Perceived social support and psychological wellbeing of children orphaned by HIV/AIDS in Southwestern Uganda

ABSTRACT

Evidence points to a correlation between perceived social support and children’s psychological well-being globally. However, only a few studies have examined the relationship between perceived social support (PSS) from multiple sources and children’s psychological outcomes. Even fewer studies have examined the relationship between perceived social support from multiple sources and the psychological outcomes of children orphaned by HIV/AIDS in Sub-Saharan Africa (SSA). This study examines whether PSS from multiple sources (parents/caregivers, teachers, friends and classmates) and family cohesion are independently and collectively associated with the psychological well-being of children orphaned by HIV/AIDS in Uganda. This study used baseline data from a National Institute of Health (NIH)-funded Suubi-Maka (Hope for families) study, conducted in Southwestern Uganda. A total of 346 child-caregiver dyads from 10 comparable primary schools participated in the study. Multivariate and multivariable regression analyses were conducted to examine: (1) variations in PSS from multiple sources and family cohesion, and (2) the relationship between PSS, family cohesion and children’s psychological outcomes, measured by depression, hopelessness, and self-concept. Controlling for participants’ demographic and household characteristics, the combined measure of PSS from multiple sources was positively associated with self-concept (b = .32, 95% CI = .23, .41, p ≤ .001) and negatively associated with hopelessness (b = ?.19, 95% CI = ?.29, ?.09, p ≤ .001) and depressive symptoms (b = ?.13, 95% CI = ?.23, ?.03, p ≤ .01). PSS from parents/guardians and teachers was a significant predictor. In addition, family cohesion was positively associated with self-concept (b = .37, 95% CI = .15, .58, p ≤ .001) and negatively associated with depressive symptoms (b = ?.36, 95%CI = ?.59, ?.13, p≤ = .01). Findings indicate that family cohesion and perceived social support, especially from parent/caregivers and teachers were associated with better children’s psychological outcomes. In HIV-impacted communities, interventions designed to strengthen family relationships and social support are essential to offset children’s psychological well-being.     

Perceived neighborhood social cohesion and stroke

Research in the last three decades has shown that negative neighborhood factors such as neighborhood violence, noise, traffic, litter, low neighborhood socioeconomic status, and poor air quality increase the risk of poor health. Fewer studies have examined the potential protective effect that neighborhood factors can have on health, particularly stroke. We examined whether higher perceived neighborhood social cohesion was associated with lower stroke incidence after adjusting for traditional risk and psychological factors that have been linked with stroke risk. Prospective data from the Health and Retirement Study—a nationally representative panel study of American adults over the age of 50—were used. Analyses were conducted on a subset of 6740 adults who were stroke-free at baseline. Analyses adjusted for chronic illnesses and relevant sociodemographic, behavioral, and psychosocial factors. Over a four-year follow-up, higher perceived neighborhood social cohesion was associated with a lower risk of stroke. Each standard deviation increase in perceived neighborhood social cohesion was associated with a multivariate-adjusted odds ratio (O.R.) of 0.85 for stroke incidence (95% CI, 0.75–0.97, p < 0.05). The effect of perceived neighborhood social cohesion remained significant after adjusting for a comprehensive set of risk factors. Therefore, perceived neighborhood social cohesion plays an important role in protecting against stroke.     

The association between discrimination and PTSD in African Americans: exploring the role of gender

ABSTRACT

Background: Research has demonstrated the adverse impact that discrimination has on physical and mental health. However, few studies have examined the association between discrimination and symptoms of posttraumatic stress disorder (PTSD). There is evidence that African Americans experience higher rates of PTSD and are more likely to develop PTSD following trauma exposure than Whites, and discrimination may be one reason for this disparity.

Purpose: To examine the association between discrimination and PTSD among a cross-sectional sample largely comprising African American women, controlling for other psychosocial stressors (psychological distress, neighborhood safety, crime).

Methods: A sample of 806 participants was recruited from two low-income predominantly African American neighborhoods. Participants completed self-report measures of PTSD symptoms, perceived discrimination, perceived safety, and psychological distress. Information on neighborhood crime was obtained through data requested from the city. Multivariate linear regression models were estimated to assess adjusted relationships between PTSD symptoms and discrimination.

