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

Publication ,  Journal Article
D'Agostino, EM; Patel, HH; Hansen, E; Mathew, MS; Nardi, M; Messiah, SE
Published in: J Epidemiol Community Health
March 2018

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.

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Published In

J Epidemiol Community Health

DOI

EISSN

1470-2738

Publication Date

March 2018

Volume

72

Issue

3

Start / End Page

193 / 201

Location

England

Related Subject Headings

  • Waist-Hip Ratio
  • Residence Characteristics
  • Prospective Studies
  • Program Evaluation
  • Poverty
  • Physical Fitness
  • Obesity
  • Male
  • Humans
  • Hispanic or Latino
 

Citation

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ICMJE
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D’Agostino, E. M., Patel, H. H., Hansen, E., Mathew, M. S., Nardi, M., & Messiah, S. E. (2018). Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA. J Epidemiol Community Health, 72(3), 193–201. https://doi.org/10.1136/jech-2017-209333
D’Agostino, Emily M., Hersila H. Patel, Eric Hansen, M Sunil Mathew, Maria Nardi, and Sarah E. Messiah. “Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA.J Epidemiol Community Health 72, no. 3 (March 2018): 193–201. https://doi.org/10.1136/jech-2017-209333.
D’Agostino EM, Patel HH, Hansen E, Mathew MS, Nardi M, Messiah SE. Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA. J Epidemiol Community Health. 2018 Mar;72(3):193–201.
D’Agostino, Emily M., et al. “Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA.J Epidemiol Community Health, vol. 72, no. 3, Mar. 2018, pp. 193–201. Pubmed, doi:10.1136/jech-2017-209333.
D’Agostino EM, Patel HH, Hansen E, Mathew MS, Nardi M, Messiah SE. Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA. J Epidemiol Community Health. 2018 Mar;72(3):193–201.

Published In

J Epidemiol Community Health

DOI

EISSN

1470-2738

Publication Date

March 2018

Volume

72

Issue

3

Start / End Page

193 / 201

Location

England

Related Subject Headings

  • Waist-Hip Ratio
  • Residence Characteristics
  • Prospective Studies
  • Program Evaluation
  • Poverty
  • Physical Fitness
  • Obesity
  • Male
  • Humans
  • Hispanic or Latino