title: A model of environmental correlates of adolescent obesity in the United States.
abstract: OBJECTIVE
  The purpose of this study was to test a conceptual model of proximal (home) and distal (neighborhood) environmental correlates of adolescent obesity.
  
  
  METHODS
  This was a descriptive, cross-sectional study, using the 2007 National Survey of Children's Health, of 39,542 children aged 11-17 years. Structural equation modeling was used to test the fit of the model, identify direct and indirect effects of the proximal and distal environmental correlates, and determine reliabilities for latent constructs (Access to Physical Activity, Neighborhood Conditions, Social Capital Home Sedentary Behavior, and Physical Activity).
  
  
  RESULTS
  The model fitted the data well (Root Mean Square Standard Error of Approximation: .038 (90% confidence interval .038-.039), Comparative Fit Index: .950, and Tucker-Lewis Index: .934). Access to Physical Activity, Social Capital, Home Sedentary Behavior, and Physical Activity had direct effects on obesity (-.026, p = .001; .061, p < .001; .110, p < .001; and -.119, p < .001, respectively). Neighborhood Condition had indirect effects on obesity through Access to Physical Activity, Social Capital, and Home Sedentary Behavior (-.001, p = .009; .032, p < .001; and .044, p < .001, respectively). Access to Physical Activity had indirect effects on obesity through Physical Activity, Social Capital, and Home Sedentary Behavior (-.013, p < .001; -.005, p < .001; and -.005, p = .003, respectively). Home Sedentary Behavior had indirect effect on obesity through Physical Activity (.052, p <.001).
  
  
  CONCLUSIONS
  Results of this model fit to the U. S. population-based data suggest that interventions should target not only sedentary behavior and physical activity but also parent perceptions of safety, access to physical activity, and the neighborhood condition.
authors.affiliation: Department of Physical Therapy, University of the Pacific, Stockton, California. Electronic address: cnesbit@pacific.edu.
authors.forename: Kathryn C
authors.initials: KC
authors.lastname: Nesbit
authors.affiliation: Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Thubi H
authors.initials: TH
authors.lastname: Kolobe
authors.affiliation: Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Sisson
authors.affiliation: Ghement Statistical Consulting Company, Richmond, British Columbia, Canada.
authors.forename: Isabella R
authors.initials: IR
authors.lastname: Ghement
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology*; D012111:Residence Characteristics; D012307:Risk Factors; D057185:Sedentary Behavior; D012931:Social Environment; D014481:United States / Q000453:epidemiology
keywords: Adolescence; Environment; Obesity; Physical activity; Sedentary behavior; Structural equation modeling