Advertisement

Canadian Journal of Public Health

, Volume 107, Issue 2, pp e168–e175 | Cite as

Exploring the mediating roles of physical activity and television time on the relationship between the neighbourhood environment and childhood obesity

  • Andrew W. TuEmail author
  • Louise C. Mâsse
  • Scott A. Lear
  • Carolyn C. Gotay
  • Chris G. Richardson
Quantitative Research

Abstract

OBJECTIVE: Understanding the mechanisms by which neighbourhood environments influence childhood obesity is needed to facilitate the development of prevention strategies. The objective of this cross-sectional study was to identify the distinct types of neighbourhoods in which Canadian children reside and examine the extent to which physical activity and sedentary behaviour mediate the relationship between neighbourhood type and childhood obesity.

METHODS: Baseline data from the National Longitudinal Survey of Children and Youth (1994/1995) were used for this study. Latent class analysis was used to group children (age 0–11; N = 22,831) into neighbourhood types based on perceived and census-derived measures of neighbourhood attributes. A path analysis was used to determine the extent to which levels of physical activity and sedentary behaviour mediated the relationship between the resulting neighbourhood types and obesity.

RESULTS: Five neighbourhood types were identified. Children living in the high safety-low deprivation neighbourhood type, which had the most supportive attributes with regard to physical activity, were significanlty less likely to be obese than children living in the other neighbourhood types. Relative to the high safety-low deprivation neighbourhood, the relationship between neighbourhood type and obesity was partially mediated by physical activity and sedentary behaviour (7%–12% of total effect) among the other urban neighbourhoods, and no mediating effect was found in the rural neighbourhood.

CONCLUSIONS: Intervention strategies attempting to address the increased risk of obesity associated with neighbourhood environments should be tailored according to urban and rural setting and should consider taking a comprehensive approach aimed at improving a range of obesity-related behaviours.

Key words

Childhood obesity physical activity sedentary behaviour neighbourhood mediation 

Résumé

OBJECTIF: Il est nécessaire de comprendre les mécanismes par lesquels l’environnement du quartier influence l’obésité juvénile pour faciliter l’élaboration de stratégies de prévention. L’objectif de cette étude transversale était de cerner les différents types de quartiers où habitent les enfants canadiens et d’examiner la mesure dans laquelle l’activité physique et le comportement sédentaire médient la relation entre le type de quartier et l’obésité juvénile.

MÉTHODE: Nous avons utilisé des données de référence de l’Enquête longitudinale nationale sur les enfants et les jeunes (1994–1995) pour cette étude. Au moyen d’une analyse de structure latente, nous avons regroupé les enfants (âgés de 0 à 11 ans; N = 22 831) en types de quartiers d’après des indicateurs (subjectifs et dérivés du Recensement) des attributs des quartiers. Une analyse des pistes causales a permis de déterminer la mesure dans laquelle les niveaux de l’activité physique et du comportement sédentaire médient la relation entre le type de quartier obtenu et l’obésité.

RÉSULTATS: Nous avons recensé cinq types de quartiers. Les enfants vivant dans le type de quartier à sécurité élevée et à faible défavorisation, lequel avait le plus d’attributs soutenant l’activité physique, étaient significativement moins susceptibles d’être obèses que les enfants vivant dans les autres types de quartiers. Comparativement au quartier à sécurité élevée et à faible défavorisation, la relation entre le type de quartier et l’obésité était partiellement médiée par l’activité physique et le comportement sédentaire (7% à 12% de l’effet total) dans les autres quartiers urbains, et aucun effet de médiation n’a été constaté dans le quartier rural.

CONCLUSIONS: Les stratégies d’intervention qui tentent d’aborder le risque accru d’obésité associé aux environnements de quartiers devraient être adaptées au milieu urbain ou rural et devraient envisager une approche globale pour améliorer une gamme de comportements liés à l’obésité.

