ACHPER Healthy Lifestyles Journal – 1



James F. Sallis, Ph.D., Director

alr@projects.sdsu.edu

Leslie S. Linton, JD, MPH, Deputy Director

llinton@projects.sdsu.edu

Introduction to the Active Living Research Reference List for 2004-2005

The following pages are a summary of the literature studying the relationships between the built environment, physical activity, and obesity for 2004-2005. We understand how difficult it can be to keep track of the literature in a transdisciplinary field, so we hope you find the information useful. We found 101 references in 2004 and 160 in 2005. The articles were published in 100 different journals.

To create this list of references, a group of researchers at ALR conducted systematic literature searches. To collect information represented in the fields of public health, transportation/planning, and recreation/leisure studies, we used the following databases: Medline, PubMed, SportDiscus, Leisure Tourism Database, and Web of Science. A comprehensive list of search terms was developed by the team and is provided on the following page. The physical activity-related terms were entered in the first search field and the environment-related terms were entered in the second field. Terms within fields were separated with “OR.” The two separate fields were combined with “AND.” The physical activity-related terms were limited to use in the title only, while the environment-related terms were limited to use in the title, abstract, or key words field depending on the database. Additional known references were also added. Relevant articles were agreed upon by two researchers and included in the following list. The citations and abstracts will be posted at: .

While we have intended for this list to be comprehensive for 2004 and 2005, we are certain to have missed some articles. For this reason, we welcome feedback about our procedures, search terms and the databases utilized. Also, please let us know if we missed any relevant articles so we can add them to the posted list. We plan to continue compiling, emailing, and posting updated literature searches twice per year, with the hope that they assist your research. Please join our mailing list at to receive these updates. Your feedback will help us improve this service.

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

Sincerely,

The Active Living Research Staff

|Physical Activity Related Terms |Environment Related Terms |

|Non motorized transport OR multimodal transportation OR |Environment OR sprawl OR neighbor* OR recreation* OR metropolitan OR rural |

|active transportation OR driving OR NMT OR active living OR |OR suburban OR pedestrian* OR equipment OR geograph* OR aesthet* OR conven* |

|inactivity OR fit* OR body mass index OR BMI OR car OR |OR urban form OR destination* OR trail OR park OR path OR distance OR access|

|leisure OR television OR obes* OR weight OR journey* OR |OR planning OR location OR transport* OR feature* OR polic* OR facilities OR|

|automobile OR inactive OR travel OR walk* OR cycl* OR bik* OR|crime OR architecture OR building OR transit OR street OR stairs OR |

|sedentary OR commut* OR exercise* OR physical* activ* |playground* OR urban design OR neighborhood development OR smart growth OR |

| |outdoor OR indoor OR connectivity OR accessibility OR new urbanism OR |

| |healthy places OR healthy communities OR greenway OR rail-trail OR home OR |

| |school OR land use OR saf* |

Please note:

These terms were our "original" search terms. This list of terms will be expanded based on the additional articles that we found while preparing this summary and based on additional articles that we receive following publication of this summary.

Search terms varied slightly depending on the database being searched.

