Psychosocial mediators of the association between distress related to COVID-19 and physical activity among rural cancer survivors

https://openworks.mdanderson.org/sumexp22/1129/thumbnail.jp

The Impact of COVID-19 on Psychosocial Distress and Quality of Life Among Rural Cancer Survivors

https://openworks.mdanderson.org/sumexp22/1028/thumbnail.jp

THE IMPACT OF HOME AVAILABILITY OF THE RELATIONSHIP BETWEEN NEIGHBORHOOD AVAILABILITY AND FRUIT AND VEGETABLE CONUMPTION IN LOW-INCOME ETHNIC MINORITIES

Purpose: High availability of grocery stores and supermarkets has been positively associated with increased fruit and vegetable consumption, yet some studies have reported that the relationship between availability and consumption is equivocal or inconclusive indicating that availability does not directly translate to increased consumption. The purpose of this study was to investigate the mediating effect of home availability of fruits and vegetables on the relationship between neighborhood availability of supermarkets and grocery stores and fruit and vegetable consumption in low-income, ethnic minority neighborhoods. Methods: Data used in this study was taken from the Healthful Options Using Streets and Transportation in Our Neighborhoods (HOUSTON) study, which aimed to identify and assess relationships between environmental factors and dietary habits in African Americans (N=216) residing in 12 public housing developments in Houston. Participating residents completed the National Institute of Health fruit and vegetable screener to measure consumption. Neighborhood availability of grocery stores and supermarkets was assessed using the Goods and Services Inventory (GASI). Home availability of fruits and vegetables were measured using a survey. Results: Participants averaged 4.76 (SD= 5.52) servings of fruits and vegetables, total servings of fruit and vegetables available in the home averaged 21.12 (SD= 7.09), and the mean total of grocery stores and supermarkets was .04 (SD= .03). Bivariate correlations found that fruit and vegetable consumption was correlated with home availability (r= .352, p\u3c .01). Neighborhood availability was not associated with consumption (r= -.036, p\u3c .01) or home availability (r= -0.027, p\u3c .01). Linear regression analyses showed that neighborhood availability of grocery stores and supermarkets was not associated with home availability or fruit and vegetable consumption (p\u3c .05). Conclusions: Home availability is an important predictor of consumption in low-income neighborhoods, but does not mediate the relationship between neighborhood availability and consumption of fruits and vegetables. A limitation to this study was the use of a mean number of grocery and supermarket stores for each housing development limiting our ability to observe the impact of neighborhood availability on home availability or consumption

Sitting Time and Cardiometabolic Risk Factors in African American Overweight Women

Findings from previous research linking sedentary time with cardiometabolic risk factors and body composition are inconsistent, and few studies address population groups most vulnerable to these compromising conditions. The purpose of this paper was to investigate the relationship of sitting time to cardiometabolic risk factors and body composition among African American women. A subsample of African American women (N = 135) completed health and laboratory assessments, including measures of blood pressure, resting heart rate, cholesterol, triglycerides, glucose, body mass index, body fat, sitting time, and demographics. Simultaneous, adjusted regression models found a positive association between weekend sitting time and glucose and an inverse association between weekly sedentary time and cholesterol (ps < .05). There were no significant associations between sedentary behavior and body composition. The unexpected relationship between sedentary time and cholesterol suggests that the relationship of sedentary behavior to cardiometabolic risk factors may depend on existing characteristics of the population and measurement definition of sedentary behavior. Results suggest distinctly different relationships between weekend and weekday sitting time, implicating a need for careful measurement and intervention that reflects these differences

Items on a Perceived Environment Tool are Grouped Differently in Low and High Income African American Women

Purpose: Prevalence of physical inactivity is greater in African American (AA) women than any other population sub group. The neighborhood environment is an important influence on physical activity, and accurate measurement of neighborhood perceptions is needed to determine the influence of neighborhood environment on physical activity. The purpose of this study was to investigate the stability of constructs represented by items from the International Prevalence Study (IPS) environmental module among high and low income AA women. Method: African American women (N=387) completed the IPS environmental module questionnaire which measured perception of neighborhood environment. A principle component analysis with varimax rotation was conducted using fifteen of seventeen items from the survey. Factor analysis was conducted separately for high and low income participants. Results: Four factors with eigenvalues ≥ 1.0 were extracted from the 15 item questionnaire for both groups. These four factors accounted for 56.6% of total variance in the high income group, and 53.1% of total variance in the low income group. The four factors for the high income group were Aesthetic Qualities and Social Environment, Neighborhood Safety, Neighborhood Infrastructure, and Destinations and Street Connectivity. The four factors for the low income group were Aesthetic Qualities and Social Environment, Neighborhood Safety, Opportunities to be active and Street Connectivity, and Public Transportation. Conclusion: The factors extracted for high and low income AA women may have been different due to dissimilarities in neighborhood infrastructure, design and quality. Inconsistent grouping of items into factors from the same instrument used to measure perceptions of neighborhood environment underscores the importance of accounting for differences in how high and low income residents perceive their neighborhood when considering physical activity interventions and policies

Fast Food and Supermarket Availability, Neighborhood Income and Health Outcomes in Public Housing Residents.

