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dc.contributor.authorCarroll, SJ
dc.contributor.authorNiyonsenga, T
dc.contributor.authorCoffee, NT
dc.contributor.authorTaylor, AW
dc.contributor.authorDaniel, M
dc.date.accessioned2020-12-21T02:18:50Z
dc.date.available2020-12-21T02:18:50Z
dc.date.issued2017-09-01
dc.identifierpii: ijerph14090953
dc.identifier.citationCarroll, S. J., Niyonsenga, T., Coffee, N. T., Taylor, A. W. & Daniel, M. (2017). Does Physical Activity Mediate the Associations between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 14 (9), https://doi.org/10.3390/ijerph14090953.
dc.identifier.issn1661-7827
dc.identifier.urihttp://hdl.handle.net/11343/256873
dc.description.abstractAssociations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m²) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.
dc.languageEnglish
dc.publisherMDPI
dc.titleDoes Physical Activity Mediate the Associations between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?
dc.typeJournal Article
dc.identifier.doi10.3390/ijerph14090953
melbourne.affiliation.departmentMedicine and Radiology
melbourne.source.titleInternational Journal of Environmental Research and Public Health
melbourne.source.volume14
melbourne.source.issue9
dc.rights.licenseCC BY
melbourne.elementsid1229627
melbourne.contributor.authorDaniel, Mark
dc.identifier.eissn1660-4601
melbourne.accessrightsOpen Access


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