Home quarantines and cumulative risk exposure among young children: Isolation and maladaptation.

Self-isolation and quarantine are common and effective measures to contain the spread of COVID-19. However, it may have detrimental implications on young children's adaptation and mental health. The present study explores the prevalence of home quarantines among young children in Israel and their associations with children's maladaptive behaviors. The analysis is based on self-reported data obtained by 374 parents of young children in November 2021. Participants completed questionnaires, assessing the prevalence of home quarantines among children (aged 3-11 years old), and maladaptive behaviors, including rage outbursts, physical violence against family or friends, and panic attacks. Multivariate regression models were used to determine the relationships between the number of child quarantines and their maladaptive behaviors. Our results suggest that 51% of parents reported having their child quarantined more than once, which did not differ across socioeconomic characteristics. Furthermore, 66% of parents reported that during the pandemic, their child exhibited maladaptive behaviors at least once. Children who were quarantined more than once were more likely to exhibit rage outbursts, physical violence, and/or panic attacks. The associations between children's quarantine and physical violence were slightly stronger among families living in high-density households. Repeated experiences of home quarantine may operate as exposure to accumulative risk and have a lasting effect on young children's development. Practice and policy recommendations for interventions for young children and their families who experience home quarantines are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Spatial data collection and qualification methods for urban parks in Brazilian capitals: An innovative roadmap.

Urban parks have been studied for their effects on health and the environment. Accessing park data from reliable and comparable sources remains challenging, reinforcing the importance of standardized search tools, notably in Latin America. We designed a systematized methodology to identify processes of accessing, collecting, verifying, and harmonizing urban park spatial data in all Brazilian capitals included in the Urban Health in Latin America (SALURBAL) project. We developed a research protocol using official and non-official sources combining the results of Google Maps (GMaps) points and OpenStreetMap (OSM) polygons-GMaps-OSM. Descriptive analyses included the frequency of the distribution of parks before and after harmonization stratified by data source. We used the intraclass correlation coefficient (ICC) to assess agreement in the area between official and GMaps-OSM data. Official data were obtained for 16 cities; for the remaining 11 capitals, we used GMaps-OSM. After verification and harmonization, 302 urban parks were obtained from official data and 128 from GMaps-OSM. In a sub-study of the 16 cities with official data (n = 302 parks), we simulated a collection of non-official data using GMaps-OSM and OSM only. From GMaps-OSM, we obtained 142 parks, and from OSM, 230 parks. Statistical analysis showed a better agreement between official data and OSM. After completing verification and harmonization, the complete dataset (official and GMaps-OSM) included 430 urban parks with a total area of 145.14 km2. The mean number of parks across cities was 16, with a mean size area of 0.33 km2. The median number of parks was nine, with a median area of 0.07 km2. This study highlights the importance of creating mechanisms to access, collect, harmonize, and verify urban park data, which is essential for examining the impact of parks on health. It also stresses the importance of providing reliable urban park spatial data for city officials.

Walking for transportation in large Latin American cities: walking-only trips and total walking events and their sociodemographic correlates.

Walking for transportation is a common and accessible means of achieving recommended physical activity levels, while providing important social and environmental co-benefits. Even though walking in rapidly growing urban areas has become especially challenging given the increasing dependence on motorised transportation, walking remains a major mode of transportation in Latin American cities. In this paper we aimed to quantify self-reported walking for transportation in Mexico City, Bogota, Santiago de Chile, Sao Paulo, and Buenos Aires, by identifying both walking trips that are conducted entirely on foot and walking events involved in trips mainly conducted on other means of transportation (e.g. private vehicle, public transit) among individuals ≥5-years old. We show how walking-only trips account for approximately 30% trips in the analysed cities, and we evidence how the pedestrian dimension of mobility is largely underestimated if walking that is incidental to other transportation modes is not accounted for: when considering all walking events, we observed an increase between 73% and 217% in daily walking time. As a result, we estimated that between 19% and 25% of residents in these cities meet the WHO physical activity guidelines solely from walking for transportation. The results of the study also suggest that the promotion of public transportation in large Latin American cities can especially help certain population groups achieve the daily recommended levels of physical activity, while among low-income groups accessibility and safety seem to be the key challenges to be addressed.

