Support for Physical Activity Policies and Perceptions of Work and Neighborhood Environments: Variance by BMI and Activity Status at the County and Individual Levels

Abstract

Purpose.

To examine support for local policies encouraging physical activity and perceived neighborhood environment characteristics by physical activity and weight status of respondents across U.S. counties.

Design.

We used a random-digit-dial, computer-assisted telephone interview (CATI) to conduct a cross-sectional telephone questionnaire in selected U.S. counties in 2011.

Setting.

Counties with high prevalences of obesity and sedentary behavior (HH; n = 884) and counties with low prevalences of obesity and sedentary behavior (LL; n = 171) were selected nationally.

Subjects.

Adult respondents from HH (n = 642) and LL (n = 566) counties.

Measures.

Questions were asked of respondents, pertaining to support for physical activity policies in various settings, neighborhood features, time spent in physical activity and sedentary behaviors, self-reported weight and height, and personal demographic information.

Analysis.

Means and frequencies were calculated; bivariable and multivariable linear and logistic regression models, developed. Models were adjusted for individual characteristics and county HH/LL status.

Results.

Respondents in LL counties perceived their neighborhood and work environments to be more supportive of healthy behaviors and were more supportive of local physical activity policies than respondents in HH counties (p < .001 for all). Positive neighborhood environment perceptions were related to reduced body mass index, increased physical activity, and decreased sedentary behavior.

Conclusion.

Policy support and neighborhood environments are associated with behaviors. Results can inform targeting policy agendas to facilitate the improvement of environments (community, work, and school) to be more supportive of physical activity.

Keywords

Physical Activity Built Environment Policy Sedentary Behavior Prevention Research Manuscript format: research Research purpose: relationship testing,descriptive Study design: nonexperimental/cross-sectional survey Outcome measure: BMI,moderate and vigorous physical activity,sedentary behavior Setting: national Health focus: weight and physical activity Strategy: built environment Target population age: adults Target population circumstances: geographic location

Get full access to this article

View all access options for this article.

References

Flegal

Carroll

Kit

Ogden

. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–497.

Nejat

Polotsky

Pal

. Predictors of chronic disease at midlife and beyond—the health risks of obesity. Maturitas. 2010;65:106–111.

Ballard-Barbash

Berrigan

Potischman

Dowling

. Obesity and cancer epidemiology. In: Berger

, ed. Cancer and Energy Balance, Epidemiology and Overview. New York, NY: Springer-Verlag New York, LLC; 2010.

Anderson

Horvath

. The growing burden of chronic disease in America. Public Health Rep. 2004;119:263–270.

Bodenheimer

Chen

Bennett

. Confronting the growing burden of chronic disease: Can the US health care workforce do the job? Health Aff (Millwood). 2009;28:64–74.

Mensah

Mokdad

Ford

. State of disparities in cardiovascular health in the United States. Circulation. 2005;111:1233–1241.

Casper

Nwaise

Croft

. Geographic disparities in heart failure hospitalization rates among Medicare beneficiaries. J Am Coll Cardiol. 2010;55:294–299.

Greer

Nwaise

Casper

. Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries. Atlanta, Ga: US Department of Health and Human Services Centers for Disease Control and Prevention; 2010.

Remington

Booske

. Measuring the health of communities—how and why? J Public Health Manag Pract. 2011;17:397–400.

10.

Zick

Smith

Fan

. Running to the store: The relationship between neighborhood environments and the risk of obesity. Soc Sci Med. 2009;69:1493–1500.

11.

Cummins

Stafford

Macintyre

. Neighbourhood environment and its association with self rated health: Evidence from Scotland and England. J Epidemiol Community Health. 2005;59:207–213.

12.

Burdette

Needham

. Neighborhood environment and body mass index trajectories from adolescence to adulthood. J Adolesc Health. 2012;50:30–37.

13.

Mujahid

Roux

Diez AV

Shen

. Relation between neighborhood environments and obesity in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol. 2008;167:1349–1357.

14.

McCormack

Giles-Corti

Lange

. An update of recent evidence of the relationship between objective and self-report measures of the physical environment and physical activity behaviours. J Sci Med Sport. 2004;7(1 suppl):81–92.

