Income and racial disparities in access to public parks and private recreation facilities.

Background: Disparities in health outcomes and health behaviors may be partially explained by neighborhood environments that are poor in resources that could support healthy behaviors. The purpose of this study was to test the hypothesis that low-income and high-minority neighborhoods have less access to public parks, open space, and private recreation facilities.

Methods: From 2004 to 2005, an inventory of 351 private recreation facilities and 465 public parks was conducted in 833 Census block groups in Maryland.

Recommendations for treatment of child and adolescent overweight and obesity.

In this article, we review evidence about the treatment of obesity that may have applications in primary care, community, and tertiary care settings. We examine current information about eating behaviors, physical activity behaviors, and sedentary behaviors that may affect weight in children and adolescents. We also review studies of multidisciplinary behavior-based obesity treatment programs and information about more aggressive forms of treatment.

Neighborhood walkability and the walking behavior of Australian adults.

Background: The physical attributes of residential neighborhoods, particularly the connectedness of streets and the proximity of destinations, can influence walking behaviors. To provide the evidence for public health advocacy on activity-friendly environments, large-scale studies in different countries are needed. Associations of neighborhood physical environments with adults' walking for transport and walking for recreation must be better understood.

Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial.

Context: No trials for childhood overweight have examined maintenance interventions to augment the effects of initial weight loss programs.

Objectives: To determine the short-term and long-term efficacy of 2 distinct weight maintenance approaches vs no continued treatment control following standard family-based behavioral weight loss treatment for childhood overweight, and to examine children's social functioning as a moderator of outcome.

Design, Setting, And Participants: A parallel-group, randomized controlled trial conducted between October 1999 and July 2004 in a university-based weight control clinic.

Clinician's comment on treatment of childhood overweight meta-analysis.

Given the prevalence and urgency of the childhood overweight problem, pediatric providers are searching for evidence-based management to translate into clinical practice, particularly in primary care. There are numerous challenges to translation and therefore to more widespread adoption of childhood overweight treatment recommendations. In this article, the authors try to bridge this gap between childhood overweight treatment research and clinical care by discussing the current evidence-based recommendations through a clinical case and by examining the challenges of translation.

Pretreatment and process predictors of outcome in interpersonal and cognitive behavioral psychotherapy for binge eating disorder.

The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined as nonabstinence from binge eating, was assessed at posttreatment and at 1 year following treatment completion.

Stepping towards causation: do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity?

Evidence documents associations between neighborhood design and active and sedentary forms of travel. Most studies compare travel patterns for people located in different types of neighborhoods at one point in time adjusting for demographics. Most fail to account for either underlying neighborhood selection factors (reasons for choosing a neighborhood) or preferences (neighborhoods that are preferred) that impact neighborhood selection and behavior.

Nutrition Environment Measures Survey in stores (NEMS-S): development and evaluation.

Background: Eating, or nutrition, environments are believed to contribute to obesity and chronic diseases. There is a need for valid, reliable measures of nutrition environments. This article reports on the development and evaluation of measures of nutrition environments in retail food stores.

Nutrition Environment Measures Study in restaurants (NEMS-R): development and evaluation.

Background: Americans are increasingly eating out, but nutrition environments in restaurants are poorly understood. An observational measure was developed to assess factors believed to contribute to food choices in restaurants, including availability of more healthy foods, facilitators and barriers to healthful eating, pricing, and signage/promotion of healthy and unhealthy foods.

Methods: Inter-rater and test-retest reliability were assessed in 217 sit-down and fast-food restaurants in four neighborhoods in 2004 and 2005.

The development of a data model for research on the environmental correlates of physical inactivity and obesity.

Development of information systems to support research on environmental correlates of physical activity and nutrition has to date been largely ad hoc and driven by single research project requirements. In this rapidly growing field, research databases are becoming increasingly complex as researchers attempt to model the impact of multiple aspects of the environment such as neighborhood characteristics, site and building design, and nutritional environments on both aggregate and individual level measures of physical activity and weight. The presentation reports on the initial implementation of a logical data model in the context of an ongoing research program that is exploring the relation of neighborhood physical and demographic characteristics on physical activity levels measured in time and space.

Visceral abdominal fat is correlated with whole-body fat and physical activity among 8-y-old children at risk of obesity.

Background: Abdominal fat is more related to health risk than is whole-body fat. Determining the factors related to children's visceral fat could result in interventions to improve child health.

Objective: Given the effects of physical activity on adults' visceral fat, it was hypothesized that, after accounting for whole-body fat, physical activity would be inversely related to children's visceral (VAT), but not to subcutaneous (SAT), abdominal adipose tissue.

Neighborhood Environment Walkability Scale: validity and development of a short form.

Purpose: The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated version (NEWS-A).

Methods: A stratified two-stage cluster sample design was used to recruit 1286 adults. The sample was drawn from residential addresses within eight high- and eight low-walkable neighborhoods matched for socioeconomic status.

