Cross-Sectional Associations of Neighborhood Walkability with Baseline Physical Activity and Sedentary Time among US South Asian Adults in the SAHELI Study.

Abstract

The associations between neighborhood walkability, physical activity (PA), and sedentary time (ST) have not been studied among US South Asians adults, a group with significantly higher cardiovascular disease (CVD) mortality compared to other race-ethnic groups. The SAHELI study randomized South Asians from the Chicago, IL metro area (18-65 years of age with CVD risk factors) to a 16-week lifestyle intervention versus control between 2018-2023. At baseline, Total PA, moderate-to-vigorous PA (MVPA), light PA (LPA), and ST were measured by accelerometer. Neighborhood walkability measures included: EPA Walkability Index and proportion of Google Street View images in a neighborhood containing crosswalks, sidewalks, and parks. In post-hoc analyses, multiple linear regressions estimated the association between each neighborhood walkability measure and baseline Total PA, MVPA, LPA, and ST. Participants from SAHELI with valid accelerometer data and neighborhood walkability data were included (N=432; 59% female, 98% immigrant, 79% Indian origin). Mean±SD Total PA was 9853 ± 5328 steps/day, MVPA was 24±19 min/day, LPA was 299±95 min/day, and ST was 564±136 min/day. Neighborhood walkability measures were not associated with MVPA. In fully-adjusted models, EPA Walkability Index and sidewalks were significantly associated with higher Total PA, LPA and lower ST while crosswalks were significantly associated with Total PA. Parks were not associated with Total PA, LPA, or ST. EPA Walkability Index and sidewalks were significantly associated with higher Total PA, LPA and lower ST, but not with MVPA. Neighborhood walkability should be considered when designing CVD prevention interventions promoting PA and minimizing ST among US South Asians.