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Measuring and understanding neighbourhood built environmental correlates of health enhancing physical activity and overweight in Nigerian adults

(2013)
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(UGent) , (UGent) and Babatunde O Adegoke
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Abstract
The increasing prevalence of physical inactivity and associated chronic diseases’ related mortality in African countries has made the prevention of chronic diseases an urgent priority in the region’s countries. Environmental and policy interventions based on the conceptual framework of the ecological models are recommended by the World Health Organization and other authoritative groups to promote physical activity and prevent obesity worldwide, but strategies should be evidence based. Africa is the only continent for which evidence is lacking on relationship of neighbourhood environment with physical activity and overweight/obesity. If evidence-based environmental interventions are to be developed in Africa, there is the need to first tailor environmental and physical activity measures to the African context. Then the adapted measures need to be used to identify promising environmental correlates of physical activity and overweight in African countries. The research presented in this thesis aimed at providing better insight into the measurement of neighbourhood built environmental attributes and physical activity in Nigeria, and at understanding neighbourhood built environmental correlates of physical activity and overweight/obesity in Nigerian adults (18-65 years). The first measurement study documented the reliability of an original un-adapted environmental measure (PANES) in a university campus environment. The reliability of the original PANES was good and acceptable, but it was unclear if findings could be extrapolated to Nigerian environments outside the university campus. Based on this assumption, the second study cross culturally adapted the PANES to Nigeria and evaluated its aspects of reliability and validity in a metropolitan Nigerian city. The reliability coefficients of items of the adapted version of PANES were found to be stronger than those of the original version. In addition, the study revealed that items on the adapted PANES were able to discriminate between environmental attributes from different neighbourhoods selected to be environmentally different, indicating good evidence of construct validity. These suggest that the adapted version was more consistent and meaningful to Nigerian residents than the original version. In the third study, similar results emerged for the psychometric testing of another adapted measure of the environment (NEWS) evaluated in two Nigerian cities. The last measurement study, found the reliability and concurrent validity of an adapted physical activity (IPAQ-SF) measure to be similar to those reported in international literature, but to have limited evidence of construct validity. Results of the first cross-sectional study on environmental correlates of physical activity and overweight in Nigerian adults, using original un-adapted measures of built environment and physical activity poorly replicated findings in the international literature and confirmed the need to use culturally applicable measures for studies in the African region. Based on adapted measures and objectively examined physical activity, the second cross-sectional study documented more consistent and expected patterns of associations of perceptions of neighbourhood safety from crime and traffic with physical activity behaviours. Furthermore, the third study identified perceptions of unfavourable features of the neighbourhood environment that include poor aesthetics, garbage and offensive odour, poor land-use mix, feeling unsafe from crime, and unsafe from traffic to be significantly associated with a substantial 40% to 60% higher risk of overweight/obesity in Nigerian adults. The findings of these two studies indicated that correlates of physical activity and body weight status are different in men and women in Nigeria. The last cross-sectional study highlighted that physical activity behaviours rather than sedentary time mediated the associations between several environmental factors and body mass index of Nigerian adults, indicating that the effects of built environment on body weight status of Nigerian adults largely occur through physical activity behaviours. The consistent associations of environmental factors like land-use mix, aesthetics, hygienic qualities and crime, and traffic safety with physical activity and body weight status are unique Nigerian findings that may have relevance for public health interventions on physical activity promotion and obesity control in this country. However, experimental studies will be required to establish causality between environmental factors and health behaviours in the African region. In the meantime, intervention studies based on ecological models need to evaluate the impact of environmental variables such as those identified in this thesis on health behaviours of African population. Furthermore, other multi-dimensional correlates (including psychosocial and socio-demographic factors) of physical activity, body weight status and sedentary behaviours need to be investigated across all age groups in the African region.

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Chicago
Oyeyemi, Adewale Luqman. 2013. “Measuring and Understanding Neighbourhood Built Environmental Correlates of Health Enhancing Physical Activity and Overweight in Nigerian Adults”. Ghent, Belgium: Ghent University. Faculty of Medicine and Health Sciences.
APA
Oyeyemi, Adewale Luqman. (2013). Measuring and understanding neighbourhood built environmental correlates of health enhancing physical activity and overweight in Nigerian adults. Ghent University. Faculty of Medicine and Health Sciences, Ghent, Belgium.
Vancouver
1.
