7 years) from 10 neighborhoods with schools in four communities wore TriTrac-R3D accelerometers recording physical movements on weekends. Minute-by-minute data were summed over 15-minute intervals providing estimates of proportion of time spent in moderate and vigorous physical activity (MVPA) and (log) mean physical activity levels on weekends (n = 7,506 intervals). Objective measures of neighborhood characteristics were calculated using geographic information systems including average daily traffic, housing density, open space, and density of employees per square kilometer in youth destinations. Linear mixed models were fit examining associations between neighborhood environmental variables and accelerometer measures of physical activity, controlling for time, day, age, body mass index, gender of respondent, race/ethnicity, precipitation, and temperature deviation. Results: On weekends, the presence of greater densities of employees in neighborhood destinations serving youth (beta = 3.96, p = 0.050) was directly associated with MVPA, independent of student characteristics. Conclusions: Young people attending schools in neighborhoods characterized by greater densities of employees in destinations for youth are more physically active on weekends. Compared with neighborhoods with lower densities, attending a school in neighborhoods with higher densities of employees in potential destinations for youth may contribute to participation in an additional 30 minutes of MVPA per day on weekends. (C) 2009 Society for Adolescent Medicine. All rights reserved.

Dunton, G. F., J. Kaplan, et al. (2009). "Physical environmental correlates of childhood obesity: a systematic review." Obes Rev 10(4): 393-402.

Increasing rates of childhood obesity in the USA and other Western countries are a cause for serious public health concern. Neighborhood and community environments are thought to play a contributing role in the development of obesity among youth, but it is not well understood which types of physical environmental characteristics have the most potential to influence obesity outcomes. This paper reports the results of a systematic review of quantitative research examining built and biophysical environmental variables associated with obesity in children and adolescents through physical activity. Literature searches in PubMed, PsychInfo and Geobase were conducted. Fifteen quantitative studies met the inclusion criteria for this systematic review. The majority of studies were cross-sectional and published after 2005. Overall, few consistent findings emerged. For children, associations between physical environmental variables and obesity differed by gender, age, socioeconomic status, population density and whether reports were made by the parent or child. Access to equipment and facilities, neighborhood pattern (e.g. rural, exurban, suburban) and urban sprawl were associated with obesity outcomes in adolescents. For most environmental variables considered, strong empirical evidence is not yet available. Conceptual gaps, methodological limitations and future research directions are discussed.

Franzini, L., M. N. Elliott, et al. (2009). "Influences of Physical and Social Neighborhood Environments on Children's Physical Activity and Obesity." American Journal of Public Health 99(2): 271-278.

Objectives. We investigated the association between physical and social neighborhood environments and fifth-grade students' physical activity and obesity. Methods. We collected data on 650 children and their primary caregivers during phase 1 of Healthy Passages, a multisite, community-based, cross-sectional study of health risk behaviors and health outcomes in children. We conducted independent systematic neighborhood observations to measure neighborhood physical characteristics, and we analyzed survey data on social processes. We modeled children's physical activity and obesity status with structural equation models that included latent variables for the physical and social environments. Results. After we controlled for children's sociodemographic factors, we found that a favorable social environment was positively associated with several measures of physical activity and that physical activity was negatively associated with obesity in these children. Physical environment was not significantly associated with physical activity. Conclusions. Our findings suggest that neighborhood social factors as well as the physical environment should be considered in the development of health policy and interventions to reduce childhood obesity. [Am J Public Health 2009-99:271-278. doi:10.2105/AJPH.2007.128702)

Fyhri, A. and R. Hjorthol (2009). "Children's independent mobility to school, friends and leisure activities." Journal of Transport Geography 17(5): 377-384.

Increased use of the car in the everyday transport of children can lead to environmental problems, and cause increased obesity and decreased independence among children. Using a structural equation model we investigate the influence of a range of background variables on mode choice for Norwegian children's transport to school or leisure activities. Distance to school and children's age were the most influential variables on children's independent mobility, measured as an index. Objective descriptors of the traffic environment only explain independent mobility via parents' safety experience. (C) 2008 Elsevier Ltd. All rights reserved.

