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dc.contributor.authorCarroll, S.-
dc.contributor.authorNiyonsenga, T.-
dc.contributor.authorCoffee, N.-
dc.contributor.authorTaylor, A.-
dc.contributor.authorDaniel, M.-
dc.identifier.citationInternational Journal of Environmental Research and Public Health, 2017; 14(9):953-1-953-17-
dc.description.abstractAssociations 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.-
dc.description.statementofresponsibilitySuzanne J. Carroll, Theo Niyonsenga, Neil T. Coffee, Anne W. Taylor and Mark Daniel-
dc.publisherMDPI AG-
dc.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 (
dc.subjectPhysical activity; cardiometabolic disease; residential environments; descriptive norms; built environment; walkability; mediation; glycosylated hemoglobin-
dc.titleDoes physical activity mediate the associations between local-area descriptive norms, built environment walkability, and glycosylated hemoglobin?-
dc.typeJournal article-
dc.identifier.orcidCoffee, N. [0000-0002-5075-0737]-
dc.identifier.orcidTaylor, A. [0000-0002-4422-7974]-
Appears in Collections:Aurora harvest 3
Geography, Environment and Population publications

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