1,993 publications from this institution
Land-use and transport policies contribute to worldwide epidemics of injuries and non-communicable diseases through traffic exposure, noise, air pollution, social isolation, low physical activity, and sedentary behaviours. Motorised transport is a major cause of the greenhouse gas emissions that are threatening human health. Urban and transport planning and urban design policies in many cities do not reflect the accumulating evidence that, if policies would take health effects into account, they could benefit a wide range of common health problems. Enhanced research translation to increase the influence of health research on urban and transport planning decisions could address many global health problems. This paper illustrates the potential for such change by presenting conceptual models and case studies of research translation applied to urban and transport planning and urban design. The primary recommendation of this paper is for cities to actively pursue compact and mixed-use urban designs that encourage a transport modal shift away from private motor vehicles towards walking, cycling, and public transport. This Series concludes by urging a systematic approach to city design to enhance health and sustainability through active transport and a move towards new urban mobility. Such an approach promises to be a powerful strategy for improvements in population health on a permanent basis.
Purpose: This study tested whether a multilevel physical activity (PA) intervention had differential effects on PA according to participants’ perceptions of their neighborhood environment. Design: Two-group cluster randomized controlled trial. Setting: San Diego, California. Subjects: Analytical sample included 319 Latinas (18-65 years) from churches randomized to the following conditions: PA (n = 8 churches, n = 157 participants) or attention control (n = 8 churches, n = 162 participants). Intervention: Over 12 months, PA participants were offered free PA classes (6/wk), while attention control participants were offered cancer prevention workshops. Measures: Baseline and 12-month follow-up measures included self-report and accelerometer-based moderate to vigorous physical activity (MVPA), sociodemographics, and perceived neighborhood environment variables. Analysis: Mixed-effects models examined each PA outcome at 12-month follow-up, adjusted for church clustering, baseline PA, and sociodemographics. We tested interactions between 7 baseline perceived environment variables and study condition. Results: Neighborhood esthetics was the only significant moderator of intervention effects on accelerometer-based MVPA and self-report leisure-time MVPA. Participants in the PA intervention had significantly higher PA at follow-up than attention control participants, only when participants evaluated their neighborhood esthetics favorably. Conclusion: Perceived neighborhood esthetics appeared to maximize the effectiveness of a multilevel PA intervention among Latinas. For sustainable PA behavior change, the environments in which Latinas are encouraged to be active may need to be evaluated prior to implementing an intervention to ensure they support active lifestyles.
Background.The current study evaluated the construct validity of a physical activity intervention in primary care by testing whether the intervention changed hypothesized mediators and whether changes in the mediators were associated with behavior change. Methods.Matched physician offices were nonrandomly assigned to intervention or control. Apparently healthy, sedentary, adult patients (N= 255) were recruited from physician offices. The intervention was brief, behaviorally based counseling by physicians, plus a telephone follow-up 2 weeks later. Assessments of physical activity and mediators were collected at baseline and at 4- to 6-week follow-up. Hypothesized mediators were processes of change, self-efficacy, and social support for exercise. Results.Patients who were counseled improved significantly more than those in the control group on behavioral and cognitive processes of change. Other changes in mediators were nonsignificant. Behavioral processes of change and self-efficacy made significant contributions to the multiple regression model explaining self-report and objective measures of physical activity. Conclusions.The intervention affected some of the targeted mediators of physical activity change. Two of three mediator variables were associated with changes in physical activity regardless of experimental condition and other variables. The construct validity of the intervention was partially supported.
Blood pressure (BP) reactivity in children, the transient elevation of BP after an acute stressor, is a stable characteristic that may predict cardiovascular disease (CVD) and hypertension. The purpose of the present study was to assess the generalizability of BP reactivity across various stressors in young children. BP reactivity was measured in 85 children (ages 3 to 6 years) after each of three different stressors. Systolic BP reactivity level was highest after physical exertion (104 mm Hg), followed by competitive task (95 mm Hg) and cognitive task (93 mm Hg). Resting systolic BP was 90. The 2-week test-retest reliability was higher for physical stress systolic BP reactivity level (r = .66) than for baseline systolic BP (r = .58) and the other two stressors. The reliability of the systolic BP change score was significant only for physical stressor (r = .33). Correlations among the three stressors ranged from .75 to .79 for systolic BP reactivity level and from .37 to .50 for change in systolic BP. Change in systolic BP after physical stress correlated with skin-fold thickness (r = .32). There was evidence of generalizability across stressors. The physical task is the most promising for future study of BP reactivity in young children.
Sedentary behaviors such as TV viewing are associated with childhood obesity, while physical activity promotes healthy weight. The role of the home environment in shaping these behaviors among youth is poorly understood. The study purpose was to examine the reliability of brief parental proxy-report and adolescent self-report measures of electronic equipment and physical activity equipment in the home and to assess the construct validity of these scales by examining their relationship to physical activity, sedentary behavior, and weight status of children and adolescents. Participants were adolescents (n = 189; mean age = 14.6), parents of adolescents (n = 171; mean age = 45.0), and parents of younger children (n = 116; parents mean age = 39.6; children's mean age = 8.3) who completed two surveys approximately one month apart. Measures included a 21-item electronic equipment scale (to assess sedentary behavior facilitators in the home, in the child or adolescent's bedroom, and portable electronics) and a 14-item home physical activity equipment scale. Home environment factors were examined as correlates of children's and adolescents' physical activity, sedentary behavior, and weight status after adjusting for child age, sex, race/ethnicity, household income, and number of children in the home. Most scales had acceptable test-retest reliability (intraclass correlations were .54 - .92). Parent and adolescent reports were correlated. Electronic equipment in adolescents' bedrooms was positively related to sedentary behavior. Activity equipment in the home was inversely associated with television time in adolescents and children, and positively correlated with adolescents' physical activity. Children's BMI z-score was positively associated with having a television in their bedroom. The measures of home electronic equipment and activity equipment were similarly reliable when reported by parents and by adolescents. Home environment attributes were related to multiple obesity-related behaviors and to child weight status, supporting the construct validity of these scales.
