@article{ref1,
title="Walking for Transportation or Leisure: What Difference Does the Neighborhood Make?",
journal="Journal of general internal medicine",
year="2007",
author="Wen, M. and Kandula, Namratha R. and Lauderdale, Diane S.",
volume="22",
number="12",
pages="1674-1680",
abstract="BACKGROUND: Patients are often advised to initiate a physical activity program by walking for transportation or leisure. This study explored whether neighborhood factors beyond the individual might affect compliance. OBJECTIVE: We examined the associations between total walking and neighborhood factors in a multi-ethnic population-based sample in California and the roles race/ethnicity plays in these associations. DESIGN: Cross-sectional study PARTICIPANTS: Individual-level data were obtained from the 2003 California Health Interview Survey. Participants' census tracts were linked to Census 2000 data to capture neighborhood SES. MEASUREMENTS AND MAIN RESULTS: The dependent variable was self-reported walking at recommended levels. Neighborhood SES was measured by a scale of 4 Census-based variables (alpha = 0.83). Social cohesion was measured by a scale tapping the extent of perceived social connectedness, trust, and solidarity among neighbors (alpha = 0.70). Neighborhood access to a park, playground, or open space was measured by a single item. Safety was measured by a scale of three items (alpha = 0.66). We performed a series of multiple logit models with robust variance estimates while taking complex survey design into account. Neighborhood social cohesion (odds ratio [OR] = 1.09, 95% CI = 1.04, 1.14) and access to a park, playground, or open space (OR = 1.26, 95% CI = 1.16, 1.36) were significant environmental correlates of walking at recommended levels, independent of individual socio-demographics. Subgroup analysis showed that neighborhood effects were different by race/ethnicity. CONCLUSIONS: Neighborhood physical and social environmental factors are significantly associated with walking at recommended levels. Being aware of the ways that the environment could affect a patient's compliance with PA recommendations may help physicians tailor recommendations to circumstances.<p /> <p>Language: en</p>",
language="en",
issn="0884-8734",
doi="10.1007/s11606-007-0400-4",
url="http://dx.doi.org/10.1007/s11606-007-0400-4"
}