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PurposeThis study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence.MethodsThe Women's Health Initiative recruited a national sample of postmenopausal women (50-79 years) across 40 U.S. clinical centers and conducted yearly assessments from 1993 to 2005 (n = 161,808). Women reporting a history of hip fracture or walking limitations were excluded, yielding a final sample of 157,583 participants. Falling was reported annually. NSES (income/wealth, education, occupation), walkability (population density, diversity of land cover, nearby high-traffic roadways), and green space (exposure to vegetation) were calculated annually and categorized into tertiles (low, intermediate, high). Generalized estimating equations assessed longitudinal relationships.ResultsNSES was associated with falling before adjustment (high vs. low, odds ratio, 1.01; 95% confidence interval, 1.00-1.01). Walkability was significantly associated with falls after adjustment (high vs. low, odds ratio, 0.99; 95% confidence interval, 0.98-0.99). Green space was not associated with falling before or after adjustment. Study arm, race and ethnicity, household income, age, low physical functioning, fall history, and climate region modified the relationship between NSES and falling. Race and ethnicity, age, fall history, and climate region modified relationships between walkability and green space and falling.ConclusionsOur results did not show strong associations of NSES, walkability, or green space with falling. Future research should incorporate granular environmental measures that may directly relate to physical activity and outdoor engagement.

Background: In Spartanburg County, SC, nearly 33.7% of children are overweight or obese. The purpose of this study was to investigate differences in eating behavior of youth by race/ethnicity and socioeconomic status. Methods: Students (N = 997) in 4th to 5th grades completed the School Nutrition and Physical Activity Survey. School databases categorized students as either White or racial/ethnic minority and free/reduced or full paid lunch status. Dietary behaviors included 13 composite measures: unhealthy proteins, healthy proteins, dairy, refined grains, whole grains, vegetables, fruit, fried snacks, sugar-sweetened beverages, sweets, and consumption of a breakfast, evening, and/or restaurant meal. Logistic regression, controlling for sex, was used to analyze differences in consumption for each nutrition variable. Results: Minority youth were less likely to consume healthy proteins (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.55-0.92) and more likely to eat at a restaurant (OR = 1.32, 95% CI = 1.02-1.70) compared to white youth. Lower socioeconomic status youth were less likely to eat an evening meal compared to higher socioeconomic status youth (OR = 0.59, 95% CI = 0.39-0.89). Conclusions: Differences in dietary behaviors may result from food accessibility and insecurity in minority and/or low-income neighborhoods. Future research should explore policy strategies that can help ensure all youth maintain healthy eating habits and weight status.

The aim of this study is to evaluate objective and perceived campus walkability as an environmental support for physical activity within a large Southeastern university. Ten university routes were evaluated twice for 24 key walkability characteristics. Eighty-three campus member surveys (62 students, 21 faculty/staff) were administered and assessed campus members' familiarity with walkability, attitudes about walking as a form of physical activity, and perceptions of whether specific elements of the campus layout encouraged physical activity. At least 90% of routes had sidewalks, curb cuts, and crosswalks. Likewise, over 85% of participants perceived the campus layout to encourage physical activity. Faculty/staff members were more familiar with the term walkability and considered walking as a form of physical activity than students (p < 0.05). Both campus members' perceptions and environmental audits identified strengths and weaknesses for diverse walkability attributes. Results will be used to improve campus infrastructure and promote increased walking and physical activity at the university.

Faith-based settings offer opportunities for reaching populations at risk for chronic conditions and are optimal settings for dissemination and implementation (D&I) research. "Faith, Activity, and Nutrition" (FAN) is an evidence-based program designed to promote physical activity (PA) and healthy eating (HE) through church policy, systems, and environmental change. We report implementation fidelity for Phase 1 of the FAN D&I project, a countywide effort. The group randomized study included pre- and postintervention assessments of core PA and HE components. We compared implementation in early intervention (n = 35) versus delayed intervention (control, n = 19) churches; assessed individual church implementation; and examined the effects of level of implementation on church member outcomes. Implementation assessments were conducted with the FAN coordinator via telephone survey. Study outcomes were assessed with church members 8 to 12 months following baseline assessment via self-administered surveys. We found significantly higher levels of implementation for PA opportunities, PA and HE guidelines, PA and HE messages, and PA and HE pastor support in intervention versus control churches and showed church-level variation in PA and HE implementation. PA self-efficacy varied by level of implementation; high and low implementers did not differ in proportion of church members physically inactive, although low implementers had fewer members inactive than controls. The high level of implementation in intervention churches shows promise for broader dissemination of FAN.

BACKGROUND: Evidence consistently shows children in the United States gain 3 to 5 times more weight during summer vacation (~2.5 months) compared to the 9-month school year. The purpose of this study is to examine within-child differences in 4 obesogenic behaviors (physical activity [PA], sedentary/screen-time, diet, and sleep) during school versus summer. METHODS: We used a repeated-measures within-subjects design. Children (N = 30 mean age = 8.2 years; 57% female; 37% overweight/obese; 100% African American) wore accelerometers on the nondominant wrist for 24 hr/d over 9 consecutive days during school and summer of 2016 to capture PA, sedentary time, and sleep. Parents completed a daily diary to report bed/wake times, diet, and screen-time of their child each day. Mixed-effect models compared summer and school behaviors. RESULTS: Children spent more time sedentary (69% vs 67% of wake wear time), less time in light PA (25% vs 23% of wake wear time), had higher screen-time (242 vs 123 minutes/day), slept longer (428 vs 413 minutes/night), and consumed more sugar-based foods (6 days vs 2.5 days/week) and fruit (7 days vs 4.7 days/week) during summer compared to school (p < 0.05). CONCLUSION: Initial evidence suggests children are displaying multiple unfavorable obesogenic behaviors during summer compared to school that may contribute to accelerated weight gain during summer.

Background: Neighborhood parks are recognized as important spaces for facilitating physical activity (PA); however, it remains unclear how the frequency of park use is associated with PA. The purpose of this study was to examine associations between minutes of moderate to vigorous PA and multiple park use indicators: (1) use of a neighborhood park, (2) unique number of neighborhood parks used, and (3) frequency of neighborhood park use. Methods: Adults were surveyed from 4 US cities (Brooklyn, NY; Greenville County, SC; Raleigh, NC; and Seattle, WA). Using a map-based survey platform, participants indicated all neighborhood parks they used and the frequency of use in the past 30 days. Participants self-reported their weekly moderate to vigorous PA. Quantile regression was used to examine associations between PA and park use indicators. Results: Of all respondents (N = 360), 60% indicated visiting a neighborhood park in the past 30 days, with an average of about 13 total neighborhood park visits (SD = 17.5). Significant, positive associations were found between moderate to vigorous PA and both unique neighborhood park visits and total number of neighborhood parks visits. Conclusions: Frequency of park visitation is associated with PA among US adults. Ensuring equitable and safe access to neighborhood parks has the potential for population-level PA health benefits. [ABSTRACT FROM AUTHOR]