Hawkins, S. S., A. Pearce, et al. (2009). "Perceived and objective measures of the neighbourhood environment and overweight in preschool children and their mothers." International Journal of Pediatric Obesity 4(3): 183-192.

Objectives. The primary aim was to examine the relationships between perceived and objective measures of the neighbourhood environment, measured in late infancy, and subsequent overweight (including obesity) in 3-year-old children and their mothers. The secondary aim was to assess whether moving residence confounded these relationships. Methods. We analysed data on 8 154 children and their mothers from the UK Millennium Cohort Study who had participated since birth and were living in England. At the first contact (late infancy), mothers reported their perceptions of their neighbourhood environment, and objective measures of the neighbourhood environment were obtained by linking national deprivation data to each child's postcode. We conducted logistic and multilevel regression analyses to examine perceived and objective measures of the neighbourhood environment, respectively, and overweight at the second contact (3 years) in children and their mothers. All analyses were adjusted for moving residence. Results. There were few consistent patterns between measures of the neighbourhood environment (perceived or objective) and early childhood overweight. However, mothers' risk of overweight increased with increasingly poor neighbourhood conditions (perceived) or residence in areas of increasing deprivation (objective), after adjustment for individual socio-demographic factors. All relationships were maintained after adjustment for moving residence. Conclusions. While area-level factors have limited influence on the development of overweight in preschool children, they are likely to affect overweight in their mothers. Policies need to address both individual and environmental factors to tackle obesity and its determinants across the life course.

He, M., S. Harris, et al. (2009). "Understanding Screen-Related Sedentary Behavior and Its Contributing Factors Among School-Aged Children: A Social-Ecologic Exploration." American Journal of Health Promotion 23(5): 299-308.

Purpose. To explore the factors that contribute to children's screen-related sedentary (S-RS) behaviors. Settings. Elementary schools. Subjects. A random sample of children in grades five and six and their parents. Measures. The outcome measure was children's S-RS activity level measured by a self-administered questionnaire. A full spectrum of potential contributing factors for children's S-RS behaviors was obtained through surveys. Multilevel linear regression methods were used to determine the associations between these factors and children's screen time (hours per day) and results were expressed as regression coefficients (g). Results. Of 955 child-parent pairs in 14 participating schools, 508 pairs (53%) completed the surveys. At an intrapersonal level, protective factors included being a girl (g = -.71); belonging to a sports team inside (g = -.56) or outside (g = -.49) of school; having a negative attitude toward S-RS activities (g = -.13); and having a positive attitude toward physical activity (g = -.48). At the interpersonal and social levels, parental leisure S-RS behaviors (g = .32) were positively associated, whereas strict parental rules on computer use (g = -.27) and family income (g = -.32) were inversely correlated with S-RS behavior. At the environmental level, the presence of TVs in children's bedrooms (g = .44) and owning videogame devices (g = .58) increased the risk of S-RS behaviors, whereas after school programs (g = -.86) and schools' participation in the Turn Off the Screen Week campaign (g = -.91) decreased the risk. Conclusions. Public health interventions should target multilevel factors, including increasing children's awareness, promoting parental involvement in healthy lifestyle pursuits, and creating less screenogenic environments.

Holt, N. L., C. T. Cunningham, et al. (2009). "Neighborhood physical activity opportunities for inner-city children and youth." Health & Place 15(4): 1022-1028.

The purpose of this study was to assess perceived physical activity (PA) opportunities and barriers for inner-city youth. Data were collected via interviews with 59 children, 8 school staff, and 13 youth workers plus objective neighborhood data. Analyses revealed three themes that influenced PA: neighborhood characteristics, family involvement, and adult-supervised programs. The neighborhood was highly walkable and multiple play spaces were available, but safety concerns restricted access. Children were rarely allowed out alone, but family accompaniment facilitated PA. Organized programs provided adult-supervised PA, but programs faced staffing problems that served to limit the provision of PA opportunities. Multiple ecological factors constrain or enable PA among inner-city youth. (C) 2009 Elsevier Ltd. All rights reserved.

