Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world

The COVID-19 crisis and parallel Black Lives Matter movement have amplified longstanding systemic injustices among people of color (POC). POC have been differentially affected by COVID-19, reflecting the disproportionate burden of ongoing chronic health challenges associated with socioeconomic inequalities and unhealthy behaviors, including a lack of physical activity. Clear and well-established benefits link daily physical activity to health and well-being—physical, mental, and existential. Despite these benefits, POC face additional barriers to participation. Thus, increasing physical activity among POC requires additional considerations so that POC can receive the same opportunities to safely participate in physical activity as Americans who are White. Framed within the Ecologic Model of Physical Activity, this commentary briefly describes health disparities in COVID-19, physical activity, and chronic disease experienced by POC; outlines underlying putative mechanisms that connect these disparities; and offers potential solutions to reduce these disparities. As behavioral medicine leaders, we advocate that solutions must redirect the focus of behavioral research toward community-informed and systems solutions.

Developing Content for the Food Environment Assessment Survey Tool (FEAST): A Systematic Mixed Methods Study with People with Disabilities

Almost 1 in every 8 adults in the U.S. have a physical disability that impairs mobility. This participatory project aimed to identify and describe environmental and personal barriers to healthy eating among people with mobility impairments using a rigorous, structured mixed methodology. Community-dwelling adults with a self-reported mobility impairment (N = 20, M = 40.4 years old, 60% female) participated in nominal group technique focus groups. The Ecologic Model of Obesity grounded stimulus questions asked about barriers to obtaining and preparing healthy food. Participants emphasized common barriers across everyday settings—focusing, for example, on the ability to reach shelved food inside the home, navigating to and inside stores and restaurants, and using delivery services. Home environments often did not afford suitable spaces for food preparation and storage. Participants reported inadequate transportation and numerous additional barriers in many settings to be able to eat healthfully. Participants reported lack of accessible transportation and architectural barriers inside stores, restaurants, and their own homes, highlighting the need for efforts aimed at improving accessibility and usability. Findings support the use of the Ecologic Model of Obesity to guide research and suggest the need for improvement in assessment practices and policies that enhance access to healthy food.

Utilizing the Socio-Ecologic Model as a Framework for the Prevention of Teen Pregnancy

Despite historic lows in teen birth rates, the U.S. still maintains the highest teen birth rate of any industrialized nation, and significant disparities exist between ethnicities and socioeconomic status (SES). The factors influencing teen birth are vast and intertwined. The socio-ecological model (SEM) provides a natural theoretical framework to study and address these multiple levels of influence, which include individual, interpersonal, institutional/organizational, and public policy. This chapter will include a summary of recent studies, and drawing from empirical findings guided by the socio-ecological model, will identify and suggest strategies at each level for reducing the teen birth rate. By addressing the overlapping layers together, as opposed to a single layer, interventions have greater potential for success.

An Exploration Of Individual And Contextual Factors Affecting The Use Of Contraceptives In Urban Slums Of Pakistan: A Socio-Ecological Analysis

We examined determinants of ever use of contraceptives among women living in urban slums of Pakistan. Data were drawn from a nationwide study, “Living Conditions in Urban Slums of Selected Cities of Pakistan,” jointly conducted by University of Gujrat; UNFPA, Islamabad; and UN Habitat, Islamabad, Pakistan. The sample consisted of 2420 married women from six cites. The study was conducted within the socio-ecological framework and examined individual, social, and geographic contextual factors. Multivariate logistic regression model with robust standard errors was used to estimate the contribution of different socio-ecologic factors for use of contraception. Results of logistic regression showed that individual, social, and geographic factors affect use of contraceptives among women in Pakistani urban slums. The socio-ecologic model can help to identify correlates of contraceptive use, especially among developing nations.

Environmental Determinants of Children’s Physical Activity in Residential Children’s Homes

Background:Children in residential children’s homes (RCH) may be at increased risk for physical inactivity due to decreased access to opportunities for activity. Little is known about environmental determinants of physical activity for children in RCH.Methods:Thirty-minute blocks of MVPA and Total METs were measured using the 3-Day Physical Activity Recall (3DPAR). A staff interview, based on the Structural Ecologic Model of Health Behavior, assessed physical activity opportunities, structures, characteristics, policies, and social environment. Wilcoxon 2-sample tests were used to examine differences in environment by location and presence of a recreation director. Mixed model ANOVAs assessed the differences in child level activity by environmental variables.Results:There were significant correlations between opportunities and characteristics of physical activity, facilities, and equipment with total METS for children. Children in homes with a recreation director and homes in rural locations reported more physical activity. Only rural location had a significant effect on physical activity. Presence of a recreation director was significant in several models.Conclusions:Rural location may be conducive for increased physical activity in children at RCH. Employing a recreation director or other trained personnel may be an important policy determinant of physical activity for children.

Obesity Prevention in Second Life

In industrialized societies, between 50% and 75% of the population weigh in at overweight or obese health status (Low, Chew Chin, Deurenberg, 2009; Ogden, 2007). Ecologic models posit that heath behavior and outcomes are related to the environmental settings in which humans live, work and play; if environmental settings are not supportive, then poor health results. (Spence & Lee, 2003) Second Life is an interactive virtual world that is global, an ideal setting to reach international audiences who are real life residents of industrialized communities at high risk for obesity. Second Life provides a unique opportunity to increase knowledge, social support and behavioral skills necessary to reduce or prevent obesity with much broader reach than traditional face to face intervention strategies. Health behavior change interventions have had success in real life by exposing participants to interventions in virtual worlds, suggesting that information and skills learned in virtual worlds may translate to real life (Anderson, Rothbaum, Hodges, 2000). The International Health Challenge in Second Life began with the goal of extending the real life mission, goals and activities of the Texas Obesity Research Center of the University of Houston into Second Life. What emerged was a fun, exciting, interactive, multicultural, multilingual, theoretically grounded, virtual setting where resident avatars of Second Life learned about healthful living, met others like them, and had virtual experiences that in turn contributed to real life health improvement. This chapter investigates the utility of applying the ecologic model of health to virtual worlds to reduce the public health burden of obesity, with the case example of the International Health Challenge.