Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/111137
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Type: | Journal article |
Title: | Does physical activity mediate the associations between local-area descriptive norms, built environment walkability, and glycosylated hemoglobin? |
Author: | Carroll, S. Niyonsenga, T. Coffee, N. Taylor, A. Daniel, M. |
Citation: | International Journal of Environmental Research and Public Health, 2017; 14(9):953-1-953-17 |
Publisher: | MDPI AG |
Issue Date: | 2017 |
ISSN: | 1661-7827 1660-4601 |
Statement of Responsibility: | Suzanne J. Carroll, Theo Niyonsenga, Neil T. Coffee, Anne W. Taylor and Mark Daniel |
Abstract: | Associations between local-area residential features and glycosylated hemoglobin (HbA1c) 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 HbA1c. HbA1c 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/m²) 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 HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. 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. |
Keywords: | Physical activity; cardiometabolic disease; residential environments; descriptive norms; built environment; walkability; mediation; glycosylated hemoglobin |
Rights: | © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
DOI: | 10.3390/ijerph14090953 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/570150 http://purl.org/au-research/grants/nhmrc/631917 |
Published version: | http://dx.doi.org/10.3390/ijerph14090953 |
Appears in Collections: | Aurora harvest 3 Geography, Environment and Population publications |
Files in This Item:
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hdl_111137.pdf | Published version | 1.35 MB | Adobe PDF | View/Open |
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