Larsen, K., J. Gilliland, et al. (2009). "The Influence of the Physical Environment and Sociodemographic Characteristics on Children's Mode of Travel to and From School." American Journal of Public Health 99(3): 520-526.

Objectives. We examined whether certain characteristics of the social and physical environment influence a child's mode of travel between home and school. Methods. Students aged 11 to 13 years from 21 schools throughout London, Ontario, answered questions from a travel behavior survey. A geographic information system linked survey responses for 614 students who lived within 1 mile of school to data on social and physical characteristics of environments around the home and school. Logistic regression analysis was used to test the influence of environmental factors on mode of travel (motorized vs "active") to and from school. Results. Over 62% of students walked or biked to school, and 72% from school to home. The likelihood of walking or biking to school was positively associated with shorter trips, male gender, higher land use mix, and presence of street trees. Active travel from school to home was also associated with lower residential densities and lower neighborhood incomes. Conclusions. Our findings demonstrate that active travel is associated with environmental characteristics and suggest that school planners should consider these factors when siting schools in order to promote increased physical activity among students.

Loucaides, C. A. (2009). "School Location and Gender Differences in Personal, Social, and Environmental Correlates of Physical Activity in Cypriot Middle School Children." Journal of Physical Activity & Health 6(6): 722-730.

A number of studies indicate higher prevalence of overweight and obesity among rural school children. The purpose of this study was to examine the differences in personal, social, and environmental correlates of physical activity between school location (urban versus rural) and gender. Methods: Middle school children (N = 676) from different districts in Cyprus completed questionnaires assessing physical activity and potential correlates. Results: Children from rural schools reported higher friend support for physical activity and more ease of walk to a bus station from their home. Urban school children reported higher presence of sidewalks in their neighborhood. Boys reported more hours per day playing outside and higher enjoyment and friend support for physical activity than girls, whereas girls reported higher means in the variable 'I see a lot of people walking or being physically active in my neighborhood'. Significant two-way interactions between gender and school location were noted with rural school girls having less favorable scores in a number of correlates of physical activity. Conclusions: More studies are needed to further understand the higher incidence of overweight and obesity observed among rural youth. Girls from rural areas may be targeted as a priority group for promoting physical activity.

Monge-Rojas, R., C. Garita-Arce, et al. (2009). "Barriers to and Suggestions for a Healthful, Active Lifestyle as Perceived by Rural and Urban Costa Rican Adolescents." Journal of Nutrition Education & Behavior 41(3): 152-160.

Objective: To assess the perceptions of rural and urban Costa Rican adolescents regarding which barriers and motivators affect their adoption of an active lifestyle. Design: Data were collected in focus group discussions. Participants: 108 male and female adolescents aged 12 to 18 from the 7th to 11th grades. Setting: Two urban and 1 rural high school in San José, Costa Rica. Phenomena of Interest: Active lifestyle; barriers and motivators for active life. Analysis: Data were reviewed for emerging themes, and themes were coded using content analysis procedures. Results: Major barriers: (a) physical education curriculum was focused on competitive sports; (b) lack of facilities in the school and community environments; (c) family did not provide good role models and reinforced the socially expected gender roles. Key motivators: (a) changed the physical education curriculum to focus on leisure and recreational activities; (b) increased the availability of facilities both in the school and in the community; and (c) provided a strong social support network. Conclusions and Implications: The school, community, and family environments are potential targets for physical activity interventions for adolescents. Future studies should explore in depth the influence of adolescent socialization patterns (particularly for females) in the establishment of an active lifestyle.

Morgenstern, M., J. D. Sargent, et al. (2009). "Relation Between Socioeconomic Status and Body Mass Index Evidence of an Indirect Path via Television Use." Archives of Pediatrics & Adolescent Medicine 163(8): 731-738.

