Center for Health Systems & Design, Texas A&M University, College Station, TX,USA.
Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX,USA.
J Phys Act Health. 2023 Aug 18;20(11):1058-1066. doi: 10.1123/jpah.2023-0045. Print 2023 Nov 1.
Creating activity-friendly communities (AFCs) is an important strategy to increase physical activity (PA). While cross-sectional links between community environments and PA are well documented, their causal relationships remain insufficiently explored.
Using the accelerometer and survey data collected from adults who moved to an AFC (cases) and similar non-AFC-residing adults who did not move (comparisons), this pre-post, case-comparison study examines if moving to an AFC increases PA. Data came from 115 participants (cases = 37, comparisons = 78) from Austin, Texas, who completed 2 waves of 1-weeklong data collection. Difference-in-difference analyses and fixed-effect models were used to test the significance of the pre-post differences in moderate-to-vigorous PA (MVPA) between cases and comparisons, for the full sample and the subsample of 37 pairs matched in key covariates using the Propensity Score Matching method.
Average treatment effect generated based on Propensity Score Matching and difference-in-difference showed that moving to this AFC led to an average of 10.88 additional minutes of daily MVPA (76.16 weekly minutes, P = .015). Fixed-effect models echoed the result with an increase of 10.39 minutes of daily MVPA after moving to the AFC. We also found that case participants who were less active at baseline and had higher income increased their MVPA more than their counterparts.
This study showed that, among our study sample, moving to an AFC increased residents' PA significantly when compared to their premove level and the comparison group. This causal evidence suggests the potential of AFCs as sustainable interventions for PA promotion.
创建适宜活动的社区（AFC）是增加身体活动（PA）的重要策略。虽然社区环境与 PA 之间的横断面联系得到了很好的证明，但它们的因果关系仍未得到充分探讨。
本预-后、病例对照研究使用从搬到 AFC 的成年人（病例）和没有搬家的类似非 AFC 居住成年人（对照）中收集的加速度计和调查数据，检验搬到 AFC 是否会增加 PA。数据来自德克萨斯州奥斯汀的 115 名参与者（病例=37，对照=78），他们完成了 2 轮为期 1 周的数据收集。差异检验分析和固定效应模型用于检验病例和对照之间在中等至剧烈 PA（MVPA）方面的预-后差异的显著性，对于全样本和使用倾向评分匹配方法对关键协变量进行匹配的 37 对亚样本。
基于倾向评分匹配和差异检验的平均处理效应表明，搬到这个 AFC 平均每天增加 10.88 分钟的 MVPA（每周 76.16 分钟，P=.015）。固定效应模型的结果与之呼应，搬到 AFC 后每天 MVPA 增加了 10.39 分钟。我们还发现，基线活动水平较低且收入较高的病例参与者比对照组参与者增加了更多的 MVPA。
本研究表明，在我们的研究样本中，与搬家前的水平和对照组相比，搬到 AFC 显著增加了居民的 PA。这一因果证据表明，AFC 作为 PA 促进的可持续干预措施具有潜力。