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

List of Journals and number of articles per journal

ACHPER Healthy Lifestyles Journal – 1

Acta Paediatrics – 1

Adolescence – 1

Age Ageing – 1

American Journal Of Health Promotion – 15

American Journal Of Preventive Medicine – 35

American Journal Of Public Health – 8

American Journal of Health Behavior – 1

Annals Of Behavioral Medicine – 5

Annals of Human Biology – 1

Annual Review of Public Health – 2

Anthropologischer Anzeiger – 1

Australia and New Zealand Journal of Public Health – 1

BMC Public Health – 1

British Medical Journal – 1

British Journal Of Sports Medicine – 2

Canadian Journal of Dietetic Practice and Research – 1

Canadian Journal of Nursing Research -1

Canadian Journal of Public Health -1

Child Care Health Development -1

Diabetes Care -1

Disability and Rehabilitation -2

Ecological Economics -1

Environmental Health Perspective -1

Environmental Science-1

Ethnicity & Disease -1

Evaluation and the Health Professions -1

Exercise Sport Science Review -3

Gerontologist -1

Health & Place -11

Health Education Research -3

Health Education & Behavior -1

Health Promotion Journal of Australia -1

Health Promotion Practice -8

Indian Heart Journal -1

International Journal of Behavioral Medicine -1

International Journal of Behavioral Nutrition and Physical Activity -5

International Journal of Epidemiology -1

International Journal of Obesity -1

International Journal of Obesity and Related Metabolic Disorders -2

International Journal of Environmental Health Research -1

International Journal of Health Promotion and Education -1

International Regional Science Review -1

International Review for the Sociology of Sport -1

Journal of Adolescent Health-2

Journal of Aging and Physical Activity -3

Journal of Allergy and Clinical Immunology -1

Journal of Allied Health -1

Journal of American College Health -1

Journal of the American Dietetic Association -1

Journal of Cardiopulmonary Rehabilitation -1

Journal of Environmental Psychology -1

Journal of Epidemiological Community Health -7

Journal of Korean Medical Science- 1

Journal of Leisure Research -2

Journal of Oklahoma State Medical Association -1

Journal of park and recreation administration -2

Journal of Physical Activity and Health -10

Journal of Planning Literature -2

Journal of Public Health Management and Practice -1

Journal of Regional Analysis & Policy -1

Journal of Rural Health -4

Journal of Science & Medicine in Sports -2

Journal of The American Planning Association -1

Journal of Sports Science -2

Journal of Urban Health -2

Journal of Urban Health-Bulletin of The New York Academy Of Medicine -3

Journal of Women & Aging -2

Landscape and Urban Planning -2

Leisure Sciences -6

Medicine and Science in Sports And Exercise -4

Morbidity and Mortality Weekly Report -1

Obesity Research -5

Occupational Therapy International -1

Parks & Recreation-3

Patient Education and Counseling -1

Pediatric exercise science-1

Pediatrics -2

Pediatrics International -1

Physical Therapy -1

Physiology & Behavior -1

Postgraduate Medical Journal -1

Preventing Chronic Disease- 4

Preventive Medicine – 12

Psychology of Sport And Exercise -1

Public Health -1

Public Health Nursing -1

Public Health Nutrition -3

Public Health Reports -2

Quest -1

Research Quarterly For Exercise and Sport -2

Social Science & Medicine -2

Sozial- und Praventivmedizin -2

Traffic Injury Prevention -1

Transportation - 1

Transportation Research Part A-Policy and Practice -3

Transportation Research Part B-Methodological -1

Transportation Research Part D-Transport and Environment -7

Travel Demand and Land Use 2004 -1

Youth Studies Australia -1

Titles and Abstracts

2004

Addy, C. L., D. K. Wilson, et al. (2004). "Associations of perceived social and physical environmental supports with physical activity and walking behavior." American Journal of Public Health 94(3): 440-3.

We evaluated perceived social and environmental supports for physical activity and walking using multivariable modeling. Perceptions were obtained on a sample of households in a southeastern county. Respondents were classified according to physical activity levels and walking behaviors. Respondents who had good street lighting; trusted their neighbors; and used private recreational facilities, parks, playgrounds, and sports fields were more likely to be regularly active. Perceiving neighbors as being active, having access to sidewalks, and using malls were associated with regular walking.

Adkins, S., N. E. Sherwood, et al. (2004). "Physical activity among African-American girls: the role of parents and the home environment." Obesity Research 12 Suppl: 38S-45S.

OBJECTIVES: African-American girls are at increased risk for becoming overweight. Increased physical activity may prevent this. This study examines measurements of girls' physical activity and associations with: BMI, parent's reported self-efficacy and support for helping daughters be active, girl's perceived support from parents for physical activity, parent's and girl's perceived neighborhood safety and access to facilities, and family environment. RESEARCH METHODS AND PROCEDURES: Fifty-two 8- to 10-year-old African-American girls and their primary caregiver in the Minneapolis/St. Paul area participated in the Girls Health Enrichment Multisite Studies pilot intervention to prevent weight gain by promoting healthy eating and physical activity. Data collected included height, weight, physical activity level, and physical activity-related psychosocial measures from girl and parent. Girls wore an activity monitor for 3 days to assess activity level. Correlations were computed among the average minutes per day of moderate to vigorous activity between 12 pm and 6 pm and BMI and psychosocial measures. RESULTS: BMI was inversely correlated with moderate to vigorous activity (r = -0.35, p < 0.01), whereas parent's self-efficacy for supporting daughter to be active was positively correlated with activity (r = 0.45, p < 0.001). There was a trend for parent's reported support of daughter's activity level to be associated with activity (r = 0.26, p < 0.06). Girl's perception of parent's support for physical activity, perceived neighborhood safety and access to facilities, and family environment were not associated with girl's activity levels. DISCUSSION: Interventions to increase physical activity among preadolescent African-American girls may benefit from a parental component to encourage support and self-efficacy for daughters' physical activity.

