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Seminar – 19 October 2015 – Dr Dafna Merom
October 19, 2015 @ 12:30 pm - 1:30 pm
All are invited to the CEDAR/MRC Epidemiology Seminar by Dr Dafna Merom, Associate Professor in Physical Activity & Health, School of Science and Health, University of Western Sydney
Meeting Rooms 1&2, Level 4, Institute of Metabolic Science, Addenbrooke’s Treatment Centre
The performance of home-based interventions to increase walking in supportive and unsupportive environmental conditions
Over the past decade extensive research has been dedicated to the relationship between the built environments and walking. Relatively consistent associations between certain perceived and objectively measured neighborhood attributes and walking have been reported for children, adolescents and young and middle-aged adults, although in older populations (>60 years) the relationships have been inconsistent. A major limitation of the evidence accumulated to date is the dominance of cross-sectional designs. Randomized controlled trials (RCTs) that aim to increase walking can potentially afford new insights on the role of neighborhood attributes; first, RCTs are longitudinal in nature and can identify neighborhood attributes at baseline which predict a change in walking, after accounting for intervention effect and psychosocial determinants (e.g., self-efficacy, social support). Second, data from RCTs can be analyzed to determine whether the response to the intervention is moderated by attributes of participants’ neighborhoods and whether intervention can buffer the effect of unsupportive environment. While many physical activity interventions in the past two decades have been focused on the promotion of walking, these have rarely examined how their effects varied by the attributes of the environment.
In two communities based RCT conducted in Australia, the performance of home-based self-paced walking program were examined in relation to perceived environment walkability at baseline. In middle aged adults participants reporting low aesthetics and street lighting engaged in 24% and 22% fewer minutes of walking respectively than did participants with high scores on these attributes. The effect of the intervention was significant only in environment perceived as “low esthetic” (p for interaction =0.001). In older adults low perceived walkability was shaped by health status and did not appear to be a barrier to walking behavior, but the intervention had greater effects in neighborhoods perceived to have poorer pedestrian infrastructure (p for interaction=0.036).
In conclusion, certain attributes of the environment facilitated walking behavior change in motivated participants even without intervention. There appears to be a greater impact of, and thus, need for, interventions to encourage walking in environments perceived not to have supportive walking conditions.
About Dr Merom
Dr Dafna Merom joined the University of Western Sydney in July 2011 as Associate Professor in Physical Activity and Health. Prior to this appointment she was a senior research fellow, in the School of Public Health University of Sydney, a specialised physical activity epidemiologist in the NSW Centre for Physical Activity and Health, University of New South Wales and a senior epidemiologist in the Israeli Centre for Disease Control, Department of Health. Her academic background comprises of education, exercise science including PDHPE and Dance Teaching Diplomas, master in public health major in epidemiology, health education and health promotion. Dafna’s research interests are in areas of physical activity measurement, surveillance, improving the knowledge-base on the role of lifestyle physical activity. Read more here.
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