Abstract
Physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) remain problematic. Consequently, the present study examined the association between MVPA and urban vs. rural residential status and the perceived environment in patients attending home-based CR. A total of 280 patients completed a questionnaire assessing demographic, clinical, MVPA, and perceived environmental variables measured at baseline and 3 months later. Patient addresses were geocoded and linked to the 2006 Canadian census to establish the urban/rural distinction. Results showed that urban and rural patients had similar baseline MVPA and improvements in MVPA by 3 months. Several perceived environmental variables were significantly related to MVPA throughout home-based CR that were common and urban/rural-specific. Therefore, although there does not appear to be an urban vs. rural advantage in MVPA levels during home-based CR, there does appear to be environmental/MVPA-specific relationships specific to urban and rural patients that may warrant attention.
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Arthur HM, Smith KM, Kodis J, McKelvie R. A controlled trial of hospital versus home-based exercise in cardiac patients. Med Sci Sports Exerc. 2002; 34(10): 1544–1550.
Smith KM, Arthur HM, McKelvie RS, Kodis J. Differences in sustainability of exercise and health-related quality of life outcomes following home or hospital-based cardiac rehabilitation. Eur J Cardiovasc Prev Rehabil. 2004; 11(4): 313–319.
Blanchard C, Reid R, Morrin L, et al. Demographic and clinical determinants of moderate to vigorous physical activity during home-based cardiac rehabilitation: the home-based determinants of exercise (HOME) study. J Cardpulm Rehabil. 2010; 30(4): 240–245.
Petter M, Blanchard C, Kemp K, Mazoff A, Ferrier S. Correlates of exercise among coronary heart diseaes patients: review, implications, and future directions. Eur J Cardiovasc Prev Rehabil. 2009; 16(5): 515–526.
Sallis J, Owen N. Ecological models. In: Glanz K, Lewis F, Rimer B, eds. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: Jossey Bass; 1999: 403–424.
Parks S, Housemann R, Brownson RC. Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States. J Epidemiol Community. 2003; 57: 29–35.
Wilcox S, Castro C, King A, Housemann R, Brownson R. Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States. J Epidemiol Community. 2000; 54: 667–672.
Tucker-Seeley R, Subramanian S, Sorensen G. Neighborhood safety, socioeconomic status, and physical activity in older adults. Am J Prev Med. 2009; 37(3): 207–213.
Wilson D, Kirtland K, Ainsworth B, Addy C. Socioeconomic status and perceptions of access and safety for physical activity. Ann Beh Med. 2004; 28(1): 20–28.
Jakicic J, Wing R, Butler B, Jeffrey R. The relationship between presence of exercise equipment in the home and physical activity. Am J Health Promot. 1997; 11(5): 363–365.
Sallis J, Johnson M, Calfas K, Caparosa S, Nichols J. Assessing perceived physical environmental variables that may influence physical activity. Res Q Exerc Sport. 1997; 68(4): 345–351.
Humpel N, Owen N, Leslie E. Environmental factors associated with adults’ perception in physical activity. Am J Prev Med. 2002; 22(3): 188–199.
Saelens B, Handy S. Built environment correlates of walking: a review. Med Sci Sports Exerc. 2008; 40: S550–S566.
INTERXVENT, CANADA. 12-week mentored health program. https://store.intervent.ca/. Accessed January 2, 2010.
Godin G, Shepard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985; 10: 141–146.
Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of ten commonly used physical activity questionnaires. Med Sci Sports Exerc. 1993; 25: 81–89.
International, Physical, Activity, Prevalence, Study. Self-administered environmental module. http://w.drjamessallis.sdsu.edu/Documents/IPAQIPS.pdf. Accessed January 1, 2006
Land Information Ontario. Ontario Road Net Element File. Ontario, Canada: Ministry of Natural Resources; 2010.
Bollman R. Rural and small town canada analysis bulletin. Statistics Canada. http://www.statcan.ca/cgi-bin/downpub/freepub.cgi. Accessed January 2, 2010.
Demissie K, Hanley J, Menzies D, Joseph L, Ernst P. Agreement in measuring socio-economic status: area-based versus individual measures. http://www.phac-aspc.gc.ca/publicat/cdic-mcc/21-1/a_e.html. Accessed January 2, 2010.
Oliver L, Schuurman N, Hall A. Comparing circular and network buffers to examine the influence of land use on walking for leisure and errands. Int J Health Geographics. 2007; 6(41): 1–11.
Raudenbush SW, Bryk TA. Hierarchical Linear Model: Applications and Data Analysis Methods. 2nd ed. Thousand Oaks, CA: 2002.
Giles-Corti B, Donovan R. Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment. Prev Med. 2002; 35: 601–611.
Cohen A. A power primer. Psychol Bull. 1992; 112: 155–159.
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This research was supported by the Social Sciences and Humanities Research Council of Canada. Dr. Blanchard is supported by the Canada Research Chairs program.
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Blanchard, C., Rainham, D., McSweeney, J. et al. Community SES, Perceived Environment, and Physical Activity During Home-Based Cardiac Rehabilitation: Is There a Need to Consider the Urban vs. Rural Distinction?. J Urban Health 89, 285–295 (2012). https://doi.org/10.1007/s11524-011-9661-7
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DOI: https://doi.org/10.1007/s11524-011-9661-7