Preventive medicine
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Preventive medicine · Feb 2017
Associations between active living-oriented zoning and no adult leisure-time physical activity in the U.S.
Nearly one-third of adults report no leisure-time physical activity (LTPA). Governmental and authoritative bodies recognize the role that community design through zoning code changes can play in enabling LTPA. This study examined the association between zoning and no adult LTPA in the U. ⋯ Except for crosswalks, all zoning provisions were associated with an 11-16% lower probability of no LTPA. Having all 12 zoning provisions was associated with a 22% lower probability of no LTPA (RR: 0.78, 95% CI: 0.72-0.83). The results suggest that active living-oriented zoning is a policy lever available to communities seeking to reduce rates of no LTPA.
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Preventive medicine · Feb 2017
ReviewUsing cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood.
Participation in recommended levels of physical activity promotes a healthy body weight and reduced chronic disease risk. To inform investment in prevention initiatives, we simulate the national implementation, impact on physical activity and childhood obesity and associated cost-effectiveness (versus the status quo) of six recommended strategies that can be applied throughout childhood to increase physical activity in US school, afterschool and childcare settings. In 2016, the Childhood Obesity Intervention Cost Effectiveness Study (CHOICES) systematic review process identified six interventions for study. ⋯ All of the six interventions are estimated to increase physical activity levels among children and adolescents in the US population and prevent cases of childhood obesity. Results do not include other impacts of increased physical activity, including cognitive and behavioral effects. Decision-makers can use these methods to inform prioritization of physical activity promotion and obesity prevention on policy agendas.
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Preventive medicine · Feb 2017
Detecting prediabetes among Hispanics/Latinos from diverse heritage groups: Does the test matter? Findings from the Hispanic Community Health Study/Study of Latinos.
The objectives of this analysis were to compare the ability of fasting plasma glucose (FPG), post oral load plasma glucose (2hPG), and hemoglobin A1c (HbA1c) to identify U. S. Hispanic/Latino individuals with prediabetes, and to assess its cardiovascular risk factor correlates. ⋯ Using 2hPG as the gold standard, the sensitivity of FPG was 40.1%, HbA1c was 45.6%, and that of HbA1c+FPG was 62.2%. The number of significant PRs for cardiovascular risk factors was higher among individuals with isolated 2hPG=7.8-11.1mmol/L, FPG=5.6-7.0mmol/L+HbA1c=5.7%-6.4%, or those who met the three prediabetes criteria. Assessing FPG, HbA1c, and cardiovascular risk factors in Hispanics/Latinos at risk might enhance the early prevention of diabetes mellitus and cardiovascular complications in this young and growing population, independent of their heritage group.
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Preventive medicine · Feb 2017
Objective reports versus subjective perceptions of crime and their relationships to accelerometer-measured physical activity in Hispanic caretaker-child dyads.
Crime and safety are commonly cited barriers to physical activity (PA). We had three objectives, 1) describe the association between objective crime measures and perceptions of crime, 2) analyze the relationships between each type of crime and accelerometer-measured physical activity in caretakers and young children (ages 3-5years), and 3) explore for early gender differences in the relationship between crime and physical activity in young children. Data are from the cross-sectional baseline data of an ongoing randomized controlled trial in Nashville, Tennessee spanning September 2012 through May 2014. ⋯ Child PA was not significantly related to caretaker perceptions of crime. However, interactions suggested that the relationship between crime rate and PA was significantly more negative for girls than for boys. Objective and subjective measures of crime rate are expected to be important correlates of PA, but they appear to have complex relationships that are different for adults than they are for young children, as well as for young girls compared to boys, and research has produced conflicting findings.