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. 2024 Dec;47(6):965-979.
doi: 10.1007/s10865-024-00505-2. Epub 2024 Aug 7.

The moderating effect of access to food facilities and recreational activity space on mHealth multiple health behavior change intervention

Samuel L Battalio  1 , Benjamin W Barrett  2 , Ivelina I Arnaoudova  2 , David J Press  2   3 , Donald Hedeker  4 , Angela Fidler Pfammatter  5 , Kiarri N Kershaw  2 , Bonnie Spring  2
Affiliations

The moderating effect of access to food facilities and recreational activity space on mHealth multiple health behavior change intervention

Samuel L Battalio et al. J Behav Med. 2024 Dec.

Abstract

Objective: To evaluate whether the neighborhood social and built environment moderates response to a mobile health multiple health behavior change intervention targeting fruit/vegetable intake, sedentary behavior, and physical activity.

Methods: Participants were 156 Chicago-residing adults with unhealthy lifestyle behaviors. Using linear mixed models, we evaluated whether access to food facilities (fast food restaurants and grocery stores) and recreational activity spaces (gyms and parks) moderated the difference in behavior change between the active intervention condition relative to control. Using spatial data analysis (cross K functions), we also assessed whether participants who achieved goal levels of behaviors ("responders") were more or less likely than those who did not achieve intervention goals ("non-responders") to reside near fast food restaurants, grocery stores, gyms, or parks.

Results: According to linear mixed models, none of the neighborhood social and built environment factors moderated the difference in behavior change between the active intervention condition and the control condition (Likelihood Ratio (χ²[1] = 0.02-2.33, P-values > 0.05). Cross K functions showed that diet behavior change responders were more likely than non-responders to reside near fast food restaurants, but not grocery stores. The results for activity behavior change were more variable. Sedentary screen time responders were more likely to reside around recreational activity spaces than non-responders. Moderate-vigorous physical activity responders had greater and lesser clustering than non-responders around parks, dependent upon distance from the park to participant residence.

Conclusions: A complex relationship was observed between residential proximity to Chicago facilities and response to multiple health behavior change intervention. Replication across diverse geographic settings and samples is necessary.

Keywords: Diet; Health Behavior Change; Health disparities; Physical activity; mHealth.

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Figures

Fig. 1
Fig. 1
Difference in cross K functions for responders vs. non-responders as defined by accomplishment of diet behavior change goals. Cross K functions are between participants and food facilities
Fig. 2
Fig. 2
Difference in cross K functions for responders vs. non-responders as defined by accomplishment of activity behavior change goals. Cross K functions are between participants and recreational activity space facilities
See this image and copyright information in PMC

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