Neighborhood built and social environment and meeting physical activity recommendations among mid to older adults with joint pain
Neighborhood built and social environment and meeting physical activity recommendations among mid to older adults with joint pain
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DOI：
10.1016/j.pmedr.2020.101063
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发表时间：
2020-06-01
影响因子：
2.8
通讯作者：
Xaverius, Pamela
中科院分区：
文献类型：
--
作者：
Gebauer, Sarah;Schootman, Mario;Xaverius, Pamela
在美国，关节炎是导致残疾的主要原因，最有效的治疗方法是体育活动（PA）。关节炎患者不太可能达到PA的建议，社区环境可能起作用。本研究考察了美国成人关节炎患者中社区步行性和社会凝聚力对PA的影响。这项横断面研究使用了2015年全国健康访谈调查数据。符合条件的参与者年龄为bb0 = 45岁，患有关节炎，近期腿部关节疼痛，数据完整。可步行性基于6个问题，这些问题涉及促进步行的设施和目的地。社会凝聚力基于4个验证问题。会议PA定义为每周150分钟。卡方检验和逻辑回归确定了社区环境与PA之间的关系，包括社会凝聚力和步行性之间的相互作用。最终的未加权样本包括3826名参与者，平均年龄为64.6岁（SE = 0.26）， 61.8%为女性，78.1%为非西班牙裔白人。在调整后的加权分析中，与高度适宜步行的社区相比，不适宜步行的社区、轻度适宜步行的社区和中度适宜步行的社区达到PA建议的几率都较低（OR= 0.61[95% CI 0.41-0.92]、OR= 0.65[95% CI 0.50-0.85]、OR= 0.75[95% CI 0.59-0.97]）。社会凝聚力与满足PA指南的几率降低独立相关（p = 0.003）。与步行性无交互作用（p = 0.405）。缺乏高度适宜步行的社区和较低的社会凝聚力与患有关节炎和近期关节疼痛的成年人达到PA建议的几率降低独立相关。由于步行是关节炎最有效的治疗方法之一，临床医生应该对患者可能感知到的步行障碍敏感。
Arthritis is a leading cause of disability in the United States, with the most efficacious treatments being physical activity (PA). Arthritis patients are less likely to meet PA recommendations and the neighborhood environment may play a role. This study examines the effect of neighborhood walkability and social cohesion on PA among arthritis patients in a sample of US adults. This cross-sectional study used 2015 National Health Interview Survey data. Eligible participants were age >= 45 years, had arthritis, recent leg-joint pain and complete data. Walkability was based on 6 questions regarding amenities and destinations that promote walking. Social cohesion was based on 4 validated questions. Meeting PA was defined as 150 min/week. Chi-squared testing and logistic regression determined associations between neighborhood environment and PA, including interaction between social cohesion and walkability. The final unweighted sample included 3,826 participants with mean age 64.6 years (SE = 0.26), 61.8% female and 78.1% non-Hispanic White. In adjusted, weighted analysis, not, slightly, and moderately-walkable neighborhoods all had lower odds of meeting PA recommendations verses highly-walkable neighborhood (OR= 0.61[95% CI 0.41-0.92], OR= 0.65[95% CI 0.50-0.85], OR= 0.75[95% CI 0.59-0.97], respectively). Social cohesion was independently associated with decreased odds of meeting PA guidelines (p = 0.003). No interaction with walkability was found (p = 0.405). Less than a highly-walkable neighborhood and lower social cohesion were independently associated with decreased odds of meeting PA recommendations among adults with arthritis and recent joint pain. Since walking is one of the most effective treatments for arthritis, clinicians should be sensitive to barriers patients may perceive to walking.