Perceived Environments as Physical Activity Correlates and Moderators of Intervention in Five Studies

Abstract

Relationships between perceived environments and physical activity may differ depending upon population groups and activity domains and merit investigation by using stronger prospective designs.

Exploring Refinements in Targeted Behavioral Medicine Intervention to Advance Public Health

“…By the same token, there are challenges attendant in discovering many moderators, as this can mean larger numbers of stratification variables and increased study complexity down the road. However, identification of a large number of moderators is rare in our experience [44,63].…”

“…Moderator analysis of the three RCTs (located in Atlanta, GA; the San Francisco peninsula region; and Eugene, OR) showed that perceived neighborhood traffic safety issues (e.g., absence of pedestrian crosswalks, speeding drivers) were significant moderators of the intervention-PA relationship across all three RCTs. For each RCT, physical activity intervention subjects endorsing negative neighborhood traffic had significantly less physical activity increases relative to intervention subjects without these negative traffic conditions (differences >90 min of physical activity per week), whereas control subjects showed no such impact on their physical activity levels (i.e., negative traffic conditions appeared to moderate the impact of the physical activity intervention in all three RCTs) [63].…”

“…One method of doing this would be to randomize individuals representing the specifically targeted subgroup to either a 'matched' or 'mismatched' intervention. For example, as suggested in the Behavior Change Consortium moderator analysis of environmental factors and physical activity change [63], one could randomize the subpopulation of individuals residing in traffic-congested neighborhoods to receive either a standard physical activity intervention or the intervention coupled with additional instructional or neighborhoodbased activities related to overcoming traffic-related physical activity barriers. If, in fact, the differential physical activity rates suggested from the post hoc exploratory analyses were verified using the experimental design, confidence in the subsequent matching of this specific subpopulation to the environmentally enhanced physical activity intervention would be increased.…”

“…A significant interaction indicates a possible moderator effect (to be evaluated further through additional evaluation of clinical significance or relevance). An example of this type of moderator analysis occurred in a recently published examination of perceived environmental factors as potential moderators of physical activity intervention effects across three RCT data sets collected as part of the NIH Behavior Change Consortium [63]. Moderator analysis of the three RCTs (located in Atlanta, GA; the San Francisco peninsula region; and Eugene, OR) showed that perceived neighborhood traffic safety issues (e.g., absence of pedestrian crosswalks, speeding drivers) were significant moderators of the intervention-PA relationship across all three RCTs.…”

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“…For example, people tend to walk in their immediate neighborhoods, and those who walk despite feeling that their neighborhoods are unsafe may be less willing or able to sustain walking behavior. Whereas several crosssectional analyses have linked unfavorable neighborhood conditions to inactivity, [15][16][17] few investigators have examined whether people who walk despite perceiving these adverse conditions are more likely to eventually stop walking.…”