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Does Physical Activity Mediate the Associations Between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?

Author

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  • Suzanne J. Carroll

    (Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia
    Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia)

  • Theo Niyonsenga

    (Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia
    Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia)

  • Neil T. Coffee

    (Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia
    Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia)

  • Anne W. Taylor

    (Discipline of Medicine, University of Adelaide, North Terrace, Adelaide 5005, Australia)

  • Mark Daniel

    (Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, University Drive, Bruce 2617, Australia
    Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, North Terrace, Adelaide 5001, Australia
    Department of Medicine, University of Melbourne, St Vincent’s Hospital, Parkville, Melbourne 3010, Australia)

Abstract

Associations between local-area residential features and glycosylated hemoglobin (HbA 1c ) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA 1c . HbA 1c was assessed three times for adults in a 10-year population-based biomedical cohort ( n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m 2 ) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA 1c , accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA 1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA 1c trajectories. Walkability was directly and indirectly protective of worsening HbA 1c . Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.

Suggested Citation

  • Suzanne J. Carroll & Theo Niyonsenga & Neil T. Coffee & Anne W. Taylor & Mark Daniel, 2017. "Does Physical Activity Mediate the Associations Between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?," IJERPH, MDPI, vol. 14(9), pages 1-17, August.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:9:p:953-:d:109517
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    References listed on IDEAS

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    Cited by:

    1. Yusheng Zhou & Christoph Buck & Werner Maier & Thomas von Lengerke & Ulla Walter & Maren Dreier, 2020. "Built Environment and Childhood Weight Status: A Multi-Level Study Using Population-Based Data in the City of Hannover, Germany," IJERPH, MDPI, vol. 17(8), pages 1-15, April.
    2. Katherine L. Baldock & Catherine Paquet & Natasha J. Howard & Neil T. Coffee & Anne W. Taylor & Mark Daniel, 2018. "Are Perceived and Objective Distances to Fresh Food and Physical Activity Resources Associated with Cardiometabolic Risk?," IJERPH, MDPI, vol. 15(2), pages 1-17, January.

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