Primary Investigator:

Karel Frömel

Research Team:

Josef Mitáš

Jan Dygrýn, Ph.D. Student

František Chmelík

Lucie Kubíčková, Ph.D. Student

Research of physical activity, lifestyle, obesity and environment (20-65 years) – Olomouc and Hradec Králové

Objective and study design
The study is an epidemiologically observed research designed to compare differences between neighborhoods – based on walkability derived from Geographic Information Systems (GIS) and socioeconomic status (from census data) in different built environments.
The main aim of the study is to estimate the associations between the built environment and total PA and transportation PA in adults living in cities in the Czech Republic.
Further, the aim is to carry out analyses of PA and the environment in the context with other socio-demographic and health factors with regard to environmental and psychosocial specifics of the Czech Republic. Among the major specifics, we regard the types and character of built environment (especially historic city centers and “socialistic” urban development), “copying” or repeating negative trends in population lifestyle (following trends in population lifestyle in more economically developed countries), minimal ethnical and racial diversity, but also very high level of walkability in the population. The following aim is to enhance positive changes in physical activity behavior in the adult population using the findings on the environment and lifestyle, and using pedometers and the supportive online system

Participant recruitment
The research will be carried out in cities of Olomouc and Hradec Králové with one hundred thousand inhabitants and with different built environment and socioeconomic status. During the periods Spring-Summer and Fall-Winter, 1280 (640 in each city) randomly selected participants aged 20-65 will gradually participate in the research. We expect to repeat the measuring in the same respondents after 6 months to observe any discrepancies based on seasonal weather. All the participants will be addressed and visited in person by trained distributors. The main monitoring period will start in October 2009 and end in November 2011. A modest incentive and a pedometer as a gift will be provided for completing the 2 rounds of surveying and accelerometer monitoring.

Subjective measures
The standardized Czech version of the IPAQ-long questionnaire will be used for the evaluation of physical activity (PA) in 4 domains: job-related, transportation, household and leisure-time. Participants report the type of the performed activity, the time of its duration (at least 10 minutes at a time) on the average per day for the period of last seven days. Physical activity of adults is categorized into time spent performing vigorous PA, moderate PA and walking. The totals for vigorous and moderate activity and walking outcome will be in MET-minutes. The transport activity outcome will be the summed in weekly minutes of walking and cycling for transport. The IPAQ-long questionnaire is a part of the ANEWS survey.
The Neighborhood Environment Walkability Scale –abbreviated (ANEWS) is used to assess several environmental characteristics: perceived residential density, proximity to, and ease of access to, nonresidential land uses, such as restaurants and retail stores (land use mix–diversity and land use mix–access), street connectivity, walking/cycling infrastructure (sidewalks and pedestrian/bike trails), aesthetics pedestrian traffic safety and crime safety. Access to both public and private recreation facilities is measured by the ANEWS.
The survey will ask participants for personal information: age, gender, height and weight for BMI [kg/m2] calculation, address, socio-demographic items, specification of respondents’ SES, family status, owning of material goods and participation in organized PA.

Objective measures
Research methods will be in compliance with the proposed IPEN methods. To monitor PA, we will simultaneously use ActiGraph GT1M (GT3X) accelerometers and Yamax SW 700 pedometers. ActiGraph monitors were selected because they are the most reliable and accurate means of measuring activity levels and energy expenditure outside of a clinical setting (ActiGraph is the only commercially available device of its kind that shows positive correlation with the doubly labeled water technique of measuring energy expenditure) and we have extensive experience with its use in Czech epidemiological studies.
The ActiGraph stores minute-by-minute averages of motion. We expect monitoring of PA in 640 participants repeatedly in both cities. They will be instructed to wear the ActiGraph during all waking hours for 7 days. The ActiGraphs will be transferred face-to-face only.
Data from the units will be downloaded into ActiLife software, processed in the MeterPlus software and transferred to the central server. To analyze PA monitoring, a uniquely developed software is going to be used which will allow to provide individual feedback on PA of participants and they will get this information in printed form. Between the first and second round of monitoring, a pedometer will be offered to each respondent and his/her family for use. As an additional technique, the motivational and assessment online system will be available for respondents’ family.

GIS analyses will be carried out in fully compatible range with the IPEN with some specifics in national census data. GIS will be used for counting the walkability index and to assess environmental characteristics of selected neighborhoods. We use ArcGIS 9 with all extensions.

Support of IPEN funds
The IPEN fund facilitates data collection, participation on meetings and enables small incentives to participants. The study in the Czech Republic is based on the currently running research project “Physical Activity and Inactivity of Inhabitants of the Czech Republic in the Context of Behavioral Changes” (2005-2010) and is supported mainly from this grant.



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