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Neighborhood walkability and physical activity among older women: Tests of mediation by environmental perceptions and moderation by depressive symptoms
Orstad, Stephanie L; McDonough, Meghan H; James, Peter; Klenosky, David B; Laden, Francine; Mattson, Marifran; Troped, Philip J
Features that enhance neighborhood walkability (higher population density, street connectivity and access to destinations) are associated with higher levels of physical activity among older adults. The perceived neighborhood environment appears to mediate associations between the objective built environment and physical activity. The role of depressed mood in these associations is poorly understood. We examined the degree to which depressive symptoms moderated indirect associations between the objective neighborhood environment and physical activity via the perceived neighborhood environment in older women. We analyzed data on 60,133 women (mean age = 73.1 ± 6.7 years) in the U.S. Nurses' Health Study cohort who completed the 2008 questionnaire. Self-reported measures included the Geriatric Depression Scale, perceived presence of recreational facilities, retail destinations, sidewalks, and crime, and participation in recreational physical activity and neighborhood walking. We created an objective walkability index by summing z-scores of intersection and facility counts within 1200-meter residential network buffers and census tract-level population density. We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation and moderated mediation. Objective walkability was associated with 1.99 times greater odds of neighborhood walking (95% BC CI = 1.92, 2.06) and 1.38 times greater odds of meeting physical activity recommendations (95% BC CI = 1.34, 1.43) via the perceived neighborhood environment. These indirect associations were weaker among women with higher depressive symptom scores. Positive associations between objective neighborhood walkability and physical activities such as walking among older women may be strengthened with a reduction in their depressive symptoms.
PMCID:6260982
PMID: 30092314
ISSN: 1096-0260
CID: 4298222
DO GOAL-DIRECTED OR OUTCOME-BASED FINANCIAL INCENTIVES PROMOTE PATIENTS' WEIGHT LOSS? THE FIREWORK INTERVENTION PROTOCOL [Meeting Abstract]
Orstad, Stephanie L.; Ladapo, Joseph A.; Wittleder, Sandra; Hernandez, Christina; Cuevas, Miguel A.; Sweat, Victoria; Jay, Melanie
ISI:000431185202288
ISSN: 0883-6612
CID: 3113882
The observed and perceived neighborhood environment and physical activity among urban-dwelling adults: The moderating role of depressive symptoms
Orstad, Stephanie L; McDonough, Meghan H; Klenosky, David B; Mattson, Marifran; Troped, Philip J
RATIONALE:Physical environmental features of neighborhoods are associated with physical activity, but the influence of mental health factors, such as depression, on these associations is poorly understood. OBJECTIVE:We examined whether the perceived neighborhood environment mediated associations between the observed neighborhood environment and physical activity, and whether these associations were moderated by depressive symptoms. METHODS:Data consisted of systematic social observations of 343 neighborhoods and resident surveys. Participants' (N = 2969) mean age was 41.9 ± 16.2 years, 60.2% were female, and 67.9% were non-White. We conducted multiple linear regression and tests for mediation and moderated mediation. RESULTS:Observed recreation facilities, commercial destinations, physical disorder, and physical deterioration were indirectly associated with walking via perceived neighborhood environment variables. Observed recreation facilities was indirectly and positively associated with leisure-time physical activity via perceived park access, and indirectly and inversely associated with walking and leisure-time physical activity via perceived traffic danger, but only among participants with low depressive symptom scores. Observed recreation facilities was indirectly and inversely associated, and observed physical disorder and physical deterioration were indirectly and positively associated with walking via perceived disorder, but only among participants with high depressive symptom scores. CONCLUSION:Depressive symptoms affected the strength and direction of associations between the observed neighborhood environment and physical activity via residents' perceptions.
PMID: 28843130
ISSN: 1873-5347
CID: 4298212
A Systematic Review of Agreement Between Perceived and Objective Neighborhood Environment Measures and Associations With Physical Activity Outcomes [Review]
Orstad, Stephanie L.; McDonough, Meghan H.; Stapleton, Shauna; Altincekic, Ceren; Troped, Philip J.
ISI:000408847100003
ISSN: 0013-9165
CID: 4298232
Correlates of Trail Use for Recreation and Transportation on 5 Massachusetts Trails
Orstad, Stephanie L; McDonough, Meghan H; Klenosky, David B; Mattson, Marifran; Troped, Philip J
BACKGROUND:Promoting use of community trails is a recommended strategy for increasing population levels of physical activity. Correlates of walking and cycling for recreation or transportation differ, though few studies have compared correlates of trail-based physical activity for recreation and transportation purposes. This study examined associations of demographic, social, and perceived built environmental factors with trail use for recreation and transportation and whether associations were moderated by age, gender, and prior trail use. METHODS:Adults (N = 1195) using 1 of 5 trails in Massachusetts responded to an intercept survey. We used multiple linear and logistic regression models to examine associations with trail use. RESULTS:Respondents' mean age was 44.9 years (standard deviation = 12.5), 55.3% were female, and 82.0% were white. Age (longer-term users only), trail use with others, travel time to the trail, and trail design were significantly associated with use for recreation (P < .05). Age, gender, trail safety (longer-term users only), travel time to the trail, trail design (younger users only), and trail beauty were associated with use for transportation (P < .05). CONCLUSIONS:Some common correlates were found for recreational and transportation trail use, whereas some variables were uniquely associated with use for 1 purpose. Tailored strategies are suggested to promote trail use for recreation and transportation.
PMID: 26998620
ISSN: 1543-5474
CID: 4298202