15.

Boslaugh

Luke

Brownson

. Perceptions of neighborhood environment for physical activity: Is it “who you are” or “where you live”? J Urban Health. 2004;81:671–681.

16.

Duncan

Spence

Mummery

. Perceived environment and physical activity: A meta-analysis of selected environmental characteristics. Int J Behav Nutr Phys Act. 2005;2:11.

17.

Addy

Wilson

Kirtland

. Associations of perceived social and physical environmental supports with physical activity and walking behavior. Am J Public Health. 2004;94:440–443.

18.

Brownson

Baker

Housemann

. Environmental and policy determinants of physical activity in the United States. Am J Public Health. 2001;91:1995–2003.

19.

Kahn

Ramsey

Brownson

. The effectiveness of interventions to increase physical activity: A systematic review. Am J Prev Med. 2002;22(4 suppl 1):73–107.

20.

Lucove

Huston

Evenson

. Workers' perceptions about worksite policies and environments and their association with leisure-time physical activity. Am J Health Promot. 2007;21:196–200.

21.

Brownson

Kelly

Eyler

. Environmental and policy approaches for promoting physical activity in the United States: A research agenda. J Phys Act Health. 2008;5:488–503.

22.

Eyler

Brownson

Schmid

Pratt

. Understanding policies and physical activity: Frontiers of knowledge to improve population health. J Phys Act Health. 2010;(7 suppl 1):S9–S12.

23.

Brownson

Chriqui

Stamatakis

. Understanding evidence-based public health policy. Am J Public Health. 2009;99:1576–1583.

24.

Heath

Brownson

Kruger

. The effectiveness of urban design and land use and transport policies and practices to increase physical activity: A systematic review. J Phys Act Health. 2006;3(suppl 1):S55–S76.

25.

Sallis

Glanz

. Physical activity and food environments: Solutions to the obesity epidemic. Milbank Q. 2009;87:123–154.

26.

Brownson

Haire-Joshu

Luke

. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annu Rev Public Health. 2006;27:341–370.

27.

Sallis

Cervero

Ascher

. An ecological approach to creating active living communities. Annu Rev Public Health. 2006;27:297–322.

28.

Kersh

Morone

. How the personal becomes political: Prohibitions, public health, and obesity. Stud Am Polit Dev. 2002;16:162–175.

29.

Economos

Brownson

DeAngelis

. What lessons have been learned from other attempts to guide social change? Nutr Rev. 2001;59(3):S40–S56.

30.

Dodson

Stamatakis

Chalifour

. State legislators' work on public health-related issues: What influences priorities? J Public Health Manag Pract. 2013;19:25–29.

31.

Koplan

Liverman

Kraak VI ; Institute of Medicine Committee on Prevention of Obesity in Children and Youth . Preventing Childhood Obesity: Health in the Balance. Washington, DC: National Academies Press; 2005.

32.

Centers for Disease Control and Prevention . Guide to Community Preventive Services. Increasing physical activity: Environmental and policy approaches. 2010. Available at: www.thecommunityguide.org/pa/environmental-policy/index.html. Accessed April 9, 2013.

33.

Centers for Disease Control and Prevention . Diabetes Interactive Atlases Web site. Available at: http://www.cdc.gov/diabetes/atlas/. Accessed April 7, 2013.

34.

Centers for Disease Control and Prevention . Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Ga: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2004–2009.

35.

US Census Bureau . Population Estimates Program. Available at: http://www.census.gov/popest/. Accessed April 4, 2013.

36.

Centers for Disease Control and Prevention . Behavioral Risk Factor Surveillance System Operational and User's Guide, Version 3.0. Available at: http://www.cdc.gov/brfss/pdf/userguide.pdf. Accessed April 7, 2013.

37.

Brownson

Schmid

King

. Support for policy interventions to increase physical activity in rural Missouri. Am J Health Promot. 1998;12:263–266.

38.

Carroll

. The mode less traveled: Using active transportation to increase physical activity. Presentated at: American College of Sports Medicine 58th Annual Meeting and 2nd World Congress on Exercise is Medicine; June 1, 2011; Denver, Colo.

39.

