Ester Cerin

Deakin University, Geelong, Victoria, Australia

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Publications (158)406.56 Total impact

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    ABSTRACT: Background Inequalities in eating behaviours are often linked to the types of food retailers accessible in neighbourhood environments. Numerous studies have aimed to identify if access to healthy and unhealthy food retailers is socioeconomically patterned across neighbourhoods, and thus a potential risk factor for dietary inequalities. Existing reviews have examined differences between methodologies, particularly focussing on neighbourhood and food outlet access measure definitions. However, no review has informatively discussed the suitability of the statistical methodologies employed; a key issue determining the validity of study findings. Our aim was to examine the suitability of statistical approaches adopted in these analyses. Methods Searches were conducted for articles published from 2000-2014. Eligible studies included objective measures of the neighbourhood food environment and neighbourhood-level socio-economic status, with a statistical analysis of the association between food outlet access and socio-economic status. Results Fifty-four papers were included. Outlet accessibility was typically defined as the distance to the nearest outlet from the neighbourhood centroid, or as the number of food outlets within a neighbourhood (or buffer). To assess if these measures were linked to neighbourhood disadvantage, common statistical methods included ANOVA, correlation, and Poisson or negative binomial regression. Although all studies involved spatial data, few considered spatial analysis techniques or spatial autocorrelation. Conclusions With advances in GIS software, sophisticated measures of neighbourhood outlet accessibility can be considered. However, approaches to statistical analysis often appear less sophisticated. Care should be taken to consider assumptions underlying the analysis and the possibility of spatially correlated residuals which could affect the results.
    07/2015; 2(3):358-401. DOI:10.3934/publichealth.2015.3.358
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    ABSTRACT: Prevalence of walking and cycling for transport is low, varying greatly across countries. Few studies have examined neighborhood perceptions related to walking and cycling for transport in different countries. Therefore it is challenging to prioritize appropriate built environment interventions. The aim of this study was to examine the strength and shape of the relationship between adults' neighborhood perceptions and walking and cycling for transport across diverse environments. As part of the International Physical activity and Environment Network (IPEN) adult project, self-report data were taken from 13,745 adults (18 - 65 years) living in physically and socially diverse neighborhoods in 17 cities across 12 countries. Neighborhood perceptions were measured using the Neighborhood Environment Walkability Scale, and walking and cycling for transport were measured using the International Physical Activity Questionnaire - Long Form. Generalized additive mixed models were used to model walking or cycling for transport during the last seven days with neighborhood perceptions. Interactions by city were explored. Walking for transport outcomes were significantly associated with perceived residential density, land use mix access, street connectivity, aesthetics, and safety. Any cycling for transport was significantly related to perceived land use mix access, street connectivity, infrastructure, aesthetics, safety, and perceived distance to destinations. Between-city differences existed for some attributes in relation to walking or cycling for transport. Many perceived environmental attributes supported both cycling and walking; however highly walkable environments may not support cycling for transport. People appear to walk for transport despite safety concerns. These findings can guide the implementation of global health strategies.
    Environmental Health Perspectives 07/2015; DOI:10.1289/ehp.1409466 · 7.98 Impact Factor
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    ABSTRACT: This study investigated the mediating role of body mass index (BMI) in the relationship between physical activity and body esteem in adolescents. Nine hundred and five Hong Kong Chinese students aged 12-18 years participated in a cross-sectional study in 2007. Students' BMI was computed as an indicator of their body composition. Their physical activity level and body esteem were examined using the Physical Activity Rating for Children and Youth (PARCY) and Body Esteem Scale (BES), respectively. Structural equation modelling was used to investigate the mediating effects of BMI and physical activity in predicting body esteem, with stratification by sex. The overall fit of the hypothesized models was satisfactory in boys (NFI = 0.94; NNFI = 0.88; CFI = 0.95; RMSEA = 0.07) and girls (NFI = 0.89; NNFI = 0.77; CFI = 0.91; RMSEA = 0.11). When BMI was considered as a mediator, higher physical activity had a significant negative total effect on body esteem in boys, but not in girls. The indirect effect of higher physical activity on body esteem via BMI was positive in boys, but negative in girls. Regular physical activity may help overweight adolescents, especially boys, improve their body esteem. Kinesiologists and health professionals could explore the use of physical activity prescriptions for weight management, aiming at body esteem improvement in community health programs for adolescents. What is Known: •Among Western adolescents, negative body esteem is more pervasive in girls than in boys. •There are consistent findings of the association between higher body mass index and lower body esteem in adolescents, but the association between physical activity and body esteem are equivocal. What is New: •A negative association between body mass index and body esteem was found in both Hong Kong adolescent boys and girls. •The indirect effect of physical activity on body esteem via body mass index was positive in Hong Kong adolescent boys, but negative in girls.
