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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2016 Mar 1;107(2):e168–e175. doi: 10.17269/cjph.107.5268

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

Andrew W Tu 17,, Louise C Mâsse 17, Scott A Lear 27, Carolyn C Gotay 17, Chris G Richardson 17
PMCID: PMC6972106  PMID: 27526214

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

Footnotes

Acknowledgements: This study was supported by a Canadian Institutes of Health Research Doctoral Award. The analysis presented was conducted at the BC Research Data Centre (BC RDC), which is part of the Canadian Research Data Centre Network (CRDCN). The services and activities provided by the BC RDC are made possible by the financial or in-kind support of the Social Science and Humanities Research Council, the Canadian Institutes of Health Research, the Canadian Foundation for Innovation, Statistics Canada and the University of British Columbia. The views expressed in this paper do not necessarily represent those of the CRDCN or its partners.

Conflict of Interest: None to declare.

References

  • 1.Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;11(1):11–25. doi: 10.1080/17477160600586747. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/S0140-6736(11)60813-1. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.2105/AJPH.2012.300740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.amepre.2011.06.036. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1207/s15324796abm3301_4. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.ypmed.2006.07.007. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1353/foc.2006.0009. [DOI] [PubMed] [Google Scholar]
  • 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.Egger G, Swinburn B. An “ecological” approach to the obesity pandemic. BMJ. 1997;315(7106):477–80. doi: 10.1136/bmj.315.7106.477. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1186/1479-5868-9-31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1186/1471-2458-13-440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1186/1479-5868-10-34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.healthplace.2010.11.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.healthplace.2011.09.004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.amepre.2012.02.009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Statistics Canada. National Longitudinal Survey of Children and Youth, Cycle 1: User Guide. Ottawa, ON: Statistics Canada; 1994. [Google Scholar]
  • 17.Vermunt JK, Magidson J. Latent class analysis. In: Lewis-Beck M, Bryman A, Liao T, editors. Encyclopedia of Social Science Research Methods. Thousand Oaks, CA: Sage Publications; 2004. pp. 550–54. [Google Scholar]
  • 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. [PubMed] [Google Scholar]
  • 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.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.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. [DOI] [Google Scholar]
  • 22.Canadian Society for Exercise Physiology. Canadian Physical Activity and Sedentary Behaviour Guidelines Handbook. Ottawa, ON: CSEP; 2012. [Google Scholar]
  • 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. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1111/j.1467-789X.2010.00826.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.healthplace.2009.09.008. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1097/PHH.0b013e3181c60e92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1016/j.amepre.2006.03.026. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1186/s12966-014-0142-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Nelson NM, Woods CB. Obesogenic environments: Are neighbourhood environments that limit physical activity obesogenic? Health Place. 2009;15(4):917–24. doi: 10.1016/j.healthplace.2009.02.001. [DOI] [PubMed] [Google Scholar]
  • 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. doi: 10.1093/her/cyq004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1111/j.1748-0361.2012.00411.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 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. doi: 10.1089/chi.2011.0090. [DOI] [PubMed] [Google Scholar]

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