Aronson, R. E. and R. F. Oman (2004). "Views on exercise and physical activity among rural-dwelling senior citizens." Journal Of Rural Health 20(1): 76-79.

Context: This study was conducted with senior citizens in the 2 rural communities of Ada and Lindsay, Oklahoma. These communities are both predominantly white, with the largest minority population being American Indian. Both communities are more than 60 miles from a metropolitan area and have a history of farming and ranching. Purpose: The purpose of this study was to explore contextual factors related to physical activity among senior citizens living in rural communities. Methods: Two focus groups were conducted. The groups were conducted in mixed-sex sessions and were audiotaped and transcribed verbatim for the purpose of analysis. Findings: Themes from the focus groups included the following: (1) the types of daily activities engaged in by seniors; (2) the meaning and connotation of the words exercise and physical activity, with physical activity connoting for some the negative imagery of physical labor, and (3) the availability and suitability of settings for physical activity. For seniors living in rural settings in Oklahoma, the lack of indoor facilities and the sometimes extreme climatic conditions serve as significant barriers to physical activity. Conclusion: This study suggests that programs seeking to encourage physical activity among seniors in rural areas could benefit from an assessment of resources and settings for physical activity and the avoidance of language that may have negative connotations for this population.

Bauer, K. W., Y. W. Yang, et al. (2004). ""How can we stay healthy when you're throwing all of this in front of us?" - Findings from focus groups and interviews in middle schools on environmental influences on nutrition and physical activity." Health Education & Behavior 31(1): 34-46.

This study aimed to identify factors in school physical and social environments that may facilitate or compete with programs and policies to improve student physical activity and nutrition. Focus groups and interviews were conducted with students, faculty, and staff of two public middle schools. Participants identified numerous aspects of the school environments as significant. Competition, teasing and bullying, time, and safety were described as major barriers for students to be physically active during physical education class, on sports teams, and before and after school. The quality of the food served, easy access to nonnutritious snacks, limited time for lunch period, and weight concerns emerged as significant reasons why students do not eat nutritious meals in school. When developing programs and policies to improve the health of students, environmental influences that undermine efforts to improve student health behaviors must be addressed.

Bertrais, S., P. Preziosi, et al. (2004). "Sociodemographic and geographic correlates of meeting current recommendations for physical activity in middle-aged French adults: the Supplementation en Vitamines et Mineraux Antioxydants (SUVIMAX) Study." American Journal of Public Health 94(9): 1560-6.

OBJECTIVE: We evaluated the characteristics of French subjects meeting current public health recommendations for physical activity. METHODS: We assessed leisure-time physical activity cross-sectionally in 7404 adults aged 45 to 68 years with applied logistic regression models. RESULTS: Meeting the recommended physical activity levels was more likely in subjects aged 60 years and older and in women with higher education levels or living in rural areas and was less likely in smokers. No association was found with time spent watching television. The contribution of vigorous activity to total time spent being active was approximately 2 times higher in subjects meeting recommendations. CONCLUSIONS: Participation in some vigorous activity may be viewed as a "facilitator" to attain physical activity recommendations. Relationships with physical environment variables in Europe need further investigation.

Bhat, R. C. and A. Lockwood (2004). "On distinguishing between physically active and physically passive episodes and between travel and activity episodes: an analysis of weekend recreational participation in the San Francisco Bay area." Transportation Research Part A-Policy And Practice 38(8): 573-592.

