Perceived Neighborhood Environmental Attributes Associated with Walking and Cycling for Transport among Adult Residents of 17 Cities in 12 Countries: The IPEN Study

Physical Activity in Peri-Urban Communities: Testing Intentional and Implicit Processes within an Ecological Framework

BACKGROUND

Given the substantive health inequalities in peri-urban communities and the potential for physical activity to promote health in these communities, identifying modifiable physical activity determinants in this population is important. This study explored effects of the peri-urban environment and psychological constructs on physical activity intentions and behavioural automaticity guided by an integrated theoretical framework.

METHODS

Peri-urban Australians (N = 271) completed self-report measures of environmental (i.e. physical/social environment, and neighbourhood selection), motivational (i.e. autonomous motivation), and social cognition (i.e. attitudes, norms, and perceived behavioural control [PBC]) constructs, past behaviour, intentions, and automaticity.

RESULTS

A well-fitting path analytic model revealed that: autonomous motivation predicted all social cognition constructs; subjective norms and PBC, but not attitudes; autonomous motivation predicted intentions and automaticity; and subjective norms and PBC mediated effects of autonomous motivation on intentions. Of the environmental constructs, only neighbourhood selection was related to intentions, mediated by PBC.

CONCLUSIONS

Autonomous motivation is an important correlate of physical activity intentions and automaticity, and subjective norms and PBC also related to intentions. Individuals perceiving a supportive environment were more likely to report positive PBC and intentions. Targeting change in autonomous motivation, and normative and control beliefs may help enhance physical activity intentions and automaticity in peri-urban communities.

Correlates of Physical Activity Among Disadvantaged Groups: A Systematic Review

CONTEXT

Socioeconomically disadvantaged adults have lower engagement in leisure-time physical activity than those who are more affluent. Identification of correlates of physical activity can inform the design of effective interventions. The aim of this systematic review was to identify consistent correlates of unspecified physical activity and leisure-time physical activity among socioeconomically disadvantaged adults.

EVIDENCE ACQUISITION

PubMed and Scopus were searched up to May 2018, and titles/abstracts and full texts were screened against eligibility criteria. Methodologic quality was assessed, and correlates were synthesized from July to September 2018.

EVIDENCE SYNTHESIS

Seventy-three studies were selected for synthesis; 48 examined unspecified physical activity and 31 examined leisure-time physical activity (6 examined both). Self-rated health, functional capacity, and physical activity self-efficacy were consistently, positively associated with unspecified physical activity. Mental health status and perceived benefits and enjoyment of physical activity were consistently, positively associated with leisure-time physical activity. Most studies were cross-sectional and used validated self-report measures of physical activity; few reported response rates >50%.

CONCLUSIONS

Few factors were consistently associated with either unspecified physical activity or leisure-time physical activity. Based on available evidence, strategies to increase physical activity should consider the needs of, and focus on, those with poor self-rated health and functional capacity and should use strategies to improve physical activity self-efficacy. Strategies to increase leisure-time physical activity should focus on simultaneously addressing leisure-time physical activity and mental health concerns and improving perceptions of physical activity benefits and enjoyment. It is recommended that future studies focus on leisure-time physical activity, focus on men, use longitudinal design, examine variables related to behavioral attributes and skills, and carefully consider and plan recruitment strategies.

Correlates of Walking for Travel in Seven European Cities: The PASTA Project

BACKGROUND

Although walking for travel can help in reaching the daily recommended levels of physical activity, we know relatively little about the correlates of walking for travel in the European context.

OBJECTIVE

Within the framework of the European Physical Activity through Sustainable Transport Approaches (PASTA) project, we aimed to explore the correlates of walking for travel in European cities.

METHODS

The same protocol was applied in seven European cities. Using a web-based questionnaire, we collected information on total minutes of walking per week, individual characteristics, mobility behavior, and attitude (N=7,875). Characteristics of the built environment (the home and the work/study addresses) were determined with geographic information system (GIS)-based techniques. We conducted negative binomial regression analyses, including city as a random effect. Factor and principal component analyses were also conducted to define profiles of the different variables of interest.

RESULTS

Living in high-density residential areas with richness of facilities and density of public transport stations was associated with increased walking for travel, whereas the same characteristics at the work/study area were less strongly associated with the outcome when the residential and work/study environments were entered in the model jointly. A walk-friendly social environment was associated with walking for travel. All three factors describing different opinions about walking (ranging from good to bad) were associated with increased minutes of walking per week, although the importance given to certain criteria to choose a mode of transport provided different results according to the criteria.

