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Objective: Despite efforts to increase physical activity through new green space infrastructure such as trails, disparities in physical activity may persist. The current study compared observed vigorous physical activity (VPA) engagement among White and Latinx men and women on a new urban trail, and whether engagement varied over time. Design, sample, and measures: We used a modified System for Observing Play and Recreation in Communities (SOPARC) methodology to determine observed race/ethnicity, gender, and physical activity level of trail users (n = 15,109). Results: Logistic regression analyses revealed the odds of engaging in VPA were lower for Latina women than all other population subgroups (vs. White men: OR 0.19, CI 0.17–0.22; vs. White women: OR 0.48, CI 0.42–0.54, vs. Latino men: OR 0.23, CI 0.19–0.26). VPA engagement by White and Latina women increased across the study years (OR 1.31, CI 1.17–1.46; OR 1.36, CI 1.08–1.71, respectively) but did not differ significantly by year for White and Latino men. Conclusion: Future efforts to address racial/ethnic‐gender disparities in VPA should take an intersectional approach to ensure that the needs of the most vulnerable population subgroups are properly accounted for. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether cigarette smoking mediated the association of racial discrimination with depressive symptoms among pregnant Black women. Design: Cross‐sectional. Sample: Two hundred Black women at 8–29 weeks gestation. Measurements: Women completed questionnaires including the Experiences of Discrimination and the Center for Epidemiologic Studies‐Depression (CES‐D) scales, as well as questions about sociodemographic characteristics and cigarette smoking. Results: The mean age of the sample was 26.9 ± 5.7 years and the mean gestational age at data collection was 15.6 ± 5.7 weeks. Approximately 17% of women reported prenatal cigarette smoking; 27% had prenatal CES‐D scores ≥23, which have been correlated with depression diagnoses; and 59% reported ever (lifetime) experiencing discrimination in at least one situation (e.g., at work). Path analysis results indicated that the standardized indirect effect of experiences of racial discrimination on CES‐D scores through prenatal smoking was statistically significant (standardized indirect effect = 0.03; 95% CI: 0.001, 0.094; p =.042). Conclusion: Cigarette smoking during pregnancy partially mediated the association between lifetime experiences of racial discrimination and prenatal depressive symptoms among pregnant Black women. Smoking cessation programs should focus on identifying and treating depressive symptoms among pregnant Black women. [ABSTRACT FROM AUTHOR]

Objective: Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas.Methods: In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014.Results: Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period.Conclusions: Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population. [ABSTRACT FROM AUTHOR]

Objective: To estimate the causal effects of a population-scale behavioral weight management program and to determine whether the program's effectiveness depends on participants' geographic access to places to purchase healthy and less healthy foods.Data Sources: Secondary data from U.S. Department of Veterans Affairs clinical and administrative records (2008-2014), retail food environment measures from commercial databases (2008-2014), and the American Community Survey (2009-2014).Study Design: We estimated the effect of the VA's MOVE! weight management program on body mass index after 6 months using difference-in-difference regressions to compare participants with a propensity score-matched control group. We estimated treatment effects overall and in subgroups with different access to supermarkets, fast-food restaurants, and convenience stores.Principal Findings: MOVE! reduced BMI by about 0.71 units among men and 0.70 units among women. The program was slightly less effective for men living near fast-food restaurants or convenience stores. We found no evidence that treatment effects varied with the food environment among women.Conclusions: The residential food environment modestly alters MOVE! effectiveness among men. A greater understanding of environmental barriers to and facilitators of intentional weight loss is needed. This study highlights important potential intersections between health care and the community. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes.Objectives: The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment.Significance: Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance. [ABSTRACT FROM AUTHOR]

Objective Prior research suggests that adverse neighborhood conditions are related to preterm birth. One potential pathway by which neighborhood conditions increase the risk for preterm birth is by increasing women's psychological distress. Our objective was to examine whether psychological distress mediated the relationship between neighborhood conditions and preterm birth. Design and Sample One hundred and one pregnant African-American women receiving prenatal care at a medical center in Chicago participated in this cross-sectional design study. Measures Women completed the self-report instruments about their perceived neighborhood conditions and psychological distress between 15-26 weeks gestation. Objective measures of the neighborhood were derived using geographic information systems ( GIS). Birth data were collected from medical records. Results Perceived adverse neighborhood conditions were related to psychological distress: perceived physical disorder ( r = .26, p = .01), perceived social disorder ( r = .21, p = .03), and perceived crime ( r = .30, p = .01). Objective neighborhood conditions were not related to psychological distress. Psychological distress mediated the effects of perceived neighborhood conditions on preterm birth. Conclusions Psychological distress in the second trimester mediated the effects of perceived, but not objective, neighborhood conditions on preterm birth. If these results are replicable in studies with larger sample sizes, intervention strategies could be implemented at the individual level to reduce psychological distress and improve women's ability to cope with adverse neighborhood conditions. [ABSTRACT FROM AUTHOR]