    European Journal of Pediatrics 07/2015; DOI:10.1007/s00431-015-2586-5 · 1.98 Impact Factor
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    ABSTRACT: Investigate associations of TV viewing time and accelerometry-derived sedentary time with inflammatory and endothelial function biomarkers in children. Cross-sectional analysis of 164 7-10-year-old children. TV viewing time was assessed by parental proxy report and total and patterns of sedentary time accumulation (e.g. prolonged bouts) were assessed by accelerometry. C-reactive protein (CRP), homeostasis model assessment of insulin resistance, interleukin-2, -6, -8, -10, tumour necrosis factor alpha, adiponectin, resistin, brain-derived neurotrophic factor, soluble intercellular and vascular adhesion molecule 1, plasminogen activator inhibitor 1 and soluble E-selectin were assessed. Generalised linear models assessed the associations of TV viewing and sedentary time with biomarkers, adjusting for sex, waist circumference, moderate- to vigorous-intensity physical activity and diet density. Each additional h week(-1) of TV viewing was associated with 4.4% (95% CI: 2.1, 6.7) greater CRP and 0.6% (0.2, 1.0) greater sVCAM-1 in the fully adjusted model. The association between frequency and duration of 5-10 min bouts of sedentary time and CRP was positive after adjustment for sex and waist circumference but attenuated after adjustment for diet density. This study suggests that TV viewing was unfavourably associated with several markers of inflammation and endothelial dysfunction. The detrimental association between 5 and 10 min bouts of sedentary time and CRP approached significance, suggesting that further research with a stronger study design (longitudinal and/or experimental) is needed to better understand how the accumulation of sedentary time early in life may influence short and longer term health. © 2015 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity.
    Pediatric Obesity 06/2015; DOI:10.1111/ijpo.12045 · 2.42 Impact Factor
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    ABSTRACT: Ecological models of health behaviour are an important conceptual framework to address the multiple correlates of obesity. Several single-country studies previously examined the relationship between the built environment and obesity in adults, but results are very diverse. An important reason for these mixed results is the limited variability in built environments in these single-country studies. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and BMI/weight status in a multi-country study including 12 environmentally and culturally diverse countries. A multi-site cross-sectional study was conducted in 17 cities (study sites) across 12 countries (Australia, Belgium, Brazil, China, Colombia, Czech Republic, Denmark, Mexico, New Zealand, Spain, the UK and USA). Participants (n = 14222, 18-66 years) self-reported perceived neighbourhood environmental attributes. Height and weight were self-reported in eight countries, and measured in person in four countries. Three environmental attributes were associated with BMI or weight status in pooled data from 12 countries. Safety from traffic was the most robust correlate, suggesting that creating safe routes for walking/cycling by reducing the speed and volume of traffic might have a positive impact upon weight status/BMI across various geographical locations. Close proximity to several local destinations was associated with BMI across all countries, suggesting compact neighbourhoods with more places to walk related to lower BMI. Safety from crime showed a curvilinear relationship with BMI, with especially poor crime safety being related to higher BMI. Environmental interventions involving these three attributes appear to have international relevance and focusing on these might have implications for tackling overweight/obesity.