Is self-reported park proximity associated with perceived social disorder? Findings from eleven cities in Latin America.

Parks and greenspaces can enhance personal health in various ways, including among others, through psychological restoration and improved well-being. However, under certain circumstances, parks may also have adverse effects by providing isolated and hidden spaces for non-normative and crime-related activities. This study uses a survey conducted by the Development Bank of Latin America in a cross-sectional representative sample of 7,110 respondents in eleven Latin-American cities. We examine associations between self-reported park proximity with perceived social disorder (drug use/sales, gangs, prostitution and assault and/or crime), and whether these associations are modified by neighborhood characteristics (informal neighborhoods, poor street-lighting, abandoned buildings, illegal dumping). High self-reported park proximity was associated with lower perceptions of social disorder, but these associations were no longer significant following adjustment for neighborhood characteristics. Significant interactions were observed between park proximity and neighborhood characteristics suggesting that the likelihood of perceiving social disorder increases with high park proximity in informal neighborhoods and in the presence of certain neighborhood characteristics, such as poor street-lighting, abandoned buildings, and illegal dumping in residential streets. The differential associations between reported park proximity and perceived social disorder in different living environments highlight the importance of supportive social and physical infrastructure to maximize the restorative benefits of parks in all urban areas.

Associations of Urban Environment Features with Hypertension and Blood Pressure across 230 Latin American Cities.

BACKGROUND: Features of the urban physical environment may be linked to the development of high blood pressure, a leading risk factor for global burden of disease. OBJECTIVES: We examined associations of urban physical environment features with hypertension and blood pressure measures in adults across 230 Latin American cities. METHODS: In this cross-sectional study we used health, social, and built environment data from the SALud URBana en América Latina (SALURBAL) project. The individual-level outcomes were hypertension and levels of systolic and diastolic blood pressure. The exposures were city and subcity built environment features, mass transit infrastructure, and green space. Odds ratios (ORs) and mean differences and 95% confidence intervals (CIs) were estimated using multilevel logistic and linear regression models, with single- and multiple-exposure models adjusted for individual-level age, sex, education, and subcity educational attainment. RESULTS: A total of 109,176 participants from 230 cities and eight countries were included in the hypertension analyses and 50,228 participants from 194 cities and seven countries were included in the blood pressure measures analyses. Participants were 18-97 years of age. In multiple-exposure models, higher city fragmentation was associated with higher odds of having hypertension (OR per standard deviation (SD) increase=1.11; 95% CI: 1.01, 1.21); presence (vs. no presence) of mass transit in the city was associated with higher odds of having hypertension (OR=1.30; 95% CI: 1.09, 1.54); higher subcity population density was associated with lower odds of having hypertension (OR per SD increase=0.90; 95% CI: 0.85, 0.94); and higher subcity intersection density was associated with higher odds of having hypertension [OR per SD increase=1.09; 95% CI: 1.04, 1.15). The presence of mass transit was also associated with slightly higher systolic and diastolic blood pressure in multiple-exposure models adjusted for treatment. Except for the association between intersection density and hypertension, associations were attenuated after adjustment for country. An inverse association of greenness with continuous blood pressure emerged after country adjustment. DISCUSSION: Our results suggest that urban physical environment features-such as fragmentation, mass transit, population density, and intersection density-may be related to hypertension in Latin American cities. Reducing chronic disease risks in the growing urban areas of Latin America may require attention to integrated management of urban design and transport planning. https://doi.org/10.1289/EHP7870.

The equigenic effect of greenness on the association between education with life expectancy and mortality in 28 large Latin American cities.