Purpose: The availability of fast food restaurants (FFRs) and supermarkets varies by neighborhood income level and may influence health outcomes such as body mass index (BMI) and blood pressure (BP). The purpose of this study was to determine whether neighborhood income moderates the association between fast food restaurant or supermarket availability and health outcomes in public housing residents. Method: Number of FFRs and supermarkets on every street segment in neighborhoods surrounding public housing developments (N=12) in Houston, Texas were counted, then aggregated at the neighborhood level. Residents (N=213) completed measures of BMI (kg/m2) and resting BP. Median household income at the census block level for each housing development was obtained from the 2006-2010 American Community Survey. Linear regression models determined whether availability of fast food restaurants and supermarkets predicts BMI or BP after controlling for age and gender, and if neighborhood income moderated these associations. Results: Participants were middle aged (M=43.5±17.1 years) females (n=138) and males (n=75). BP did not differ by gender (M=121.5/74.0±17.5/12.8 mmHg), females were on average obese (MBMI=33.0±8.7kg/ m2) and males were overweight (MBMI=33.0±8.7kg/ m2). Neighborhood income ranged from $9,226 to$57,618. There were (M=.003±.03) FFRs per neighborhood and (M=.001±.008) supermarkets per neighborhood. Bivariate correlations found that neighborhood income was associated with fast food restaurant (r=.205, p.05). Income did not moderate these associations (p\u3e.05). Conclusions: BP changes with age, and BMI varies by gender. After controlling for these variables, fast food restaurant and supermarket availability did not predict BMI or BP in public housing residents, and neighborhood income did not affect the direction of these associations. Actual consumption of the foods sold at these places may have a more direct relationship with health outcomes. Limited variability in the number of FFRs and supermarkets in each neighborhood may have diminished our ability to detect an effect of these neighborhood factors on BMI and BP

Solving the Obesity Epidemic in African American and Hispanic Communities: Voices from the Community

Purpose: Science & Community: Ending Obesity Improving Health (Science & Community) aimed at reducing obesity in Houston by developing partnerships and collaborating with community organizations to identify community research priorities and develop an obesity reduction program. Method: Partnership members were recruited from Science & Community events and invited to participate in in-depth interviews to gain insight on obesity prevalence, causes, and solutions. Partnership and community members (N=22) completed a 60-90 minute in-depth interview with a trained Science & Community team member. The interview guide consisted of 30 questions about pressing health problems in the community, potential solutions to health problems and obesity, and how the environment has impacted obesity and health behaviors in the community. Interviews were led by trained researchers and were transcribed by an external medical transcription company. Transcribed interviews were coded independently by two coders in ATLAS.ti version 6.2. Results: Interviewees (n=12 women and 10 men) were mostly Hispanic or Latino (n=9) and African American (n=7). Common problems identified by interviewees were childhood obesity, balancing a healthy diet, and physical inactivity. Interviewees identified obesity as a major problem in their communities and cited access to quality food and physical activity resources as both the problem and a solution. Additional emergent themes focused on solutions and included increasing awareness and education, coordinated efforts among organizations and using an ecologic approach to combat obesity. Conclusions: Community insight gleaned from this study be used to enhance relevance and sustainability of programs developed to reduce obesity and suggests possible avenues for participatory research and intervention

Measured and Self-reported Neighborhood Characteristics and Physical Activity Among African American Women

African American women are vulnerable to physical inactivity compared to white women. Measured and self-reported neighborhood characteristics may be associated with physical activity (PA), yet few studies have examined these factors among minority women. The purpose of this study was to investigate the associations of measured and self-reported neighborhood characteristics with individual PA. The Pedestrian Environment Data Scan was completed for 25% of randomly selected residential street segments within a 400 meter radius of each participants’ address. African American women (N=262, M age=44.4 yrs) completed interviewer administered questionnaires assessing self-reported neighborhood characteristics. PA was measured using the International Physical Activity Questionnaire (IPAQ) long (M MET minutes/week=2519) and accelerometry (M MVPA=19.0 min/day). Most women were obese (N=176, 67.2%; M BMI= 34.0). IPAQ PA was not associated with accelerometer PA. Bivariate correlations suggested relationships between greater measured pedestrian facility density and more IPAQ transportation PA , greater reported pedestrian facility density and more IPAQ leisure time PA, greater reported bicycle facility density and more IPAQ moderate PA and IPAQ total PA (ps\u3c.05). Simultaneous ecological multiple regression models demonstrated that reported pedestrian facility density (Beta=.138, t=2.181) and body fat percentage (Beta= -.089, t= -1.398) were associated with IPAQ leisure time PA (R²=.027; p=.04), reported bicycle facility density (Beta=.138, t=2.161) was associated with IPAQ moderate PA (R²=.019; p=.03), and reported bicycle facility density (Beta=.130, t=2.041) was associated with IPAQ total PA (R²= .017; p=.04). No measured or reported neighborhood characteristics were associated with accelerometer measured PA. Measured and reported built environment attributes are significantly associated with self-reported PA but may be mediated by weight status

