Cross-sectional associations between the neighborhood built environment and physical activity in a rural setting: the Bogalusa Heart Study

Abstract

Background Insufficient physical activity (PA) is a common health risk and more prevalent in rural populations. Few studies have assessed relationships between the built environment and PA in rural settings, and community policy guidance to promote PA through built environment interventions is primarily based on evidence from urban studies. Methods Participants in the Bogalusa Heart Study, a longitudinal study in rural Louisiana, with International Physical Activity Questionnaire data from 2012 to 2013 and a valid residential address (N = 1245) were included. PA was summarized as the number of weekly metabolic equivalent (MET)-minutes of total, transportation, and leisure time PA. The Rural Active Living Assessment street segment audit tool and Google Street View were used to assess features of the built environment overall and in six categories (path features, pedestrian safety features, aesthetics, physical security, destinations and land use) that influence PA. Scores for street segment built environment (overall and in categories) were calculated, for segments and buffers of 0.25, 0.50, 1.00 and 1.50 miles. Associations between built environment scores and PA were assessed with generalized estimating equations. Results Participants reported little weekly total, leisure time, and transportation PA (mean 470, 230 and 43 MET-minutes per week, respectively). A 1-point increase in the overall built environment score was associated with 10.30 additional weekly leisure time MET-minutes within a 1.50 mile buffer (p-value 0.05), with a similar magnitude observed for a 1.00-mile buffer. A 1-point increase in the aesthetic score was associated with significantly higher leisure time PA for all geographic units (from 22.21 to 38.75 MET-minutes weekly) when adjusted for individual covariates, but was attenuated and only significant for the segment of the residence after accounting for other neighborhood characteristics. Conclusions Significant associations between features of the environment (overall and aesthetic scores) with leisure time PA were observed among adults in this rural population. Built environment interventions in rural settings face additional barriers of lower population density and greater distances for infrastructure projects, and it is important to identify approaches that are both feasible for rural communities and can promote PA.

Association of the Neighborhood Built Environment With Incident and Prevalent Depression in the Rural South

“…We evaluated cross-sectional and longitudinal associations between structural features of the rural built environment and depressive symptoms among participants in the Bogalusa Heart Study. Previous research in this population identified significant associations between scores for features of the neighborhood built environment and physical activity ( 11 ). We hypothesized that higher scores (environments more conducive to physical activity) would be associated with lower baseline prevalence of depression and lower depression incidence and that these associations would be mediated by physical activity.…”

“…We developed scales for built environment overall in 6 domains of street segment features identified a priori and refined following principal components analysis. This process has been reported in detail elsewhere ( 11 ). Briefly, scales were developed by creating 1 variable for features that were assessed across multiple RALA variables (eg, sidewalks, paths), with all variables coded so higher values indicated features that promote physical activity.…”

“…Neighborhood scales were developed for all features assessed, and for features in domains of path, pedestrian safety, aesthetics, commercial and civic destinations, physical security, and land use. Reliability of the neighborhood scales, assessed with intraclass correlation coefficients for duplicate audits of 196 street segments, has previously been reported to be acceptable for all domains except physical security features ( 11 ).…”

“…Built environment features that impede physical activity are more prevalent in rural locales than in urban ones. For example, rural residents may have greater distances to travel, roads with higher speed limits, and fewer pedestrian or cyclist safety features (10). Research has not determined whether depression among rural populations is associated with the built environment and whether it is mediated by physical activity.…”

Evaluating the Spatial Quality of Urban Living Streets: A Case Study of Hengyang City in Central South China

“…In the majority of existing studies, the evaluation of living street space is conducted from two perspectives. The primary objective is to develop an evaluation system based on semantic segmentation of street physical environment elements extracted from street view images (SVIs) [11][12][13]. The second objective is to quantify the subjective human reaction to SVIs using measurements derived from deep learning technology [14][15][16].…”