Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA

Emily M. D'Agostino, Hersila H. Patel, Eric Hansen, M. Sunil Mathew, Maria Nardi, Sarah Messiah

Research output: Contribution to journalArticle

7 Scopus citations


Background The WHO calls for affordable populationbased prevention strategies for reducing the global burden of cardiovascular disease (CVD) on morbidity and mortality; however, effective, sustainable and accessible community-based approaches for CVD prevention in at-risk youth have yet to be identified. We examined the effects of implementing a daily park-based afterschool fitness programme on youth CVD risk profiles over 5 years and across area poverty subgroups. Methods The study included 2264 youth (mean age 9.4 years, 54% male, 50% Hispanic, 47% non-Hispanic black, 70% high/very high area poverty) in Miami, Florida, USA. We used three-level repeated measures mixed models to determine the longitudinal effects of programme participation on modifiable CVD outcomes (2010-2016). Results Duration of programme participation was significantly associated with CVD risk profile improvements, including body mass index (BMI) z-score, diastolic/systolic blood pressure, skinfold thicknesses, waist-hip ratio, sit-ups, push-ups, Progressive Aerobic Cardiovascular Endurance Run (PACER) score, 400 m run time, probability of developing systolic/diastolic hypertension and overweight/obesity in high/very high poverty neighbourhoods (P>0.001). Diastolic blood pressure decreased 3.4 percentile points (95% CI-5.85 to-0.85), 8.1 percentile points (95% CI-11.98 to-4.26), 6.1 percentile points (95% CI-11.49 to-0.66), 7.6 percentile points (95% CI-15.33 to-0.15) and 11.4 percentile points (95% CI-25.32 to 2.61) for 1-5 years, respectively, in high/very high poverty areas. In contrast, significant improvements were found only for PACER score and waist-hip ratio in low/mid poverty areas. Conclusion This analysis presents compelling evidence demonstrating that park-based afterschool programmes can successfully maintain or improve at-risk youth CVD profiles over multiple years.

Original languageEnglish (US)
Pages (from-to)193-201
Number of pages9
JournalJournal of Epidemiology and Community Health
Issue number3
StatePublished - Mar 1 2018



  • cardiovascular disease
  • child health
  • health inequalities
  • physical activity
  • poverty

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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