DISCUSSION

The present study supports findings from previous research regarding the role of the built environment in the promotion of walking for travel and provides new findings to help in achieving sustainable, healthy, livable, and walkable cities. https://doi.org/10.1289/EHP4603.

Socioecological Correlates of Park-based Physical Activity in Older Adults: A Comparison of Hong Kong and Leipzig Parks

AIMS

The present study aimed to examine and compare the socioecological correlates of park-based physical activity (PA) among Hong Kong and Leipzig older adults in terms of types of activity areas, perceived park environment, psychosocial factors, and the interactions between the perceived park environmental and psychosocial factors.

METHODS

Based on the SOPARC, systematic observations were conducted in six randomly selected urban parks in each city. A total of 317 Hong Kong (Mage = 69.96; SD = 6.81) and 311 Leipzig (Mage = 72.06; SD = 6.78) older adults from these six parks completed an interviewer-delivered survey measuring their perceived park environment, psychosocial variables, and park-based PA.

RESULTS

In both cities, the types of activity areas were positively associated with the number of older adults observed being active in parks. Psychosocial factors, especially self-efficacy and perceived barriers, had larger associations with park-based PA compared with the perceived park environment. The interaction between perceived park features and self-efficacy in the association with park-based PA was found in Leipzig, but not in Hong Kong.

CONCLUSION

Findings of the current study contribute to the cross-cultural understanding of the socioecological correlates of park-based PA among older adults.

Impact of the Built Environment and Bicycling Psychological Factors on the Acceptable Bicycling Distance of Rural Residents

The ability to understand bicycling behavior in China’s rural areas is critical in constructing an improved, sustainable, countryside amid the rapid urbanization in the country. This study analyzes the influence of individual bicycling psychology, objective, and perceived built environment on the acceptable bicycling distance of rural residents. This research is conducted by controlling for the socio-demographic characteristics of the residents on the bases of a face-to-face questionnaire survey and an on-site measurement. Exploratory factor analysis shows three attitudinal common factors on bicycling infrastructure, namely, bicycling ancillary facilities, bicycle lane conditions, and safety, and two bicycling motivation factors, namely, convenience and other motivations. Multiple linear regression was estimated and results of the models were consistent. Individual bicycling psychology and built environment factors significantly influence the acceptable bicycling distance of rural residents. The socio-demographic variables insignificantly influence the acceptable bicycling distance, which is inconsistent with the existing literature. The research results provide a broad empirical base for the complex relationships among individual bicycling psychological factors, objective and perceived built environment, and bicycling behavior. This study presents the first research on bicycling in Chinese rural areas and provides guidance for the development of effective countermeasures in constructing ecovillages.

Measuring the Destination Accessibility of Cycling Transfer Trips in Metro Station Areas: A Big Data Approach

Cycling is a green, sustainable, and healthy choice for transportation that has been widely advocated worldwide in recent years. It can also encourage the use of public transit by solving the “last-mile” issue, because transit passengers can cycle to and from transit stations to achieve a combination of speed and flexibility. Cycling as a transfer mode has been shown to be affected by various built environment characteristics, such as the urban density, land-use mix, and destination accessibility, that is, the ease with which cyclists can reach their destinations. However, cycling destination accessibility is loosely defined in the literature and the methods of assessing cycling accessibility is often assumed to be equivalent to walking accessibility using the same decay curves, such as the negative exponential function, which ignores the competitive relationship between cycling and walking within a short distance range around transit stations. In this study, we aim to fill the above gap by measuring the cycling destination accessibility of metro station areas using data from more than three million bicycle-metro transfer trips from a dockless bicycle-sharing program in Shenzhen, China. We found that the frequency of bicycle-metro trips has a positive association with a trip distance of 500 m or less and a negative association with a trip distance beyond 500 m. A new cycling accessibility metric with a lognormal distribution decay curve was developed by considering the distance decay characteristics and cycling’s competition with walking. The new accessibility model outperformed the traditional model with an exponential decay function, or that without a distance decay function, in predicting the frequency of bicycle-metro trips. Hence, to promote bicycle-metro integration, urban planners and government agencies should carefully consider the destination accessibility of metro station areas.

