Residential Neighbourhood Environments and Health Behaviours Among Children and Adolescents Initiating Obesity Management Care: Secondary Analyses of Data From the CANadian Paediatric Weight Management Registry ( CANPWR )

ABSTRACT Objective Examine associations between neighbourhood characteristics and health behaviours (physical activity, screen time, sleep duration) in boys and girls initiating obesity management care across Canada. Methods We analysed cross‐sectional data from the CANadian Paediatric Weight management Registry (2013–2017) for 803 participants (with overweight or obesity; 5–17 years old). Questionnaire‐assessed health behaviours included total physical activity (PA), organised PA outside of school, screen time, and sleep duration. Total PA was classified as high vs. low based on current recommendations, organised PA as high vs. low based on average attained levels for Canadian children, and screen time and sleep duration as meeting vs. not meeting recommendations. Neighbourhood characteristics (walkability, greenness, material and social deprivation) were computed for the first three digits of residential postal codes. Covariate‐adjusted associations were examined using generalised estimating equations stratified by sex. Results Participants (50% boys; mean ± SD: age, 11.9 ± 3.1 years; BMI z‐score, 3.28 ± 1.06) living in low (vs. high) social deprivation neighbourhoods were more likely to engage in high total PA, particularly among boys (PR = 1.32, 95% CI: 1.01, 1.73). Boys living in neighbourhoods with high (vs. low) walkability (PR = 3.56, 95% CI: 1.97, 6.44) and higher greenness (PR = 1.72, 95% CI: 1.17, 2.64) were more likely to engage in high organised PA. Girls living in neighbourhoods with very low (vs. high) material deprivation were more likely to engage in high organised PA (PR = 4.17, 95% CI: 1.52, 11.45). No associations were found for screen time or sleep duration. Conclusions This study adds to the evidence linking neighbourhood environments to health behaviours in children and adolescents living with obesity and who are initiating obesity management care. Specifically, less social deprivation and greater walkability and greenness were associated with higher PA among boys, while less material deprivation was linked to higher PA among girls.