Built Environment and Health Behaviors Among African Americans. A Systematic Review

Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA.
American journal of preventive medicine (Impact Factor: 4.53). 03/2009; 36(2):174-81. DOI: 10.1016/j.amepre.2008.09.037
Source: PubMed


An overall understanding of environmental factors that affect weight-related behaviors and outcomes in African American adults is limited. This article presents a summarization of the literature on the built environment and its association with physical activity, diet, and obesity among African Americans.
A systematic review was conducted by searching the PubMed electronic database from inception to July 31, 2007, reviewing bibliographies of eligible articles, and searching authors' personal databases using various search terms for the built environment, physical activity, diet, and obesity. Eligible articles were observational studies that included a study population >or=90% African American (or subgroup analysis), adults (>or=18 yrs), and were published in English; final article data abstraction occurred from October 2007 through February 2008.
A total of 2797 titles were identified from the initial search, and 90 were deemed eligible for abstract review. Of these, 17 articles were eligible for full review and ten met all eligibility criteria. The median sample size was 761 (234 to 10,623), and half of the articles included only African Americans. Light traffic, the presence of sidewalks, and safety from crime were more often positively associated with physical activity, although associations were not consistent (OR range = 0.53-2.43). Additionally, perceived barriers to physical activity were associated with obesity. The presence of supermarkets and specialty stores was consistently positively associated with meeting fruit and vegetable guidelines.
With relatively few studies in the literature focused on African Americans, more research is needed to draw conclusions on features of the built environment that are associated with physical activity, diet, and obesity.

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    • "c o m / l o c a t e / c o n c l i n t r i a l [14] [15] [16], cultural preference for a larger body size [17], fewer options for leisure time physical activity [18], lower metabolic rate [19], genetic predisposition [20], lower sleep quality [21] [22], higher levels of stress [14] [23], and lower socioeconomic status [24] [25]. Although evidence suggests that environmental and sociocultural factors influence weight-related behaviors in African-American women [11], most weight loss trials do not address barriers beyond individual-level factors related to diet and physical activity [12] [26] [27]. "
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    ABSTRACT: Despite the high prevalence of obesity among African American women and modest success in behavioral weight loss interventions, the development and testing of weight management interventions using a community-based participatory research (CBPR) approach has been limited. Doing Me: Sisters Standing Together for Healthy Mind and Body (Doing Me!) is an intervention adapted from an evidence-based behavioral obesity intervention using a CBPR approach. The purpose of Doing Me! is to test the feasibility and acceptability of this adapted intervention and determine its efficacy in achieving improvements in anthropometrics, diet, and physical activity. Sixty African American women, from a low-income, urban community, aged 30-65 years will be randomized to one of two arms: 16-week Doing Me! (n=30) or waitlist control (n=30). Doing Me! employs CBPR methodology to involve community stakeholders and members during the planning, development, implementation, and evaluation phases of the intervention. There will be thirty-two 90-minute sessions incorporating 45minutes of instruction on diet, physical activity, and/or weight management plus 45minutes of physical activity. Data will be collected at baseline and post-intervention (16weeks). Doing Me! is one of the first CBPR studies to examine the feasibility/acceptability of an adapted evidence-based behavioral weight loss intervention designed for obese African American women. CBPR may be an effective strategy for implementing a weight management intervention among this high-risk population. Copyright © 2015. Published by Elsevier Inc.
    Contemporary clinical trials 06/2015; 43. DOI:10.1016/j.cct.2015.06.006 · 1.94 Impact Factor
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    • "A recent systematic review of studies in which community-based interventions were initiated to improve community levels of physical activity reported inconsistent results, and emphasized the need for well-designed intervention studies [33]. Prior studies have reported that food availability and affordability [34] and presence of supermarkets [35] are associated with healthy food purchases, whereas difficulty accessing produce and high quality groceries promoted the consumption of fast food [36]. A recent systematic review of 28 studies, mostly from the United States showed that greater accessibility to supermarkets or less access to takeaway outlets was associated with a lower prevalence of overweight/obesity. "
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    ABSTRACT: Background: Rapid change in food intake, physical activity, and tobacco use in recent decades have contributed to the soaring rates of obesity, type 2 diabetes and cardiovascular disease (CVD) in Aboriginal populations living in Canada. The nature and influence of contextual factors on Aboriginal health behaviours are not well characterized. Methods: To describe the contextual determinants of health behaviours associated with cardiovascular risk factors on the Six Nations reserve, including the built environment, access and affordability of healthy foods, and the use of tobacco.In this cross-sectional study, 63 adults from the Six Nations Reserve completed the modified Neighbourhood Environment Walkability Scale (NEWS), questionnaire assessing food access and availability, tobacco pricing and availability, and the Environmental Profile of Community Health (EPOCH) tool. Results: The structured environment of Six Nations Reserve scored low for walkability, street connectivity, aesthetics, safety, and access to walking and cycling facilities. All participants purchased groceries off-reserve, although fresh fruits and vegetables were reported to be available and affordable both on and off-reserve. On average $151/week is spent on groceries per family. Ninety percent of individuals report tobacco use is a problem in the community. Tobacco is easily accessible for children and youth, and only three percent of community members would accept increased tobacco taxation as a strategy to reduce tobacco access. Conclusions: The built environment, access and affordability of healthy food and tobacco on the Six Nations Reserve are not perceived favourably. Modification of these contextual factors described here may reduce adverse health behaviours in the community.
    BMC Public Health 11/2012; 12(1):952. DOI:10.1186/1471-2458-12-952 · 2.26 Impact Factor
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    • "Elements of the built environment can create conditions for either positive or negative social determinants of health. To-date, most of the current research on the built environment focuses on its impact on nutrition and physical activity [9]. Mental health and sexual health are also critical components of functional well-being. "
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    ABSTRACT: Research related to the intersection of the built environment and health has particularly flourished in the last decade. The authors highlight the theoretical and policy insights that have been made while also noting paucity in this literature as specifically related to mental and sexual health. Overall, the authors discuss policy implications of aspects of the built environment on both mental and sexual health behaviors and outcomes and suggest avenues for future research, program implementation, and policymaking for advancing health equity in these areas.
    06/2012; 2012. DOI:10.5402/2012/806792
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