Neighbourhood walkability and home neighbourhood-based physical activity: an observational study of adults with type 2 diabetes

Samantha Hajna, Yan Kestens, Stella S Daskalopoulou, Lawrence Joseph, Benoit Thierry, Mark Sherman, Luc Trudeau, Rémi Rabasa-Lhoret, Leslie Meissner, Simon L Bacon, Lise Gauvin, Nancy A Ross, Kaberi Dasgupta, Diabetes, GPS, and Walkablilty Study Group, Sabiha Awan, Alexis Baass, Jean-Marie Boutin, Candace Lee, Carolina Capelle, Joanna Caron, Stavroula Christopolous, Karen Dahan, Maxine Dumas-Pilon, Roy Eappen, Leah Feldman, Natasha Garfield, Dominique Garrell, Lawrence Green, Walter Gregory, Wen Hu, Sofia Hussaini, John Hughes, Catherine Kudo, April Kinghorn, Evelyn Kyle, Leonora Lalla, Andrea Lalonde, Pierre Larochelle, Khue Ly, Richard Mackler, Agnieszka Majdan, Goldie Marmor, Sara Meltzer, Hortensia Mircescu, David Morris, Kimberly Munro, Vivian Petropoulos, Barry Posner, Brent Richards, Juan Rivera, Ghislaine Roederer, Samantha Sacks, Alicia Schiffrin, David Shannon, Raymond Sorge, Donald Sproule, Susan Still, Robert Wistaff, Mark Yaffe, Jean-Francois Yale, Hans Zingg, Samantha Hajna, Yan Kestens, Stella S Daskalopoulou, Lawrence Joseph, Benoit Thierry, Mark Sherman, Luc Trudeau, Rémi Rabasa-Lhoret, Leslie Meissner, Simon L Bacon, Lise Gauvin, Nancy A Ross, Kaberi Dasgupta, Diabetes, GPS, and Walkablilty Study Group, Sabiha Awan, Alexis Baass, Jean-Marie Boutin, Candace Lee, Carolina Capelle, Joanna Caron, Stavroula Christopolous, Karen Dahan, Maxine Dumas-Pilon, Roy Eappen, Leah Feldman, Natasha Garfield, Dominique Garrell, Lawrence Green, Walter Gregory, Wen Hu, Sofia Hussaini, John Hughes, Catherine Kudo, April Kinghorn, Evelyn Kyle, Leonora Lalla, Andrea Lalonde, Pierre Larochelle, Khue Ly, Richard Mackler, Agnieszka Majdan, Goldie Marmor, Sara Meltzer, Hortensia Mircescu, David Morris, Kimberly Munro, Vivian Petropoulos, Barry Posner, Brent Richards, Juan Rivera, Ghislaine Roederer, Samantha Sacks, Alicia Schiffrin, David Shannon, Raymond Sorge, Donald Sproule, Susan Still, Robert Wistaff, Mark Yaffe, Jean-Francois Yale, Hans Zingg

Abstract

Background: Converging international evidence suggests that diabetes incidence is lower among adults living in more walkable neighbourhoods. The association between walkability and physical activity (PA), the presumed mediator of this relationship, has not been carefully examined in adults with type 2 diabetes. We investigated the associations of walkability with total PA occurring within home neighbourhoods and overall PA, irrespective of location.

Methods: Participants (n = 97; 59.5 ± 10.5 years) were recruited through clinics in Montreal (QC, Canada) and wore a GPS-accelerometer device for 7 days. Total PA was expressed as the total Vector of the Dynamic Body Acceleration. PA location was determined using a Global Positioning System (GPS) device (SIRF IV chip). Walkability (street connectivity, land use mix, population density) was assessed using Geographical Information Systems software. The cross-sectional associations between walkability and location-based PA were estimated using robust linear regressions adjusted for age, body mass index, sex, university education, season, car access, residential self-selection, and wear-time.

Results: A one standard deviation (SD) increment in walkability was associated with 10.4 % of a SD increment in neighbourhood-based PA (95 % confidence interval (CI) 1.2, 19.7) - equivalent to 165 more steps/day (95 % 19, 312). Car access emerged as an important predictor of neighbourhood-based PA (Not having car access: 38.6 % of a SD increment in neighbourhood-based PA, 95 % CI 17.9, 59.3). Neither walkability nor car access were conclusively associated with overall PA.

Conclusions: Higher neighbourhood walkability is associated with higher home neighbourhood-based PA but not with higher overall PA. Other factors will need to be leveraged to facilitate meaningful increases in overall PA among adults with type 2 diabetes.

Keywords: Accelerometry; Environmental epidemiology; Global Positioning Systems; Health geography; Neighbourhood walkability; Physical activity; Physical activity locations; Type 2 diabetes.

Figures

Fig. 1
Fig. 1
Selection of study cohort

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Source: PubMed

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