Associations of Neighborhood Factors and Activity Behaviors: The Mediators of Atherosclerosis in South Asians Living in
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ORIGINAL PAPER
Associations of Neighborhood Factors and Activity Behaviors: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study Stella S. Yi1 · Alka M. Kanaya2 · Ming Wen3 · Rienna Russo1 · Namratha Kandula4
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Social and built environments may influence physical activity (PA). However, evidence for South Asian Americans (SAA), a group with low PA levels and high cardiometabolic risk, is lacking. We assessed the association between five neighborhood factors and PA behaviors in a community-based cohort of SAA. Data were from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study 2010–2013 (n = 906). Adjusted multivariable models stratified by sex regressing PA behaviors on neighborhood factors were run. Higher neighborhood social cohesion was associated with 17% more PA MET minutes/week in men (p 500 MET minutes/week) [25].
All analyses were stratified by sex given differences in PA level [18, 19]. Demographic and other characteristics were assessed overall, and differences by sex were assessed using t-tests for continuous variables and chi-squared tests for categorical variables. Both continuous PA outcomes (PA in MET minutes/week) were log-transformed as they were non-normally distributed. Multivariable models regressing PA outcomes on neighborhood factors were run; logistic regression models were used for the binary outcome of meeting 2008 PA guidelines, and linear regression models were used for the continuous outcome of log-transformed PA MET minutes/week. Models were adjusted for study site, age, sex, education, income, marital status, time in the U.S., traditional cultural beliefs score, and social support. Neighborhood factors were not found to be collinear with each other. STATA (version 12.0; College Station, Texas) was used for all analysis.
Additional Covariates Acculturation and/or proxy measures of acculturation (e.g., years in U.S., nativity) have been previously shown to be associated with PA and was therefore considered a key covariate in this analysis [3, 5, 17, 26–28]. Acculturation was measured as years living in the U.S. and the traditional cultural beliefs scale (α = 0.83 for MASALA participants). This 7-item South Asian traditional cultural beliefs scale assessed to what extent participants believed the following behaviors should be practiced in America: (1) religious ceremonies or rituals, (2) consuming South Asians sweets during ceremonies, (3) the spiritual practice of fasting, (4) a joint family living structure, (5) arranged marriage practices, (6) consuming traditional ethnic foods, and (7) using traditional spices for health purposes. The scale included five response options ranging from absolute agreement to not agreeing at all with the seven items. Scores had a possible range of 0–28, with lower scores reflecting stronger traditional cultural beliefs and higher scores reflecting weaker cultural beliefs [29]. Social support was assessed by the ENRI
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