Open Access
Do associations of sex, age and education with transport and leisure-time physical activity differ across 17 cities in 12 countries?
(BioMed Central, 2019) Mitas, Josef; Cerin, Ester; Reis, Rodrigo S.; Conway, Terry L.; Cain, Kelli L.; Adams, Marc A.; Schofield, Grant; Sarmiento, Olga L.; Christiansen, Lars Breum; Davey, Rachel; Salvo, Deborah; Orzanco Garralda, María Rosario; Ciencias de la Salud; Osasun Zientziak
Background: Leisure-time and transport activity domains are studied most often because they are considered more amenable to intervention, but to date evidence on these domains is limited. The aim of the present study was to examine patterns of socio-demographic correlates of adults' leisure-time and transport physical activity and how these associations varied across 17 cities in 12 countries. Methods: Participants (N = 13,745) aged 18-66 years in the IPEN Adult study and with complete data on socio-demographic and self-reported physical activity characteristics were included. Participants reported frequency and duration of leisure-time and transport activities in the last 7 days using the self-administered International Physical Activity Questionnaire-Long Form. Six physical activity outcomes were examined in relation with age, education, and sex, and analyses explored variations by city and curvilinear associations. Results: Sex had the most consistent results, with five of six physical activity outcomes showing females were less active than males. Age had the most complex associations with self-report transport and leisure-time physical activity. Compared to older people, younger adults were less likely to engage in transport physical activity, but among those who did, younger people were likely to engage in more active minutes. Curvilinear associations were found between age and all three leisure-time physical activity outcomes, with the youngest and the oldest being more active. Positive associations with education were found for leisure-time physical activity only. There were significant interactions of city with sex and education for multiple physical activity outcomes. Conclusions: Although socio-demographic correlates of physical activity are widely studied, the present results provide new information. City-specific findings suggest there will be value in conducting more detailed case studies. The curvilinear associations of age with leisure-time physical activity as well as significant interactions of leisure-time activity with sex and education should be further investigated. The findings of lower leisure-time physical activity among females as well as people with low education suggest that greater and continued efforts in physical activity policies and programs tailored to these high-risk groups are needed internationally.
Open Access
Do associations between objectively-assessed physical activity and neighbourhood environment attributes vary by time of the day and day of the week? IPEN adult study
(BioMed Central, 2017) Cerin, Ester; Mitas, Josef; Cain, Kelli L.; Conway, Terry L.; Adams, Marc A.; Schofield, Grant; Sarmiento, Olga L.; Reis, Rodrigo S.; Schipperijn, Jasper; Davey, Rachel; Salvo, Deborah; Orzanco Garralda, María Rosario; MacFarlane, Duncan; Bourdeaudhuij, Ilse de; Owen, Neville; Sallis, James F.; Dyck, Delfien Van; Ciencias de la Salud; Osasun Zientziak
Background: To more accurately quantify the potential impact of the neighbourhood environment on adults’ physical activity (PA), it is important to compare environment-PA associations between periods of the day or week when adults are more versus less likely to be in their neighbourhood and utilise its PA resources. We examined whether, among adults from 10 countries, associations between objectively-assessed neighbourhood environment attributes and moderate-to-vigorous physical activity (MVPA) varied by time of the day and day of the week. The secondary aim was to examine whether such associations varied by employment status, gender and city. Methods: This cross-sectional study included 6,712 adults from 14 cities across 10 countries with ≥1 day of valid accelerometer-assessed MVPA and complete information on socio-demographic and objectively-assessed environmental characteristics within 0.5 and 1 km street-network buffers around the home. Accelerometer measures (MVPA min/h) were created for six time periods from early morning until late evening/night, for weekdays and weekend days separately. Associations were estimated using generalized additive mixed models. Results: Time of the day, day of week, gender and employment status were significant moderators of environment- MVPA associations. Land use mix was positively associated with MVPA in women who were employed and in men irrespective of their employment status. The positive associations between MVPA and net residential density, intersection density and land use mix were stronger in the mornings of weekdays and the afternoon/evening periods of both weekdays and weekend days. Associations between number of parks and MVPA were stronger in the mornings and afternoon/evenings irrespective of day of the week. Public transport density showed consistent positive associations with MVPA during weekends, while stronger effects on weekdays were observed in the morning and early evenings. Conclusions: This study suggests that space and time constraints in adults’ daily activities are important factors that determine the impact of neighbourhood attributes on PA. Consideration of time-specific associations is important to better characterise the magnitude of the effects of the neighbourhood environment on PA. Future research will need to examine the contribution of built environment characteristics of areas surrounding other types of daily life centres (e.g., workplaces) to explaining adults’ PA at specific times of the day.