    International Journal of Behavioral Nutrition and Physical Activity 05/2015; 12(1):62. DOI:10.1186/s12966-015-0228-y · 3.68 Impact Factor
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    ABSTRACT: Sitting time is a public health concern. This study examined associations of objectively measured neighbourhood environmental attributes with non-transport sitting time and motorised transport in 484 Hong Kong older adults. Neighbourhood attributes encouraging walking may help older adults replace some sitting time at home and on motorised transport with light-to-moderate-intensity activities such as strolling around the neighbourhood or walking to/from neighbourhood destinations. Thus, we hypothesised environmental attributes found to be related to walking would show associations with non-transport sitting time and motorised transport opposite to those seen for walking. Cross-sectional. Hong Kong, an ultradense urban environment. 484 ethnic Chinese Hong Kong residents aged 65+ recruited from membership lists of four Hong Kong Elderly Health Centres representing catchment areas of low and high transport-related walkability stratified by socioeconomic status (response rate: 78%). Attributes of participants' neighbourhood environments were assessed by environmental audits, while non-transport sitting time and motorised transport were ascertained using the International Physical Activity Questionnaire-Long Form (Chinese version). Daily non-transport sitting minutes were 283 (SD=128) and motorised transport 23 (SD=28). Prevalence of signs of crime/disorder, streetlights, public facilities (toilets and benches) and pedestrian safety were independently negatively related, and sloping streets positively related, to sitting outcomes. Places of worship in the neighbourhood were predictive of more, and prevalence of public transit points of less, non-transport sitting. Associations of either or both sitting outcomes with prevalence of food/grocery stores and presence of parks were moderated by path obstructions and signs of crime/disorder. The findings suggest that access to specific destinations and relatively low-cost, minimal impact modifications to the urban form, such as street lighting, public toilets, benches and public transit points, could potentially reduce sitting time and associated negative health outcomes in Hong Kong older adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 05/2015; 5(4):e007557. DOI:10.1136/bmjopen-2014-007557 · 2.06 Impact Factor
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    ABSTRACT: Background The transition from active employment to retirement is a potentially critical period for promoting maintenance or development of recreational physical activity in older age. Park proximity and quality might be important correlates of recreational physical activity in this age group. However, research on park-physical activity relationships among mid-older aged adults is limited and inconclusive. Furthermore, while knowledge of individual moderators of park-physical activity relationships is crucial for tailoring interventions, this knowledge is also limited. We investigated relationships between perceived park proximity, park quality and recreational physical activity among mid-older aged adults. Additionally, we examined the potential moderating effects of gender, education level, retirement status, functional limitations and area of residence on these relationships. Methods Self-reported data on demographics, functional limitations, park proximity, park quality, recreational walking and other recreational moderate- to vigorous-intensity physical activity (MVPA) were collected among 2700 Australian adults (57–67 years) in 2012. Objective information on area of residence was collected. To examine associations of park-related variables with recreational walking and other recreational MVPA, zero-inflated negative binomial (ZINB) regression models were used. Results Park proximity significantly interacted with retirement status; non-retired participants who reported living near a park were more likely to participate in recreational walking, whereas no relationship was observed in retired participants. Among those who walked for recreation, higher park quality was related to more weekly minutes of recreational walking. No significant relationships with other recreational MVPA and no moderating effects of gender, education level, functional limitations and area of residence were observed. Conclusions Parks may stimulate engagement in recreational walking among non-retirees and more walking among those who already walk. Future research should investigate which environmental factors relate to engagement in recreational walking among retirees and examine whether improvements in park quality actually lead to increases in mid-older aged adults’ recreational walking.
    International Journal of Behavioral Nutrition and Physical Activity 04/2015; 12(1). DOI:10.1186/s12966-015-0205-5 · 3.68 Impact Factor
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    ABSTRACT: Aim: To compare the cumulative (three-day) effect of prolonged sitting on metabolic responses during a mixed meal tolerance test (MTT), with sitting that is regularly interrupted with brief bouts of light-intensity walking. Research design and methods: Overweight/obese adults (n=19) were recruited for a randomized, three-day, outpatient, crossover trial involving: 1) 7-hour days of uninterrupted sitting (SIT); and, 2) 7-hour days of sitting with light-intensity activity breaks [BREAKS; 2-minutes of treadmill walking (3.2 km/hour) every 20 minutes (total: 17 breaks/day)]. On days 1 and 3, participants underwent a MTT (75g carbohydrate, 50g fat), and the incremental area under the curve (iAUC) was calculated from hourly blood samples. GEE models were adjusted for gender, BMI, energy intake, treatment order and pre-prandial values to determine effects of time, condition and time x condition. Results: The glucose iAUC was 1.3 ± 0.5 and 1.5 ± 0.5 mmol.hr.L-1 (mean difference ± SEM) higher in SIT compared with BREAKS on days 1 and 3 respectively (condition effect: P=0.001), with no effect of time (P=0.48) or time x condition (P=0.8). The insulin iAUC was also higher on both days in SIT (Day 1: ∆151 ± 73, Day 3: ∆91 ± 73 pmol.hr.L-1, P=0.01), with no effect of time (P=0.52) or time x condition (P=0.71). There was no between-treatment difference in triglycerides iAUC. Conclusion: There were significant between-condition effects but no temporal change in metabolic responses to MTT, indicating that breaking up sitting over three days sustains, but does not enhance, the lowering of postprandial glucose and insulin.