Oyeyemi AL. Measuring and understanding neighbourhood built environmental correlates of health enhancing physical activity and overweight in Nigerian adults. [Ghent, Belgium]: Ghent University. Faculty of Medicine and Health Sciences; 2013.
MLA
Oyeyemi, Adewale Luqman. “Measuring and Understanding Neighbourhood Built Environmental Correlates of Health Enhancing Physical Activity and Overweight in Nigerian Adults.” 2013 : n. pag. Print.
@phdthesis{4132474,
  abstract     = {The increasing prevalence of physical inactivity and associated chronic diseases{\textquoteright} related mortality in African countries has made the prevention of chronic diseases an urgent priority in the region{\textquoteright}s countries. Environmental and policy interventions based on the conceptual framework of the ecological models are recommended by the World Health Organization and other authoritative groups to promote physical activity and prevent obesity worldwide, but strategies should be evidence based. Africa is the only continent for which evidence is lacking on relationship of neighbourhood environment with physical activity and overweight/obesity.
If evidence-based environmental interventions are to be developed in Africa, there is the need to first tailor environmental and physical activity measures to the African context. Then the adapted measures need to be used to identify promising environmental correlates of physical activity and overweight in African countries. The research presented in this thesis aimed at providing better insight into the measurement of neighbourhood built environmental attributes and physical activity in Nigeria, and at understanding neighbourhood built environmental correlates of physical activity and overweight/obesity in Nigerian adults (18-65 years).
The first measurement study documented the reliability of an original un-adapted environmental measure (PANES) in a university campus environment. The reliability of the original PANES was good and acceptable, but it was unclear if findings could be extrapolated to Nigerian environments outside the university campus. Based on this assumption, the second study cross culturally adapted the PANES to Nigeria and evaluated its aspects of reliability and validity in a metropolitan Nigerian city. The reliability coefficients of items of the adapted version of PANES were found to be stronger than those of the original version. In addition, the study revealed that items on the adapted PANES were able to discriminate between environmental attributes from different neighbourhoods selected to be environmentally different, indicating good evidence of construct validity. These suggest that the adapted version was more consistent and meaningful to Nigerian residents than the original version. In the third study, similar results emerged for the psychometric testing of another adapted measure of the environment (NEWS) evaluated in two Nigerian cities. The last measurement study, found the reliability and concurrent validity of an adapted physical activity (IPAQ-SF) measure to be similar to those reported in international literature, but to have limited evidence of construct validity.
Results of the first cross-sectional study on environmental correlates of physical activity and overweight in Nigerian adults, using original un-adapted measures of built environment and physical activity poorly replicated findings in the international literature and confirmed the need to use culturally applicable measures for studies in the African region. Based on adapted measures and objectively examined physical activity, the second cross-sectional study documented more consistent and expected patterns of associations of perceptions of neighbourhood safety from crime and traffic with physical activity behaviours. Furthermore, the third study identified perceptions of unfavourable features of the neighbourhood environment that include poor aesthetics, garbage and offensive odour, poor land-use mix, feeling unsafe from crime, and unsafe from traffic to be significantly associated with a substantial 40\% to 60\% higher risk of overweight/obesity in Nigerian adults. The findings of these two studies indicated that correlates of physical activity and body weight status are different in men and women in Nigeria. The last cross-sectional study highlighted that physical activity behaviours rather than sedentary time mediated the associations between several environmental factors and body mass index of Nigerian adults, indicating that the effects of built environment on body weight status of Nigerian adults largely occur through physical activity behaviours.
The consistent associations of environmental factors like land-use mix, aesthetics, hygienic qualities and crime, and traffic safety with physical activity and body weight status are unique Nigerian findings that may have relevance for public health interventions on physical activity promotion and obesity control in this country. However, experimental studies will be required to establish causality between environmental factors and health behaviours in the African region. In the meantime, intervention studies based on ecological models need to evaluate the impact of environmental variables such as those identified in this thesis on health behaviours of African population. Furthermore, other multi-dimensional correlates (including psychosocial and socio-demographic factors) of physical activity, body weight status and sedentary behaviours need to be investigated across all age groups in the African region.},
  author       = {Oyeyemi, Adewale Luqman},
  language     = {eng},
  pages        = {232},
  publisher    = {Ghent University. Faculty of Medicine and Health Sciences},
  school       = {Ghent University},
  title        = {Measuring and understanding neighbourhood built environmental correlates of health enhancing physical activity and overweight in Nigerian adults},
  year         = {2013},
}