Step It Up! Prioritization of Community Supports for Walking Among US Adults

PURPOSE

Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities (Call to Action) presents goals and supporting strategies to promote walking. We assessed the presence and prioritization of 4 community supports for walking related to the goals of the Call to Action from the perspective of US adults.

DESIGN

Cross-sectional web-based survey.

SETTING

US adults.

PARTICIPANTS

A total of 4043 respondents.

MEASURES

SummerStyles 2016 survey assessing the reported presence and prioritization of 4 community supports for walking.

ANALYSIS

Estimated prevalence of the presence of supports overall and by demographic characteristics, and prevalence and adjusted prevalence ratios of their prioritization.

RESULTS

The most commonly reported community supports for walking were access to walkable locations (46.5%) and safe streets (29.2%), followed by walking groups (12.9%) and promotional campaigns (9.6%). Access to walkable locations (60.0%) and safe streets (50.6%) were most often prioritized by respondents, followed by promotional campaigns (23.6%) and walking groups (18.8%). Many differences in prioritization by demographic characteristics remained significant after adjusting for presence and other demographic characteristics, such as increased prioritization of all supports with older age groups.

CONCLUSIONS

Presence and prioritization of community supports for walking varied widely by type of support and by demographic characteristics. Opportunities exist to improve access and public sentiment related to these supports to promote walking in the United States.

National-level environmental perceptions and walking among urban and rural residents: Informing surveillance of walkability

Built environments that provide activity-friendly routes (e.g., sidewalks) to everyday destinations (e.g., shops) can increase physical activity. Surveillance of supports and destinations is important, and identifying which are associated with walking could prioritize surveillance questions. Our purpose was to identify the significant associations between supports and destinations with walking among a nationally-representative sample of urban- and rural-dwelling adults. Participants in the 2015 National Health Interview Survey, Cancer Control Supplement (n = 29,925) reported the near-home presence of walkable supports (roads, sidewalks, paths, or trails; sidewalks on most streets), destinations (shops; transit; movies, libraries, or churches; relaxing places), and past-week walking for leisure or transportation. We used stepwise logistic regression to quantify associations between supports and destinations and walking, including by urban/rural residence. We calculated the prevalence of walking across counts of reported elements by urban/rural residence. Among all participants, roads, sidewalks, paths, or trails and relaxing destinations were associated with leisure walking. Among urban residents, sidewalks on most streets and all four destination types were associated with transportation walking; among rural residents, roads, sidewalks, paths, or trails; movies, libraries, or churches; and relaxing destinations were associated with transportation walking. Walking was more common when more environmental elements were reported. To improve efficiency, communities may match surveillance priorities to behavioral priorities (i.e., leisure versus transportation walking) and environmental context (i.e., urban/rural areas). Surveillance of environments supporting leisure walking might focus on recreation-oriented spaces. Surveillance of environments supporting transportation walking might differ for urban and rural areas, and assessing destinations may be particularly important.

From End Treatment to Source Prevention: Socio-Ecological Approaches to Promote Research on the Environment and Non-Communicable Chronic Diseases with Special Reference to China

Globally, the pandemic of non-communicable chronic diseases (NCDs) has become a critical public health problem. Although NCD prevention has been shifting from individual behavioral interventions to broad environmental interventions, it is still necessary to promote research on the environment and NCDs as a whole. Therefore, this conceptual paper aimed to develop a general and novel framework to advance this line of research. The framework uses socio-ecological approaches that emphasize source prevention rather than the end treatment. Specifically, this framework comprehensively covered integrative research approaches, prioritized areas, urgent efforts, innovative methodologies, and improved funding. The framework used China as a typical context, where its public health policies, similar to other nations, still focus on the end treatment of NCDs, placing emphasis on biomedical approaches and technologies. China’s relevant efforts may furnish new insights and approaches concerning NCD prevention, and these efforts may benefit the improvement of global health and well-being. Such social-ecological research efforts can help to accelerate a shift from existing individual interventions to environmental interventions, thereby ultimately achieving the effective source prevention of NCDs in China and around the globe.