    Clinical Science 03/2015; 129(2). DOI:10.1042/CS20140790 · 5.63 Impact Factor
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    ABSTRACT: The Dutch Obesity Intervention in Teenagers (DOiT) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands. The initial programme showed promising results during an effectiveness trial. The programme was adapted and prepared for nationwide dissemination. To gain more insight into the process of translating evidence-based approaches into ‘real world’ (i.e., ‘natural’) conditions, our research aims were to evaluate the impact of the DOiT-implementation programme on adolescents’ adiposity and energy balance-related behaviours during natural dissemination and to explore the mediating and moderating factors underlying the DOiT intervention effects. We conducted a cluster-controlled implementation trial with 20 voluntary intervention schools (n=1002 adolescents) and 9 comparable control schools (n = 484 adolescents). We measured adolescents’ body height and weight, skinfold thicknesses, and waist circumference. We assessed adolescents’ dietary and physical activity behaviours by means of self-report. Data were collected at baseline and at 20-months follow-up. We used multivariable multilevel linear or logistic regression analyses to evaluate the intervention effects and to test the hypothesised behavioural mediating factors. We checked for potential effect modification by gender, ethnicity and education level. We found no significant intervention effects on any of the adiposity measures or behavioural outcomes. Furthermore, we found no mediating effects by any of the hypothesised behavioural mediators. Stratified analyses for gender showed that the intervention was effective in reducing sugar-containing beverage consumption in girls (B = -188.2 ml/day; 95% CI = -344.0; -32.3). In boys, we found a significant positive intervention effect on breakfast frequency (B = 0.29 days/week; 95% CI = 0.01; 0.58). Stratified analyses for education level showed an adverse intervention effect (B = 0.09; 95% CI = 0.02; 0.16) on BMI z-scores for adolescents attending the vocational education track. Although not successful in changing adolescents’ adiposity, the DOiT-implementation programme had some beneficial effects on specific obesity-related behaviours in subgroups. This study underlines the difficulty of translating intervention effectiveness in controlled settings to real world contexts. Adaptations to the implementation strategy are needed in order to promote implementation as intended by the teachers. Trial registration Current Controlled Trials ISRCTN92755979.
    International Journal of Behavioral Nutrition and Physical Activity 12/2014; 11(1). DOI:10.1186/s12966-014-0158-0 · 3.68 Impact Factor
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    ABSTRACT: The World Health Organization recommends strategies to improve urban design, public transportation, and recreation facilities to facilitate physical activity for non-communicable disease prevention for an increasingly urbanized global population. Most evidence supporting environmental associations with physical activity comes from single countries or regions with limited variation in urban form. This paper documents variation in comparable built environment features across countries from diverse regions. The International Physical Activity and the Environment Network (IPEN) study of adults aimed to measure the full range of variation in the built environment using geographic information systems (GIS) across 12 countries on 5 continents. Investigators in Australia, Belgium, Brazil, Colombia, the Czech Republic, Denmark, China, Mexico, New Zealand, Spain, the United Kingdom, and the United States followed a common research protocol to develop internationally comparable measures. Using detailed instructions, GIS-based measures included features such as walkability (i.e., residential density, street connectivity, mix of land uses), and access to public transit, parks, and private recreation facilities around each participant’s residential address using 1-km and 500-m street network buffers. Eleven of 12 countries and 15 cities had objective GIS data on built environment features. We observed a 38-fold difference in median residential densities, a 5-fold difference in median intersection densities and an 18-fold difference in median park densities. Hong Kong had the highest and North Shore, New Zealand had the lowest median walkability index values, representing a difference of 9 standard deviations in GIS-measured walkability. Results show that comparable measures can be created across a range of cultural settings revealing profound global differences in urban form relevant to physical activity. These measures allow cities to be ranked more precisely than previously possible. The highly variable measures of urban form will be used to explain individuals’ physical activity, sedentary behaviors, body mass index, and other health outcomes on an international basis. Present measures provide the ability to estimate dose–response relationships from projected changes to the built environment that would otherwise be impossible.
