Background & Aims
Physical activity (PA) has been widely accepted as an effective non-pharmacological pain management strategy, yet many Latinos with pain do not engage in moderate-to-vigorous physical activity (MVPA). Furthermore, Latinos have been found to spend 71% of their day being sedentary. Latinos with chronic spine pain (CSP) face distinct challenges to engaging in MVPA and reducing sedentary behavior (SB) that may be influenced by multiple levels of the socioecological model including intrapersonal (e.g., age, gender, pain intensity or beliefs, or PA-related beliefs), interpersonal (e.g., social support), and environmental factors (e.g., neighborhood walkability). The purpose of this study was to determine the extent to which multilevel factors are associated with minutes of MVPA and SB.
Methods
This study was a secondary analysis of baseline data from a clinical trial conducted at a Federally Qualified Health Center near the US-Mexico border. Baseline assessments consisted of surveys and 7-days of free-living activity monitoring. PA data was processed with the Troiano processing algorithm and Freedson cut-points were used to derive average minutes spent in MVPA and SB. Participants self-reported their sociodemographic information, pain intensity, exercise beliefs, and social support using validated questionnaires. Zip codes were used to calculate neighborhood walkability and indices for neighborhood transportation and clean environment. PA was measured with an ActiGraph GT3X+. Bivariate associations between each independent variable and the primary outcomes were assessed using Pearson’s correlations, ANOVAs, and t-tests. Variables that were associated with MVPA or SB (p<0.15) from bivariate analyses were included in two hierarchical linear regressions assessed at p<.05.
Results
Participants (N=154) were on average 47.5 ± 12.1 years of age. Most participants were female (70.1%), born in Mexico (70.1%), spoke Spanish as their primary language (74.0%), had low back pain (79.2%), and were not a high school graduate (50.6%). On average, participants spent 56.1 ± 71.1 min/week in MVPA and 550.3 ± 140.9 min/week in SB. Three factors (i.e., age, income, and fear-avoidance beliefs [FAB]) were associated with MVPA and included in the regression model. Eight factors (i.e., age, gender, acculturation, income, employment, FAB, transportation, and self-efficacy) were associated with SB and included in a separate regression model. Results of the 2-block hierarchical regression for MVPA indicated that the final Model R2= .137 was significant at F(1, 114)=6.0, p < 0.05 (age ? = -2.92, p<.05; income ? = .17, p=.05; FAB ? = -.06, p=.47). Results of the 3-block hierarchical regression for SB indicated that the final Model R2= .118 was not significant at F(1, 95)=1.6, p =.14.
Conclusions
Age and income together explained a small yet significant percentage of the variance (14%) in MVPA in this sample of Latinos with CSP. This is similar to previous studies in pain-free individuals where younger Latinos tended to engage in more MVPA activity than their older counterparts. Findings suggest the need to investigate if older Latinos with CSP are engaging in low intensity activity and why they do not engage in MVPA in order to develop age appropriate PA programs. In our study, income was also positively associated with MVPA but not with objective neighborhood level indicators of income (e.g., walkability, transportation, or clean environment) which is in contrast to previous PA literature. These findings suggest the need to investigate subjective perceptions and assessments of neighborhood features by income level to determine what neighborhood or other environmental characteristics should be considered when developing PA programs for Latinos with CSP who are low-income.
References
1.Law LF, Sluka KA. How does physical activity modulate pain? Pain. 2017;158(3):369-370. doi:10.1097/j.pain.0000000000000792
2.Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. Jan 14 2017;1(1):Cd011279. doi:10.1002/14651858.CD011279.pub2
3.Huckleby J, Williams F, Ramos R, Nápoles AM. The effects of race/ethnicity and physician recommendation for physical activity on physical activity levels and arthritis symptoms among adults with arthritis. BMC Public Health. 2021/08/18 2021;21(1):1564. doi:10.1186/s12889-021-11570-6
4.Merchant G, Buelna C, Castañeda SF, et al. Accelerometer-measured sedentary time among Hispanic adults: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med Rep. 2015/01/01/ 2015;2:845-853. doi:https://doi.org/10.1016/j.pmedr.2015.09.019
5.Hollingshead NA, Ashburn-Nardo L, Stewart JC, Hirsh AT. The Pain Experience of Hispanic Americans: A Critical Literature Review and Conceptual Model. The journal of pain. 2016;17(5):513-528. doi:10.1016/j.jpain.2015.10.022
6.Bronfenbrenner U. The ecology of human development: Experiments by nature and design. Harvard university press; 1979.
7.Kanavaki AM, Rushton A, Klocke R, Abhishek A, Duda JL. Assessing moderate-to-vigorous physical activity in hip and knee osteoarthritis using accelerometers: Implications of different patterns and cut-points for health and well-being. Journal of Sports Sciences. 2022;40(2):156-163. doi:10.1080/02640414.2021.1981689
8.Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Medicine & Science in Sports & Exercise. 1998;30(5)
9.Duncan DT, Aldstadt J, Whalen J, Melly SJ. Validation of Walk Scores and Transit Scores for estimating neighborhood walkability and transit availability: a small-area analysis. GeoJournal. 2013;78(2):407-416.
10.Maizlish N, Delaney T, Dowling H, et al. California Healthy Places Index: Frames Matter. Public Health Rep. Jul/Aug 2019;134(4):354-362. doi:10.1177/0033354919849882
11.Arredondo EM, Sotres-Alvarez D, Stoutenberg M, et al. Physical Activity Levels in U.S. Latino/Hispanic Adults: Results From the Hispanic Community Health Study/Study of Latinos. Am J Prev Med. Apr 2016;50(4):500-508. doi:10.1016/j.amepre.2015.08.029
12.Silveira SL, Motl RW. Environmental correlates of health-promoting leisure physical activity in persons with multiple sclerosis using a social cognitive perspective embedded within social ecological model. Prev Med Rep. 2019/09/01/ 2019;15:100921. doi:https://doi.org/10.1016/j.pmedr.2019.100921
Presenting Author
Patricia Dionicio
Poster Authors
Topics
- Lifestyle Issues: Sleep/Diet/Exercise/Social Interactions