Objective: To test the hypothesis that media use mediates the relation between socioeconomic status (SES) and body mass index (BMI). Design: Analysis of 2 large cross-sectional surveys, 1 from Germany and 1 from the United States. Setting: Twenty-seven public schools in northern Germany; telephone interviews in the United States. Participants: A total of 4810 German children and adolescents aged 10 to 17 years (mean age, 12.8 years); 4473 US children and adolescents aged 12 to 16 years (mean age, 14.0 years) recruited using random-digit-dial methods. Main Exposures: Media exposure was assessed via survey questions about the presence of a television in the bedroom, television screen time, computer and video game screen time, and movie viewing. The SES was derived from type of school (German sample) or parental reports of their own education and family income (US sample). Main Outcome Measures: The BMI was assessed by the use of self-reports in both samples, supplemented by parental reports (US sample) for height and weight. Results: In both samples, SES was inversely associated with BMI, and media use was directly associated with BMI. The effect of SES on overweight was partially mediated by media exposure, which explained 35% of the SES-BMI association in the German sample and 16% in the US sample. In both groups, television in the bedroom and television screen time had statistically significant indirect paths, whereas video game use and movie viewing did not. Conclusions: Students from low-SES backgrounds are at higher risk for overweight in part because of higher levels of television viewing. The change of media use habits could modify this health disparity.

Mota, J., M. Almeida, et al. (2009). "Association of Perceived Environmental Characteristics and Participation in Organized and Non-Organized Physical Activities of Adolescents." Pediatric Exercise Science 21(2): 233-239.

Specific behavior context such as type of PA (organized vs. nonorganized) might be associated with different environmental correlates. The main goal of this cross-sectional survey was to examine perceived environmental associations with type of adolescents' physical activity (PA) choices (organized and nonorganized). A sample of this study comprised 425 girls with mean age of 14.5 years-old. Environmental variables and PA were assessed by questionnaire, which allowed to define the type (organized or nonorganized) of PA. No associations were found between environmental perceptions and the participation in organized activities. However, different dimensions of environmental variables such as accessibilities to facilities (p ⩽ .05) aesthetics (p ⩽ .05) and social environment (p ⩽ .05) were associated to girls' PA participation in nonorganized activities (NOPA). Our findings suggested that some environmental characteristics might play an important role in girls' NOPA participation.

Nelson, N. M. and C. B. Woods (2009). "Obesogenic environments: Are neighbourhood environments that limit physical activity obesogenic?" Health & Place 15(4): 917-924.

The impact of obesogenic environments on adolescent health is poorly understood. This study examines if neighbourhood features related to physical activity are also related to unhealthy weight status. Adolescents (N = 4587, age 15-17 years, 51.4% male) self-reported physical activity and neighbourhood perceptions. Trained researchers measured height and weight. Logistic regression identified if neighbourhood perceptions predicted overweight or obesity. Adolescents who reported convenient physical activity facilities were 2% less likely to be overweight/obese and 5% less likely to be obese, controlled for socio-demographic variables and clustering by school. Physical activity does not appear to directly influence or mediate the relationship between perceived convenient facilities and weight status. (C) 2009 Elsevier Ltd. All rights reserved.

Nichol, M. E., W. Pickett, et al. (2009). "Associations Between School Recreational Environments and Physical Activity." Journal of School Health 79(6): 247-254.

Background: School environments may promote or hinder physical activity in young people. The purpose of this research was to examine relationships between school recreational environments and adolescent physical activity. Methods: Using multilevel logistic regression, data from 7638 grade 6 to 10 students from 154 schools who participated in the 2005/06 Canadian Health Behaviour in School-Aged Children Survey were analyzed. Individual and cumulative effects of school policies, varsity and intramural athletics, presence and condition of fields, and condition of gymnasiums on students’ self-reported physical activity (≥2 h/wk vs ................
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