Neighborhood Socioeconomic Environment and Its Influence on Cardiorespiratory Fitness and Physical Activity in Youth

Among youth, inadequate cardiorespiratory fitness and physical inactivity are powerful markers of health associated with numerous health outcomes across the lifespan. Unfortunately, a majority of U.S. youth have inadequate cardiorespiratory fitness levels and do not meet physical activity guidelines. While previous research has identified several individual-level factors associated with youth cardiorespiratory fitness and physical activity, environmental factors have been increasingly recognized. Of particular interest is the neighborhood socioeconomic environment, which has been consistently associated with several health outcomes among adults. However, little is known regarding the relationship between the neighborhood socioeconomic environment, cardiorespiratory fitness, and physical activity among younger populations. Hence, the overall purpose of this dissertation was to determine how characteristics of neighborhood socioeconomic environment are associated with cardiorespiratory fitness and physical activity in diverse samples of youth. Three studies were conducted to address this overarching purpose. In study one, the relationship between cardiorespiratory fitness and area-level socioeconomic environment was examined. The extent to which sex, grade level, race/ethnicity, and family socioeconomic status moderated this relationship was also examined. Results indicated that cardiorespiratory fitness was positively associated with area-level socioeconomic environment among school-age youth in South Carolina. More specifically, the odds of achieving the Healthy Fitness Zone for cardiorespiratory fitness decreased by approximately 25-34% with increasing deprivation of the socioeconomic environment, after controlling for covariates. Additionally, the association between cardiorespiratory fitness and area-level socioeconomic environment varied significantly by sex, grade level, and race/ethnicity. Study two investigated the association between cardiorespiratory fitness and neighborhood socioeconomic environment; and examined the extent to which physical activity mediated this relationship in a nationally representative sample of U.S. youth. The findings from this study indicated that neighborhood socioeconomic environment was not significantly associated with cardiorespiratory fitness or physical activity. While non-significant, cardiorespiratory fitness was observed to decrease as deprivation of neighborhood socioeconomic environment increased. It is plausible that limitations in the study design and/or lack of statistical power may have contributed to the null findings. The purpose of the study three was to describe the longitudinal association of neighborhood socioeconomic environment with physical activity in youth during the transition from childhood to adolescence, and to determine if access to physical activity facilities moderated this relationship. Findings demonstrated that changes in physical activity from 5th grade to 7th grade were significantly associated with neighborhood socioeconomic environment. Over time, decreases in physical activity varied by degree of neighborhood socioeconomic deprivation. However, access to physical activity facilities did not moderate this relationship. In conclusion, the findings of this dissertation suggest that neighborhood socioeconomic environment is associated with cardiorespiratory fitness and physical activity in youth. In general, increased deprivation of the neighborhood socioeconomic environment was associated with lower cardiorespiratory fitness and physical activity levels in youth. However, some inconsistencies were observed across the findings of the three studies. Additional studies are needed to better understand the complex relationships among neighborhood socioeconomic environment, cardiorespiratory fitness, and physical activity in youth

Associations among neighborhood socioeconomic deprivation, physical activity facilities, and physical activity in youth during the transition from childhood to adolescence

BACKGROUND: This study aims to examine the longitudinal association of neighborhood socioeconomic deprivation (SED) with physical activity in youth during the transition from elementary to middle school, and to determine if access to physical activity facilities moderates this relationship. METHODS: Data were obtained from the Transitions and Activity Changes in Kids (TRACK) study, which was a multilevel, longitudinal study designed to identify the factors that influence changes in physical activity as youth transition from elementary to middle school. The analytic sample for the current study included 660 youth with complete data in grades 5 (baseline) and 7 (follow-up). A repeated measures multilevel framework was employed to examine the relationship between SED and physical activity over time and the potential moderating role of elements of the built environment. RESULTS: Decreases in physical activity varied by the degree of neighborhood SED with youth residing in the most deprived neighborhoods experiencing the greatest declines in physical activity. Access to supportive physical activity facilities did not moderate this relationship. CONCLUSION: Future research studies are needed to better understand how neighborhood SED influences youth physical activity over time