Results: Discrimination was significantly associated with PTSD symptoms with a small effect size, controlling for relevant sociodemographic variables. This association remained consistent after controlling for psychological distress, perceived safety, and total neighborhood crime. There was no evidence of a gender by discrimination interaction. Participants who experienced any discrimination were significantly more likely to screen positive for PTSD.

Conclusions: Discrimination may contribute to the disparate rates of PTSD experienced by African Americans. PTSD is associated with a range of negative consequences, including poorer physical health, mental health, and quality of life. These results suggest the importance of finding ways to promote resilience in this at-risk population.     

Longitudinal associations of neighborhood environment features with pediatric body mass index

IntroductionIt has been posited that policies to promote child health and prevent obesity should target neighborhood environments but evidence on the impact of neighborhoods on child weight is conflicting and longitudinal studies (which have benefits for causal inference) are scarce.MethodsWe used electronic health records (2007–2016) from an urban, pediatric integrated delivery system and linked children (N = 51,873, ages 6–19 years, 77% African American) to neighborhood-level data to investigate how changes in neighborhood environments relate to changes in body mass index (BMI). Measures of neighborhood environment were resources for healthy foods and physical activity (‘resources’), greenness, violent crime rate, perceived safety and social cohesion. Fixed effects models estimated associations between changes in neighborhood environment exposures and changes in BMI z-score and whether effects differed by sex, baseline age, neighborhood socioeconomic status and population density.ResultsApproximately 22% of the cohort was obese (BMI z-score ≥ 95th percentile). In adjusted models, increases in neighborhood greenness and perceived safety were associated with decreases in BMI z-score (mean change in BMI z-score for 1-SD increase for both: -0.012; 95% CI= (−0.018, −0.007)). Increases in neighborhood safety had a stronger effect in children ages 6–10 years than in older children. Increases in social cohesion were associated with increases in BMI z-score (mean change: 0.005 95% CI = (0.003, 0.008)) especially in boys. Increases in food and physical activity resources were not associated with changes in BMI.ConclusionsThis study suggests that increasing neighborhood greenness and safety are potential approaches to reduce children's BMI.     

Salir Adelante: Social capital and resilience during the Covid-19 pandemic in Argentina

The Covid-19 pandemic has stimulated new appraisals of how social cohesion, including neighborhood-level social capital, fosters resilience in the face of crisis. Several studies suggest better health outcomes in neighborhoods with higher level of social capital, in general and during the pandemic. Building on a growing body of research which suggests that those who live in close-knit neighborhoods have fared better during the pandemic, this article analyzes how social capital influences individual and collective perceptions and attitudes about the experiences of the Covid-19 pandemic in Tucumán, Argentina. To assess this question, we used a mixed-methods approach, combining focus groups, semi-structured interviews, and an online survey (n = 701 respondents) conducted in September 2021. We find widespread experiences of resilience in response to the Covid-19 pandemic, in spite of difficult socioeconomic conditions and perceived poor government performance. Results from logistic regression analysis indicate that perceptions of high neighborhood social capital are associated with more positive outcomes in many dimensions, including personal resilience, ability to cope with uncertainty, perceptions of community solidarity, and reported compliance with public health measures. We further argue that conceptualizations of social cohesion need to be adjusted to local or national-level cultural norms to accurately capture the experience of countries of the Global South.     

Perceived neighborhood social cohesion and the 10-year risk of cardiovascular disease in low- and middle-income countries: The World Health Organization Study on Global Aging and Adult Health

Low- and middle-income countries (LMICs) bear the greatest burden of cardiovascular disease (CVD) worldwide. Emerging evidence, mostly from industrialized countries, suggest that neighborhood characteristics influence cardiovascular health. This study presents results from 27,797 participants living in six LMICs on the association of perceived neighborhood social cohesion, the degree of connectedness among neighbors, with 10-year risk of CVD. We observed that greater perceived neighborhood social cohesion was associated with lower odds of high (>20%) 10-year CVD risk (OR = 0.67, 95%CI: 0.53–0.86). These novel findings, suggest that interventions to enhance social cohesion may have beneficial effects on cardiovascular health in LMICs.     

