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    • There are several strengths and limitations of this research

    2018-11-05

    There are several strengths and limitations of this research that should be noted. Strengths of this research include objective measurement of physical activity and the unique study population. Physical activity was objectively collected using accelerometry, a validated method of assessing time spent active (Watson, Carlson, Carroll, & Fulton, 2014; Hooker, Feeney, & Hutto, 2011). Study participants were new Cuban immigrants that relocated to the Miami area within 90 days of study enrollment and reported having little choice in where they hydroxylase inhibitor lived upon initial arrival in the US. This permitted the examination of the early effects of acculturation on physical activity in a Hispanic subgroup whose physical activity behaviors are not often observed. Most study participants reported choosing to living with or near relative or being provided housing by nonprofit organizations (Brown et al. 2013). Given less than 2% of the study participants had a choice in residential location, this study addresses, in part, the selection bias that characterizes much of the literature on neighborhood characteristics and health (Brown et al. 2013; James, Hart, & Arcaya, 2015). There remains the possibility that the overall sample selected for participation includes individuals with the social and material resources necessary to migrate to Miami from Cuba. This may explain, in part, the high levels of physical activity observed among participants. Limitations to this research include the loss to follow-up, the amount of missing data on current residence, the limited number of data assessment periods, and the potential effect of neighborhood self-selection. Observational epidemiological studies that have examined neighborhood environment as a predictor of health are often unable to control for neighborhood self-selection (i.e. freedom to select area of residence) (Arcaya, Subramanian, Rhodes, & Waters, 2014; McCormack, & Shiell, 2011). A systematic review conducted by McCormack et al. in (2010) found that neighborhood self-selection attenuated associations between built environment and physical activity in many of the studies included in the review (McCormack and Shiell, 2011). The fact that participants in the current study received assistance from non-profit organizations to relocate to the Miami area or moved in with family members might may have reduced the effect of self-selection bias on point estimates (Brown et al., 2013). Furthermore, neighborhood SES was categorized into tertiles for ease of interpretation, which might have influenced our ability to observe a statistically significant effect. Sensitivity analyses performed indicated that neighborhood SES was not associated with MVPA in models where neighborhood SES score was modeled as a continuous time-varying variable.
    Conclusions
    Authors’ contributions
    Acknowledgments Research presented in this paper was supported by a research grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number 1R01-DK-074687 (J. Szapocznik, Principal Investigator; T. Perrino, Project Director). Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award number T32HL105349 and the National Cancer Institute of the National Institutes of Health under award number R25CA057699. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge Dr. Gregory Pavela of UAB Nutrition Obesity Research Center for his assistance with reviewing the final content presented in this manuscript.
    1. Introduction Promoting physical activity and exercise in older people can be expected to help in improving their functional status, motor ability, mental health, and social function (Taylor et al., 2004) and in preventing mortality from stroke and coronary heart disease (Noda et al., 2005), arthralgia (Heesch, Miller, & Brown, 2007), fracture (Gregg, Cauley, Seeley, Ensrud, & Bauer, 1998), depressive symptoms (Smith et al., 2010), and dementia (Ravaglia et al., 2008). Indeed, older people have been advised to participate in moderate-intensity aerobic activity for at least 150min per week (Nelson et al., 2007; Elsawy & Higgins, 2010). However, research on older people often reports dropouts in self-training after interventions such as aerobic exercise and strength training (Ansai & Rebelatto, 2015). Therefore, the impact of exercise on individual behavior change is not necessarily large.