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  • Author: Christine Hoehner x
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Tegan K. Boehmer, Christine M. Hoehner, Kathleen W. Wyrwich, Laura K. Brennan Ramirez and Ross C. Brownson

Background:

Neighborhood environmental supports for physical activity are assessed via telephone surveys (perceived) and environmental audits (observed), but the correspondence between methods is not known.

Methods.

Surveys (N = 1068) and audits were conducted concurrently in four diverse urban settings to measure recreational facilities, land use, transportation environment, and aesthetics. Agreement was assessed with kappa (κ) statistics.

Results.

Kappa values ranged from –0.06 to 0.47 for the 28 item-pairs: 17 item-pairs were classified as poor agreement (κ ≤ 0.20), 10 as fair (κ = 0.21-0.40), and 1 as good (κ = 0.47). The highest agreement was observed for proximity to parks, trails, and various land-use destinations, presence of sidewalks, and measures of neighborhood maintenance and cleanliness.

Conclusions.

Methodological issues and/or the likelihood of capturing distinct aspects of the environment may explain the generally low correspondence between survey and audit measures. Our findings should help researchers make informed decisions regarding measurement of environmental supports for physical activity.

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Ross C. Brownson, Christine M. Hoehner, Laura K. Brennan, Rebeka A. Cook, Michael B. Elliott and Kathleen M. McMullen

Purpose:

To understand the relationships between street-scale environments and rates of physical activity, it is crucial to develop reliable methods of measurement. Community audits are commonly used to test the walkability and bikability of environments, yet few have been tested for reliability.

Methods:

Audit tools were collected from the peer-reviewed literature, the Internet, and experts from a variety of backgrounds. Two versions of an audit instrument were created: an “analytic” (with Likert-scale and ordinal-response choices) and a “checklist” (with dichotomous response choices) audit tool. Audits were conducted in St Louis, MO for 147 street segments, representing both higher and lower income neighborhoods. The same segments were re-audited to assess interrater reliability.

Results:

Characteristics of the physical environment varied considerably across lower and higher income segments. For example, in the checklist audit, physical disorder was present for 67 segments in lower income segments, compared with 0 segments in higher income segments. Among 8 questions from each audit tool designed to broadly capture environmental attributes, most had moderate to poor agreement. Most of the transportation and land-use items demonstrated high (substantial or perfect) agreement, and the aesthetics and social environment items showed reliability in the moderate to fair range.

Conclusions:

A community audit tool can be relatively easy and quick to administer and, for many domains, is reliable. Our audit tools appear particularly well suited for capturing elements in the transportation and land-use environments.

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Pedro C. Hallal, Rodrigo S. Reis, Diana C. Parra, Christine Hoehner, Ross C. Brownson and Eduardo J. Simões

Background:

To evaluate the association between perceived environmental factors and leisure-time and transport-related physical activity.

Methods:

A random-digit-dialing telephone cross-sectional survey in Recife, Brazil, was conducted among individuals aged 16 years or older (n = 2046). Leisure-time and transport-related physical activity were measured using the long version of the International Physical Activity Questionnaire. Three outcome variables were used: leisure-time physical activity (min/wk), transport-related physical activity (min/wk), and walking for leisure (min/wk). A cutoff of 150 min/wk was used for all outcome variables. The environmental module of the questionnaire was based on the short version of the Neighborhood Environment Walkability Scale (A-NEWS), and included 12 environmental items.

Results:

The proportions of subjects reaching the 150-minutes per week threshold were 30.6% for leisure-time physical activity, 26.6% for transport-related physical activity and 18.2% for walking for leisure. Lack of sidewalks and low access to recreational facilities were associated with a lower likelihood of performing 150 minutes per week or more of leisure-time physical activity. Lack of sidewalks was associated with low levels of walking for leisure. Neighborhood aesthetics was inversely associated with transport-related physical activity.

