Vamos Cheryl A, Sun Haichun, Flory Sara B, DeBate Rita, Daley Ellen M, Thompson Erika, Bleck Jennifer, Merrell Laura
Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA,
Matern Child Health J. 2015 Jul;19(7):1584-92. doi: 10.1007/s10995-015-1668-3.
Although physical activity is a key behavior targeted during the preconception period given its significant impact on pregnancy/birth outcomes and psychological well-being, few women meet national guidelines. While intrapersonal factors influencing physical activity among this population have been studied, community factors remain unexplored. The objective of this study was to examine community level predictors of physical activity among preconception women. Data from Add Health were limited to women (Wave III; age 18-28; n = 7,596) and excluded respondents who were pregnant, physically disabled, and missing data. The outcome variable was ≥5 instances of moderate-vigorous physical activity (MVPA) in 1 week. Community predictor variables included neighborhood-level structural and social determinants (e.g., socio-demographic composition; landscape diversity; urbanization; access to resources; crime; vehicle availability). Multilevel logistic regression modeling was used to estimate the odds of engaging in ≥5 instances of MVPA. Few women (26 %) reported ≥5 instances of MVPA in 1 week. Adjusted multilevel analysis revealed women in the preconception period were more likely to report high MVPA when living in communities with larger population densities (OR 1.34, 95 % CI 1.02-1.77) and median household income greater than $50,000 (OR 1.33, 95 % CI 1.06-1.66). Additionally, a significant inverse trend was found between high MVPA and proportion of the community without a high school diploma. Findings suggest that neighborhood composition may have an impact on preconception physical activity status. Implications include increased efforts targeting community conditions for facilitating physical activity; ultimately, improving health among women and subsequent offspring.
尽管鉴于体育活动对怀孕/分娩结局及心理健康有重大影响，它是孕前阶段的一个关键行为目标，但很少有女性达到国家指南的要求。虽然已经对影响这一人群体育活动的个人因素进行了研究，但社区因素仍未得到探索。本研究的目的是探讨孕前女性体育活动的社区层面预测因素。“青少年健康纵向研究”（Add Health）的数据仅限于女性（第三轮；年龄18 - 28岁；n = 7596），并排除了怀孕、身体残疾和数据缺失的受访者。结果变量是1周内进行≥5次中等至剧烈体育活动（MVPA）。社区预测变量包括邻里层面的结构和社会决定因素（例如，社会人口构成；景观多样性；城市化；资源获取；犯罪率；车辆可获得性）。采用多水平逻辑回归模型来估计进行≥5次MVPA的几率。很少有女性（26%）报告1周内进行≥5次MVPA。调整后的多水平分析显示，孕前女性在居住于人口密度较大的社区（比值比1.34，95%置信区间1.02 - 1.77）以及家庭收入中位数大于5万美元的社区时，更有可能报告高MVPA水平（比值比1.33，95%置信区间1.06 - 1.66）。此外，在高MVPA水平与社区中未获得高中文凭的人口比例之间发现了显著的负相关趋势。研究结果表明邻里构成可能会对孕前体育活动状况产生影响。这意味着需要加大力度针对社区条件来促进体育活动；最终改善女性及其后代的健康状况。