This paper examines the out-of-home recreational episode participation of individuals over the weekend, with a specific focus on analyzing the determinants of participation in physically active versus physically passive pursuits and travel versus activity episodes (travel episodes correspond to recreational pursuits without any specific out-of-home location, such as walking, bicycling around the block, and joy-riding in a car, while activity episodes are pursued at a fixed out-of-home location, such as playing soccer at the soccer field and swimming at an aquatics center). The above disaggregation of recreational episodes facilitates the better analysis and modeling of activity-travel attributes, such as travel mode, episode duration, time-of-day of participation and location of participation. From a broader societal standpoint, the disaggregation of recreational episodes provides important information to encourage active participatory recreational pursuits, which can serve to relieve mental stress, improve the physical health of the population, and contribute to a socially vibrant society through increased interactions among individuals. The paper employs a mixed multinomial logit formulation for examining out-of-home recreational episode type participation using the 2000 San Francisco Bay area travel survey. A variety of variables, including individual and household sociodemographics, location attributes, and day of week and seasonal effects, are considered in the model specification. Individual-specific unobserved factors affecting the propensity to participate in different types of recreational episodes are also accommodated. (C) 2004 Elsevier Ltd. All rights reserved.

Boslaugh, S. E., D. A. Luke, et al. (2004). "Perceptions of neighborhood environment for physical activity: is it "who you are" or "where you live"?" Journal of Urban Health 81(4): 671-81.

Lack of physical activity among American adults is a serious public health concern. Many factors influence activity levels, and most research has focused on either individual factors, such as race and income, or on characteristics of the physical environment, such as the availability of parks. Our study used a cross-sectional multilevel design to examine the influences of individual- and neighborhood-level characteristics on participant's perceptions of their neighborhood as an appropriate venue for physical activity. Study participants were 1,073 African American and white adults living in the St. Louis, Missouri, metropolitan area. Individual-level information was gathered from self-administered questionnaires; neighborhood-level data for these same individuals were obtained from the 2000 US Census. We found that both individual and neighborhood characteristics were significant predictors of how individuals perceived physical activity opportunities in their neighborhood, and that African Americans perceived their neighborhoods as less safe and less pleasant for physical activity than did whites, regardless of the racial composition of the neighborhood. We suggest that any evaluation of opportunities for physical activity within a neighborhood should include consideration of resident's perceptions of the safety and pleasantness of using them, and that the role of perceived and actual neighborhood conditions in explaining disparities in physical activity between African American and other populations should be examined further.

Braza, M., W. Shoemaker, et al. (2004). "Neighborhood design and rates of walking and biking to elementary school in 34 California communities." American Journal of Health Promotion 19(2): 128-36.

PURPOSE: This study evaluates the relationship between neighborhood design and rates of students walking and biking to elementary school. DESIGN: Pairwise correlations and multiple regression models were estimated based on a cross-sectional study of elementary schools and their surrounding neighborhoods. Setting and Subjects. Thirty-four (23%) of 150 California public elementary schools holding October 1999 Walk to School Day events participated in the study. MEASURES: Teachers asked fifth-grade students how they arrived to school 1 week before Walk to School Day. 1990 U.S. Census data measured population density and number of intersections per street mile, whereas 1998-1999 California Department of Education data measured school size, the percentage of students receiving public welfare, and the percentage of students of various ethnicities. RESULTS: Population density (p =.000) and school size (p =.053) were significantly associated with walking and biking rates in regression models controlling for number of intersections per street mile, the percentage of students receiving public welfare, and the percentage of students of various ethnicities. The number of intersections per street mile was associated with walking and biking rates in pairwise correlations (p =.003) but not in regression models. CONCLUSIONS: The results support the hypothesis that the walking and biking rates are higher in denser neighborhoods and to smaller schools but do not support the hypothesis that rates are higher in neighborhoods with a high number of intersections per street mile. We suggest that detailed data for a larger sample of students would allow statistical models to isolate the effect of specific design characteristics.

Brownson, R. C., E. A. Baker, et al. (2004). "A community-based approach to promoting walking in rural areas." American Journal of Preventive Medicine 27(1): 28-34.

