Biomedical subjects

Christine M Hoehner

Publications and source records attributed to Christine M Hoehner.

6 recordsLinked to original sources

PubMed2006

Indicators of activity-friendly communities: an evidence-based consensus process.

BACKGROUND: Regular physical activity, even at modest intensities, is associated with many health benefits. Most Americans, however, do not engage in the recommended levels. As practitioners seek ways to increase population rates of physical activity, interventions and advocacy efforts are being targeted to the community level. Yet, advocates, community leaders, and researchers lack the tools needed to assess local barriers to and opportunities for more active, healthy lifestyles. Investigators used a systematic review process to identify key indicators of activity-friendly communities that can assess and improve opportunities for regular physical activity. METHODS: Investigators conducted a comprehensive literature review of both peer-reviewed literature and fugitive information (e.g., reports and websites) to generate an initial list of indicators for review (n=230). The review included a three-tiered, modified Delphi consensus-development process that incorporated input of international, national, state, and local researchers and practitioners from academic institutions, federal and state government agencies, nonprofit organizations, and funding agencies in public health, transportation, urban planning, parks and recreation, and public policy. RESULTS: Ten promising indicators of activity-friendly communities were identified: land use environment, access to exercise facilities, transportation environment, aesthetics, travel patterns, social environment, land use economics, transportation economics, institutional and organizational policies, and promotion. CONCLUSIONS: Collaborative, multidisciplinary approaches are underway to test, refine, and expand this initial list of indicators and to develop measures that communities, community leaders, and policymakers can use to design more activity-friendly community environments.

Consensus↗

PubMed2005

Perceived and objective environmental measures and physical activity among urban adults.

BACKGROUND: Enhancing community environments to support walking and bicycling serves as a promising approach to increase population levels of physical activity. However, few studies have simultaneously assessed perceptions and objectively measured environmental factors and their relative association with transportation or recreational physical activity. METHODS: For this cross-sectional study, high- and low-income study areas were selected among census tracts in St. Louis MO ("low-walkable" city) and Savannah GA ("high-walkable" city). Between February and June 2002, a telephone survey of 1068 adults provided measures of the perceived environment and physical activity behavior. In this timeframe, objective measures were collected through environmental audits of all street segments (n =1158). These measures were summarized using 400-m buffers surrounding each respondent. Neighborhood characteristics included the land use environment, transportation environment, recreational facilities, aesthetics, and social environment. Associations were examined between neighborhood features and transportation- and recreation-based activity. RESULTS: After adjusting for age, gender, and education, transportation activity was negatively associated with objective measures of sidewalk levelness and perceived and objective neighborhood aesthetics. It was positively associated with perceived and objectively measured number of destinations and public transit, perceived access to bike lanes, and objective counts of active people in the neighborhood. Recreational activity was positively associated with perceived access to recreational facilities and objective measures of attractive features. CONCLUSIONS: These findings indicate that physical activities for transportation or recreational are associated with different perceived and objective environmental characteristics. Modifications to these features may change the physical activity behavior of residents exposed to them.

Adolescent↗

PubMed2002

Association of the insulin resistance syndrome and microalbuminuria among nondiabetic native Americans. The Inter-Tribal Heart Project.