Examination of neighborhood disadvantage and sleep in a multi-ethnic cohort of adolescents

PurposeNeighborhood-level socioeconomic disadvantage and lower individual-level socioeconomic status are associated with poorer sleep health in adults. However, few studies have examined the association between neighborhood-level disadvantage and sleep in adolescents, a population at high-risk for sleep disturbances.MethodsThe current study is the first to examine how objective (i.e. via census tract-level data) and subjective measures of neighborhood disadvantage are associated with sleep in a racially/ ethnically and socioeconomically diverse sample of 2493 youth [Non-Hispanic White (20%), Hispanic (46%), Asian (21%), and Multiracial/ Other (13%)].ResultsFindings indicated that greater perceived neighborhood-level social cohesion and lower neighborhood-level poverty were associated with better sleep outcomes in adolescents. However, there was some evidence that the magnitude of the associations differed according to family-level socioeconomic status and race/ ethnicity.ConclusionsFindings suggest that subjective and objective neighborhood characteristics may affect the sleep health of older adolescents, with certain demographic subgroups being particularly vulnerable.     

A Child’s View: Social and Physical Environmental Features Differentially Predict Parent and Child Perceived Neighborhood Safety

Parent and child perceived neighborhood safety predicts child health outcomes such as sleep quality, asthma, physical activity, and psychological distress. Although previous studies identify environmental predictors of parent perceived safety, little is known about predictors of child perceived safety. This study aims to identify the social and physical environmental neighborhood features that predict child and parent perceived neighborhood safety and, simultaneously, to assess the association between child and parent perceptions. Data were from the QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort, an ongoing study of Caucasian children (aged 8–10 years) with a parental history of obesity, and their biological parents from Québec, Canada. Measures of social and physical neighborhood features were collected using a spatial data infrastructure and in-person audits. Structural equation modeling was used to test direct and indirect associations between neighborhood features, child and parent perceived safety. Results suggest that among children (N = 494), trees and lighting were positively associated with perceived neighborhood safety, whereas a high proportion of visible minorities was associated with poorer perceived safety. Parents’ perceptions of safety were more strongly tied to indicators of disorder and a lack of community involvement, and to traffic. Child perceived safety was partly explained by parent perceived safety, suggesting moderate concordance between perceptions. Although associated with each other, parent and child perceived safety seemed to be determined by distinct environmental features. Though this study focused on determinants of child and parent perceived safety, future research investigating the impact of neighborhood safety on child health should consider both child and parent perspectives.     

Contextualizing physical activity in rural adults: Do relationships between income inequality,neighborhood environments,and physical activity exist?

Objective

To examine if income inequality, social cohesion, and neighborhood walkability are associated with physical activity among rural adults.

Data Source

Cross-sectional data came from a telephone survey (August 2020–March 2021) that examined food access, physical activity, and neighborhood environments across rural counties in a southeastern state.

Study Design

Multinomial logistic regression models assessed the likelihood of being active versus inactive and insufficiently active versus inactive in this rural population. Coefficients are presented as relative risk ratios (RRRs). Statistical significance was determined using 95% confidence intervals (CIs). All analyses were performed in STATA 16.1.

Data Collection/Extraction Methods

Trained university students administered the survey. Students verbally obtained consent, read survey items, and recorded responses into Qualtrics software. Upon survey completion, respondents were mailed a $10 incentive card and printed informed consent form. Eligible participants were ≥18 years old and current residents of included counties.

Principal Findings

Respondents in neighborhoods with relatively high social cohesion versus low social cohesion were more likely to be active than inactive (RRR = 2.50, 95% CI: 1.27–4.90, p < 0.01), after accounting for all other variables in the model. Income inequality and neighborhood walkability were not associated with different levels of physical activity in the rural sample.

Conclusions

Study findings contribute to limited knowledge on the relationship between neighborhood environmental contexts and physical activity among rural populations. The health effects of neighborhood social cohesion warrant more attention in health equity research and consideration when developing multilevel interventions to improve the health of rural populations.     

The relationship between negative life events,psychological distress and life satisfaction: a population-based study

Purpose

Negative life events may increase psychological distress and reduce life satisfaction (LS). This study investigates associations between negative life events and both positive and negative indicators of mental health and explores the extent to which these associations are buffered by sense of mastery and perceived social support.

Methods

Data were obtained from a large (N = 4,823), nationally representative sample of Norwegians aged 16 and older. Psychological distress was measured by The Hopkins Symptom Check List (HSCL-25), LS by a single question on overall satisfaction with life and negative life events by a 12-item list of threatening experiences. Moderating variables, sense of mastery and social support, were measured using standard instruments.