Using the PARA to Evaluate Physical Activity Resource Attributes in Houston and Austin, TX

Many adults do not achieve recommended levels of physical activity (PA), and ecologic models suggest that environmental factors such as physical activity resources (PARs) may influence PA participation. Attributes of PARs, such as accessibility, features, amenities and incivilities, are related to PA. The Physical Activity Resource Assessment (PARA) is an environmental audit tool to assess the type, size, accessibility, incivilities, amenities and features of a PAR. Using the PARA to explore how incivilities and quality of features and amenities differ by location, size or accessibility is an essential step in understanding which attributes influence PA. The purpose of this study was to compare the type, size, accessibility, incivilities and quality of features and amenities of PARs in Houston and Austin, TX and examine the differences in incivilities and quality of features and amenities of PARs by city, type, and accessibility of the resource. Using the PARA, PARs were counted and assessed in Houston (N=1322) and Austin (N=297) and categorized by type, size, and cost (a measure of accessibility). The quality of PAR features and amenities were rated (0=none, 1=poor, 2=mediocre, and 3=good); incivilities were rated using an operational classification (0=none, 1=some, 2=medium, 3=excessive). T-tests for city and ANOVAs for type, size and accessibility were used to determine group differences in features, amenities and incivilities. The most common type of resource found in Houston and Austin were schools (Houston n=453; Austin n=88), followed by parks (Houston n=386; Austin n=87). The quality of features per resource was not significantly different between Houston and Austin. The quality of amenities per resource was greater in Houston compared to Austin (t(473)=4.183, p\u3c.001); incivilities were greater in Austin compared to Houston (t(385)=-6.909, p\u3c.001). Significant differences were found in the quality of features (F(8,1589)=27.95, p\u3c.001), amenities (F(8,1587)=52.14, p\u3c.001) and incivilities (F(8,1587)=14.24, p\u3c.001) between types of physical activity resources. Combination resources had the best features, fitness clubs had the best amenities, and trails had the greatest number of incivilities. Free PARs had better features (F(3,566)=18.481, p\u3c.001) and better amenities than less accessible PARs (F(3,1565)=3.754, p=.011). However, free PARs had for a higher number of incivilities than pay-for-use PARs (F(3,1566)=23.720, p\u3c.001). Quality of PARs differed by location, type, and accessibility of the resource. Findings from this study can inform improvement of PARs to increase PA among adults. Future studies should examine the influence of type, accessibility, location, size, and quality of features, amenities and incivilities on PA

Neighborhood Safety and Attractiveness Influence Physical Activity among African American and Hispanic or Latina Women

Introduction: Although the benefits of adopting physical activity (PA) are well publicized, physical inactivity rates remain high, and African American and Hispanic or Latina women do less PA compared to white women. Many interventions have begun to focus on conveniently performed lifestyle PA, such as walking. The purpose of this study was to investigate the relationship between neighborhood safety and attractiveness and PA in a sample of African American (AA) and Hispanic or Latina (HL) women participating in Health Is Power (1R01CA109403). Method: Women (AA N=202 and HL N=107) who enrolled in the study were middle-aged (M=45.8 years), overweight (M BMI=34.2 kg/m2) and largely sedentary (M accelerometer measured PA=19.6 min/day). Self-reported PA was measured by the International Physical Activity Questionnaire (IPAQ) long form and objectively measured PA was collected using an accelerometer at baseline (T1) and post intervention (T2). Neighborhood safety and attractiveness were measured by trained observers using the Pedestrian Environment Data Scan (PEDS). Results: At T1, African American women did more moderate intensity PA (M=24.3 vs. 10.9 minutes of moderate PA per day) and reported doing more walking (M=867.7 vs. 432.2 MET-minutes per day) than Hispanic or Latina women. At T2, African American still did more PA than Hispanic or Latina women (M=25.0 vs. 11.7 minutes of moderate PA per day), but there were no differences in self-reported PA. Bivariate associations showed that as safety (r=-0.144) and attractiveness (r=-0.149) for bicycling increased, self-reported walking decreased (ps\u3c0.05). Linear regression analyses indicated attractiveness for bicycling predicted increased T2 accelerometer measured PA (p=0.025), after adjusting for ethnicity, site, socioeconomic status (SES) and age. Conclusions: Neighborhood safety and attractiveness may influence PA. Community leaders and policy makers should consider the relationship between the built environment, PA and obesity in communities where African American and Hispanic or Latina reside when passing and/or enforcing public policies and amendments