BACKGROUND: Ecologic models are often recommended to promote physical activity, yet sparse data exist on their effectiveness. DESIGN: A quasi-experimental design examined changes in walking behavior in six rural intervention communities in the Missouri "bootheel" region and in six comparison communities in Arkansas and Tennessee. SETTING/ PARTICIPANTS: The communities ranged in population from 2399 to 17,642; interventions focused on adults aged >/=18 years. INTERVENTION: Interventions were developed with community input and included individually tailored newsletters, interpersonal activities that stressed social support, and community-wide events such as walk-a-thons. MAIN OUTCOME MEASURES: Primary outcomes were rates of walking-trail use, total number of minutes walked in the past week, and total minutes walked for exercise. RESULTS: Among persons who used trails at baseline (16.9% of the total population), 32.1% reported increases in physical activity since they began using the trail. From community-wide samples, two subgroups indicated a positive net change in rates of 7-day total walking: people with high school degrees or less and people living in households with annual incomes of or =95th percentile. The distance between each child's residence and the nearest public playground and fast food restaurant was determined with geographic information systems. Neighborhood safety was defined by the number of police-reported crimes per 1,000 residents per year in each of 46 city neighborhoods. RESULTS: Overall, 9.2% of the children were overweight, 76% black, and 23% white. The mean (+/- SD) distances from a child's home to the nearest playground and fast food restaurant were 0.31 (+/- 0.22) and 0.70 (+/- 0.38) miles, respectively. There was no association between child overweight and proximity to playgrounds, proximity to fast food restaurants, or level of neighborhood crime. The association between child overweight and playground proximity did not differ by neighborhood crime level. CONCLUSIONS: Within a population of urban low-income preschoolers, overweight was not associated with proximity to playgrounds and fast food restaurants or with the level of neighborhood crime.

Cawley, J. (2004). "An economic framework for understanding physical activity and eating behaviors." American Journal of Preventive Medicine 27(3 Suppl): 117-25.

This paper offers an economic framework of human behavior with respect to physical activity and nutrition. Economics offers useful insights into these behaviors because it is the study of how people allocate their scarce resources of time and money to maximize their lifetime happiness. This paper outlines the criteria for policy interventions from an economic perspective and also considers arguments for policy intervention that are not based on economic considerations. The implications of the economic framework are summarized and its limitations are described.

Chambliss, H. O. (2004). "Behavioral approaches to obesity treatment." Quest 56(1): 142.

Obesity is at the forefront of the public health agenda. Why, with all the emphasis on the health risks of obesity and the availability of multiple treatment options, is it so difficult for people to successfully lose and maintain weight? The answer is simple: Most obesity treatment plans tell people what to do but not how to change their behavior. Furthermore, many people attempting weight loss focus on narrow aspects of weight loss behaviors (e.g., specific eating or exercise plans, over-the-counter weight loss products, medication, and in growing numbers, gastric surgery). However, weight gain is ultimately a consequence of multiple environmental and biologic factors that encourage behaviors that result in positive energy balance. It is unlikely that most obesity treatments will be successful unless people learn to address the environmental, biologic, and behavioral barriers that influence their ability to make eating and physical activity choices that promote long-termweight management. Behavioral approaches to obesity treatment help people develop the skills they need to successfully manage their weight in a way that is consistent with their individual barriers, goals, and lifestyles.

Cohen, S. J., J. S. Meister, et al. (2004). "Special action groups for policy change and infrastructure support to foster healthier communities on the Arizona-Mexico border." Public Health Reports 119(1): 40-47.

Coogan, P. F. and M. A. Coogan (2004). "When worlds collide: observations on the integration of epidemiology and transportation behavioral analysis in the study of walking." American Journal of Health Promotion 19(1): 39-44.

Since obesity has emerged as a public health crisis in the United States, the factors that influence physical activity are of interest to both epidemiologists and transportation researchers. This article describes different approaches taken by the two disciplines to this issue. "Utilitarian" walking to accomplish a task, as opposed to structured exercise, could be a highly sustainable way for people to achieve recommended levels of physical activity. Transportation planners have begun to investigate factors of urban form and transportation services that influence the choice to walk. Epidemiologists have become more aware of the importance of factors in the built and social environment that could influence health behaviors like walking. Few transportation studies focus on the generation of the utilitarian walk trip as the key variable; rather, they include it in more general discussions of urban form. Likewise, most epidemiologic studies have not focused on utilitarian walking, but have folded it into an overall measure of physical activity that emphasizes structured exercise. Further transportation research should examine the effects of improved mobility services in addition to alterations of the built environment. Integration of epidemiologic and transportation behavioral research could enhance our understanding of the role of urban and transportation factors on physical activity.