    International Journal of Health Geographics 10/2014; 13(1):43. DOI:10.1186/1476-072X-13-43 · 2.62 Impact Factor
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    Gang He · Ester Cerin · Wendy Y Huang · Stephen H Wong
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    ABSTRACT: Background Relationships between the neighborhood environment and children’s physical activity have been well documented in Western countries but are less investigated in ultra-dense Asian cities. The aim of this study was to identify the environmental facilitators and barriers of physical activity behaviors among Hong Kong Chinese children using nominal group technique. Methods Five nominal groups were conducted among 34 children aged 10–11 years from four types of neighborhoods varying in socio-economic status and walkability in Hong Kong. Environmental factors were generated by children in response to the question “What neighborhood environments do you think would increase or decrease your willingness to do physical activity?” Factors were prioritized in order of their importance to children’s physical activity. Results Sixteen unique environmental factors, which were perceived as the most important to children’s physical activity, were identified. Factors perceived as physical activity-facilitators included “Sufficient lighting”, “Bridge or tunnel”, “Few cars on roads”, “Convenient transportation”, “Subway station”, “Recreation grounds”, “Shopping malls with air conditioning”, “Fresh air”, “Interesting animals”, and “Perfume shop”. Factors perceived as physical activity-barriers included “People who make me feel unsafe”, “Crimes nearby”, “Afraid of being taken or hurt at night”, “Hard to find toilet in shopping mall”, “Too much noise”, and “Too many people in recreation grounds”. Conclusions Specific physical activity-related environmental facilitators and barriers, which are unique in an ultra-dense city, were identified by Hong Kong children. These initial findings can inform future examinations of the physical activity-environment relationship among children in Hong Kong and similar Asian cities.
    PLoS ONE 09/2014; 9(9):e106578. DOI:10.1371/journal.pone.0106578 · 3.23 Impact Factor
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    Yi-Nam Suen · Ester Cerin · Robin R Mellecker
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    ABSTRACT: Background Parents¿ perceived informal social control, defined as the informal ways residents intervene to create a safe and orderly neighbourhood environment, may influence young children¿s physical activity (PA) in the neighbourhood. This study aimed to develop and test the reliability of a scale of PA-related informal social control relevant to Chinese parents/caregivers of pre-schoolers (children aged 3 to 5 years) living in Hong Kong.Methods Nominal Group Technique (NGT), a structured, multi-step brainstorming technique, was conducted with two groups of caregivers (mainly parents; n¿=¿11) of Hong Kong pre-schoolers in June 2011. Items collected in the NGT sessions and those generated by a panel of experts were used to compile a list of items (n¿=¿22) for a preliminary version of a questionnaire of informal social control. The newly-developed scale was tested with 20 Chinese-speaking parents/caregivers using cognitive interviews (August 2011). The modified scale, including all 22 original items of which a few were slightly reworded, was subsequently administered on two occasions, a week apart, to 61 Chinese parents/caregivers of Hong Kong pre-schoolers in early 2012. The test-retest reliability and internal consistency of the items and scale were examined using intraclass correlation coefficients (ICC), paired t-tests, relative percentages of shifts in responses to items, and Cronbach¿s ¿ coefficient.ResultsThirteen items generated by parents/caregivers and nine items generated by the panel of experts (total 22 items) were included in a first working version of the scale and classified into three subscales: ¿Personal involvement and general informal supervision¿, ¿Civic engagement for the creation of a better neighbourhood environment¿ and ¿Educating and assisting neighbourhood children¿. Twenty out of 22 items showed moderate to excellent test-test reliability (ICC range: 0.40-0.81). All three subscales of informal social control showed acceptable levels of internal consistency (Cronbach ¿ >0.70).ConclusionsA reliable scale examining PA-related informal social control relevant to Chinese parents/caregivers of pre-schoolers living in Hong Kong was developed. Further studies should examine the factorial validity of the scale, its associations with Chinese children¿s PA and its appropriateness for other populations of parents of young children.