Mots clés

obésité juvénile activité physique comportement sédentaire quartier médiation 

References

  1. 1.
    Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006;11(1):11–25. PMID: 17902211. doi: 10.1080/17477160600586747.CrossRefGoogle Scholar
  2. 2.
    Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: Shaped by global drivers and local environments. Lancet 2011;378(9793):804–14. PMID: 21872749. doi: 10. 1016/S0140-6736(11)60813-1.CrossRefGoogle Scholar
  3. 3.
    Ferdinand AO, Sen B, Rahurkar S, Engler S, Menachemi N. The relationship between built environments and physical activity: A systematic review. Am J Public Health 2012;102(10):e7–13. PMID: 22897546. doi: 10.2105/AJPH.2012.300740.CrossRefGoogle Scholar
  4. 4.
    Ding D, Sallis JF, Kerr J, Lee S, Rosenberg DE. Neighborhood environment and physical activity among youth: A review. Am J Prev Med 2011;41(4):442–55. PMID: 21961474. doi: 10.1016/j.amepre.2011.06.036.CrossRefGoogle Scholar
  5. 5.
    Roemmich JN, Epstein LH, Raja S, Yin L. The neighborhood and home environments: Disparate relationships with physical activity and sedentary behaviors in youth. Ann Behav Med 2007;33(1):29–38. PMID: 17291168. doi: 10.1207/s15324796abm3301_4.CrossRefGoogle Scholar
  6. 6.
    Roemmich JN, Epstein LH, Raja S, Yin L, Robinson J, Winiewicz D. Association of access to parks and recreational facilities with the physical activity of young children. Prev Med 2006;43(6):437–41. PMID: 16928396. doi: 10.1016/j.ypmed.2006.07.007.CrossRefGoogle Scholar
  7. 7.
    Sallis JF, Glanz K. The role of built environments in physical activity, eating, and obesity in childhood. Future Child 2006;16(1):89–108. PMID: 16532660. doi: 10.1353/foc.2006.0009.CrossRefGoogle Scholar
  8. 8.
    Gebel K, King L, Bauman A, Vita P, Gill T, Rigby A, et al. Creating Healthy Environments: A Review of Links Between the Physical Environment, Physical Activity and Obesity. Sydney: NSW Health Department and NSW Centre for Overweight and Obesity, 2005.Google Scholar
  9. 9.
    Egger G, Swinburn B. An “ecological” approach to the obesity pandemic. BMJ 1997;315(7106):477–80. PMID: 9284671. doi: 10.1136/bmj.315.7106.477.CrossRefGoogle Scholar
  10. 10.
    Veitch J, Van Stralen MM, Chinapaw MJ, te Velde SJ, Crawford D, Salmon J, et al. The neighborhood social environment and body mass index among youth: A mediation analysis. Int J Behav Nutr Phys Act 2012;9(1):31. PMID: 22429957. doi: 10.1186/1479-5868-9-31.CrossRefGoogle Scholar
  11. 11.
    Dulin-Keita A, Kaur Thind H, Affuso O, Baskin ML. The associations of perceived neighborhood disorder and physical activity with obesity among African American adolescents. BMC Public Health 2013;13:440. PMID: 23642107. doi: 10.1186/1471-2458-13-440.CrossRefGoogle Scholar
  12. 12.
    Adams MA, Ding D, Sallis JF, Bowles HR, Ainsworth BE, Bergman P, et al. Patterns of neighborhood environment attributes related to physical activity across 11 countries: A latent class analysis. Int. J. Behav. Nutr. Phys. Act. 2013;10:34. PMID: 23497187. doi: 10.1186/1479-5868-10-34.CrossRefGoogle Scholar
  13. 13.
    Weden MM, Bird CE, Escarce JJ, Lurie N. Neighborhood archetypes for population health research: Is there no place like home? Health Place 2011;17(1):289–99. PMID: 21168356. doi: 10.1016/j.healthplace.2010.11.002.CrossRefGoogle Scholar
  14. 14.
    McDonald K, Hearst M, Farbakhsh K, Patnode C, Forsyth A, Sirard J, et al. Adolescent physical activity and the built environment: A latent class analysis approach. Health Place 2012;18(2):191–98. PMID: 21975286. doi: 10.1016/j.healthplace.2011.09.004.CrossRefGoogle Scholar
  15. 15.
    Wall MM, Larson NI, Forsyth A, Van Riper DC, Graham DJ, Story MT, et al. Patterns of obesogenic neighborhood features and adolescent weight: A comparison of statistical approaches. Am J Prev Med 2012;42(5):e65–75. PMID: 22516505. doi: 10.1016/j.amepre.2012.02.009.CrossRefGoogle Scholar
  16. 16.
    Statistics Canada. National Longitudinal Survey of Children and Youth, Cycle 1: User Guide. Ottawa, ON: Statistics Canada, 1994.Google Scholar
  17. 17.
