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Physical Activity and Health > Chapter 14 - Environmental and Policy approach to promote PA > Flashcards

Chapter 14 - Environmental and Policy approach to promote PA Flashcards

1
Q

difference btw
BUILT ENVIRONMENT
PHYSICAL ENVIRONMENT
in relation to PA

A

BUILT ENVIRONMENT
- man-made structures that influence opportunities for PA
- positive: sidewalks
- negative highways
PHYSICAL ENVIRONMENT
- build structures as well as other physical supports or barriers to being physically active in the natural environment

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2
Q

how is health related to the physical environment? (4)

A
  • quality of water and air
  • types of housing
  • roads
  • safety issues
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3
Q
  • approaches used to promote PA = initiatives to improve what?
  • approaches focuses on what? vs what?
A
  • initiatives to improve public health!
  • directly affects organizations and physical structures, rather than individuals –> to reach more people and have longer-term results

*involves many sectors outside of healthcare system

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4
Q

define ACCESS
- dictionary
- vs PA and public health view

A

DICTIONARY:
- refers to the right to approach or use something
PA and PH:
- enhances access to places that promote PA
- evidence-based strategy for increasing PA and exercise in a community

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5
Q

what are 2 types of accesses? + describe
- the first one can be measured in 2 ways

A
  1. geographic access:
    - features of built environment in a neighbourhood
    - measured in 2 ways:
    a) availability (ie number of parks nearby)
    b) accessibility (ease of reaching the park)
  2. economic access: having the means to get into certain parks/courts (ie entrance fee)
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6
Q

is simply building new places to be active enough? why or why not?

A

NOT enough!
- need to be supplemented with informational outreaches!
- outreaches must be appropriate and targeted to let people know about the existence of these new areas to be more physically active

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7
Q

what are 3 ish benefits of increase access?
- effectiveness of having more access to ares that promote PA have been seen in which populations (3)

A
  • physiological and behavioural aspects are in favor of increased PA in studies with increased access
  • calorie expenditure should increase by 8% + cardiorespiratory fitness should increase by 5% on average for ppl with increased access to environments for PA
  1. low-income communities
  2. various racial and ethnic groups
  3. men and women –> seem to respond equally well for increasing active lifestyles
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8
Q

what is another way that PA can be influenced (apart from increasing access fo environments for PA?)
- evidence based?
- 2 main goals

A
  • by build and physical environment (ie urban design (?)) –> separate constructs but frequently combined
  • no evidence based recipe for perfect urban design or land-use elements –> many strategies have been shown to work + community dependent
    GOAL is always:
    1. maximize PA options
    2. minimize risk of danger while being active
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9
Q

what are 2 main categories of land use policies? + explain

A
  1. MANAGEMENT, PLANNING AND DEVELOPMENT OF LAND
    - usually at local level to advance the well-being of community that controls land
  2. ZONING:
    - commonly used in term that is synonymous with legislatively determined land-use policy
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10
Q

define urban design
- used in what (4 + 3 ish)
- why necessary for increasing PA?

A

form, function and outward appearance of the physical environment
USED in:
- neighbourhoods
- towns
- cities
- communities –> municipal parks, street design for pedestrian safety, recreation center design and placement within a community

  • adequate urban design is necessary for proper access to built environment ressources to increase PA
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11
Q

what are 2 scales of urban design?

A
  • community-scale
  • street scale
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12
Q
  • define community-scale urban design
  • goal?
  • how (5 ish)
A
  • changes to the physical and built environment of large urban areas
  • goal = strive to make entire community more amenable to PA
    1. connecting transportation arteries
    2. creating landscaping and lighting to enhance aesthetics and perceived safety of community
    3. tax incentives for developers to build sidewalks and walking trails in new developments
    4. implementing community wide programs that encourage bicycling
    5. designing residential areas! –> ensure that final destinations are within safe walking or bicycling distances (ie workplaces, schools, areas for leisure and recreation) –> would this change your method of travel?
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13
Q

community-scale urban design
- what are the PA outcomes?
- 2 constructs to measure?