BACKGROUND: Recent studies highlight the equigenic potential of greenspaces by showing narrower socioeconomic health inequalities in greener areas. However, results to date have been inconsistent and derived from high-income countries. We examined whether urban greenness modifies the associations between area-level education, as a proxy for socioeconomic status, and life expectancy and cause-specific mortality in Latin American cities. METHODS: We included 28 large cities, >137 million inhabitants, in nine Latin American countries, comprising 671 sub-city units, for 2012-2016. Socioeconomic status was assessed through a composite index of sub-city level education, and greenness was calculated using the normalized difference vegetation index. We fitted multilevel models with sub-city units nested in cities, with life expectancy or log(mortality) as the outcome. FINDINGS: We observed a social gradient, with higher levels of education associated with higher life expectancy and lower cause-specific mortality. There was weak evidence supporting the equigenesis hypothesis as greenness differentially modified the association between education and mortality outcomes. We observed an equigenic effect, with doubling magnitudes in the violence-related mortality reduction by education in areas with low greenness compared to medium-high greenness areas among men (16% [95% CI 12%-20%] vs 8% [95% CI 4%-11%] per 1 SD increase in area-level education). However, in contradiction to the equigenesis hypothesis, the magnitude in cardiovascular diseases (CVD) mortality reduction by education was stronger in areas with medium-high greenness compared to areas with low greenness (6% [95% CI 4%-7%] vs 1% [95% CI -1%-3%] and 5% [95% CI 3%-7%] vs 1% [95% CI -1%-3%] per 1 SD increase in area-level education, in women and men, respectively). Similarly, each 1-SD increase in greenness widened the educational inequality in life expectancy by 0.15 years and 0.20 years, in women and men, respectively. The equigenic effect was not observed in violence-related mortality among women and in mortality due to communicable diseases, maternal, neonatal and nutritional conditions (CMNN). INTERPRETATION: Our results confirm socioeconomic health inequalities in Latin American cities and show that the equigenic properties of greenspace vary by health outcome. Although mixed, our findings suggest that future greening policies should account for local social and economic conditions to ensure that greenspaces provide health benefits for all, and do not further exacerbate existing health inequalities in the region. FUNDING: Wellcome Trust (Grant, 205177/Z/16/Z).

Latin American cities with higher socioeconomic status are greening from a lower baseline: evidence from the SALURBAL project.

The characteristics of urban green space have context-dependent associations with socioeconomic status (SES). Latin American cities provide a unique but understudied context to assess the green space-SES associations. We measured the quantity and quality of green space as greenness from satellite-derived Normalized Difference Vegetation Index, and we modeled the relationship between greenness and SES in 371 major Latin American cities between 2000 and 2010. We found that SES was negatively associated with average greenness at city and sub-city scales, which could be explained by urbanization generally improving SES while reducing the provision of green space. About 82% of the cities and 64% of the sub-cities experienced greening or increases in greenness over time. Although with lower average greenness, cities with higher SES had greater greening; however, it was the opposite for sub-cities. We suggest that greening is more likely to take place in peripheral sub-cities where SES tends to be lower. The findings challenge the belief that places with higher SES have better access to environmental resources and amenities; instead, this relationship is context dependent.

International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures.

INTRODUCTION: Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese). METHODS AND ANALYSIS: The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status. ETHICS AND DISSEMINATION: Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

Park use, perceived park proximity, and neighborhood characteristics: Evidence from 11 cities in Latin America.

This study examines how park use may be associated with perceived park proximity, neighborhood-built environment and perceived social disorder in Latin American cities. The study uses self-reported data from the 2016 CAF survey, including 7,970 urban residents from 11 cities across Latin America. Results show positive graded associations between perceived park proximity and use, holding all others constant. Additional factors that were found to be associated with park use are neighborhood formality and related built-environment characteristics, including paved streets and sidewalks. Park use was mostly unrelated to perceived social disorder, with the exception of indigence, with which it is was positively associated. Stronger associations between park proximity and use were observed among those who reported higher prevalence of indigence or begging in their household block. These findings stress the importance of perceived park proximity in enhancing their use in urban Latin America, and challenge the role of social disorder and crime as a barrier for park use.

Development and validation of the neighborhood environment walkability scale for youth across six continents.

BACKGROUND: The IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents' physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability. METHODS: Adolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status. RESULTS: Final country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity. CONCLUSIONS: A robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.

The Relationships between Adolescents' Obesity and the Built Environment: Are They City Dependent?