Objective To describe how characteristics of food retail stores (potential access) and other factors influence self-reported food shopping behavior (realized food access) among low-income, rural Central Appalachian women. Design and Sample Cross-sectional descriptive. Potential access was assessed through store mapping and in-store food audits. Factors influencing consumers' realized access were assessed through in-depth interviews. Results were merged using a convergent parallel mixed methods approach. Food stores ( n = 50) and adult women ( n = 9) in a rural Central Appalachian county. Results Potential and realized food access were described across five dimensions: availability, accessibility, affordability, acceptability, and accommodation. Supermarkets had better availability of healthful foods, followed by grocery stores, dollar stores, and convenience stores. On average, participants lived within 10 miles of 3.9 supermarkets or grocery stores, and traveled 7.5 miles for major food shopping. Participants generally shopped at the closest store that met their expectations for food availability, price, service, and atmosphere. Participants' perceptions of stores diverged from each other and from in-store audit findings. Conclusions Findings from this study can help public health nurses engage with communities to make affordable, healthy foods more accessible. Recommendations are made for educating low-income consumers and partnering with food stores. [ABSTRACT FROM AUTHOR]

Objective: Smartphone‐based ecological momentary assessment (EMA), or real‐time, repeated sampling of participants' states, behaviors, or experiences over time, is a promising approach to understanding obesity‐related behaviors in African‐American women—a population with the highest obesity prevalence. In this study, we explored participants' experiences with this methodology. Design and Sample: In this secondary analysis of data, 100 African‐American women participated in seven consecutive days of EMA data collection. Measures: Measures related to acceptability (technical challenges, daily burden, emotional responses, willingness to participate in future studies) and data quality (reporting accuracy, behavior reactivity, adherence), as well as demographics, were collected. Results: While there were few demographic differences, women who were unemployed, had the lowest educational levels, or had the lowest per capita income reported the greatest enjoyment with mobile technology‐based EMA, while at the same time reporting the highest levels of challenge with use of the equipment. Participants consistently indicated willingness to participate in future EMA studies and indicated that the study method was acceptable. EMA methodology produced data of sufficient quality. Conclusion: Findings suggest future studies using smartphone‐based EMA with African‐American women are feasible. [ABSTRACT FROM AUTHOR]

Several acculturation theories note the importance of surrounding context, but few studies describe neighborhood influences on immigrant adaptation. The purpose of this study was to examine relationships among neighborhood immigrant concentration, acculturation, and alienation for 151 women aged 44–80 from the former Soviet Union who lived in the US fewer than 13 years. Participants resided in 65 census tracts in the Chicago area with varying concentrations of Russian-speaking and diverse immigrants. Results from self-report questionnaires suggest that the effect of acculturation on alienation varies depending on neighborhood characteristics. The study also demonstrates the complexity of individual and contextual influences on immigrant adoption. Understanding these relationships is important for developing community-based and neighborhood-level interventions to enhance the mental health of immigrants. © 2008 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The purposes of this study were to identify strategies successful in the recruitment of African American (AA) women to a home-based walking program and to examine factors that contribute to attrition, eligibility, and ineligibility during the recruitment screening protocol. Of the 696 women who contacted the researchers, 281 (40.4%) women enrolled in the study, 227 (32.6%) were lost to attrition, and 188 (27%) were ineligible. Those not enrolled due to attrition during screening or ineligibility reported more family risk for cardiovascular disease (CVD) and lived in neighborhoods with higher poverty. Although our recruitment strategies may have been successful in attracting low-income AA women, we were not as successful in preventing their attrition during the screening protocol, particularly for those living in poorer neighborhoods. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29:176–189, 2006 [ABSTRACT FROM AUTHOR]