A
  • physical and built environments can improve levels of PA an avg of more than 160% –> major influencer of PA habits in community
    1. connectivity: how easy it is to get from one place to another in a given neighbourhood
    2. walkability: how easy it is to walk as transportation based on elements of the built environment
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14
Q

what are 3 benefits of community scale urban design?

A
  • higher green space to encourage PA
  • greater sense of community
  • lower crime rates
    *all positive outcomes that may help advocacy efforts for more PA friendly communities
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15
Q

define street scale urban design
- generally limited to what?
- outcome?
- benefits?

A
  • changes to the built and physical environment in smaller geographic areas
  • limited to a few blocks
  • neighbourhoods become more livable + amenable to a variety of PA opportunities
  • with appropriate street scale changes –> PA can be expected to increase by 35%
    *changes depend on neighbourhood that is targeted –> lots of variability + no specific guidelines for success
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16
Q

what are 3 strategies for street scale urban design?

A
  1. enhancements for pedestrians –> market street crossing areas + pedestrian bridges over multilane highway
  2. traffic calming strategies –> traffic circles, stoplights, speed bumps
  3. safety strategies –> bicycle lanes, repair of broken windows and graffiti (increases safety and improves aesthetics)
17
Q

why is i important to measure the built environment (3)

A
  1. due to importance of built environment in PA promotion
  2. important to determine baseline for comparison
  3. important to determine effectiveness of changes made
18
Q

why is it difficult to measure/compare different built environments?

A
  • geography
  • culture
  • socioeconomic status
    *all contribute to overall PA
19
Q

what are 3 ways to measure the built environment?

A
  1. self-reported measures of perception of environment
  2. direct observation techniques
  3. secondary analyses techniques –> use existing data sets and geographic information systems
20
Q

how to conduct self-reported measures of perception of environment?
- assess what? (6)
- delivery methods? (5 ish)

A
  • through questionnaires that assess perceptions of environmental supports or barriers to PA (community or street-scale)
  • assess traffic, aesthetics, urban design, safety, crime, availability of local PA resources
  • interviews (telephone or in person), internet surveys, mail survey, email survey
21
Q

what are 2 benefits + 3 ish drawbacks of self-report?

A

BENEFITS
- able to gather a lot of information from a large population (quantitative and qualitative)
- relatively inexpensive to administer (can be used in large populations)
DRAWBACKS:
- respondents may over- or underestimate aspects of environment based on their personal situation or health status –> subjective data
- less active ppl may be not aware of built environment resources in their area so might report it as low, which might be false
- lack of agreement of what constitutes a neighbourhood

22
Q

studies relying on self-report often ask respondents to identify the PA resources in their neighbourhoods
- what is a neighbourhood?

A

no agreements of what exactly constitues a neighbourhood
- variability introduces substantial uncertainty into assessment techniques and to make comparisons among studies very difficule

23
Q

what is a direct observation technique to measure built and physical environment?
- used to minimize what?
- quantifies what? (4 examples

A

audits! (objective and direct measure/observation of built environment)
- used to minimize bias of self-report
- quantifies aspects of built environments at community and street levels that can be OBSERVED!
ie completeness of sidewalks, noise and traffic level, presence of abandoned or unsafe buildings, cleanliness and usability of parks and park equipment

24
Q

what are the 2 benefits of audits + 2 drawbacks?

A

BENEFITS
- more standardized
- less prone to respondent bias
DRAWBACKS
- more expensive to administer
- personnel needed to collect and enter data for analysis and interpretation –> training personnel to collect audit data is crucial + need to standardize terms and observation techniques to reduce variability of observations

25
Q

how to conduct secondary analyses techniques to measure built environment?
- describe technique (2)
- can be used to explain (2)

A

geographic informations systems!
- objective technique that allows multiple inputs from secondary data sources –> assists in analyzing geographic and social data by overlying data and map information from multiple sources
- can be used to explain
1. barriers to and supports of PA
2. relate the presence of those barriers and supports to PA levels in the community

26
Q

what are the 4 benefits and 2 drawbacks of GIS?