Results

Adjusting for age, sex, education and income, all of the negative life events were significantly associated with both psychological distress and LS, with the exception of events pertinent to bereavement. Of the life events examined, financial strain constituted the strongest predictor. Overall, negative life events were more closely associated with psychological distress than LS. Altogether, negative life events explained 22.3 and 11.4 % of the variance in psychological distress and LS, respectively. Sense of mastery, but not perceived social support, emerged as a moderating factor between financial strain and both psychological distress and LS.

Conclusion

Negative life events are associated with higher psychological distress and lower LS, but the strength of the associations varies across events. The impact of financial strain and conflict appears particularly strong, but may be moderated by self-perceived mastery.     

A Multilevel Analysis of Neighborhood Context and Youth Alcohol and Drug Problems

Various sources of data were used to examine hypothesized relations among neighborhood variables and youth alcohol and drug problems. Family members (N = 1186) were from 55 neighborhoods: 57% female, 41% African American, and 59% White. Data were clustered by neighborhood and analyzed within a multilevel design. At the neighborhood level, the study examined relations among poverty, stores selling alcohol, neighborhood social cohesion, neighborhood problems with youth alcohol and drug use, and drug and alcohol arrests. At the individual level, gender, ethnicity, adult versus child status, neighborhood social cohesion, and neighborhood problems were examined. Results indicated that more stores sold alcohol in higher poverty neighborhoods, which was associated with less social cohesion. Lower social cohesion was related to greater perceived neighborhood problems with youth alcohol and drug use, which was positively related to neighborhood youth drug and alcohol arrests. The study showed significant variation across neighborhoods and demonstrates the utility of combining different sources of neighborhood data to examine relations of interest.     

Subjective Social Status and Psychological Distress in Mothers of Young Children

Introduction Perceptions of social standing have increasingly well-documented relationships with health. Higher subjective social status (SSS) is associated with better psychological well-being among women, and mothers of newborns. The relationship between SSS and psychological distress among mothers of young children, however, is largely unknown. SSS may provide insight into aspects of maternal functioning that are relevant to parenting capacity, as well as insight into future health; in addition, SSS is brief, and may be perceived as less intrusive than other measures of socioeconomic status or mental health. We evaluated the relationship between SSS and psychological distress among mothers of 5-year-old children from diverse socioeconomic backgrounds. Methods One hundred and sixty-two mothers of 5-year old children, who participated in a study of child self-regulation, completed surveys that assessed sociodemographics, mental health, and perceived social support. The MacArthur Scale of SSS used pictures of ten-rung ladders to assess respondents’ social position in relation to the US (SES ladder) and their community (community ladder). Quantile regression models were used to assess the relationship between maternal psychological distress (perceived social support, depressive symptoms, anxiety) and the ladders (individually and together), adjusting for maternal age, race, education, and number of children. To examine whether the SSS–health relationships differed by race, the models were also stratified by race. Results Community ladder ranking was positively associated with social support (β = 1.34, SE = 0.33, p < .001), and negatively associated with depressive symptoms (β = ?1.34, SE = 0.52, p < .05). SES ladder ranking was positively associated with social support (β = 1.17, SE = 0.52, p < .05). Findings in the full sample were driven by more robust relationships between psychological distress and community SSS among Black/African-American mothers. Discussion The findings suggest that perceived social standing in one’s community is associated with maternal psychological well-being. Community SSS may be particularly influential for Black/African-American mothers’ well-being.     

Neighborhood contributions to psychological distress among Latino New York City adults

Objective: Neighborhood-level factors such as ethnic densities and social cohesion have been negatively associated with psychological distress among Latino Americans. Yet, existing evidence is based on either specific neighborhood factors or particular Latino subgroups. The objective of the study was to assess difference in psychological distress between each of four Latino subgroups (Puerto Ricans, Dominicans, Mexicans, other Latinos) and non-Latino white adults in New York City, and quantify total neighborhood-level influence on these differences.

Design: We used the combined Community Health Survey data from 2009, 2010, and 2012 surveys. We estimated the odds ratios (ORs) for self-reported non-specific psychological distress (Kessler-6 questions scale ≥ 13) by race/ethnicity using logistic regression models. We further adjusted these estimates for both observed and unobserved neighborhood-level confounding using the conditional pseudolikelihood method for complex survey data.

