TY - JOUR
T1 - Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups
T2 - 5-year results from an afterschool fitness programme in the USA
AU - D'Agostino, Emily M.
AU - Patel, Hersila H.
AU - Hansen, Eric
AU - Mathew, M. Sunil
AU - Nardi, Maria
AU - Messiah, Sarah
PY - 2018/3/1
Y1 - 2018/3/1
N2 - 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.
AB - 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.
KW - cardiovascular disease
KW - child health
KW - health inequalities
KW - physical activity
KW - poverty
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U2 - 10.1136/jech-2017-209333
DO - 10.1136/jech-2017-209333
M3 - Article
C2 - 29175865
AN - SCOPUS:85042868429
VL - 72
SP - 193
EP - 201
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
SN - 0143-005X
IS - 3
ER -