title: Association between social and built environments and leisure-time physical activity among Chinese older adults--a multilevel analysis.
abstract: BACKGROUND
  Social and physical environments are not only hypothesized to influence physical activity (PA), they are also interrelated and influence each other. However, few studies have examined the relationships of PA with social and physical environments simultaneously. Accordingly, the current study aims to examine the association between physical and social attributes of neighborhood with leisure-time physical activity (LTPA) among the Chinese elders.
  
  
  METHODS
  By employing a two-stage stratified random sampling procedure, 2783 elders were identified from 47 neighborhoods in Shanghai during July and September in 2014. Social and physical attributes of neighborhood were assessed using a validated and psychometrically tested measures, and the Chinese version of the International Physical Activity Questionnaire--Long Form was used to assess LTPA. Control variables included sex, age, marital status, education level, self-rated health and chronic conditions. Multilevel logistic regression analysis was conducted to explore whether individual- and neighborhood-level social and physical attributes were associated with LTPA.
  
  
  RESULTS
  The overall prevalence of leisure-time active (LTA) was 46.6%. After controlling for individual covariates, 1) compared to participants with the first quartile of social participation, the odds ratios of LTA for participants with the second, third and fourth quartile of social participation were 1.86 (95% CI: 1.44-2.41), 2.37 (95% CI: 1.82-3.08) and 4.27 (95% CI: 3.27-5.58); 2) compared to participants with the first quartile of social cohesion, the odds ratios of LTA for participants with the second, third and fourth quartile of social cohesion were 1.09 (95% CI: 1.07-1.20), 1.14 (95% CI: 1.08-3.50) and 1.31 (95% CI: 1.11-1.58); 3) compared to participants living in neighborhoods with the first quartile of walkability, the odds ratios of LTA for participants living in neighborhoods with the second, third and fourth quartile of walkability were 1.13 (95% CI: 1.03-2.02), 1.73 (95% CI: 1.12-3.21) and 1.85 (95% CI: 1.19-3.35).
  
  
  CONCLUSIONS
  Both social and physical attribute of neighborhood associate with LTPA among Chinese older adults. It may promote LTPA among Chinese older adults to encourage them to participate in social activities, meanwhile, building walkable and cohesive neighborhoods.
authors.affiliation: School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China. jlgao@fudan.edu.cn.
authors.forename: Junling
authors.initials: J
authors.lastname: Gao
authors.affiliation: School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China. hfu@fudan.edu.cn.
authors.forename: Hua
authors.initials: H
authors.lastname: Fu
authors.affiliation: School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China. jiangli_fd@fudan.edu.cn.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.affiliation: School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China. jyn@fudan.edu.cn.
authors.forename: Yingnan
authors.initials: Y
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D004777:Environment; D015444:Exercise; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D016017:Odds Ratio; D012111:Residence Characteristics; D012931:Social Environment; D016138:Walking