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  • br Discussion The findings from our

    2018-11-05


    Discussion The findings from our study were generally consistent with previous research that showed a significant association between neighborhood social order MLN4924 and physical activity. Specifically, several studies have shown that high neighborhood social cohesion is associated with greater physical activity (Echeverría et al., 2008; Samuel et al., 2015; Cleland et al., 2010; Shelton et al., 2011). The mechanisms underlying these associations may involve both direct and indirect processes that promote more active living. For example, neighborhoods with high social cohesion may also have built environment factors such as access to parks and more walkable spaces that are known to promote physical activity (Bauman, Reis, & Sallis, 2012; McNeill, Kreuter, & Subramanian, 2006; Sallis, Floyd, & Rodríguez, 2012). Similarly, individuals who report a sense of trust and connection with their neighbors may be more physically active due to indirect processes related to psychological and emotional well-being that can promote health-enhancing behaviors (House, Landis, & Umberson, 1988; Inoue et al., 2013; Kawachi & Berkman, 2001; Seeman, 1996). Social norms may also play a role such that neighborhoods with high levels of neighborhood social cohesion promote social norms related to physical activity that may be more easily transmitted through group-shared values that are not present in neighborhoods with low levels of neighborhood social cohesion. Obtaining a further understanding of neighborhood predictors of physical activity is critical to inform the development of effective public health strategies that can lead to population-level increases in the prevalence of physical activity among Latinos, the largest growing minority population in the US. Our study also contributes to the emerging literature on factors related to physical activity outcomes across Latinos subgroups. We found that associations of neighborhood social cohesion and aerobic activity varied by Latino subgroup. Among Mexicans/Mexican-Americans and Cuban-Americans, our findings showed that high neighborhood social cohesion was associated with meeting the aerobic activity guideline. However, the results for Cuban/Cuban-Americans suggest a stronger relationship between neighborhood social cohesion and physical activity compared with other subgroups. A similar pattern of increased physical activity with increasing neighborhood social cohesion was observed for Puerto Ricans and Central/ South Americans, although associations were not statistically significant. A recent large-scale epidemiologic cohort study of Latinos (Hispanic Community Health Study/ Study of Latinos) also showed differences in objectively measured physical activity data across Latino groups (Arredondo et al., 2015) but did not examine the contribution of neighborhood-level factor to physical activity. In contrast to our findings for all other Latino groups, in Dominicans medium levels of neighborhood social cohesion were associated with lower odds of meeting the aerobic activity guideline. One potential explanation for the differences observed in Dominicans may be due to where they were sampled. For example, it is possible that individuals in NHIS were sampled from areas where there is a high concentration of Dominicans, such as New York City where approximately 47% of Dominicans resided in 2013 (Lopez, 2013). Arredondo and colleagues (Arredondo et al., 2015) showed that Dominicans had the lowest level of overall levels of leisure-time physical activity of all Latino groups, but had higher levels of transportation-related activity, attributing this finding to the fact that the study population was largely recruited from New York City. Thus, lower levels of LTPA may miss other forms of physical activity individuals engage in depending on where they live. Our findings for Dominicans and to some extent Cuban Americans, suggest that immigrant-related factors may also influence associations between neighborhood-level determinants and physical activity in Latino groups. For example, given that more than half of the Dominican population is foreign born (Lopez, 2013), residing in Dominican immigrant enclaves may play a role in their physical activity outcomes. Previous research has shown that Latinos living in neighborhoods with a higher proportion of immigrants are less likely to be physically active (Osypuk, Roux, & Hadley, 2009). Another possible explanation is the role of both individual and neighborhood-level socioeconomic condition shaping physical activity behaviors. For instance, a recent study that examined the association between neighborhood socioeconomic status environment and changes in physical activity over time in a sample of Cuban individuals found that physical activity was not associated with neighborhood socioeconomic environment (Affuso, Singleton, & Brown, 2016). However, this association may have been driven by the select group of Cuban Americans sampled in the study, which only included recent immigrants who generally have lower levels of income and education than prior immigrants. As a national sample, we may have captured an older cohort of Cuban Americans with a wider socioeconomic range and thus possibly allowing us to detect neighborhood-physical activity associations. Additionally, we note that our p-value for interaction was 0.06, although likely due to the increased power needed to detect differences across groups. Lastly, the unexpected association observed in Dominicans may be due to the lack of variation in both neighborhood social cohesion and physical activity, as Dominicans reported the lowest levels of neighborhood social cohesion and aerobic physical activity. Additional research is warranted to obtain further insight into the various neighborhood factors that independently and jointly with prior immigration history and time in the U.S. influence aerobic activity levels in Latino subgroups.