Results: Puerto Ricans were more likely to be psychologically distressed (OR?=?1.58, 95% CI?=?1.18, 2.12) compared with non-Latino whites, whereas the opposite was seen in other Latino subgroups. Accounting for full neighborhood-level confounding increased the disparity for Puerto Ricans (OR?=?1.79, 95% CI?=?1.26–2.54). For the other subgroups, lower odds of psychological distress were no longer observed or attenuated after accounting for neighborhood-level confounding. Overall neighborhood-level factors were associated with lower psychological distress at greater extent among all Latinos subgroups versus non-Latino whites in New York City.

Conclusion: Despite substantial variations of psychological distress across Latino subgroups, the study shows evidence that neighborhood-level factors might play a protective role in all Latino subgroups.     

Do neighborhood characteristics of sober living houses impact recovery outcomes? A multilevel analysis of observational data from Los Angeles County

ObjectiveTo identify neighborhood factors associated with recovery outcomes for sober living house (SLH) residents.MethodsSix-month longitudinal data for new SLH residents (n = 557) was linked with census tract data, services available, alcohol outlets, and Walk Scores® (0–100 score indicating access to neighborhood resources) for 48 SLHs in 44 neighborhoods in Los Angeles County.ResultsNon-significant neighborhood characteristics in separate regressions for all outcomes were residents' ratings of perceived risk, percentage of residences with access to a car, percentage of homes over $500,000, percentage of renter-occupied units, percentage with income less than $25,000, percentage that were non-white, the density of substance inpatient within 10 miles, and transit scores from Walk Score®. Multilevel regressions found outpatient substance abuse treatment and density of AA groups were positively associated with more abstinent days. No neighborhood variables were associated with psychiatric symptoms. Higher perceived neighborhood cohesion, lower crime ratings, and better transportation ratings were associated with higher recovery capital.ConclusionGreater neighborhood densities of substance abuse services and AA groups may help residents achieve more days abstinent. While residents may achieve better substance use outcomes even with negative perceptions of the neighborhood, positive perceptions of the neighborhoods may help them acquire more recovery capital.     

Racially mixed neighborhoods, perceived neighborhood social cohesion, and adolescent health in Canada

Using data from the Canadian Census and the National Longitudinal Survey of Children and Youth, we examine the effects of neighborhood concentration of racial minorities on general health status and depressive symptoms of Canadian adolescents. We also examine the role of perceived neighborhood cohesion and the extent to which it contributes to adolescent health. Our findings show that the racial concentration of ethnic minorities represents a health disadvantage for visible minority youth while perceived neighborhood cohesion is found to be a protective factor for both health outcomes. Perceived neighborhood cohesion is beneficial for the general health status (but not depression) of adolescents residing in neighborhoods with a high concentration of racial minorities.     

Perceived Neighborhood Environment Affecting Physical and Mental Health: A Study with Korean American Older Adults in New York City

This study examined how subjective perceptions of the neighborhood environment (e.g., perceived ethnic density, safety, social cohesion, and satisfaction) influenced the physical and mental health of Korean American older adults. Using data from 420 residents of the New York City metropolitan area (M _age = 71.6, SD = 7.59), health perceptions and depressive symptoms were estimated with hierarchical regression models entered in the order of (1) demographics and acculturation, (2) health-related variables, and (3) perceived neighborhood environment. After controlling for the effects of the individual-level variables, perceived neighborhood environment was found to make a significant contribution to both outcomes. Individuals less satisfied with their overall neighborhood environment were more likely to have negative perceptions of health and depressive symptoms. A strong linkage between perceived neighborhood safety and depressive symptoms was also observed. Findings from the study highlight the importance of subjective evaluations of neighborhood environment and provide implications for health promotion.     

Does disorder get “into the head” and “under the skin”? Layered contexts and bi-directional associations

This paper utilizes a layered context approach to examine how neighborhood and household conditions are associated with the objective and subjective well-being of older adults. Using two waves of data from the National Social Life, Health, and Aging Project (n=2261), we assess subjective mental health through self-reported measures of perceived stress and distress and objective physical health through C-reactive protein (CRP). Environmental disorder was measured by independent, trained interviewers. Cross-sectional results indicate that household disorder is positively associated with perceived stress and distress, overwhelming the association between neighborhood disorder and mental health outcomes. Yet longitudinal findings point to a reverse process, whereby highly stressed women experience deterioration in their home environment across the two waves. Few significant findings surfaced for CRP. Taken together, our findings illustrate the complex interplay between health and proximal environments and underscore how feedback cycles operate between “health” and “place” across multiple outcomes.     