    Vermunt JK, Magidson J. Latent class analysis. In: Lewis-Beck M, Bryman A, Liao T (Eds.), Encyclopedia of Social Science Research Methods. Thousand Oaks, CA: Sage Publications, 2004;550–54.Google Scholar
  18. 18.
    Pampalon R, Hamel D, Gamache P, Raymond G. A deprivation index for health planning in Canada. Chronic Dis Can 2009;29(4):178–91. PMID: 19804682.PubMedGoogle Scholar
  19. 19.
    World Health Organization. WHO Anthro (Version 3.2.2, January 2011) and Macros. Available at: http://www.who.int/childgrowth/software/en/ (Accessed April 29, 2016).
  20. 20.
    WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Growth Velocity Based on Weight, Length and Head Circumference: Methods and Development. Geneva: World Health Organization, 2009.Google Scholar
  21. 21.
    Nylund KL, Asparouhov T, Muthén B. Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Struct Equ Model A Multidiscip J 2007;14(4):535–69. doi: 10.1080/10705510701575396.CrossRefGoogle Scholar
  22. 22.
    Canadian Society for Exercise Physiology. Canadian Physical Activity and Sedentary Behaviour Guidelines Handbook. Ottawa, ON: CSEP, 2012.Google Scholar
  23. 23.
    Hayes AF, Preacher KJ. Statistical mediation analysis with a multicategorical independent variable. Br J Math Stat Psychol 2013;67:451–70. doi: 10.1111/bmsp.12028.CrossRefGoogle Scholar
  24. 24.
    Durand CP, Andalib M, Dunton GF, Wolch J, Pentz MA. A systematic review of built environment factors related to physical activity and obesity risk: Implications for smart growth urban planning. Obes Rev 2011;12(5):e173–82. PMID: 21348918. doi: 10.1111/obr.2011.12.issue-5.CrossRefGoogle Scholar
  25. 25.
    Feng J, Glass TA, Curriero FC, Stewart WF, Schwartz BS. The built environment and obesity: A systematic review of the epidemiologic evidence. Health Place 2010;16(2):175–90. PMID: 19880341. doi: 10.1016/j.healthplace.2009.09.008.CrossRefGoogle Scholar
  26. 26.
    Norman GJ, Adams MA, Kerr J, Ryan S, Frank LD, Roesch SC. A latent profile analysis of neighborhood recreation environments in relation to adolescent physical activity, sedentary time, and obesity. J Public Health Manag Pract 2010;16(5):411–19. PMID: 20689390. doi: 10.1097/PHH.0b013e3181c60e92.CrossRefGoogle Scholar
  27. 27.
    Nelson MC, Gordon-Larsen P, Song Y, Popkin BM. Built and social environments associations with adolescent overweight and activity. Am J Prev Med 2006;31(2):109–17. PMID: 16829327. doi: 10.1016/j.amepre.2006.03.026.CrossRefGoogle Scholar
  28. 28.
    Martin A, Ogilvie D, Suhrcke M. Evaluating causal relationships between urban built environment characteristics and obesity: A methodological review of observational studies. Int J Behav Nutr Phys Act 2014;11(1):142. PMID: 25406733. doi: 10.1186/sl2966-014-0142-8.CrossRefGoogle Scholar
  29. 29.
    Nelson NM, Woods CB. Obesogenic environments: Are neighbourhood environments that limit physical activity obesogenic? Health Place 2009;15(4):917–24. PMID: 19285449. doi: 10.1016/j.healthplace.2009.02.001.CrossRefGoogle Scholar
  30. 30.
    Moore JB, Jilcott SB, Shores KA, Evenson KR, Brownson RC, Novick LF. A qualitative examination of perceived barriers and facilitators of physical activity for urban and rural youth. Health EducRes 2010;25(2):355–67. PMID: 20167607. doi: 10.1093/her/cyq004.Google Scholar
  31. 31.
    Befort CA, Nazir N, Perri MG. Prevalence of obesity among adults from rural and urban areas of the United States: Findings from NHANES (2005–2008). J Rural Health 2012;28(4):392–97. PMID: 23083085. doi: 10.1111/jrh.2012.28.issue-4.CrossRefGoogle Scholar
  32. 32.
    Liu J-H, Jones SJ, Sun H, Probst JC, Merchant AT, Cavicchia P. Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: An urban and rural comparison. Child Obes 2012;8:440–48. PMID: 23061499. doi: 10.1089/chi.2011.0090.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 1996

Authors and Affiliations

  • Andrew W. Tu
    • 1
    Email author
  • Louise C. Mâsse
    • 1
  • Scott A. Lear
    • 2
  • Carolyn C. Gotay
    • 1
  • Chris G. Richardson
    • 1
  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.Faculty of Health SciencesSimon Fraser UniversityVancouverCanada

Personalised recommendations