Neighborhood Characteristics and Changes in Movement Behaviors During Pediatric Obesity Care: A Secondary Analysis of the CANadian Pediatric Weight Management Registry

BACKGROUND: Neighborhood environments are recognized as important determinants of movement behaviors; however, their role in shaping behavior change following the initiation of obesity care remains poorly understood. We examined associations between neighborhoods and movement behavior changes among children and adolescents 1 year after initiating obesity care. METHODS: = 481; 5-17 years). At both time points, questionnaire-assessed behaviors included total physical activity (PA), organized PA, screen time, and sleep duration. PA outcomes were categorized as always high/increased versus always low/declined. Screen time and sleep duration were categorized using age-specific recommendations (always/newly meeting vs. never/no longer meeting recommendations). Neighborhood walkability, greenness, and material and social deprivation were obtained for three-digit postal codes. Generalized estimating equations were used to model associations between neighborhood characteristics and outcomes. RESULTS: Participants (51% boys; mean ± standard deviation: age, 11.9 ± 3.1 years; zBMI, 3.3 ± 1.1) residing in the least (vs. most) materially deprived neighborhoods were more likely to report always high/increased participation in organized PA (prevalence ratio [PR] = 1.22, 95% confidence interval [CI]: 1.09-1.37). Participants residing in medium (vs. most) materially deprived neighborhoods were more likely to report always high/increased total PA (PR = 1.18, 95% CI: 1.01-1.37). When restricting to participants with low PA at baseline, only material deprivation remained associated with improvements in organized PA (PR = 2.09, 95% CI: 1.31-3.32). CONCLUSIONS: Children in less materially deprived neighborhoods may be more likely to improve or maintain PA over 1 year of obesity care, independent of family-level socioeconomic status. Other neighborhood characteristics showed no association with movement behavior changes.