Does physical activity mediate the associations between local-area descriptive norms, built environment walkability, and glycosylated hemoglobin?

Research output: Contribution to journalArticle

9 Citations (Scopus)
5 Downloads (Pure)

Abstract

Associations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m2) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.

Original languageEnglish
Article number953
Pages (from-to)1-17
Number of pages17
JournalInternational Journal of Environmental Research and Public Health
Volume14
Issue number9
DOIs
Publication statusPublished - 1 Sep 2017

Fingerprint Dive into the research topics of 'Does physical activity mediate the associations between local-area descriptive norms, built environment walkability, and glycosylated hemoglobin?'. Together they form a unique fingerprint.

Cite this