    International Journal of Behavioral Nutrition and Physical Activity 07/2014; 11(1):87. DOI:10.1186/s12966-014-0087-y · 3.68 Impact Factor
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    ABSTRACT: Background While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults’ PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants’ PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults’ PA behaviors. Methods A systematic search was conducted in databases of various disciplines, including: health, architecture and urban planning, transportation, and interdisciplinary databases. From 3,047 articles identified in the physical activity, initial search, 31 articles published from 1996 to 2012 met all inclusion criteria. An inductive content analysis was performed on the extracted findings to identify emerging environmental elements related to older adults’ PA. The identified environmental elements were then grouped by study methodologies [indoor interviews (individual or focus groups) vs spatial methods (photo-voice, observations, walk-along interviews)]. Results This review provides detailed information about environmental factors that potentially influence older adults’ PA behaviors. These factors were categorized into five themes: pedestrian infrastructure, safety, access to amenities, aesthetics, and environmental conditions. Environmental factors especially relevant to older adults (i.e., access to facilities, green open spaces and rest areas) tended to emerge more frequently in studies that combined interviews with spatial qualitative methods. Conclusions Findings showed that qualitative research can provide in-depth information on environmental elements that influence older adults’ PA. Future qualitative studies on the physical environment and older adults’ PA would benefit from combining interviews with more spatially-oriented methods. Multidisciplinary mixed-methods studies are recommended to establish quantitative relationships complemented with in-depth qualitative information.
    International Journal of Behavioral Nutrition and Physical Activity 07/2014; 11(1):79. DOI:10.1186/1479-5868-11-79 · 3.68 Impact Factor
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    ABSTRACT: Background Latino children are at high risk of becoming obese. Physical activity (PA) can help prevent obesity. Parents can influence children’s PA through parenting practices. This study aimed to examine the independent contributions of (1) sociodemographic, (2) cultural, (3) parent perceived environmental, and (4) objectively measured environmental factors, to PA parenting practices. Methods A cross-sectional sample of Latino parents (n = 240) from Harris County, TX in 2011–2012 completed validated questionnaires to assess PA parenting practices, acculturation, familism, perception of their neighborhood environment, and demographics. Home addresses were mapped and linked to Census block-level crime and traffic data. Distance to the closest park was mapped by GIS. Regression models were built in a hierarchical step-wise fashion. Results Combined models showed R2 of 6.8% to 38.9% for different parenting practices. Significant correlations included sociodemographic variables with having outdoor toys available, psychological control, and promotion of inactivity. Cultural factors correlated with PA safety concern practices. Perceived environmental attributes correlated with five of seven parenting practices, while objectively-measured environmental attributes did not significantly correlate with PA parenting practices. Conclusion Interventions promoting PA among Latino preschoolers may need to address the social-ecological context in which families live to effectively promote PA parenting, especially parents’ perceptions of neighborhoods.
    BMC Public Health 07/2014; 14(1):707. DOI:10.1186/1471-2458-14-707 · 2.32 Impact Factor
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    ABSTRACT: Background: Physical activity (PA) has been consistently implicated in the etiology of obesity, whereas recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose–response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose–response associations of accelerometer-based PA and sedentary time with body mass index (BMI) and weight status in 10 countries, and the moderating effects of study site and gender.
    International journal of obesity (2005) 07/2014; 39(2). DOI:10.1038/ijo.2014.115 · 5.39 Impact Factor
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    ABSTRACT: Physical activity and sedentary behaviour are important contributors to adolescents' health. These behaviours may be affected by the school and neighbourhood built environments. However, current evidence on such effects is mainly limited to Western countries. The International Physical Activity and the Environment Network (IPEN) - Adolescent study aims to examine associations of the built environment with adolescent physical activity and sedentary behaviour across five continents.We report on the repeatability of measures of in-school and out-of school physical activity, plus measures of out-of-school sedentary and travel behaviours adopted by the IPEN - Adolescent study and adapted for Chinese-speaking Hong Kong adolescents participating in the international Healthy environments and active living in teenagers - (Hong Kong) [iHealt(H)] study, which is part of IPEN - Adolescent.