Open Access
Efficacy of educational interventions in adolescent population with feeding and eating disorders: a systematic review
(Springer, 2023) Ladrón Arana, Sergio; Orzanco Garralda, María Rosario; Escalada Hernández, Paula; Aguilera-Serrano, Carlos; Gutiérrez Valencia, Marta; Urbiola-Castillo, Jordi; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Educational interventions are a key element in the care of young patients with feeding and eating disorders, forming part of the majority of therapeutic approaches. The aim of this review is to evaluate the impact of educational interventions in adolescents with feeding and eating disorders. Methods: Following the PRISMA recommendations electronic databases were searched up to 29 June 2023. Studies related to educational interventions in young population diagnosed with feeding and eating disorders (anorexia nervosa, avoidant/ restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders and binge- eating disorder) in Spanish and English language, without temporal limitation, were located in the databases: PubMed, Scopus, CINAHL, Cochrane Library, PsycINFO, CUIDEN, DIALNET, and ENFISPO. A search in the databases of grey literature was performed in OpenGrey and Teseo. The review protocol was registered in PROSPERO (CRD42020167736). Results: A total of 191 articles were selected from the 9744 citations screened. Ten publications were included. The results indicated variability between educational programs, including individual and group interventions, learning techniques and various research methodologies. Variables such as learning, attitudinal and perceptual changes, anthropometric parameters, symptom improvement, normalization of eating patterns, evaluation of the program and cognitive fexibility were identifed. The risk of bias was high due to the low methodological quality of a large number of studies analyzed. Conclusion: The results indicate that educational interventions can infuence the improvement of knowledge level and have a positive efect on health outcomes. Although education is a common practice in the treatment of these pathologies, highquality studies were not identifed. Thus, this review concludes that additional evidence is needed to evaluate the efectiveness of educational programs, with further research studies, especially randomized controlled trials, to confrm these results. Level of evidence: Level I: Systematic review.
Open Access
Perceived neighbourhood environmental attributes associated with adults’ recreational walking: IPEN Adult study in 12 countries
(Elsevier, 2014) Sugiyama, Takemi; Cerin, Ester; Owen, Neville; Oyeyemi, Adewale L.; Conway, Terry L.; Dyck, Delfien Van; Schipperijn, Jasper; MacFarlane, Duncan; Salvo, Deborah; Orzanco Garralda, María Rosario; Ciencias de la Salud; Osasun Zientziak
This study examined the strength and shape of associations between perceived environmental attributes and adults’ recreational walking, using data collected from 13,745 adult participants in 12 countries. Perceived residential density, land use mix, street connectivity, aesthetics, safety from crime, and proximity to parks were linearly associated with recreational walking, while curvilinear associations were found for residential density, land use mix, and aesthetics. The observed associations were consistent across countries, except for aesthetics. Using data collected from environmentally diverse countries, this study confirmed findings from prior single-country studies. Present findings suggest that similar environmental attributes are associated with recreational walking internationally.
