Perceptions of neighborhood environments and their association with overweight in children, adolescents, and caretakers in a medium-sized city in Brazil

Background: Previous studies conducted in developed countries have suggested associations between perceptions of neighborhood characteristics and weight gain. However, there are few studies regarding the adult perception of the residential environment and overweight in children and adolescents in countries with low and medium income. The aim of the study was to assess the associations between caretakers'perceptions of environmental characteristics and overweight in themselves and in their children, in a medium-sized city in Brazil. Methods: Cross-sectional study was performed with 708 children and adolescents and their caretakers. Anthropometric measurements and a structured questionnaire filled out by caretakers concerning child and family characteristics were completed. For environmental assessment, 408 caretakers answered the Portugues eversion of the"Neighborhood Environment Walkability Scale"by telephone call. A 95% confidence interval (95%CI)was used in the analysis. Unadjusted prevalence ratios (PR) were calculated, as were PR adjusted for age, gender, family income, and total time of exercise the children or adolescents practiced (from Poisson regression models predicting children's and adolescents'overweight), and for age and family income (from Poisson regression models predicting caretakers'overweight). Statistical significance was defined as ap value <0.05.Results:Adult perceptions about the absence of sidewalks on most streets (PR = 0.49, 95%CI = 0.42­0.98) and the absence of interesting things to look at (esthetics) in the neighborhood (PR = 0.65, 95%CI = 0.44­0.90) were inversely associated with the prevalence of overweight in the children and adolescents after adjustment. The absence of hillsin the neighborhood (PR = 1.24, 95%CI = 1.05­1.45) and the perception of heavy exhaust fumes (PR = 1.26, 95%CI =1.02­1.56) were directly associated with the prevalence of overweight in the caretakers. Finally, the high speed of traffic on the street (PR = 0.76, 95%CI = 0.63­0.92) was inversely associated with the prevalence of adult overweight. Conclusions: The results showed, in Brazil, the importance of understanding aspects related to obesogenic environment in the context of medium-sized Brazilian cities.

FATORES RELACIONADOS À SAÚDE DE CRIANÇAS, ADOLESCENTES, SEUS RESPONSÁVEIS E A ASSOCIAÇÃO DELES COM A VIZINHANÇA / FACTORS RELATED TO CHILDREN, ADOLESCENTS, THEIR CAREGIVERS AND THEIR ASSOCIATION WITH THE NEIGHBOURHOOD / FACTORES RELACIONADOS CON LA SALUD DE NIÑOS, ADOLESCENTES, SUS RESPONSABLES Y LA ASOCIACIÓN DE ELLOS CON LA VECINDAD

Os fatores relacionados às crianças, aos adolescentes, a seus responsáveis e a associação deles com a satisfação da vizinhança, revelam que a satisfação com a vizinhança pode ter um papel relevante na determinação da saúde dos indivíduos. O objetivo do estudo foi verificar os fatores sociodemográficos e de estilo de vida de crianças, adolescentes e seus responsáveis relacionados à satisfação da vizinhança em uma cidade de médio porte. Para tanto, realizou-se um estudo epidemiológico transversal com 370 indivíduos de Juiz de Fora, Minas Gerais. A coleta de dados ocorreu nas escolas e realizou-se antropometria e entrevista estruturada com os responsáveis. Para avaliação do ambiente, entrevistas telefônicas foram realizadas com a versão validada na língua portuguesa da Neighbourhood Environment Walkability Scale. Os resultados indicaram que a maioria dos adultos estava insatisfeita com a vizinhança. Observou-se maior insatisfação com acesso à diversão (82,4%) e maior satisfação com o número de pessoas conhecidas na vizinhança (95,4%). A cor de pele não branca das crianças prevaleceu entre os responsáveis insatisfeitos e indivíduos com maior renda estão mais satisfeitos. A satisfação com a vizinhança não foi associada com o sexo das crianças, a prática de atividade física, a idade, o índice de massa corporal e a circunferência da cintura dos responsáveis. Concluiu-se que características ambientais, como segurança, boa infraestrutura das ruas, espaços adequados para lazer e a boa convivência com as pessoas, relacionam-se com a satisfação com o ambiente, o bem- -estar e a saúde dos indivíduos.

The factors related to children, adolescents and their caregivers and their association with neighborhood satisfaction, reveal that neighborhood satisfaction may play a relevant role in determining individuals' health. The objective of this study was to verify sociodemographic and lifestyle factors of children, adolescents and their caregivers related to neighborhood satisfaction in a medium-sized town. For that purpose, a cross-sectional epidemiological study carried out with 370 individuals from Juiz de Fora, Minas Gerais. Data collection took place in schools and anthropometry and structured interviews were conducted with the caregivers. In order to evaluate the environment, telephone interviews were conducted with the Portuguese version of the Neighborhood Environment Walkability Scale. The results indicate that the majority of adults were dissatisfied with the neighborhood. The was a greater dissatisfaction with access to fun (82.4%) and greater satisfaction with the amount of known people in the neighborhood (95.4%). Children's non-white skin color prevailed among unsatisfied caregivers and individuals with higher income were more satisfied. Neighborhood satisfaction was not associated with children's sex, physical activity practice, age, body mass index, and waist circumference of the caregivers. Thus, in conclusion, environmental characteristics such as security, good infrastructure of the streets, suitable spaces for leisure and good living with people, are related to the satisfaction with the environment, the well-being and the health of the individuals.

Los factores relacionados con niños, adolescentes y sus responsables y la asociación de los mismos con la satisfacción de la vecindad, revelan que la satisfacción con la vecindad puede tener un papel relevante en la determinación de la salud de los individuos. El objetivo de tal temática fue verificar factores sociodemográficos y de estilo de vida de niños, adolescentes y sus responsables relacionados a la satisfacción de la vecindad en una ciudad de medio porte. Para ello se realizó un estudio transversal con 370 individuos de Juiz de Fora, Minas Gerais. La recolección de datos ocurrió en las escuelas y se realizó antropometría y entrevista estructurada con los responsables. Para la evaluación del ambiente, fueron realizadas entrevistas telefónicas con la versión validada en lengua portuguesa de la Neighbourhood Environment Walkability Scale. Los resultados indican que la mayoría de los adultos están insatisfechos con la vecindad. Se observó una mayor insatisfacción con el acceso a la diversión (82,4%) y mayor satisfacción con el número de personas conocidas en la vecindad (95,4%). El color de piel no blanca de los niños prevaleció entre los responsables insatisfechos y los individuos con mayores ingresos están más satisfechos. La satisfacción con la vecindad no fue asociada con el sexo de los niños, la práctica de actividad física, la edad, el índice de masa corporal y la circunferencia de la cintura de los responsables. Así, se concluyó que características ambientales como seguridad, buena infraestructura de las calles, espacios adecuados para el ocio y buena convivencia con las personas, se relacionan con la satisfacción con el ambiente, el bienestar y la salud de los individuos.