Conclusions:

Lack of sidewalks and low access to recreational facilities were predictors of low levels of leisure-time physical activity, suggesting that policy strategies aimed at improving these environmental features may be warranted.

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Cheryl Carnoske, Christine Hoehner, Nicholas Ruthmann, Lawrence Frank, Susan Handy, James Hill, Sherry Ryan, James Sallis, Karen Glanz and Ross Brownson

Background:

Although public support for physical activity-friendly Traditional Neighborhood Developments (TNDs) appears to be growing, information is lacking on private sector perspectives and how economic factors (eg, fuel prices) might influence the development and sale of TNDs.

Methods:

A sample of realtors from the National Association of Realtors (n = 4950) and developers from the National Association of Home Builders (n = 162) were surveyed in early 2009 to assess factors influencing homebuyers' decisions; incentives and barriers to developing TNDs; effects of depressed housing market conditions and financing on sales; trends in buying; and energy considerations (eg, green building).

Results:

Realtors believed that homebuyers continue to rank affordability, safety and school quality higher than TND amenities. Developers reported numerous barriers to TNDs, including the inability to overcome governmental/political hurdles, lack of cooperation between government agencies, and lack of market demand. Yet, realtors believed clients are increasingly influenced by gas and oil prices, and developers reported that clients are looking for energy efficient homes, reduced commute time, and walkable neighborhoods. Respondents reported consumers are more interested in living in a TND than 5 years ago.

Conclusions:

Activity-friendly TNDs appear to be increasing in demand, but developers and realtors reported significant barriers to creating these communities.

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Christine Hoehner, Jesus Soares, Diana C. Parra, Isabela C. Ribeiro, Michael Pratt, Mario Bracco, Pedro C. Hallal and Ross C. Brownson

Background:

This review assessed whether conference abstracts yield useful information on the types and effectiveness of community-based physical activity (PA) interventions in Latin America, beyond that from interventions included in a recent systematic review of peer-reviewed literature.

Methods:

Abstracts from 9 conferences were searched for community-based interventions to promote PA in Latin America and summarized. Three reviewers classified and screened abstracts. Evaluated interventions that were not included in the previous review were assessed.

Results:

Search of abstracts from 31 proceedings of 9 conferences identified 87 abstracts of studies on community-based interventions focused on increasing PA. Only 31 abstracts reported on studies with a control group and an outcome related to PA. Ten of these abstracts represented interventions that had not been included in the previous review of peer-reviewed literature, but the abstracts were insufficient in number or detail to make a practice recommendation for any single intervention.

Conclusions:

This review highlighted the challenges and low added value of including conference abstracts in a systematic review of community PA interventions in Latin America. Stronger evaluation design and execution and more published reports of evaluated interventions are needed to build an evidence base supporting interventions to increase PA in Latin America.

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Rodrigo S. Reis, Pedro C. Hallal, Diana C. Parra, Isabela C. Ribeiro, Ross C. Brownson, Michael Pratt, Christine M. Hoehner and Luiz Ramos

Background:

Community programs have been suggested to be an important and promising strategy for physical activity (PA) promotion. Limited evidence is available regarding knowledge of and participation in these programs in Latin America.

Objective:

To describe participation in and knowledge of community PA programs and to explore associations with leisure-time PA in the city of Curitiba, Brazil.

Methods:

A cross sectional telephone survey was conducted among adults in Curitiba, Brazil (n = 2097). The International Physical Activity Questionnaire was used to determine levels of PA, and specific questions were used to evaluate the extent to which respondents knew about or participated in the programs conducted by the municipality. Logistic regression was used to assess the meeting of PA recommendations in leisure time based on program knowledge and participation.

Results:

Knowledge of PA programs was high (91.6%) and 5.6% of population participated in the programs. After adjusting for individual characteristics, exposure to Curitiba's PA community programs was associated with leisure-time PA (POR = 2.9, 95% CI = 2.9−3.0) and walking for leisure (POR = 2.4; 95% CI = 2.3−2.4). The associations were stronger among men than among women.