Active commuting to school: Associations with environment and parental concerns.

Purpose: This study examined the association of objective and perceived neighborhood environmental characteristics and parent concerns with active commuting to school, investigated whether parental concerns varied by environmental characteristics, and compared the association of the perceived environment, parental concerns, and objective environment on the outcome active commuting to school.

Methods: Randomly selected parents of children (aged 5-18 yr), in neighborhoods chosen for their variability in objectively measured walkability and income, completed questionnaires about their neighborhood environment, concerns about children walking to school, and children's behavior (N = 259). Objective measures of the environment were available for each participant and each neighborhood.

Measuring Physical Environments of Parks and Playgrounds: EAPRS Instrument Development and Inter-Rater Reliability.

Background: Reliable and comprehensive measurement of physical activity settings is needed to examine environment-behavior relations.

Methods: Surveyed park professionals (n = 34) and users (n = 29) identified park and playground elements (e.g.

Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers.

Objective: Information regarding the prevalence, nature, sources, and psychosocial correlates of teasing was obtained for overweight (OV) children (10 to 14 years of age) vs. non-overweight (non-OV) peers. It was hypothesized that weight-related teasing would be negatively correlated with self-esteem in specific domains and with enjoyment of physical/social activities and positively correlated with loneliness, bulimic behaviors, body dissatisfaction, and enjoyment of sedentary/isolative activities.

Healthy nutrition environments: concepts and measures.

The authors provide a conceptual model of a healthy nutrition environment, then review the types of measures required to assess various aspects of this environment. Measures fall into priority categories of consumer and community environments.

Residents' perceptions of walkability attributes in objectively different neighbourhoods: a pilot study.

Physical attributes of local environments may influence walking. We used a modified version of the Neighbourhood Environment Walkability Scale to compare residents' perceptions of the attributes of two neighbourhoods that differed on measures derived from Geographic Information System databases. Residents of the high-walkable neighbourhood rated relevant attributes of residential density, land-use mix (access and diversity) and street connectivity, consistently higher than did residents of the low-walkable neighbourhood.

The association of neighborhood design and recreational environments with physical activity.

Purpose: To determine the association of neighborhood design factors and recreational environments with physical activity.

Methods: Randomly selected adults (n = 102, 52% female, 81% white, mean age = 48 years) completed a survey of eight neighborhood design variables, convenient recreational facilities, and availability of home equipment. Physical activity was measured by self-report and 7 days of accelerometer monitoring.

Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ.

Background: To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment.

Objective: To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant's home while controlling for sociodemographic covariates.

Methods: Objective measures of the built environment unique to each household's physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity.

Psychological adjustment of obese youth presenting for weight management treatment.

Objective: To determine the prevalence of psychological maladjustment in clinic-based treatment-seeking obese children and adolescents (BMI > or = 95th percentile) and the degree to which maternal, demographic, and youth factors correlate to the youths' psychological adjustment.

Research Methods And Procedures: Anthropometrics, demographics (race, sex, insurance status), measures of youth psychological adjustment (self- and mother-report; Behavior Assessment System for Children), and maternal self-report of psychological distress (Symptom Checklist 90-Revised) were collected from 121 obese children and adolescents (55% white, 45% black) and their mothers.

Results: Approximately one-third of youths self-reported some psychological maladjustment, but two-thirds of youth were described by their mothers as experiencing some degree of psychological maladjustment.

Environmental correlates of physical activity in a sample of Belgian adults.

Purpose: This study investigated the variance in sitting, walking, and moderate and vigorous physical activity explained by neighborhood design and recreational environmental variables above and beyond the variance accounted for by individual demographic variables.

Design: Cross-sectional analyses of self-reported survey data.

Setting: A random sample of inhabitants of Ghent, Belgium, aged 18-65 years, was drawn.

Neighborhood-based differences in physical activity: an environment scale evaluation.

Objectives: This study evaluated a neighborhood environment survey and compared the physical activity and weight status of the residents in 2 neighborhoods.

Methods: On 2 occasions, 107 adults from neighborhoods with differing "walkability" were selected to complete a survey on their neighborhood environment. Physical activity was assessed by self-report and by accelerometer; height and weight were assessed by self-report.

Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures.

Research in transportation, urban design, and planning has examined associations between physical environment variables and individuals' walking and cycling for transport. Constructs, methods, and findings from these fields can be applied by physical activity and health researchers to improve understanding of environmental influences on physical activity. In this review, neighborhood environment characteristics proposed to be relevant to walking/cycling for transport are defined, including population density, connectivity, and land use mix.

Overweight children's barriers to and support for physical activity.

Objective: As the epidemic of overweight increases among youth, research needs to examine factors that may influence children's participation in weight-related health behaviors. This study examined overweight children's perceived barriers to and support for physical activity compared with nonoverweight children.

Research Methods And Procedures: Barriers to and support for physical activity were examined among 84 overweight children attending a summer fitness camp or a university-based weight loss clinic.