Physical activity as a mediator linking neighborhood environmental supports and obesity in African Americans in the path trial.

Abstract

Objective African Americans have the highest rates of obesity in the United States. Engaging in recommended levels of physical activity (PA) reduces risk for obesity. Social and environmental supports for PA may be important to increase PA. This study hypothesized that PA would mediate the effects of neighborhood and social supports for PA on body mass index (BMI). Method Baseline data were collected from 434 underserved African American adults in the Positive Action for Today’s Health (PATH) trial. Features of the neighborhood environment (i.e., infrastructure for walking, access to services, and crime) and peer social support were measured with validated surveys. Moderate-to-vigorous PA (MVPA) was assessed based on 7-day accelerometry estimates (in minutes per day), and self-reported walking and exercise were obtained using the Four-Week Physical Activity History questionnaire. Results The sample was predominantly female (63%) and obese (MBMI = 30.88 kg/m2, SD = 8.43). Neither crime nor social support was significantly associated with either PA or BMI; thus, they were excluded from the final models. Infrastructure for walking predicted MVPA (B = 4.06, p = .01) and self-reported walking (B = 7.39, p = .03). A positive association between access to services and MVPA approached significance (B = 2.27, p = .06). MVPA (B = −0.07, p < .001) and self-reported walking (B = −0.02, p = .01) predicted BMI, but only MVPA mediated the effect of infrastructure for walking on BMI (B = −0.03, p = .04). No significant direct or indirect effects of predictors were found for self-reported exercise. Conclusion Findings suggest that MVPA is a mediator linking infrastructure for walking and BMI in underserved communities.

Environmental and personal correlates of physical activity and sedentary behavior in African American women: An ecological momentary assessment study

“…While results have been inconsistent overall, some research has found that individuals living in areas with fewer or lower quality settings for PA (e.g., parks, recreation facilities) and poorer infrastructure (e.g., sidewalks) engage in less PA than those residing in areas with fewer of these built environmental barriers (Mama et al 2015;Siceloff, Coulon, and Wilson 2014). Neighborhood social environmental factors, including crime-and trafficrelated safety concerns and unsupportive social norms, may also impede PA and promote SB (Lee et al 2011;Strong et al 2013;Harley et al 2009;Joseph et al 2015), as may insufficient positive social support or negative social support (Baruth et al 2014;Soltero et al 2015).…”

Assessing environmental support for better health: Active living opportunity audits in rural communities in the southern United States

“…Department of Health and Human Services, 2014; Singh et al, 2011). Previous research provides evidence that social, neighborhood, and environmental characteristics play an important role in influencing health in communities (Casagrande et al, 2009, Diez Roux and Mair, 2010, Doubeni et al, 2011, Siceloff et al, 2013), perhaps by limiting access to health promoting resources.…”

Design of the Lifestyle Improvement through Food and Exercise (LIFE) study: A randomized controlled trial of self-management of type 2 diabetes among African American patients from safety net health centers

“…Social-environmental factors include lower socioeconomic status and the high-risk environments experienced by African Americans,[12, 13], including lack of access to affordable low energy density foods[14-16] and fewer opportunities for physical activity[17, 18]. Medical factors include poorer quality of care[19, 20] and lack of insurance.…”