Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/111137
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Type: Journal article
Title: Does physical activity mediate the associations between local-area descriptive norms, built environment walkability, and glycosylated hemoglobin?
Author: Carroll, S.
Niyonsenga, T.
Coffee, N.
Taylor, A.
Daniel, M.
Citation: International Journal of Environmental Research and Public Health, 2017; 14(9):953-1-953-17
Publisher: MDPI AG
Issue Date: 2017
ISSN: 1661-7827
1660-4601
Statement of
Responsibility: 
Suzanne J. Carroll, Theo Niyonsenga, Neil T. Coffee, Anne W. Taylor and Mark Daniel
Abstract: Associations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m²) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.
Keywords: Physical activity; cardiometabolic disease; residential environments; descriptive norms; built environment; walkability; mediation; glycosylated hemoglobin
Rights: © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
RMID: 0030075476
DOI: 10.3390/ijerph14090953
Grant ID: http://purl.org/au-research/grants/nhmrc/570150
http://purl.org/au-research/grants/nhmrc/631917
Appears in Collections:Geography, Environment and Population publications

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