Open Access
Influencia de las características urbanísticas ambientales en el nivel de actividad física de la población de 18 a 65 años del área metropolitana de Pamplona
(Ministerio de Sanidad, Consumo y Bienestar Social, 2016) Orzanco Garralda, María Rosario; Guillén Grima, Francisco; Sáinz Suberviola, María Lourdes; Redín Areta, María Dolores; Rosa Eduardo, Rosanna de la; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
Fundamentos: Un entorno adecuado puede favorecer la práctica de la actividad física, siendo una opción fácil para la población. El objetivo fue determinar la influencia de la percepción de los factores urbanísticos ambientales en el nivel de actividad física de las personas adultas. Métodos: Estudio transversal basado en el International Physical Activity and the Environment Network. Las personas participantes fueron seleccionadas de forma aleatoria y estratificada de la población de las zonas básicas de salud del Área Metropolitana de Pamplona entre las que tenían edad de 18 a 65 años. Se utilizó un cuestionario autoadministrado que incluyó la versión completa de la escala Neighborhood Environment Walkability Scale para valorar la percepción de los factores urbanísticos ambientales y la versión larga del International Physical Activity Questionnaire para recoger datos de actividad física. Se calculó la chi2 y se realizó un análisis multivariable mediante regresión logística no condicional Resultados: Participaron 905 sujetos (54,70% mujeres). Tener sendas de paseo próximas al domicilio o lugar de trabajo se relacionó con practicar actividad física moderada OR: 3,86 (IC 95% 1,70-8,74)] y actividad física total (suma de actividad física vigorosa, moderada y caminar) OR: 2,61 (IC 95% 1,24-5,45)]. La presencia en el barrio de lugares a los que podían ir caminando se asoció con dedicar más tiempo a caminar [OR: 1,26 (IC 95% 1,01-1,58)] y disponer cerca del domicilio o lugar de trabajo de espacios deportivos se asoció conpracticar más actividad física vigorosa [OR: 1,46 (IC 95% 1,01 - 2,12). Conclusiones: Existe asociación directa entre las personas que se declaran más activas y los factores urbanísticos ambientales, como sendas de paseo o instalaciones deportivas.
Open Access
Influencia del entorno en la actividad física de la población adulta del Área Metropolitana de Pamplona
(2015) Orzanco Garralda, María Rosario; Aguinaga Ontoso, Inés; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua: 2443/2009
El objetivo general de esta tesis doctoral es estudiar la influencia de la percepción sobre las características ambientales y los factores psicosociales en la práctica de la actividad física de la población (de 18 a 65 años) del Área Metropolitana de Pamplona. La hipótesis de este estudio sostiene que la percepción de las características ambientales en relación a la densidad residencial, la diversidad del uso del suelo, la accesibilidad a servicios (tiendas comerciales, restaurantes, servicios docentes y administrativos....), la conectividad entre las calles, la infraestructura para peatones y ciclistas, la estética, la seguridad ciudadana de los barrios, el entorno de la casa, la disponibilidad de zonas al aire libre e instalaciones deportivas próximas a su domicilio o trabajo, así como de los factores psicosociales (auto-eficacia, apoyo social y las barreras), influyen en los patrones de actividad física de los residentes. La metodología utilizada está fundamentada en la propuesta de IPEN Adult (International Physical Activity and the Environment Network Adult) y se utiliza parte del cuestionario Neighborhood Quality of Life Study (NQLS 1). Tras el análisis de los datos se llega a las siguientes conclusiones: 1) Los datos de los acelerómetros y de la versión larga del cuestionario International Phisycal Activity Questionnaire mostraron para la Suma del tiempo de actividad física vigorosa, moderada y caminar una correlación débil. 2) Los residentes en las zonas del área centro e intermedia caminan más en desplazamientos habituales de la vida cotidiana y durante el tiempo libre que los habitantes del área periférica, y el nivel de transitabilidad percibido es más alto en el área centro. 3) Disponer de paseos próximos a los lugares de residencia se asocia con mayor nivel de actividad física moderada; y tener cerca de los domicilios o lugares de trabajo instalaciones deportivas se asocia con mayor práctica de actividad física vigorosa. 4) Poseer perro y que las calles en las que se vive tengan numerosas conexiones entre ellas, se asocian al hecho de caminar más durante el tiempo libre. La percepción del tráfico lento se asocia con mayor actividad física en el tiempo libre. 5) La presencia de árboles en las aceras favorece y anima a las personas a realizar sus desplazamientos caminando. El desarrollo de infraestructuras que faciliten la movilidad de los peatones se asocia con mayor uso de la bicicleta para los desplazamientos. 6) La percepción que tienen las personas de su auto-eficacia para practicar actividad física moderada influye positivamente en la realización de actividad física en el tiempo libre. 7) Las personas que consiguen mayor nivel de actividad física vigorosa durante el tiempo libre, realizan ejercicio con sus amigos; mientras que el grupo que más camina en el tiempo libre, practica ejercicio con su familia. 9) Las personas con patrones de actividad física más inactivos señalan la falta de tiempo, de interés, de compañía o mala climatología, como los motivos que les impiden realizar actividad física de manera regular.