This study investigated the association between microalbuminuria and the insulin resistance syndrome (IRS) among nondiabetic Native Americans. In a cross-sectional survey, age-stratified random samples were drawn from the Indian Health Service clinic lists for one Menominee and two Chippewa reservations. Information was collected from physical examinations, personal interviews, and blood and urine samples. The urinary albumin:creatinine ratio (ACR) was measured using a random spot urine sample. The IRS was defined by the number of composite traits: hypertension, impaired fasting glucose (IFG), high fasting insulin, low HDL cholesterol, and hypertriglyceridemia. Among the 934 eligible nondiabetic participants, 15.2% exhibited microalbuminuria. The prevalence of one, two, and three or more traits was 27.0, 16.6, and 7.4%, respectively. After controlling for age, sex, smoking, body mass index, education, and family histories of diabetes and kidney disease, the odds ratio (OR) for microalbuminuria was 1.8 (95% confidence interval [CI], 1.1 to 2.8) for one IRS trait, 1.8 (95% CI, 1.0 to 3.2) for two traits, and 2.3 (95% CI, 1.1 to 4.9) for three or more traits (versus no traits). The pattern of association appeared weaker among women compared with men. Of the individual IRS traits, only hypertension and IFG were associated with microalbuminuria. Among these nondiabetic Native Americans, the IRS was associated with a twofold increased prevalence of microalbuminuria. Health promotion efforts should focus on lowering the prevalence of hypertension, as well as glucose intolerance and obesity, in this population at high risk for renal and cardiovascular disease.

Adult↗

PubMedDate not supplied

Trends in heart disease death rates in diabetic and nondiabetic Pima Indians.

BACKGROUND: Secular trends over 34 years (1965-1998) in overall and cause-specific mortality were examined in 4,623 Pima Indians >or=35 years old. METHODS: The underlying and contributing causes of the 1,363 deaths were determined from a review of all available clinical records; 540 of the deaths occurred in the 2,528 nondiabetic participants and 823 in the 2,095 participants who had diabetes during all or part of the study period. Age/sex-adjusted death rates were calculated across four 8.5-year time intervals. RESULTS: In the nondiabetic participants, the rate of death from natural causes declined gradually over time (20.4, 17.3, 17.3, and 16.0 deaths per 1,000 persons/year; P=.11); deaths from ischemic heart disease (IHD) were uncommon (n=22), and the rate did not change appreciably, remaining as the fifth leading natural cause of death. In the diabetic participants, the rate of death from natural causes was unchanged over time, but the rate of death from IHD (n=141) increased nearly twofold (3.3, 4.2, 6.4, and 6.4 deaths per 1,000 persons/year; P<.01), becoming the leading cause of death in the third and fourth time intervals. CONCLUSIONS: The rate of death from IHD remained stable in nondiabetic Pima Indians but increased among those with diabetes. This finding suggests that, in the absence of diabetes, the underlying susceptibility to IHD in this population has not changed.

Adult↗

PubMedDate not supplied

How reliably do community members audit the neighborhood environment for its support of physical activity? Implications for participatory research.

Environmental audits are used to assess supports for physical activity in the community. Understanding the suitability of such instruments for use by community members is crucial for advocacy and participatory research. This study examined the reliability of an audit instrument filled out by trained researchers and untrained community members. Two researchers and five community members conducted environmental audits on a total of 335 street segments in lower-income areas in St Louis, Missouri (representing a "low-walkable city"), and Savannah, Georgia (representing a "high-walkable" city). The audit tool consisted of six major sections--land use environment, recreational facilities, transportation environment, aesthetics, signage, and social environment. Interrater agreement between researchers and community members was assessed using percent observed agreement and the kappa statistic. According to observed agreement, the majority of audit items (67 of 76) had substantial to almost perfect agreement (> or =0.60) between researchers and community members. However, much lower agreement was observed using the kappa statistic (only 8 of 76 items with kappas > or =0.60). With some formal training, this audit tool may be useful for advocacy and participatory research to assess the activity friendliness of neighborhood environments.

Community Participation↗

PubMedDate not supplied

Opportunities for integrating public health and urban planning approaches to promote active community environments.

The growing emphasis on promoting environmental change as a means to increase physical activity has motivated conversation and collaboration between researchers and practitioners in the fields of public health and urban planning. Although these fields share similar objectives, their methodological approaches for examining the association between the environment and behavior often differ in significant ways. To facilitate communication, this article discusses ways these fields can collaborate in developing and applying conceptual frameworks, adopting behavioral and environmental measures, and strengthening study designs. By collaborating to build synergism in research and dissemination, public health and urban planning professionals can enhance efforts to increase the number of communities that promote active living.

City Planning↗