Hebert Wertheim School of Public Health and Longevity Science, UC San Diego, San Diego, CA 92093, USA.
Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center, Houston School of Public Health (UTHealth School of Public Health), Department of Epidemiology, Human Genetics and Environmental Science, Austin Campus, Austin, TX 78701, USA.
Int J Environ Res Public Health. 2022 Sep 1;19(17):10925. doi: 10.3390/ijerph191710925.
Cross-sectional association between the neighborhood-built environment and physical activity (PA) has been demonstrated previously, indicating the importance of neighborhood perception characteristics such as walkability, safety, and the connectivity of streets on PA levels. Our study aimed to assess the longitudinal data from participants of the Multi-Ethnic Study of Atherosclerosis (MESA) to evaluate the potential relationship between perceived environment and PA patterns. We analyzed data from a subset of participants (n = 3097) with available PA data who participated in a prospective cohort conducted from 2000 to 2018. The exposure variables were the perceived aspects of the neighborhood environment and the perception of safety, and the outcome was patterns of PA. Patterns were defined as categories reflecting meeting versus not meeting PA guidelines over time. We created the following categories: adopters (individuals who did not meet guidelines at baseline but met guidelines at Exam 6), relapsers (individuals who met guidelines at baseline but did not meet guidelines at Exam 6), maintainers (individuals who met guidelines both at baseline and Exam 6), and insufficiently active (individuals who did not meet guidelines at either baseline or Exam 6). The maintainers' group was considered the reference category. We estimated the relative risk to assess the magnitude effect of the association between environmental perceptions and the outcome. Individuals who reported that lack of parks and playgrounds was "not a problem" in their neighborhood had a 2.3-times higher risk of decreasing their physical activity (i.e., the "relapser" category) compared to maintainers. After full adjustment, perceiving poor sidewalks as "somewhat a serious problem" was associated with a 64% lower risk of becoming an adopter than a maintainer. When compared to those who perceive the neighborhood as "very safe", perception of the neighborhood as "safe" to "not at all safe" (ratings 3, 4, and 5, respectively, on the perceived safety scale) was significantly associated with being classified in the adopter category. As the first longitudinal study of the association of perceived environment and physical activity within the MESA cohort, we conclude that a few aspects are longitudinally associated with being physically active among adults.
先前已有研究表明，邻里环境与身体活动（PA）之间存在横断面关联，这表明邻里感知特征（如可步行性、安全性和街道连通性）对 PA 水平很重要。我们的研究旨在评估多民族动脉粥样硬化研究（MESA）参与者的纵向数据，以评估感知环境与 PA 模式之间的潜在关系。我们分析了一组有可用 PA 数据的参与者（n=3097）的数据，这些参与者参加了一项从 2000 年到 2018 年进行的前瞻性队列研究。暴露变量是邻里环境的感知方面和对安全的感知，结果是 PA 模式。模式定义为反映随着时间的推移是否符合 PA 指南的类别。我们创建了以下类别：采用者（基线时不符合指南但在第六次检查时符合指南的个体）、复发性者（基线时符合指南但第六次检查时不符合指南的个体）、维持者（基线和第六次检查时均符合指南的个体）和活动不足者（基线或第六次检查时均不符合指南的个体）。维持者组被视为参考类别。我们估计相对风险来评估环境感知与结果之间关联的强度效应。报告邻里缺乏公园和游乐场“不是问题”的个体与维持者相比，降低体力活动的风险增加了 2.3 倍（即“复发性者”类别）。在充分调整后，将人行道状况较差视为“有些严重的问题”与成为采用者而非维持者的风险降低 64%相关。与那些认为邻里“非常安全”的人相比，认为邻里“安全”到“一点也不安全”（感知安全量表上的评分分别为 3、4 和 5）与被归类为采用者显著相关。作为 MESA 队列中感知环境与体力活动关联的第一项纵向研究，我们的结论是，一些方面与成年人的体力活动呈纵向关联。
