Features of the Built Environment Related to Physical Activity Friendliness and Children's Obesity and Other Risk Factors

• Published in: Public health Nursing Vol. 31; no. 6; pp. 545 - 555
• Main Authors: Taylor, Wendell C., Upchurch, Sandra L., Brosnan, Christine A., Selwyn, Beatrice J., Nguyen, Thong Q., Villagomez, Evangelina Trejo, Meininger, Janet C.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-11-2014; Wiley Subscription Services, Inc
• Subjects: Adolescent; Body mass index; central adiposity; Child; Child, Preschool; children's health; Correlation analysis; Cross-Sectional Studies; CVD risk factors; Environment Design - statistics & numerical data; environmental audits; Exercise; Female; Hierarchy of Walking Needs; Humans; Hypertension - epidemiology; Male; Motor Activity; Nursing Research; Obesity; Pediatric Obesity - epidemiology; physical activity friendliness; Poverty; Prevalence; Public Health Nursing; Residence Characteristics - statistics & numerical data; Risk Factors; Socioeconomic Factors; Southeastern United States - epidemiology; Waist Circumference; Waist-Height Ratio; United States > US; prevalence; Hierarchy of Walking Needs; physical activity friendliness; children's health; central adiposity; CVD risk factors; environmental audits; obesity
• ISSN: 0737-1209; 1525-1446
• DOI: 10.1111/phn.12144

Objectives
We investigated the relationships among environmental features of physical activity friendliness, socioeconomic indicators, and prevalence of obesity (BMI status), central adiposity (waist circumference, waist‐height ratio), and hypertension.
Design and Sample
The design was cross‐sectional; the study was correlational. The sample was 911 kindergarteners through sixth graders from three schools in an urban school district residing in 13 designated neighborhoods.
Measures
Data from walking environmental community audits, census data for socioeconomic indicators, body mass index, waist circumference, waist‐height ratio, and blood pressure were analyzed. A modified Alfonzo's Hierarchy of Walking Needs model was the conceptual framework for environmental features (i.e., accessibility, safety, comfort, and pleasurability) related to physical activity.
Results
Accessibility was significantly and negatively correlated with prevalence of obesity and with prevalence of a waist‐height ratio >0.50. When neighborhood education was controlled, and when both neighborhood education and poverty were controlled with partial correlational analysis, comfort features of a walking environment were significantly and positively related to prevalence of obesity. When poverty was controlled with partial correlation, accessibility was significantly and negatively correlated with prevalence of waist‐height ratio >0.50.
Conclusions
The built environment merits further research to promote physical activity and stem the obesity epidemic in children. Our approach can be a useful framework for future research.