An Ruopeng, Yang Yan, Li Kaigang
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 1206 South 4th Street, Champaign, IL, 61820, USA.
Department of Health and Exercise Science, College of Health & Human Sciences, Colorado State University, B 215E Moby Complex, Fort Collins, CO, 80523, USA.
Matern Child Health J. 2017 May;21(5):1026-1036. doi: 10.1007/s10995-016-2198-3.
Objectives Children with special health care needs (SHCN) have or are at elevated risk for chronic physical, developmental, behavioral or emotional conditions and therefore require specialized health care services. This study examines the relationship between residential neighborhood amenities and physical activity among U.S. children with SHCN. Methods A nationally representative sample of 113,767 children aged 6-17 years was taken from National Survey of Children's Health (NSCH) 2007-2008 and 2011-2012. Residential neighborhood amenities were defined by parent-reported presence or absence of sidewalks, parks/playgrounds, and recreation center. Physical activity was measured by parent-reported number of physically active days (0-7), defined as 20 min or longer during the past week. Negative binomial regressions were performed to estimate the associations between residential neighborhood amenities and physical activity among U.S. children with and without SHCN, adjusting for various neighborhood (detracting condition and safety) and individual characteristics and NSCH sampling design. Results Approximately 23% of young children aged 6-11 years and adolescents aged 12-17 years had SHCN. Number of weekly physically active days was both 4.8 among young children with and without SHCN, and 3.7 and 4.1 among adolescents with and without SHCN, respectively. Among young children with SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.23; whereas among young children without SHCN, number of weekly physically active days was not associated with the availability of any amenity. Among adolescents with SHCN, neighborhood availability of parks/playgrounds was associated with increased weekly physically active days by 0.33, whereas neighborhood availability of sidewalks was associated with reduced weekly physically active days by 0.21. Conversely, among adolescents without SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.22. Conclusions for Practice Vulnerable health status and high dependence on health care may prevent children with SHCN from being physically active. Provision of adequate amenities in residential neighborhoods could be essential in promoting physical activity and preventing obesity among children/adolescents with SHCN.
目标 有特殊医疗需求（SHCN）的儿童患有慢性身体、发育、行为或情感疾病，或处于此类疾病的高风险中，因此需要专门的医疗服务。本研究探讨了美国有特殊医疗需求儿童居住社区的便利设施与身体活动之间的关系。方法 从2007 - 2008年和2011 - 2012年的全国儿童健康调查（NSCH）中选取了113767名6 - 17岁具有全国代表性的儿童样本。居住社区的便利设施由家长报告的人行道、公园/游乐场和娱乐中心的有无来定义。身体活动通过家长报告的身体活跃天数（0 - 7天）来衡量，定义为过去一周内20分钟或更长时间的活动。进行负二项回归以估计居住社区便利设施与有和没有特殊医疗需求的美国儿童身体活动之间的关联，并对各种社区（减损条件和安全性）、个体特征以及NSCH抽样设计进行了调整。结果 大约23%的6 - 11岁幼儿和12 - 17岁青少年有特殊医疗需求。有和没有特殊医疗需求的幼儿每周身体活跃天数均为4.8天，有和没有特殊医疗需求的青少年每周身体活跃天数分别为3.7天和4.1天。在有特殊医疗需求的幼儿中，社区有娱乐中心与每周身体活跃天数增加0.23天相关；而在没有特殊医疗需求的幼儿中，每周身体活跃天数与任何便利设施的有无均无关。在有特殊医疗需求的青少年中，社区有公园/游乐场与每周身体活跃天数增加0.33天相关，而社区有人行道与每周身体活跃天数减少0.21天相关。相反，在没有特殊医疗需求的青少年中，社区有娱乐中心与每周身体活跃天数增加0.22天相关。实践结论 脆弱的健康状况和对医疗保健的高度依赖可能会妨碍有特殊医疗需求的儿童进行身体活动。在居住社区提供充足的便利设施对于促进有特殊医疗需求的儿童/青少年的身体活动和预防肥胖可能至关重要。
