Cerin Ester, Leslie Eva
Institute of Human Performance, The University of Hong Kong, Hong Kong, China.
Soc Sci Med. 2008 Jun;66(12):2596-609. doi: 10.1016/j.socscimed.2008.02.012. Epub 2008 Mar 21.
The aim of this cross-sectional study was to identify individual, social, and environmental contributors (mediators) to individual- and area-level differences in leisure-time physical activity across socio-economic groups. A two-stage stratified sampling design was used to recruit 20-65 year old adults (N=2194) living in 154 census collection districts of Adelaide, Australia (overall response rate: 12%). Participants completed two surveys six months apart (response rate on the second survey: 83%). Individual-level socio-economic status (SES) was assessed using self-report measures on educational attainment, household income, and household size. Area-level SES was assessed using census data on median household income and household size for each selected census district. Bootstrap generalized linear models were used to examine associations between SES, potential mediators, and leisure-time physical activity. The product-of-coefficient test was used to estimate mediating effects. All SES measures were independently associated with potential individual and social mediators of the SES-activity relationships. Individual- and area-level income was also associated with perceived neighborhood attributes. Self-efficacy and social support for physical activity explained virtually all of the differences in physical activity across educational attainment groups. Physical barriers to walking and access to public open space contributed in part to the explanation of differences in recreational walking across income groups. Yet, self-efficacy and social support were the key mediators of the observed relationships between individual- and area-level income and physical activity. This study suggests that in order to increase physical activity participation in the more disadvantaged segments of the population, comprehensive, multilevel interventions targeting activity-related attitudes and skills as well as social and physical environments are needed.
这项横断面研究的目的是确定个体、社会和环境因素（中介因素），这些因素导致了不同社会经济群体在休闲时间身体活动方面的个体差异和地区差异。采用两阶段分层抽样设计，招募了居住在澳大利亚阿德莱德154个人口普查收集区的20至65岁成年人（N = 2194）（总体回复率：12%）。参与者在相隔六个月的时间里完成了两项调查（第二次调查的回复率：83%）。个体层面的社会经济地位（SES）通过对教育程度、家庭收入和家庭规模的自我报告测量来评估。地区层面的SES通过每个选定人口普查区的家庭收入中位数和家庭规模的普查数据来评估。使用Bootstrap广义线性模型来检验SES、潜在中介因素和休闲时间身体活动之间的关联。系数乘积检验用于估计中介效应。所有SES测量指标均与SES-活动关系的潜在个体和社会中介因素独立相关。个体层面和地区层面的收入也与感知到的邻里属性相关。自我效能感和对身体活动的社会支持几乎解释了不同教育程度群体在身体活动方面的所有差异。步行的身体障碍和公共开放空间的可达性部分解释了不同收入群体在休闲步行方面的差异。然而，自我效能感和社会支持是个体层面和地区层面收入与身体活动之间观察到的关系的关键中介因素。这项研究表明，为了提高弱势群体的身体活动参与度，需要针对与活动相关的态度和技能以及社会和物理环境进行全面的多层次干预。