    BMC Pediatrics 06/2014; 14(1):142. DOI:10.1186/1471-2431-14-142 · 1.92 Impact Factor
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    ABSTRACT: METHODS AND RESULTS: Overweight/obese adults (n = 19; aged 45-65 years) were recruited for a randomized three-treatment crossover trial with a one-week washout between treatments: 1) uninterrupted sitting; 2) sitting with 2 min bouts of light-intensity walking at 3.2 km/h every 20 min; and, 3) sitting with 2 min bouts of moderate-intensity walking at between 5.8 and 6.4 km/h every 20 min. After an initial 2 h period seated, participants consumed a test meal (75 g carbohydrate, 50 g fat) and completed each condition over the next 5 h. Resting blood pressure was assessed oscillometrically every hour as a single measurement, 5 min prior to each activity bout. GEE models were adjusted for sex, age, BMI, fasting blood pressure and treatment order. After adjustment for potential confounding variables, breaking up prolonged sitting with light and moderate-intensity activity breaks was associated with lower systolic blood pressure [light: 120 ± 1 mmHg (estimated marginal mean ± SEM), P = 0.002; moderate: 121 ± 1 mmHg, P = 0.02], compared to uninterrupted sitting (123 ± 1 mmHg). Diastolic blood pressure was also significantly lower during both of the activity conditions (light: 76 ± 1 mmHg, P = 0.006; moderate: 77 ± 1 mmHg, P = 0.03) compared to uninterrupted sitting (79 ± 1 mmHg). No significant between-condition differences were observed in mean arterial pressure or heart rate.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 05/2014; 24(9). DOI:10.1016/j.numecd.2014.04.011 · 3.88 Impact Factor
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    ABSTRACT: Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multi-site evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively-measured PA outcomes; between-site differences in such associations; and, the extent to which perceived environmental attributes explain between-site differences in PA. This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and USA. Participants were 6,968 adults residing in administrative units stratified by socio-economic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min/week of MVPA). Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix - access were significant predictors of both PA outcomes in the fully-adjusted models. Environmental attributes accounted for within-site variability in MVPA corresponding to a 3 min/d or 21 min/week standard deviation. Large between-site differences in PA outcomes were observed: 15.9% to 16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Residents' perceptions of neighborhood attributes that facilitate walking were positively associated with objectively-measured MVPA and meeting the guidelines for cancer/weight gain prevention at the within- and between-site levels. Associations were similar across study sites, lending support for international recommendations for designing PA-friendly built environments.
    Medicine and science in sports and exercise 04/2014; 46(12). DOI:10.1249/MSS.0000000000000367 · 4.46 Impact Factor

Publication Stats

3k Citations
406.56 Total Impact Points

Institutions

  • 2014–2015
    • Deakin University
      • • Centre for Physical Activity and Nutrition Research
      • • School of Exercise and Nutrition Sciences
      Geelong, Victoria, Australia
  • 2006–2014
    • The University of Hong Kong
      • Institute of Human Performance
      Hong Kong, Hong Kong
  • 2008–2013
    • Baylor College of Medicine
      • • Department of Pediatrics
      • • Children's Nutrition Research Center
      Houston, Texas, United States
  • 2012
    • Baker IDI Heart and Diabetes Institute
      • Clinical Diabetes and Epidemiology Research Group
      Melbourne, Victoria, Australia
  • 2009
    • Queensland Health
      Brisbane, Queensland, Australia
  • 2004–2008
    • University of Queensland 
      • • Cancer Prevention Research Centre
      • • School of Population Health
      Brisbane, Queensland, Australia
  • 2007
    • Cancer Council Queensland
      Brisbane, Queensland, Australia
  • 2005
    • Griffith University
      Southport, Queensland, Australia
  • 2000–2004
    • Nottingham Trent University
      • School of Social Sciences
      Nottigham, England, United Kingdom