The longitudinal association between neighbourhood quality and cardiovascular risk factors among youth receiving obesity treatment.
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2023-12
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Abstract
Background
Neighbourhood factors are associated with cardiovascular health in adults, but these relationships are under-explored in youth.Objectives
To characterize the associations between neighbourhood factors and child and adolescent health among youth with obesity.Methods
Data were drawn from patient health records at a pediatric weight management clinic (n = 2838) and the Child Opportunity Index (COI). Exposures were area-level neighbourhood factors (commute duration, walkability, greenspace and industrial pollutants). Outcomes included BMI relative to the 95th percentile (BMIp95) and blood pressure (continuous variables). Longitudinal models examined associations between COI indicators and outcomes.Results
Shorter commute duration (β = -4.31, 95% CI: -5.92, -2.71) and greater walkability (β = -4.40, 95% CI: -5.98, -2.82) were negatively associated with BMIp95. Increased greenspace availability was positively associated with BMIp95 (β = 1.93, 95% CI: 0.19, 3.67). None of the COI indicators were associated with cardiovascular outcomes in the full sample. Analyses stratified by sex and race/ethnicity showed similar patterns for BMIp95. For commute duration, there was a negative association with blood pressure for female, non-Hispanic White and other race/ethnicity youth.Conclusions
Neighbourhood factors should be considered as contextual factors when treating youth with obesity. Additional research is needed to understand the relationship between neighbourhood factors and cardiovascular outcomes.Type
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Neshteruk, Cody D, Shivani Chandrashekaran, Sarah C Armstrong, Asheley C Skinner, Jesse Delarosa and Emily M D'Agostino (2023). The longitudinal association between neighbourhood quality and cardiovascular risk factors among youth receiving obesity treatment. Pediatric obesity, 18(12). p. e13080. 10.1111/ijpo.13080 Retrieved from https://hdl.handle.net/10161/33961.
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Scholars@Duke
Cody D Neshteruk
Cody Neshteruk, PhD is a public health researcher whose work focuses on improving the health and well-being of children and families. In particular, he is interested in promoting cardiovascular health and reducing obesity through helping families adopt healthy eating and physical activity behaviors in a variety of settings including community centers, early care and education programs, and clinical pediatric weight management. His expertise includes designing, delivering, and disseminating behavioral interventions, physical activity measurement, and implementation science methods.
Areas of Expertise: Nutrition, Physical Activity, Obesity, Health Behavior, Implementation Science
Sarah Commisso Armstrong
Dr. Armstrong's clinical and research interests include pediatric nutrition and the treatment of childhood and adolescent obesity, along with related health problems. As director of the Duke Children's Healthy Lifestyles Program, Dr. Armstrong oversees a cohort of over 3000 overweight children and teenagers. She is a member of the Executive Committee for the American Academy of Pediatrics Section on Obesity. Dr. Armstrong's research focuses on leveraging innovative strategies to improve children's nutrition and activity, including mobile health interventions, community partnerships, and medication or surgical approaches.
Emily Meredith D'Agostino
Dr. D’Agostino is a community-engaged epidemiologist and Associate Professor in the Department of Orthopaedic Surgery, Duke University School of Medicine. She also is the Associate Editor of Childhood Obesity, Director of Community-Engaged Research Practice in the Division of Occupational Therapy, and co-Director of the Duke Center for Child Obesity Research. Dr. D’Agostino’s research draws from over 20 years of experience working directly in school and park settings to develop innovative, community-based strategies targeting health access for all. She holds expertise in physical activity, obesity, fitness, and mental well-being in community settings, multilevel modeling techniques, analysis of complex longitudinal datasets, and methods of epidemiology instruction. Dr. D’Agostino serves as PI on the Youth Empowered Self-Care (YES) and Going Places studies to promote youth well-being and physical activity in close collaboration with Parks and Recreation. She also serves as Co-PI on the You & Me: Test and Treat study, Co-PI on the You and Me Healthy Registry program, and Co-I on the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program that coordinates 143 research projects and develops community-engaged research capacity nationally. She holds appointments in the Duke Department of Population Health Sciences, the Duke Global Health Institute, and is a faculty member of the Duke Clinical Research Institute. Dr. D’Agostino obtained her doctoral training in epidemiology at the City University of New York, Graduate School of Public Health and Health Policy.
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