Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III)

C Cunningham-Myrie; K P Theall; N Younger-Coleman; J Wiggan; S McFarlane; D Francis; N Bennett; M Tulloch-Reid; T S Ferguson; T Davidson; I Govia; N Guthrie-Dixon; W Aiken; A Grant; K Webster-Kerr; R Wilks

doi:10.1016/j.pmedr.2022.101998

Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III)

Prev Med Rep. 2022 Sep 21:30:101998. doi: 10.1016/j.pmedr.2022.101998. eCollection 2022 Dec.

Authors

C Cunningham-Myrie¹, K P Theall², N Younger-Coleman³, J Wiggan⁴, S McFarlane³, D Francis⁵, N Bennett³, M Tulloch-Reid³, T S Ferguson³, T Davidson⁴, I Govia³, N Guthrie-Dixon³, W Aiken⁶, A Grant⁴, K Webster-Kerr⁴, R Wilks³

Affiliations

¹ Department of Community Health & Psychiatry, University of the West Indies, Mona, Kingston, Jamaica.
² Departments of Social, Behavioral, and Population Sciences and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
³ Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica.
⁴ Ministry of Health & Wellness, Jamaica.
⁵ School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA.
⁶ Department of Surgery, Radiology, Anaesthesia & Intensive Care, University of the West Indies, Mona, Kingston, Jamaica.

Abstract

Decreased physical activity (PA) has been associated with residents living in neighborhoods perceived as being disordered or having high crime levels. What is unknown are the characteristics of individuals who engage in moderate to vigorous levels of PA (MVPA) despite living in these vulnerable neighborhoods, or who may be referred to as positive deviants (PD). We examined the factors associated with PD for PA among Jamaicans. Between 2016 and 2017 the Jamaica Health and Lifestyle Survey, a cross-sectional nationally representative survey (n = 2807), was conducted on individuals aged 15 years and older. Regression analyses were performed to identify associations with PD, defined using engagement in MVPA among persons living in vulnerable neighborhoods (N = 1710). Being female (odds ratio [OR]a = 0.64 (0.48, 0.86); p = 0.003), obese while living in an urban area (ORa = 0.39; 95 % CI = 0.26, 0.59; p < 0.0001), unemployed (ORa = 0.53; 95 % CI = 0.39, 0.73; p < 0.0001), or a student (ORa = 0.62; 95 % CI = 0.39, 0.98); p = 0.041) was associated with a significantly lower likelihood of PD, while having a personal medical history of at least one chronic disease significantly increased likelihood (ORa = 1.43; 95 % CI = 1.08, 1.90; p = 0.014). Taking a PD approach may be one angle to consider in trying to determine what is working and for whom, so that this may be harnessed in policy, prevention and intervention programming to increase PA.

Keywords: BMI, Body mass index; Caribbean; Developing country; IPAQ, International Physical Activity Questionnaire; JHLS, Jamaica Health and Lifestyle Survey; MVPA, Moderate to vigorous physical activity; NCD, Non-Communicable Disease; PA, Physical activity; PALs, Physical activity levels; PD, Positive Deviance; Physical activity; Positive deviance; USA, United States of America; Vulnerable neighborhoods.