RESUMEN
OBJECTIVES: The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health (WYHH) intervention, one component of the multilevel Community Approaches to Cardiovascular Health: Pathways to Heart Health (CATCH:PATH) intervention designed to promote physical activity and reduce cardiovascular risk among non-Hispanic Black and Hispanic residents of Detroit, Michigan. The study was designed and implemented using a community-based participatory research approach that actively engaged community residents, health service providers and academic researchers. It was implemented between 2009 and 2012. METHOD: WYHH was a 32-week community health promoter-facilitated walking group intervention. Groups met three times per week at community-based or faith-based organizations, and walked for 45 to 90 minutes (increasing over time). The study used a cluster randomized control design to evaluate effectiveness of WYHH, with participants randomized into intervention or lagged intervention (control) groups. Psychosocial, clinical, and anthropometric data were collected at baseline, 8, and 32 weeks, and pedometer step data tracked using uploadable peisoelectric pedometers. RESULTS: Participants in the intervention group increased steps significantly more during the initial 8-week intervention period, compared with the control group (ß = 2004.5, p = .000). Increases in physical activity were associated with reductions in systolic blood pressure, fasting blood glucose, total cholesterol, waist circumference and body mass index at 8 weeks, and maintained at 32 weeks. CONCLUSION: The WYHH community health promoter-facilitated walking group intervention was associated with significant reductions in multiple indicators of cardiovascular risk among predominantly Hispanic and non-Hispanic Black participants in a low-to-moderate income urban community. Such interventions can contribute to reductions in racial, ethnic, and socioeconomic inequities in cardiovascular mortality.
Asunto(s)
Negro o Afroamericano , Enfermedades Cardiovasculares/etnología , Promoción de la Salud/organización & administración , Hispánicos o Latinos , Caminata , Adulto , Factores de Edad , Glucemia , Presión Sanguínea , Índice de Masa Corporal , Pesos y Medidas Corporales , Investigación Participativa Basada en la Comunidad , Femenino , Humanos , Lípidos/sangre , Masculino , Michigan , Persona de Mediana Edad , Pobreza , Características de la Residencia , Factores de Riesgo , Factores Sexuales , Apoyo Social , Población UrbanaRESUMEN
OBJECTIVE: The present study examined food shopping behaviours, particularly distance to grocery shop, and exposure to discrimination. DESIGN: Cross-sectional observational study utilizing data from a community survey, neighbourhood food environment observations and the decennial census. SETTING: Three communities in Detroit, Michigan, USA. SUBJECTS: Probability sample of 919 African-American, Latino and white adults in 146 census blocks and sixty-nine census block groups. RESULTS: On average, respondents shopped for groceries 3·1 miles (4·99 km) from home, with 30·9 % shopping within 1 mile (1·61 km) and 22·3 % shopping more than 5 miles (8·05 km) from home. Longer distance to shop was associated with being younger, African-American (compared with Latino), a woman, higher socio-economic status, lower satisfaction with the neighbourhood food environment, and living in a neighbourhood with higher poverty, without a large grocery store and further from the nearest supermarket. African-Americans and those with the lowest incomes were particularly likely to report unfair treatment at food outlets. Each mile (1·61 km) increase in distance to shop was associated with a 7 % increase in the odds of unfair treatment; this relationship did not differ by race/ethnicity. CONCLUSIONS: The study suggests that unfair treatment in retail interactions warrants investigation as a pathway by which restricted neighbourhood food environments and food shopping behaviours may adversely affect health and contribute to health disparities. Efforts to promote 'healthy' and equitable food environments should emphasize local availability and affordability of a range of healthy food products, as well as fair treatment while shopping regardless of race/ethnicity or socio-economic status.
Asunto(s)
Conducta de Elección , Comercio , Etnicidad , Abastecimiento de Alimentos , Prejuicio , Características de la Residencia , Clase Social , Adulto , Negro o Afroamericano , Factores de Edad , Anciano , Comportamiento del Consumidor , Estudios Transversales , Dieta , Femenino , Hispánicos o Latinos , Humanos , Renta , Masculino , Michigan , Persona de Mediana Edad , Pobreza , Prejuicio/etnología , Factores Sexuales , Población BlancaRESUMEN
BACKGROUND: There is growing interest in the contributions of characteristics of the neighborhood environment to inequalities in physical activity. However, few studies have examined the relationship between observed neighborhood environmental characteristics and physical activity in a multiethnic urban area. PURPOSE: The purpose of this study was to assess relationships between neighborhood environments and physical activity and the extent to which these associations varied by demographic characteristics or perceptions of the physical and social environment. METHODS: Cross-sectional analyses drew upon data collected from a stratified proportional probability sample of non-Hispanic Black, Hispanic and non-Hispanic White (NHW) adults (n = 919) in low-to-moderate income neighborhoods in Detroit, Michigan. Physical activity was assessed as self-reported duration and frequency of vigorous and moderate physical activity. Observed physical environment was assessed through systematic social observation by trained observers on blocks adjacent to survey respondents' residences. RESULTS: We find a positive association of sidewalk condition with physical activity, with stronger effects for younger compared with older residents. In addition, physical disorder was more negatively associated with physical activity among NHW and older residents. CONCLUSIONS: These findings suggest that sidewalk improvements and reductions in physical disorder in urban communities may promote greater equity in physical activity.