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

Journal Article (Journal Article)

BACKGROUND: The WHO calls for affordable population-based 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.

Full Text

Duke Authors

Cited Authors

  • D'Agostino, EM; Patel, HH; Hansen, E; Mathew, MS; Nardi, M; Messiah, SE

Published Date

  • March 2018

Published In

Volume / Issue

  • 72 / 3

Start / End Page

  • 193 - 201

PubMed ID

  • 29175865

Electronic International Standard Serial Number (EISSN)

  • 1470-2738

Digital Object Identifier (DOI)

  • 10.1136/jech-2017-209333


  • eng

Conference Location

  • England