Effects of Crime Type and Location on Park Use Behavior

Crime and the fear of crime can be a barrier to park use, and locations of crimes can have varied effects. Unsafe areas in or around the park, around the residence, or along the route to the park can alter park use behavior. Our study aimed to examine associations between objective measures of types and location of crimes and park use behaviors. In 2013 we surveyed a sample (N = 230) of residents in Greensboro, North Carolina, about park use, with responses matched to objective crime and spatial measures. We measured all crimes and violent crimes near home, near the closest park, and along the shortest route between home and park. By using ordered and binary logistic modeling, we examined the relationships between the locations of crime and park use and duration of park visit, park rating, and never visiting parks. Additional models included distance to the closest park. Increased crime in parks and near home was associated with fewer park visits. Greater violent crime in all locations was related to fewer park visits. Park ratings were lower for parks with high violent crime rates. Given the importance of parks as settings for outdoor recreation and physical activity, crime may have a detrimental effect on physical activity and, therefore, public health

Prescribing Time in Nature for Human Health and Well-Being: Study Protocol for Tailored Park Prescriptions

BackgroundeHealth technologies offer an efficient method to integrate park prescriptions into clinical practice by primary health care (PHC) providers to help patients improve their health via tailored, nature-based health behavior interventions. This paper describes the protocol of the GoalRx Prescription Intervention (GPI) which was designed to leverage community resources to provide tailored park prescriptions for PHC patients.MethodsThe GPI study was designed as a 3-arm, multi-site observational study. We enrolled low-income, rural adults either at-risk of or living with hypertension or diabetes (n = 75) from Federally Qualified Health Centers (FQHC) in two counties in North Carolina, USA into the 3-month intervention. Eligible participants self-selected to receive (1) a tailored park prescription intervention; (2) a tailored home/indoor PA prescription intervention; or (3) a healthy eating prescription (with no PA prescription beyond standard PA counseling advice that is already routinely provided in PHC) as the comparison group. The GPI app paired patient health data from the electronic health record with stated patient preferences and triggered app-integrated SMS motivation and compliance messaging directly to the patient. Patients were assessed at baseline and at a 3-month follow-up upon the completion of the intervention. The primary outcome (mean difference in weekly physical activity from baseline (T0) to post-intervention (T1) as measured by the Fitbit Flex 2) was assessed at 3 months. Secondary outcomes included assessment of the relationship between the intervention and biological markers of health, including body mass index (BMI), systolic and diastolic blood pressure, HbA1c or available glucose test (if applicable), and a depression screen score using the Patient Health Questionnaire 9. Secondary outcomes also included the total number of SMS messages sent, number of SMS messages responded to, number of SMS messages ignored, and opt-out rate.DiscussionThe goal was to create a protocol utilizing eHealth technologies that addressed the specific needs of rural low-income communities and fit into the natural rhythms and processes of the selected FQHC clinics in North Carolina. This protocol offered a higher standard of health care by connecting patients to their PHC teams and increasing patient motivation to make longer-lasting health behavior changes

Genetic drivers of heterogeneity in type 2 diabetes pathophysiology

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P &lt; 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care.</p

Urban Adolescents' Perceptions of their Neighborhood Physical Activity Environments

Reduced physical activity is particularly pronounced among lower income individuals and racial/ethnic minorities, and may be related to unsupportive neighborhood environments for physical activity. The purpose of this research was to conduct focus groups with low-income urban Black and Latino adolescents to identify whether these adolescents were physically active, in what settings, and what features of the settings were important for encouraging their physical activity. Results suggest potential gender differences, but little difference across race/ethnicity. Results can inform the development of a park/physical activity setting characteristics survey to help improve conditions of parks

Role of built environments in physical activity, obesity, and cardiovascular disease

In industrialized nations like the United States and Sweden, the vast majority of adults do not meet the physical activity guidelines of 150 minutes per week.(1) Inactive lifestyles put most adults at risk of cardiovascular diseases (CVD), diabetes, obesity, some cancers, osteoporosis, and psychological disorders.(2) Physical activity can be effective at all phases of chronic disease management, from primordial prevention (prevention of risk factors) through treatment and rehabilitation.(2) There is particular interest in the potential for physical activity to prevent chronic diseases, thereby improving quality of life and reducing health care costs.(3) In the past decade, limitations of prevention approaches that target mainly individuals with educational and motivational programs have been recognized, triggering a trend to consider influences on behavior that are outside the person, such as the built environment.(4,5) The purposes of the present paper are to describe multilevel ecological models of behavior as they apply to physical activity, describe key concepts, summarize evidence on the relation of built environment attributes to physical activity and obesity, and provide recommendations for built environment changes that could increase physical activity. The intent of this non-systematic review is to present conclusions from previous reviews then illustrate results by highlighting selected studies