Methods for accounting for neighbourhood self-selection in physical activity and dietary behaviour research: a systematic review

Abstract

Background: Self-selection into residential neighbourhoods is a widely acknowledged, but under-studied problem in research investigating neighbourhood influences on physical activity and diet. Failure to handle neighbourhood self-selection can lead to biased estimates of the association between the neighbourhood environment and behaviour. This means that effects could be over-or underestimated , both of which have implications for public health policies related to neighbourhood (re)design. Therefore, it is important that methods to deal with neighbourhood self-selection are identified and reviewed. The aim of this review was to assess how neighbourhood self-selection is conceived and accounted for in the literature. Methods: Articles from a systematic search undertaken in 2017 were included if they examined associations between neighbourhood environment exposures and adult physical activity or dietary behaviour. Exposures could include any objective measurement of the built (e.g., supermarkets), natural (e.g., parks) or social (e.g., crime) environment. Articles had to explicitly state that a given method was used to account for neighbourhood selfselection. The systematic review was registered with the PROSPERO International Prospective Register of Systematic Reviews (number CRD42018083593) and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Of 31 eligible articles, almost all considered physical activity (30/31); few examined diet (2/31). Methods used to address neighbourhood self-selection varied. Most studies (23/31) accounted for items relating to participants' neighbourhood preferences or reasons for moving to the neighbourhood using multi-variable adjustment in regression models (20/23) or propensity scores (3/23). Of 11 longitudinal studies, three controlled for neighbourhood self-selection as an unmeasured confounder using fixed effects regression.

Effects of resistance training and turmeric supplementation on reactive species marker stress in diabetic rats

“…In addition, we advocate that the influence of diet on physical activity parameters is not discarded, as is well documented by other authors [80,81], and it is necessary in future studies to analyze the interaction of diet on physical activity parameters considering individual characteristics to guarantee the correct ingestion of antioxidant supplementation and their beneficial effects on the whole body [33].…”

Individual and Contextual Factors Associated With Hazardous Drinking in Spain: Evidence From a National Population‐Based Study

“…This type of bias has been studied in more depth in the fields of physical activity and dietary behavior. Unfortunately, the impact of adjusting for neighborhood self‐selection on the results remained unclear (Lamb et al, 2020). Future research is needed to examine the influence of neighborhood self‐selection in alcohol consumption and related problems.…”

Methods to Address Self-Selection and Reverse Causation in Studies of Neighborhood Environments and Brain Health

“…The most common approach to address self-selection is through covariate adjustment in multivariable regression models [ 28 , 29 ]. Participant or neighborhood characteristics that are known or theorized to influence neighborhood choice are included as additional predictors in regression models.…”

“…Participant or neighborhood characteristics that are known or theorized to influence neighborhood choice are included as additional predictors in regression models. Such variables could include demographics (e.g., age, education, marital status, race/ethnicity) or measures that describe or relate to choice of neighborhood (e.g., preference for urban vs. rural or ranking of importance of neighborhood characteristics) [ 29 ]. For example, a study of individuals from eight neighborhoods in Northern California examined cross-sectional associations between neighborhood BE characteristics and frequency of walking to the store, while controlling for self-reported neighborhood preferences when determining where to live (i.e., accessibility, safety, physical activity options, socializing, outdoor spaciousness, and attractiveness) [ 30 ].…”

“…Longitudinal study design is an often recommended method to reduce the chances of self-selection and reverse causation bias [ 29 ]. Presumably, multi-year follow-up of individuals allows for the estimation of the effect of an exposure/treatment early on in the follow-up and longitudinal change in outcome or later development of disease (i.e., establishes temporality of exposure and outcome).…”