A

BENEFITS:
- less expensive than full audit
- can be used for large areas
- can merge multiple study’s information
- allows for unique findings –> supports or barriers in specific regions of a city
DRAWBACKS:
- could be secondary information that was collected for different reasons other than research leading to incompleteness or errors
- measures of PA may differ btw collected data

27
Q

what is urbanism? (2)

A
  • how people live in a town or city and interact with the built environment
  • neighbourhood planning approach to create sustainable communities
28
Q

what are 6 important components of urbanism?

A
  1. diverse and mixed use environment (shops, offices, residencies) –> all in a geographically convenient area
  2. connectivity –> interconnected street grid
  3. walkability –> pedestrian friendly street design
  4. aesthetically pleasing and high-quality architecture
  5. public spaces in the neighbourhoods need to be prevalent
  6. mixed housing: variety of housing choices
29
Q

what is physical activity policy?
- policy change through (4 groups ish) can lead to what?

A
  • a legislative action including formal and informal rules, that is instituted by an organization with power to support or inhibit PA (ie government, school, workplaces…)
  • through environmental approches to PA promotion! (must result from some kind of policy change) –> governments, non-governmental agencies, neighbourhood associations, social groups
30
Q

how can environmental approaches lead to lower health costs?

A

environmental approaches influence PA behaviour which affects health of individuals and population —> better health leads to lower health care costs

31
Q

PA policies can includes (3)

A
  1. formal written codes
    - ie municipal zoning regulations: regulate the types of businesses that can operate in a given area –> city codes that require a certain distance of building setback from street to accommodate sidewalks and pedestrian traffic
  2. regulations
  3. court decisions that carry legal authority
32
Q

PA policy: what is
- non-legal policy
- unwritten social norms
- social groups

A

NON LEGAL POLICY
- standards that are accepted and written –> are not usually mandated changes
- as a result of traditional or professional standard, these types of policies can become standards of practice and can be used to encourage or impeded PA participation
UNWRITTEN SOCIAL NORMS
- more difficult to quantify
- usually based in culture of an organization or society
- have the ability to influence PA in a variety of ways
SOCIAL GROUPS
- members that value exercise may encourage new members to be physically active

33
Q

which Montreal neighbourhood is the “walker’s paradise?

A

Ville-Marie
(to the est of Mcgill, avenue du Parc ish)
- 93 walk score –> walker’s paradise: daily errands do not require a car
- 75 bike score: very steep hills, excellent bike lanes

34
Q

describe walk scores
90-100
70-89
50-69
25-49
0-24

A

90-100: walker’s paradise: daily errands do not require a car
70-89: very walkable: most errands can be accomplished on foot
50-69: somewhat walkable: some errands can be accomplished on foot
25-49: car-dependent: most errands require a car
0-24: car-dependent: almost all errands require a car

35
Q

effects of neighbourhood walkability on PA and sedentary behaviour in long-term post bariatric surgery patients
1. why study this?
2. study population?
3. what was measured? how?
4. how were the participants separated after data collection?
5. results?
6. conclusion?

A
  1. bc chronic inactivity and weight regain are both serious health concerns following bariatric surgery –> and neighbourhood walkability is associated with PA in normal populations
  2. 71 adults having undergone bariatric surgery 8.9 years prior to study
  3. daily septs, sedentary time –> using activ-Pal accelerometer! attached to mid-thigh for 7 consecutive days
  4. into car dependent, somewhat walkable, very walkable, walker’s paradise neighborhoods, defined using walkscore
  5. neighbourhood walkability did NOT affect daily steps or sedentary time
  6. walkability of neighbourhood does not appear to affect daily sedentary time or PA long-term post-bariatric surgery –> more research is needed to enhance PA and reduce sedentarism in this important population!

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