Conclusions:

Knowledge and participation in Curitiba's community PA programs were associated with meeting recommended levels of PA in leisure time.

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Isabela C. Ribeiro, Andrea Torres, Diana C. Parra, Rodrigo Reis, Christine Hoehner, Thomas L. Schmid, Michael Pratt, Luiz R. Ramos, Eduardo J. Simões and Ross C. Brownson

Background:

The Guide for Useful Interventions for Activity in Brazil and Latin America (GUIA), a systematic review of community-based physical activity (PA) interventions in Latin American literature, selected the CuritibAtiva program for a comprehensive evaluation. We describe the process of developing logic models (LM) of PA community interventions from Curitiba, Brazil, and discuss influential factors.

Methods:

The year-long process included engaging stakeholders involved in the promotion of PA in Curitiba, working with stakeholders to describe the programs and their goals, and developing LMs for the 2 main secretaries promoting PA in the city.

Results & Conclusions:

As a result of stakeholder interviews and discussion and the development of the LMs, local officials are coordinating programming efforts and considering ways the programs can be more complementary. The process has prompted program managers to identify overlapping programs, refine program goals, and identify gaps in programming. It also helped to frame evaluation questions, identify data sources, describe realistic outcomes, and reinforce the importance of intersectoral alliances for public health impact. Developing LMs proved to be feasible in the Latin American context, therefore adaptable and useful for other PA promotion programs in the region.

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Christine M. Hoehner, Ross C. Brownson, Diana Allen, James Gramann, Timothy K. Behrens, Myron F. Floyd, Jessica Leahy, Joseph B. Liddle, David Smaldone, Diara D. Spain, Daniel R. Tardona, Nicholas P. Ruthmann, Rachel L. Seiler and Byron W. Yount

Background:

We synthesized the results of 7 National Park Service pilot interventions designed to increase awareness of the health benefits from participation in recreation at national parks and to increase physical activity by park visitors.

Methods:

A content analysis was conducted of the final evaluation reports of the 7 participating parks. Pooled data were also analyzed from a standardized trail-intercept survey administered in 3 parks.

Results:

The theme of new and diverse partnerships was the most common benefit reported across the 7 sites. The 2 parks that focused on youth showed evidence of an increase in awareness of the benefits of physical activity. Many of the other sites found high levels of awareness at baseline (approaching 90%), suggesting little room for improvement. Five of the 7 projects showed evidence of an increase in physical activity that was associated with the intervention activities. Multivariate analyses suggested that the media exposure contributed to a small but significant increase in awareness of the importance of physical activity (6%) and number of active visits (7%).

Conclusions:

Enhancements and replication of these programs represents a promising opportunity for improving partnerships between public health and recreation to increase physical activity.

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Ross C. Brownson, Diana C. Parra, Marsela Dauti, Jenine K. Harris, Pedro C. Hallal, Christine Hoehner, Deborah Carvalho Malta, Rodrigo S. Reis, Luiz Roberto Ramos, Isabela C. Ribeiro, Jesus Soares and Michael Pratt

Background:

Physical inactivity is a significant public health problem in Brazil that may be addressed by partnerships and networks. In conjunction with Project GUIA (Guide for Useful Interventions for Physical Activity in Brazil and Latin America), the aim of this study was to conduct a social network analysis of physical activity in Brazil.

Methods:

An online survey was completed by 28 of 35 organizations contacted from December 2008 through March 2009. Network analytic methods examined measures of collaboration, importance, leadership, and attributes of the respondent and organization.

Results:

Leadership nominations for organizations studied ranged from 0 to 23. Positive predictors of collaboration included: south region, GUIA membership, years working in physical activity, and research, education, and promotion/practice areas of physical activity. The most frequently reported barrier to collaboration was bureaucracy.

Conclusion:

Social network analysis identified factors that are likely to improve collaboration among organizations in Brazil.