Crombie, I. K., L. Irvine, et al. (2004). "Why older people do not participate in leisure time physical activity: a survey of activity levels, beliefs and deterrents." Age Ageing 33(3): 287-92.

BACKGROUND: Regular physical activity has been shown to have many health benefits. However, many older people are physically inactive. OBJECTIVE: To investigate why older people are reluctant to participate in leisure time physical activity and to identify strategies to encourage increased activity. DESIGN: Cross-sectional survey. SETTING: 16 general practices in Dundee, Scotland. METHODS: 409 randomly selected older people (65-84 years) who lived independently were interviewed at home. Forty-six percent of those invited to take part were recruited into the study. RESULTS: Levels of knowledge about the specific health benefits of physical activity were high. Almost all participants (95%) believed that physical activity was beneficial and 79% believed that they did enough to keep healthy. However, 36% did no leisure time physical activity and a further 17% did less than 2 hours per week. Regression modelling identified 11 factors that exerted significant independent effects on levels of leisure time physical activity. The most powerful deterrent was lack of interest (OR = 7.8). Other factors included lack of daily access to a car, shortness of breath, joint pain, dislike of going out alone or in the evening, perceived lack of fitness, lack of energy, doubting that exercise can lengthen life, not belonging to a group and doubting that meeting new people is beneficial. CONCLUSIONS: Increasing leisure time physical activities poses major challenges. Beliefs about desirable levels of activity in older people would need to be changed. Action would be needed to relieve physical symptoms and address fears about perceived ability to undertake physical activity. Finally, easily accessible facilities would be needed to encourage participation in physical activity.

Croteau, K. A. (2004). "Strategies used to increase lifestyle physical activity in a pedometer-based intervention." Journal of Allied Health 33(4): 278-81.

The purpose of this study was to determine the self-selected strategies participants used to increase physical activity during an 8-week, pedometer-based lifestyle intervention. Participants were 34 employees of a small northeastern private college, with a mean age of 44.3 (+/- 9.3) years. The intervention consisted of a counseling session (goal setting, strategy selection), daily pedometer usage, and self-monitoring. Measures included height, weight, and pedometer-assessed ambulatory activity. Participants were placed in body mass index (BMI) and weekly physical activity improvement tertiles. BMI categories included normal weight (BMI 18.6-24.9), overweight (BMI 25-29.9), and obese (BMI > or =30). Weekly physical activity improvement categories included small/no improvement (5%/wk). Data analysis consisted of descriptive and nonparametric inferential statistics (chi2). Participants in this study used 11 primary strategies on a regular basis to increase daily physical activity. The percentage of participants who used these strategies was as follows: walked to a meeting or work-related errand (64.7%), after work (50.0%), before work (35.3%), at lunch (47.1%), on the weekend (32.4%), while traveling (32.4%), with the dog (32.4%), or to a destination (work/store) (29.4%). Additionally, participants parked farther away (50%), used the stairs rather than an elevator (23.5%), and performed other cardiovascular activity (52.9%). Differences among BMI groups were found for the parking further strategy (p < 0.05), with obese participants using this strategy significantly more than overweight participants. No significant differences were found among weekly physical activity improvement groups. This study indicates that participants in a pedometer-based lifestyle physical activity intervention used a variety of strategies to increase daily physical activity.

Cunningham, G. O. and Y. L. Michael (2004). "Concepts guiding the study of the impact of the built environment on physical activity for older adults: a review of the literature." American Journal of Health Promotion 18(6): 435-43.

