Longitudinal associations of physical activity patterns and the environment: the Multi-Ethnic Study of Atherosclerosis (MESA)
Insufficient physical activity (PA) contributes to morbidity and premature mortality, while the perception of the environment may play a role in PA engagement. We analyzed longitudinal data from participants of the Multi-Ethnic Study of Atherosclerosis to evaluate the potential relationship between perceived environment and PA patterns over time. Exposure variables were the perceived aspects of the neighborhood environment and the perception of safety. MET-minutes/week were calculated from self-reported intentional PA, and participants were categorized into meeting (≥ 500 MET-minutes/week) versus not meeting PA guidelines. Based on data obtained at visits 1 and 6, we created categories of participants regarding meeting or not PA guidelines (adopters, relapsers, maintainers, and insufficiently active). Multinomial Poisson regression models were used to assess the association between environmental perceptions and outcome. Model 1 was adjusted for study site and contextual markers of SES; Model 2 was further adjusted for age, sex, race/ethnicity, educational level, marital status, and occupation; Model 3 was further adjusted for waist circumference, LDL cholesterol, HDL cholesterol, and triglycerides levels, hypertension diagnosis, diabetes diagnosis, smoking status, alcohol consumption, emphysema, asthma, arthritis, pain in the lower limbs and swelling of the feet and ankles. Perception of “lack of parks and playgrounds” as “not problematic” increased the risk of being a relapser, compared to be in the “maintainers” group. Perception of “poor sidewalks” as “somewhat a serious problem” was associated with a lower risk of becoming an adopter of PA. The perception of “unsafe neighborhood” was associated with the adopter and the insufficiently active group.