There is evidence that the built environment can promote unhealthy habits which may increase the risk for obesity among adolescents. However, the majority of evidence is from North America, Europe and Australia, and less is known about other world regions. The purpose of this study was to examine how the number of overweight and obese adolescents may vary in relation to the built environment, area socioeconomic status (SES), physical activity (PA) and nutritional home environment. We performed a telephone survey of 904 adolescents ages 15-18 from three different cities in Israel. The questionnaire included: reported PA, sedentary behaviors and nutritional home environment. Body Mass Index (BMI) was attained from records of Maccabi Healthcare Services (MHS). The built environment measures were calculated by Geographic Information System (GIS). Multivariable logistic regression analysis was performed to identify variables associated with adolescents' overweight and obesity. The highest level of overweight and obese adolescents was in Beer Sheva (29.2%). The three cities did not differ in built environment characteristics, PA and sedentary behaviors. In Haifa, a more positive nutritional home environment was reported (p = 0.001). Boys, in all three cities presented higher rates of overweight and obesity (29%). After adjusting for covariates, adolescents' overweight and obesity was associated with built environment measures only in a low SES peripheral city (OR = 0.72; 95% CI: 0.56-0.92), and positively associated with higher level of sedentary behavior in the total sample (OR = 1.23; 95% CI:1.03-1.47). This may imply a much more complex causal pathway between the built environment, SES and obesity than suggested in previous literature.

Is the Grass Always Greener in Suburban Neighborhoods? Outdoors Play in Suburban and Inner-City Neighborhoods.

Children's outdoors play (OP) is an important source of physical activity that has been decreasing in recent years due to changes in neighborhood design, parent safety concerns and child sedentary leisure. However, few studies examined such determinants from children's perspectives. This study explores environmental and socio-cultural aspects of children's OP using a qualitative and quantitative approach. Data was collected in two phases: (1) a survey on OP and related variables among 5th and 6th graders (10-12 years old) (n = 573); and (2) a mapping activity and semi-structured interview among a subsample of the survey (n = 80). The most common locations for routine OP were parks (40%) followed by public facilities (26%) and streets (17%). OP was significantly associated with perceived environment, independent mobility and gender, but not with neighborhood type. Inner-city participants reported a higher number and greater variety of OP areas (23 vs. 14). Three main barriers of OP were identified-low quality and poorly maintained play areas, other people in public spaces, and social norms that undermine OP. Thus, in order to encourage routine OP, environmental change to create safe and attractive OP settings should be accompanied by community interventions to enhance social norms that are supportive of OP.

Getting to Know a Place: Built Environment Walkability and Children's Spatial Representation of Their Home-School (h-s) Route.

The literature on environmental walkability to date has mainly focused on walking and related health outcomes. While previous studies suggest associations between walking and spatial knowledge, the associations between environmental walkability and spatial knowledge is yet to be explored. The current study addresses this lacuna in research by exploring children's mental representations of their home-school (h-s) route, vis.

Exploring the Objective and Perceived Environmental Attributes of Older Adults' Neighborhood Walking Routes: A Mixed Methods Analysis.

Walking is a central form of physical activity among older adults that is associated with the physical environment at various scales. This mixed-methods study employs a concurrent nested design to explore objective and perceived environmental characteristics of older adults' local walking routes. This was achieved by integrating quantitative Geographic Information System (GIS) data with qualitative data obtained using the Stanford Discovery Tool (DT). Fifty-nine community-dwelling middle-aged and older adults (14 men and 45 women aged 50+) were recruited in a snowball approach through community centers in the city of Haifa (Israel). Four neighborhood environment themes were identified: pedestrian infrastructure, access to destinations, aesthetics, and environmental quality. Both geometrical traits (i.e., distance, slope) and urban features (i.e., land-uses, greenery) of the route may impact the experience of walking. The findings thus highlight the importance of micro-scale environmental elements in shaping environmental perceptions, which may consequently influence the choice of being active.

Leveraging Citizen Science and Information Technology for Population Physical Activity Promotion.