The built environment predicts observed physical activity

Background: In order to improve our understanding of the relationship between the built environment and physical activity, it is important to identify associations between specific geographic characteristics and physical activity behaviors. Purpose: Examine relationships between observed physical activity behavior and measures of the built environment collected on 291 street segments in Indianapolis and St. Louis. Methods: Street segments were selected using a stratified geographic sampling design to ensure representation of neighborhoods with different land use and socioeconomic characteristics. Characteristics of the built environment on-street segments were audited using two methods: in-person field audits and audits based on interpretation of Google Street View imagery with each method blinded to results from the other. Segments were dichotomized as having a particular characteristic (e.g., sidewalk present or not) based on the two auditing methods separately. Counts of individuals engaged in different forms of physical activity on each segment were assessed using direct observation. Non-parametric statistics were used to compare counts of physically active individuals on each segment with built environment characteristic. Results: Counts of individuals engaged in physical activity were significantly higher on segments with mixed land use or all non-residential land use, and on segments with pedestrian infrastructure (e.g., crosswalks and sidewalks) and public transit. Conclusion: Several micro-level built environment characteristics were associated with physical activity. These data provide support for theories that suggest changing the built environment and related policies may encourage more physical activity

Stepping It Up: Walking Behaviors in Children Transitioning from 5th to 7th Grade

The purpose of this study was to (1) describe children’s walking behaviors in 5th to 7th grade and change over time and (2) examine associations between walking behaviors and Walk Score®. Participants consisted of n = 586 students from the Transitions and Activity Changes in Kids (TRACK) Study. Children reported any walking behavior (e.g., exercise and transportation) over the past five days. Walk Score was calculated based on children’s home address. Descriptive statistics summarized walking behaviors by gender and time, and repeated measure mixed models examined the relationship between walking behaviors and Walk Score. Approximately 46.8% and 19.2% of 5th grade children reported walking for exercise and transportation, respectively, and these percentages declined through 7th grade. Girls reported higher levels of total walking behavior and walking for exercise than boys (p \u3c 0.001). Girls with a higher Walk Score had 63% higher odds of reporting walking for transportation than girls with a lower Walk Score (OR = 1.63, 95% CI = 1.02, 2.62). Walking behaviors among children were infrequent with significant declines over time, and of the nine associations examined with Walk Score, only one was significant. Efforts should prioritize frequent walking behavior and community design to increase children’s physical activity

Moderating Effect of the Neighborhood Physical Activity Environment on the Relation Between Psychosocial Factors and Physical Activity in Children: A Longitudinal Study

Background Few studies have examined the moderating role of neighbourhood environments on the relation between psychosocial factors and physical activity, and results of these studies are mixed. This study examined this relationship in 636 fifth to seventh graders from South Carolina, USA. Methods From 2010 to 2013, children and their parent/guardian completed annual self-reported surveys assessing psychosocial factors, and children wore accelerometers for 1 week each year. Neighbourhood environments were classified as supportive or non-supportive for physical activity (PA) based on in-person audits of facilities near children’s homes and windshield surveys of children’s streets. Growth curve analyses were completed to assess the moderating effect of the neighbourhood physical activity environment (NPAE) on the relation between psychosocial factors and total physical activity (TPA) over time. Results Significant interactions on TPA were found for (1) time, NPAE and parent-reported parent support for PA; (2) time, NPAE and child-reported equipment in the home; (3) child-reported parental support for PA and time; (4) child-reported parental support for PA and NPAE; (5) PA self-schema and time and (6) child-reported parental encouragement and time. Parental support and a supportive NPAE were important for TPA, especially as children transitioned to middle school, whereas home equipment and a supportive NPAE were important for fifth graders’ TPA. Conclusion Consistent with the socioecological model, PA behaviour was dependent on interacting effects across levels of influence. Generally, both a supportive NPAE and positive psychosocial factors were needed to support TPA. Factors influencing PA across multiple levels should be addressed in PA interventions

Association of environment and policy characteristics on children's moderate-to-vigorous physical activity and time spent sedentary in afterschool programs

Afterschool programs (ASPs) are an important setting in which to promote children’s physical activity. This study examines the association of environmental and policy characteristics on the moderate-to-vigorous physical activity (MVPA) and sedentary behavior of children attending ASPs