Resumen de Neighborhood Environments and Objectively Measured Physical Activity in 11 Countries.
Ester Cerin, kelli L. Cain, Terry Conway, Delfien van Dyck, Erica A. Hinckson, Jasper Schipperijn, Ilse de Bourdeaudhuij, Neville Owen, Rachel C. Davey, Adriano Akira Ferreira Hino, Josef Mitas, Rosario Orzanco Garralda, Deborah Salvo, James F. Sallis, Olga L. Sarmiento, Lars B. Christiansen, Duncan J. MacFarlane, Grant Schofield
AB Purpose: Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multisite evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively measured PA outcomes, between-site differences in such associations, and the extent to which perceived environmental attributes explain between-site differences in PA. Methods: This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and United States of America. Participants were 6968 adults residing in administrative units stratified by socioeconomic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min[middle dot]wk-1 of MVPA). Results: Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix-access were significant predictors of both PA outcomes in the fully adjusted models. Environmental attributes accounted for within-site variability in MVPA, corresponding to an SD of 3 min[middle dot]d-1 or 21 min[middle dot]wk-1. Large between-site differences in PA outcomes were observed; 15.9%-16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Conclusions: Residents' perceptions of neighborhood attributes that facilitate walking were positively associated with objectively measured MVPA and meeting the guidelines for cancer/weight gain prevention at the within- and between-site levels. Associations were similar across study sites, lending support for international recommendations for designing PA-friendly built environments.
