Overcoming the challenges of conducting physical activity and built environment research in Latin America: IPEN Latin America

Abstract

Objective There is evidence linking the built environment (BE) with physical activity (PA), but few studies have been conducted in Latin America (LA). State-of-the-art methods and protocols have been designed in and applied in high-income countries (HIC). In this paper we identify key challenges and potential solutions to conducting high quality PA and BE research in LA. Methods The experience of implementing the IPEN data collection protocol (IPEN: International Physical Activity Environment Network) in Curitiba, Brazil; Bogotá, Colombia; and Cuernavaca, Mexico (2010-2011); is described to identify challenges for conducting PA and BE research in LA. Results Five challenges were identified: Lack of academic capacity (implemented solutions (IS): building a strong international collaborative network); limited data availability, access and quality (IS: partnering with influential local institutions, and crafting creative solutions to use the best-available data); socio-political, socio-cultural and socio-economic context (IS: in-person recruitment and data collection, alternative incentives); safety (IS: strict rules for data collection procedures, and specific measures to increase trust); appropriateness of instruments and measures (IS: survey adaptation, use of standardized additional survey components, and employing a context-based approach to understanding the relationship between PA and the BE). Advantages of conducting PA and BE research in LA were also identified. Conclusions Conducting high quality PA and BE research in LA is challenging but feasible. Networks of institutions and researchers from both HIC and LMIC play a key role. The lessons learnt from the IPEN LA study may be applicable to other LMIC.

Relationships between active school transport and adiposity indicators in school-age children from low-, middle- and high-income countries

“…38,39 Specifically, in LMIC where car availability remains relatively low in comparison with HIC, AST may be more reflective of need rather than choice since a significant proportion of the children walk to school because they have no other option for transportation. Therefore, our results could be used to classify countries into four typologies that could be useful for future AST interventions ( Figure 2).…”

Global Matrix 2.0: Report Card Grades on the Physical Activity of Children and Youth Comparing 38 Countries

“…Multicountry studies have shown similar proportions of active transportation involvement in significantly differing contexts. 89,90 To understand these patterns a "need-based framework" has been proposed for LMIC, where active transportation represents the only option for transportation because motorized vehicle availability remains relatively low in comparison with HIC. The patterns observed in HIC can be understood within a "choice-based framework" where policies and infrastructure facilitate active transportation as an option to commute.…”

Harnessing Technology and Citizen Science to Support Neighborhoods that Promote Active Living in Mexico

“…Cuernavaca, an urban setting with a population of 365,168 inhabitants located 76 km south of Mexico City, has a similar prevalence of overweight and obesity compared to the whole country, 3 and can be considered a standard Mexican city in size and structure. 25,26 Additionally, Cuernavaca is home to the headquarters of the Mexican National Public Health Institute (Instituto Nacional de Salud Pública, INSP). Moreover, Cuernavaca served as the Mexican site for the International Physical Activity Environment Network (IPEN) Adult Study.…”

“…For IPEN-Mexico, Cuernavaca census tracts were stratified according to socioeconomic status (SES) (median split: high/low) and walkability (median split: high/low) and eight census tracts were randomly selected per SES/walkability stratum. 25,26 The walkability index was calculated using z-scores of intersection density (number of 4-way intersections over total area per census tract), land use mix (diversity of land use types per census tract, using a normalized entropy score ranging from 0 to 1), 28 proportion of commercial land use (over total census tract area), and net residential density (total residences over area destined for residential use per census tract). 27 We selected one neighborhood from each stratum (low SES/ high walkability; low SES/low walkability; high SES/high walkability; high SES/low walkability) to examine the acceptability and feasibility of the Nuestra Voz approach to measuring and potentially modifying local neighborhood environments in distinct types of Mexican neighborhoods.…”

“…Recruitment occurred using a systematic community-based door-to-door approach, proven to be successful for IPEN-Mexico and other studies in Mexico. 3,26 Procedures The Our Voice citizen science approach has been described previously. [20][21][22][23][24]29 Briefly, this community-engaged and participatory approach is driven by residents, who utilize a GPS-enabled electronic tablet-based application (the Discovery Tool) with simple audio-based instructions to take photographs and record audio narratives of facets of their neighborhood that promote or hinder active living.…”