Cerin

Saelens

Sallis

. Neighborhood Environment Walkability Scale: Validity and development of a short form. Med Sci Sports Exerc. 2006;38:1682–1691.

40.

Cortina

. What is coefficient alpha: An examination of theory and applications. J Appl Psychol. 1993;78:98–104.

41.

Centers for Disease Control and Prevention . Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, Ga: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2009.

42.

Evenson

McGinn

. Test-retest reliability of adult surveillance measures for physical activity and inactivity. Am J Prev Med. 2005;28:470–478.

43.

Merrill

Richardson

. Validity of self-reported height, weight, and body mass index: Findings from the National Health and Nutrition Examination Survey, 2001–2006. Prev Chronic Dis. 2009;6:A121.

44.

US Department of Health and Human Services . 2008 physical activity guidelines for Americans. Available at: http://www.health.gov/paguidelines/. Accessed April 7, 2013.

45.

Sallis

Glanz

. The role of built environments in physical activity, eating, and obesity in childhood. Future Child. 2006;16:89–108.

46.

Evans

Finkelstein

Karnerow

Renaud

. Public perceptions of childhood obesity. Am J Prev Med. 2005;28:26–32.

47.

Oliver

Lee

. Public opinion and the politics of obesity in America. J Health Polit Policy Law. 2005;30:923–954.

48.

Morain

Mello

. Survey finds public support for legal interventions directed at health behavior to fight noncommunicable disease. Health Aff. 2013;32:486–496.

49.

Gustat

Healy

Litt

. Lessons in promoting active living: The collaborative perspective. J Public Health Manag Pract. 2013;19(3):S58–S64.

50.

Kraft

Lee

Brennan

. Active living by design sustainability strategies. Am J Prev Med. 2012;43(5 suppl 4):S329–S336.

51.

Ball

Bauman

Leslie

Owen

. Perceived environmental aesthetics and convenience and company are associated with walking for exercise among Australian adults. Prev Med. 2001;33:434–440.

52.

Brown

Werner

Amburgey

Szalay

. Walkable route perceptions and physical features: Converging evidence for en route walking experiences. Environ Behav. 2007;39:34–61.

53.

Hale

Knapp

Bardwell

. Connecting food environments and health through the relational nature of aesthetics: Gaining insight through the community gardening experience. Soc Sci Med. 2011;72:1853–1863.

54.

Cerin

Leslie

Owen

. Explaining socio-economic status differences in walking for transport: An ecological analysis of individual, social and environmental factors. Soc Sci Med. 2009;68:1013–1020.

55.

Arnberger

Eder

. The influence of green space on community attachment of urban and suburban residents. Urban Forestry Urban Greening. 2012;11:41–49.

56.

Richard

Katie

Walker

. Characteristics of urban sidewalks/streets and objectively measured physical activity. J Urban Health. 2008;85:178–190.

57.

Carlson

Guide

Schmid

. Public support for street-scale urban design practices and policies to increase physical activity. J Phys Act Health. 2011;(8 suppl 1):S125–S134.

58.

Gordon-Larsen

Nelson

Page

Popkin

. Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics. 2006;117:417–424.

59.

Blumberg

Luke

Cynamon

. Telephone coverage and health survey estimates: Evaluating the need for concern about wireless substitution. Am J Public Health. 2006;96:926–931.

60.

McGinn

Evenson

Herring

. The association of perceived and objectively measured crime with physical activity: A cross-sectional analysis. J Phys Act Health. 2008;5:117–131.

61.

Evenson

Block

Roux

Diez AV

. Associations of adult physical activity with perceived safety and police-recorded crime: The Multi-ethnic Study of Atherosclerosis. Int J Behav Nutr Phys Act. 2012;9:146–146.

62.

Ainsworth

Caspersen

Matthews

. Recommendations to improve the accuracy of estimates of physical activity derived from self report. J Phys Act Health. 2012;9(suppl 1):S76–S84.

63.

Shephard

. Limits to the measurement of habitual physical activity by questionnaires. Br J Sports Med. 2003;37:197–206.

64.

Prince

Adamo

Hamel

. A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. Int J Behav Nutr Phys Act. 2008;5:56.