利物浦儿童中高贫困家庭及邻里环境与健康相关变量之间的横断面关联。
Cross-sectional associations between high-deprivation home and neighbourhood environments, and health-related variables among Liverpool children.
作者信息
Noonan Robert J, Boddy Lynne M, Knowles Zoe R, Fairclough Stuart J
机构信息
The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, Merseyside, UK.
Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK Department of Physical Education and Sport Sciences, University of Limerick, Ireland.
出版信息
BMJ Open. 2016 Jan 13;6(1):e008693. doi: 10.1136/bmjopen-2015-008693.
OBJECTIVES
(1) To investigate differences in health-related, home and neighbourhood environmental variables between Liverpool children living in areas of high deprivation (HD) and medium-to-high deprivation (MD) and (2) to assess associations between these perceived home and neighbourhood environments and health-related variables stratified by deprivation group.
DESIGN
Cross-sectional study.
SETTING
10 Liverpool primary schools in 2014.
PARTICIPANTS
194 children aged 9-10 years.
MAIN OUTCOME MEASURES
Health-related variables (self-reported physical activity (PA) (Physical Activity Questionnaire for Older Children, PAQ-C), cardiorespiratory fitness, body mass index (BMI) z-scores, waist circumference), home environment variables: (garden/backyard access, independent mobility, screen-based media restrictions, bedroom media) and neighbourhood walkability (Neighbourhood Environment Walkability Scale for Youth, NEWS-Y).
EXPLANATORY MEASURES
Area deprivation.
RESULTS
There were significant differences between HD and MD children's BMI z-scores (p<0.01), waist circumference (p<0.001) and cardiorespiratory fitness (p<0.01). HD children had significantly higher bedroom media availability (p<0.05) and independent mobility scores than MD children (p<0.05). MD children had significantly higher residential density and neighbourhood aesthetics scores, and lower crime safety, pedestrian and road traffic safety scores than HD children, all of which indicated higher walkability (p<0.01). HD children's BMI z-scores (β=-0.29, p<0.01) and waist circumferences (β=-0.27, p<0.01) were inversely associated with neighbourhood aesthetics. HD children's PA was negatively associated with bedroom media (β=-0.24, p<0.01), and MD children's PA was positively associated with independent mobility (β=0.25, p<0.01). MD children's independent mobility was inversely associated with crime safety (β=-0.28, p<0.01) and neighbourhood aesthetics (β=-0.24, p<0.05).
CONCLUSIONS
Children living in HD areas had the least favourable health-related variables and were exposed to home and neighbourhood environments that are unconducive to health-promoting behaviours. Less access to bedroom media equipment and greater independent mobility were strongly associated with higher PA in HD and MD children, respectively. Facilitating independent mobility and encouraging outdoor play may act as effective strategies to enhance PA levels and reduce sedentary time in primary school-aged children.
目的
（1）调查生活在高贫困地区（HD）和中高贫困地区（MD）的利物浦儿童在健康相关、家庭和邻里环境变量方面的差异；（2）评估这些感知到的家庭和邻里环境与按贫困组分层的健康相关变量之间的关联。
设计
横断面研究。
地点
2014年利物浦的10所小学。
参与者
194名9至10岁的儿童。
主要观察指标
健康相关变量（自我报告的身体活动（PA）（《大龄儿童身体活动问卷》，PAQ-C）、心肺适能、体重指数（BMI）z评分、腰围）、家庭环境变量（花园/后院使用权、独立出行能力、基于屏幕的媒体限制、卧室媒体）和邻里步行适宜性（《青少年邻里环境步行适宜性量表》，NEWS-Y）。
解释性指标
地区贫困程度。
结果
HD组和MD组儿童的BMI z评分（p<0.01）、腰围（p<0.001）和心肺适能（p<0.01）存在显著差异。HD组儿童的卧室媒体可用性（p<0.05）和独立出行能力得分显著高于MD组儿童（p<0.05）。MD组儿童的居住密度和邻里美观度得分显著高于HD组儿童，而犯罪安全性、行人及道路交通安全得分则低于HD组儿童，所有这些均表明MD组的步行适宜性更高（p<0.01）。HD组儿童的BMI z评分（β=-0.29，p<0.01）和腰围（β=-0.27，p<0.01）与邻里美观度呈负相关。HD组儿童的身体活动与卧室媒体呈负相关（β=-0.24，p<0.01），而MD组儿童的身体活动与独立出行能力呈正相关（β=0.25，p<0.01）。MD组儿童的独立出行能力与犯罪安全性（β=-0.28，p<0.01）和邻里美观度（β=-0.24，p<0.05）呈负相关。
结论
生活在HD地区的儿童健康相关变量最不理想，且暴露于不利于促进健康行为的家庭和邻里环境中。HD组和MD组儿童分别减少卧室媒体设备的使用和增加独立出行能力与更高的身体活动水平密切相关。促进独立出行能力并鼓励户外玩耍可能是提高小学适龄儿童身体活动水平和减少久坐时间的有效策略。
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