OBJECTIVE: To identify theoretical models and key concepts used to predict the association between built environment and seniors' physical activity on the basis of a comprehensive review of the published literature. DATA SOURCE: Computer searches of Medline (1966-2002), PubMed (1966-2002), and Academic Search Elite (1966-2002) were conducted, and 27 English-language articles were found. Search terms included built environment, physical activity, exercise, walking, neighborhood, urban design, seniors, aging, aging in place, and physical environment. STUDY INCLUSION AND EXCLUSION CRITERIA: The primary inclusion criterion included the relation between the built environment and the physical activity among seniors living in neighborhoods. Studies assessing physical activity or overall health of a community-based population were included if underlying theoretical models and concepts were applicable to a senior population. Studies solely assessing social or psychosocial characteristics of place were excluded, as were review articles. DATA EXTRACTION: Extracted data included theoretical model, aspect of built environment studied, methods, and outcomes. DATA SYNTHESIS: Tables present key definitions and summarize information from empirical studies. RESULTS: Twenty-seven articles that focused on the environment-behavior relation in neighborhoods, six specific to seniors, were found. This area of research is in its infancy, and inconsistent findings reflect difficulties in measurement of the built environment. CONCLUSIONS: The relation between the built environment and the physical activity among seniors has been the subject of a limited number of studies. The choice of theoretical model drives the selection of concepts and variables considered. Safety, microscale urban design elements, aesthetics, and convenience of facilities are consistently studied across models. Few validated instruments have been developed and tested to measure neighborhood built environment.

Dempsey, T., A. Miller, et al. (2004). "Let's get physical: a policy on increasing physical activity in school-aged children." Journal of Oklahoma State Medical Association 97(3): 119-21; quiz 122-3.

Childhood obesity has reached epidemic proportions. One of the major reasons is the lack of physical activity due to time spent watching television or using computers. This lack coupled with poor dietary habits has led to significant increases in the number of children with Type II diabetes and predisposition to hypertension, coronary artery disease and others. Physicians can help reduce this trend.

Dubbert, P. M., M. W. Vander Weg, et al. (2004). "Evaluation of the 7-day physical activity recall in urban and rural men." Medicine and Science in Sports and Exercise 36(9): 1646-54.

PURPOSE: To assess reliability and validity of the 7-d physical activity recall (PAR) in 60- to 80-yr-old men from urban and rural homes in the southeastern United States. METHODS: Two hundred twenty 60- to 80-yr-old men (29% minority ethnicity) from Veterans Affairs primary care clinics completed two PAR interviews at 2- to 4-wk intervals. The PAR included modifications to elicit and score light-moderate (2-3 METs) as well as moderate (3-6 METs) and hard (>/=7 METs) physical activity. Reliability was assessed using intraclass correlations from the two interviews. Validity was assessed using Spearman correlations of PAR variables with 6-min walk performance, and with treadmill performance and accelerometer activity counts from subsamples, as well as measures of gait, balance, activities of daily living, and perceived quality of life. Results were examined separately for urban and rural participants. RESULTS: Reliability coefficients were acceptable and PAR measures of estimated energy expenditure, and time spent in hard, moderate, and light-moderate activity correlated as hypothesized with the fitness and health measures. CONCLUSION: Reliability and validity coefficients were generally similar to those found in studies of the PAR with younger samples and with instruments designed specifically for use with elders. The PAR is a useful and flexible instrument for assessing physical activity of varying intensity in older men living in both urban and rural home settings.

Duncan, S. C., T. E. Duncan, et al. (2004). "A multilevel approach to youth physical activity research." Exercise Sport Science Review 32(3): 95-9.

Social environment factors are hypothesized to interact with individual-level factors to influence youth physical activity. Multilevel analytic approaches are ideal for examining the influence of the social environment on youth physical activity as they allow examination of research questions across multiple contexts and levels (e.g., individual, family, and neighborhood levels).

Echeverria, S. E., A. V. Diez-Roux, et al. (2004). "Reliability of self-reported neighborhood characteristics." Journal Of Urban Health-Bulletin Of The New York Academy Of Medicine 81(4): 682-701.

The majority of studies examining the relation between neighborhood environments and health have used census-based indicators to characterize neighborhoods. These studies have shown that neighborhood socioeconomic characteristics are associated with a range of health outcomes. Establishing if these associations reflect causal relations requires testing hypotheses regarding how specific features of neighborhoods are related to specific health outcomes. However, there is little information on the reliability of neighborhood measures. The purpose of this study was to estimate the reliability of a questionnaire measuring various self-reported measures of the neighborhood environment of possible relevance to cardiovascular disease. The study consisted of a face-to-face and telephone interview administered twice to 48 participants over a 2-week period. The face-to-face and telephone portions of the interview lasted an average of S and 11 minutes, respectively. The questionnaire was piloted among a largely Latino and African American study sample recruited from a public hospital setting in New York City. Scales were used to assess six neighborhood domains: aesthetic quality, walking exercise environment, safety from crime, violence, access to healthy foods, and social cohesion. Cronbach's alpha's ranged from.77 to.94 for the scales corresponding to these domains, with test-retest correlations ranging from 0.78 to 0.91. In addition, neighborhood indices for presence of recreational facilities, quality of recreational facilities, neighborhood participation, and neighborhood problems were examined. Test-retest reliability measures for these indices ranged from 0.73 to 0.91. The results from this study suggested that self-reported neighborhood characteristics can be reliably measured.