PURPOSE: While technology is a major driver of many of society's comforts, conveniences, and advances, it has been responsible, in a significant way, for engineering regular physical activity and a number of other positive health behaviors out of people's daily lives. A key question concerns how to harness information and communication technologies (ICT) to bring about positive changes in the health promotion field. One such approach involves community-engaged "citizen science," in which local residents leverage the potential of ICT to foster data-driven consensus-building and mobilization efforts that advance physical activity at the individual, social, built environment, and policy levels. METHOD: The history of citizen science in the research arena is briefly described and an evidence-based method that embeds citizen science in a multi-level, multi-sectoral community-based participatory research framework for physical activity promotion is presented. RESULTS: Several examples of this citizen science-driven community engagement framework for promoting active lifestyles, called "Our Voice", are discussed, including pilot projects from diverse communities in the U.S. as well as internationally. CONCLUSIONS: The opportunities and challenges involved in leveraging citizen science activities as part of a broader population approach to promoting regular physical activity are explored. The strategic engagement of citizen scientists from socio-demographically diverse communities across the globe as both assessment as well as change agents provides a promising, potentially low-cost and scalable strategy for creating more active, healthful, and equitable neighborhoods and communities worldwide.

Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies.

BACKGROUND: While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults' PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants' PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults' PA behaviors. METHODS: A systematic search was conducted in databases of various disciplines, including: health, architecture and urban planning, transportation, and interdisciplinary databases. From 3,047 articles identified in the physical activity, initial search, 31 articles published from 1996 to 2012 met all inclusion criteria. An inductive content analysis was performed on the extracted findings to identify emerging environmental elements related to older adults' PA. The identified environmental elements were then grouped by study methodologies [indoor interviews (individual or focus groups) vs spatial methods (photo-voice, observations, walk-along interviews)]. RESULTS: This review provides detailed information about environmental factors that potentially influence older adults' PA behaviors. These factors were categorized into five themes: pedestrian infrastructure, safety, access to amenities, aesthetics, and environmental conditions. Environmental factors especially relevant to older adults (i.e., access to facilities, green open spaces and rest areas) tended to emerge more frequently in studies that combined interviews with spatial qualitative methods. CONCLUSIONS: Findings showed that qualitative research can provide in-depth information on environmental elements that influence older adults' PA. Future qualitative studies on the physical environment and older adults' PA would benefit from combining interviews with more spatially-oriented methods. Multidisciplinary mixed-methods studies are recommended to establish quantitative relationships complemented with in-depth qualitative information.

Perceived discrimination and health-related quality of life among Arabs and Jews in Israel: a population-based survey.

BACKGROUND: Studies have shown that perceived discrimination may be associated with impaired health. The aim of this study was to assess the levels of perceived discrimination on the basis of origin and ethnicity and measure the association with health in three population groups in Israel: non-immigrant Jews, immigrants from the former Soviet Union, and Arabs. METHODS: A cross sectional random telephone survey was performed in 2006 covering 1,004 Israelis aged 35-65; of these, 404 were non-immigrant Jews, 200 were immigrants from the former Soviet Union and 400 were Arabs, the final number for regression analysis was 952. Respondents were asked about their perceived experiences with discrimination in seven different areas. Quality of life, both physical and mental were measured by the Short Form 12. RESULTS: Perceived discrimination on the basis of origin was highest among immigrants. About 30% of immigrants and 20% of Arabs reported feeling discriminated against in areas such as education and employment. After adjusting for socioeconomic variables, discrimination was associated with poor physical health among non-immigrant Jews (OR = 0.42, CI = 0.19, 0.91) and immigrants (OR = 0.51, CI = 0.27, 0.94), but not among Arabs. Poor mental health was significantly associated with discrimination only among non-immigrant Jews (OR = 0.42, CI = 0.18, 0.96). CONCLUSIONS: Perceived discrimination seemed high in both minority populations in Israel (Arabs and immigrants) and needs to be addressed as such. However, discrimination was associated with physical health only among Jews (non-immigrants and immigrants), and not among Arabs. These results may be due to measurement artifacts or may be a true phenomenon, further research is needed to ascertain the results.