Open Access
Desafíos en la continuidad de cuidados para la práctica profesional de enfermería
(Universidad de La Sabana (Colombia), 2022) García Vivar, Cristina; Soto Ruiz, María Nelia; Escalada Hernández, Paula; Ferraz Torres, Marta; Orzanco Garralda, María Rosario; San Martín Rodríguez, Leticia; Ciencias de la Salud; Osasun Zientziak
La transformación de los sistemas sanitarios para dar respuesta a las necesidades del paciente crónico y pluripatológico ha situado la continuidad de cuidados como uno de los pilares en los que se basan los programas de atención y el diseño de nuevos recursos para atender a estos pacientes y a sus familias. En este contexto, la práctica profesional de las enfermeras presenta retos y desafíos en las tres dimensiones de la continuidad de cuidados: relacional, informativa y de gestión. Ante estos desafíos, la investigación en enfermería es fundamental para la profesión y necesaria para promover unos cuidados innovadores y de calidad.
Open Access
Percepción de factores psicosociales y del entorno relacionados con el desplazamiento activo
(Universitat Autònoma de Barcelona, 2018) Orzanco Garralda, María Rosario; Guillén Grima, Francisco; Sáinz Suberviola, María Lourdes; Redín Areta, María Dolores; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
El desplazamiento activo, bien caminando o en bicicleta, contribuye a incrementar el nivel de actividad física de las personas. Este hábito podría favorecerse actuando sobre ciertos factores psicosociales, y creando entornos próximos propicios. El propósito del presente trabajo fue determinar la percepción de los factores individuales y del entorno próximo, relacionados de forma especial, con cada una de las dos modalidades de desplazamiento, en una muestra poblacional de las personas adultas que residen en el área metropolitana de Pamplona. Se realizó un estudio transversal basado en la metodología propuesta por el Internacional Physical Activity and the Environment Network Adult Group, que estudia la relación entre los factores del entorno y la actividad física que practican las personas adultas. Los resultados obtenidos muestran que la falta de tiempo para practicar actividad física se asoció con mayor probabilidad con el grupo que menos se desplazó caminando, OR 1. 23(1. 08-1,. 40), y la falta de disfrute de la actividad física con el que menos se desplazó en bicicleta, OR 1. 29(1. 04-1. 61). Asimismo, la existencia de arbolado en las calles se asoció con mayor probabilidad de desplazarse caminando, OR 1. 23(1. 03-1. 46), mientras que la presencia de señales o pasos, que ayudaran a cruzar a los peatones, se relacionó con mayor probabilidad de utilizar bicicleta, OR 1. 42(1. 08 -1. 87). En conclusión, determinadas características individuales y del entorno se asocian particularmente con los desplazamientos caminando mientras que otras, lo hacen con el uso de bicicleta. Así, las personas que dedican menos tiempo a caminar para desplazase señalan la falta de tiempo como el motivo que les impide realizar actividad física, mientras que el grupo que menos usa la bicicleta para desplazarse indica la falta de disfrute. Además, la presencia de árboles en las aceras favorece y anima a las personas a realizar los desplazamientos caminando y la percepción de tráfico intenso se asocia con el grupo que menos tiempo dedica a caminar para desplazarse de un lugar a otro. Sin embargo, el desarrollo de infraestructuras que faciliten la movilidad de los peatones se asocia con mayor uso de la bicicleta para los desplazamientos.
Open Access
Neighborhood environments and objectively measured physical activity in 11 countries
(Wolters Kluwer, 2014) Cerin, Ester; Cain, Kelli L.; Conway, Terry L.; Dyck, Delfien Van; Orzanco Garralda, María Rosario; Ciencias de la Salud; Osasun Zientziak
Purpose: Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multisite evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively measured PA outcomes, between-site differences in such associations, and the extent to which perceived environmental attributes explain between-site differences in PA. Methods: This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and United States of America. Participants were 6968 adults residing in administrative units stratified by socioeconomic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min·wk−1 of MVPA). Results: Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix—access were significant predictors of both PA outcomes in the fully adjusted models. Environmental attributes accounted for within-site variability in MVPA, corresponding to an SD of 3 min·d−1 or 21 min·wk−1. Large between-site differences in PA outcomes were observed; 15.9%–16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Conclusions: Residents’ perceptions of neighborhood attributes that facilitate walking were positively associated with objectively measured MVPA and meeting the guidelines for cancer/weight gain prevention at the within- and between-site levels. Associations were similar across study sites, lending support for international recommendations for designing PA-friendly built environments.