Evenson, K. R. and A. P. McGinn (2004). "Availability of school physical activity facilities to the public in four U.S. communities." American Journal of Health Promotion 18(3): 243-50.

PURPOSE: This study documents the public availability of school physical activity facilities, reasons facilities were not made available to the public, and the barriers and benefits associated with having facilities available. DESIGN: Cross-sectional. SETTING: All schools located in four geographic locations (Washington County, Maryland; northwest suburbs of Minneapolis, Minnesota; Jackson, Mississippi; and Forsyth County, North Carolina). SUBJECTS: The survey was completed by 289 school representatives for a response rate of 82.3% (289/351 schools). For the nonrespondents, 61 of 62 schools were visited to obtain information on outdoor facilities. MEASURES: Information on indoor and outdoor physical activity facilities available to the public was collected for all schools (public, private, and colleges) using a telephone survey. Site visits were made to schools that did not participate in the survey to collect information on outdoor facilities only. RESULTS: The schools in the four geographic areas owned a wide range and number of physical activity facilities for their students. For the schools, 27% had no indoor facilities and 11% had no outdoor facilities. Private schools and colleges were less likely to have indoor or outdoor facilities compared to public schools. Outdoor facilities were available more often to the public than indoor facilities overall, across sites, and by school type (public, private, college). Among the 313 schools with outdoor facilities, 240 (77%) allowed at least some public use, and among the 210 schools with indoor facilities, 134 (64%) allowed at least some public use. Some reasons that facilities were not made available included: for student use only, supervision and personnel requirements, safety concerns, insurance, liability, and a private or church-owned status. The most common benefits of allowing the public to use the facilities included providing a space to keep youth active and good publicity for the school. CONCLUSION: These findings suggest that safety, insurance, and liability concerns are barriers that need to be addressed with schools before indoor and outdoor facilities can be made available to the public. Furthermore, emphasizing the benefits that we found, such as providing a space to keep youth active and good publicity for the school, would also be important.

Fein, A. J., R. C. Plotnikoff, et al. (2004). "Perceived environment and physical activity in youth." International Journal of Behavioral Medicine 11(3): 135-42.

The examination of physical environments to explain and promote physical activity is an important yet under-investigated area of research inquiry. This study explored relationships between the perceived availability of physical environmental resources and the perceived importance of these resources in relation to physical activity levels amongst youth. A self-report questionnaire was completed by 610 students (mean age = 15.5 years old; 62% female participants) from four high schools (grades 9-12) in rural Alberta, Canada. Perceived physical environment constructs explained 5% of the variance in physical activity, with home, neighborhood, and school as significant domains. Perceived importance constructs explained 8% of the variance in physical activity with school context showing the only significant relationship with physical activity. A hierarchical regression analysis entered sex, grade, self-efficacy, peer, family and physical education teacher relationships, as the first block and eight environmental constructs as the second block. The first block variables accounted for 22% of the variance and environmental constructs accounted for an added 4% of the variance in physical activity. Perceived importance of the school environment was the only environment variable significantly associated with physical activity (beta =.14; p 100000 people) were 15% less likely to be sedentary for overall activity classifications in comparison to small town dwellers (20,000) and rural ( or = 25). Self-reported physical activity data were used to classify adults into those who achieved > or = 5 bouts of weekly moderate-vigorous physical activity and those who did not. Results were stratified by overweight and physical activity status. RESULTS: The vast majority of young adults used car transit (work, 90.4%; school, 74.7%). A small proportion of young adults used active means of transportation to work (8.1%) and school (26.7%), and fewer used public transportation to work or school ( ................
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