Caregiving Stressors and Psychological Distress Among Veteran Resident and Immigrant Family Caregivers in Israel

Summary

The study compared caregiving stressors and psychological distress between Israeli veteran resident and immigrant family caregivers. It examined whether psychosocial variables (appraisal of caregiving, mastery, social support and coping) mediate the differences in psychological distress between these two groups. A total of 213 veteran resident and 206 immigrant (from the former Soviet Union) caregivers of chronically ill elderly were recruited from health services. The comparisons between the two groups were examined separately for spouse and adult child caregivers. The immigrant spouse and adult child caregivers reported significantly higher levels of caregiving stressors than veteran resident caregivers, but psychological distress was significantly higher only among the immigrant adult child caregivers. In multivariate analyses, the difference in psychological distress disappeared when caregiving stressors and mediating psychosocial variables were included in the regression models. Different caregiving stressors and psychosocial variables were associated with psychological distress among the spouses and among the adult child caregivers. The findings suggest that the caregiving stressors and psychosocial variables explain differences in psychological health outcomes between veteran resident and immigrant caregivers. Social work interventions should address these factors among caregivers, take into account the relationship to the care recipient, be culturally adapted to the immigrant caregivers, and target immigrant adult child caregivers in particular.     

Determinants, correlates and mediators of psychological distress: A longitudinal study

This study examined determinants and correlates of psychological distress focusing on the roles of psychosocial resources, such as sense of mastery and social support in mediating and/or moderating the effects of life stressors, such as unfavourable socioeconomic conditions (SES), poor physical health and chronic daily stress on individuals' level of distress. Additionally, the above examination was conducted for men and women separately and the results were compared. The study was based on secondary analyses of data collected by Statistics Canada in two cycles of the National Population Health Survey: 2002/2003 and 2004/2005. The sample used included 2535 men and 3200 women between the ages of 25 and 64 years. Further, this research used structural equation techniques to examine pathways among life stressors, psychosocial resources and distress and block regression analysis to examine the moderating roles of mastery and social support. Chronic daily stress was measured in 2004/2005 and two years earlier, in 2002/2003. Main findings included: (1) higher levels of mastery and social support were found to be associated with less depressive symptoms for both men and women, (2) in addition to its significant main effect on distress, mastery moderated the detrimental effects of poor physical health and chronic daily stress on depressive symptoms for both genders, (3) the effects of daily stress, poor physical health and unfavourable SES on level of distress were partially mediated through mastery, (4) next to daily stress, poor physical health had the most impact on level of distress for both genders, albeit a stronger impact for women, (5) mastery played a more important role in the distress process of women compared with men, and (6) while perceived social support decreased the likelihood of distress for men directly, it decreased women's likelihood of distress by increasing their mastery. Symptoms of distress indicate present and/or future need for health care services. Thus, prevention of distress may lead to a reduction in health care costs in addition to the reduction of subjective suffering. Findings emphasize the importance of allocating resources to groups at high risk of developing distress, such as the poor and the physically unhealthy.     

Neighborhood social cohesion and youth participation in physical activity in Chicago

Many young people do not meet recommended levels of participation in physical activity. Neighborhoods may play a role in supporting healthy behavior via social and physical environmental features. We examine whether neighborhood-levels of social cohesion, range of youth services and educational attainment were associated with participation in recreational programs and general physical activity among young people. Hierarchical regression analyses were carried out using data from 680 young people (ages 11–15 years at baseline) participating in the Project on Human Development in Chicago Neighborhoods. The participants' primary caregiver reported recreational program participation at baseline and self-reported general physical activity were assessed at follow-up 2–3 years later. Neighborhood-level characteristics were obtained from census data and via a community survey. Neighborhood social cohesion was inversely associated with participation in recreational programs at baseline, controlling for availability of neighborhood services for youth, neighborhood education status, race/ethnicity, individual-level parental education, overweight status, sex, and age. Residing in an area with greater social cohesion was directly associated with frequency of reported general physical activity, independent of previously reported participation in recreational programs and other neighborhood and individual-level covariates. The present findings suggest that neighborhood social cohesion influences participation in physical activity.