Active Commuting to University and its Association with Sociodemographic Factors and Physical Activity Levels in Chilean Students

Background and Objectives: Active commuting to and from university (ACU) could be a strategy to increase physical activity levels (PA) and promote health in young university students. We aimed to a) examine the patterns of commuting to university in Chilean students; b) the association between the mode of commuting to and from university and socio-demographic factors and PA-levels. Materials and Methods: A total of 496 university students (21.6 ± 2.4 years old) from two universities from Valparaíso (central coast of Chile) participated in this study. Personal data, home address, socio-economic status, PA, and the usual mode of commuting to and from the university were self-reported by a questionnaire. The commute distances were objectively measured using Google-Maps-software. Associations were examined using binary logistic regressions. Results: The main mode of commuting was by bus (to university: 55.2% vs. from university: 59.3%; p < 0.001). The least used mode was cycling (1.4% to and from university). Students living >5-km from university were less active commuters than those living in closer distances: (2-5 km, odds ratio (OR): 4.424, 95% and 95% confidence intervals (CI): 2.443-8.011, p < 0.001; 2 km, OR: 143.052, 95% CI: 55.154-371.030, p < 0.001). Students with low PA-levels were less active commuters than those with medium (OR: 1.446; 95% CI: 0.864-2.421; p = 0.160) or higher levels (OR: 1.880; 95% CI: 1.880-1.094; p = 0.022). Students who lived between 2 and 5 km, presented a significant association to be active commuters when they showed medium PA-levels (OR: 5.244, 95% CI: 1.358-20.246; p = 0.016). Conclusions: Chilean university students from Valparaíso are mainly passive commuters using public transport as the main mode of commuting to and from university; longer distances from home to the university are associated with low PA levels. ACU in distances between 2-5 km (mainly walking) could contribute to having medium PA-levels in Chilean university students. Thus, promoting the ACU walking to and from the university in such distances could be an effective strategy to increase the overall PA levels in Chilean university students.

The perceived neighborhood environment is associated with health-enhancing physical activity among adults: a cross-sectional survey of 13 townships in Taiwan

Background

Many environmental factors have been associated with physical activity. The environment is considered a key factor in terms of the rate of engagement in physical activity. This study examined the perceived effect of environmental factors on different levels of health-enhancing physical activity among Taiwanese adults.

Methods

Data were collected from 549 adults aged at least 18 years from the northern, central, southern and eastern regions of Taiwan. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) showcard version, and participants were divided into three categories: those who performed low-, moderate-, or high-levels of physical activity, as suggested by the IPAQ scoring protocol. The perceived neighborhood environment in relation to physical activity was adapted from the Physical Activity Neighborhood Environment Scale. A multinomial logistic regression was conducted to ascertain associations between individual perceptions of the neighborhood environment and different physical activity levels.

Results

Respondents who perceived their neighborhood environment as having easy access to services and stores, and higher traffic safety were more likely to be moderate level of physical activity (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.07–3.37; OR: 1.77, 95% CI: 1.12–2.80). The perception of having easy access to services and stores and seeing many physically active people in the neighborhood were both positively associated with a high level of physical activity (OR: 2.25, 95% CI: 1.01–5.01; OR: 2.40, 95% CI: 1.11–5.23).

Conclusions

Different perceived neighborhood environmental factors were associated with moderate and high levels of physical activity, respectively. These findings highlight the importance of an activity-friendly neighborhood environment to stimulate engagement in physical activity among adults in Taiwan. Therefore, policies and programs should focus on improving friendliness and diversity in neighborhoods to facilitate individuals’ transitions from inactive to active lifestyles.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6848-4) contains supplementary material, which is available to authorized users.

The potential for walkability to narrow neighbourhood socioeconomic inequalities in physical function: A case study of middle-aged to older adults in Brisbane, Australia

Residents of disadvantaged neighbourhoods have poorer physical function than their advantaged counterparts, although the reasons for this remain largely unknown. We examined the moderating effects of walkability in the relationship between neighbourhood disadvantage and physical function using 2013 cross-sectional data from 5115 individuals aged 46-72 living in 200 neighbourhoods in Brisbane, Australia. The relationship between neighbourhood disadvantage and physical function differed by levels of walkability: positive associations as levels of walkability increased for those living in more disadvantaged neighbourhoods, and no difference for those living in more advantaged neighbourhoods. Further work is required to better understand the underlying mechanisms.

Precision medicine and healthy living: The importance of the built environment

The built environment encompasses the major physical spaces, including buildings, streets, homes, schools, parks, playgrounds and other infrastructure in which we live, work and play. In an ideal world, the built environment should support and facilitate a healthy engagement in physical activity across the lifespan. However, in the context of an environment characterized by increased mechanization and urbanization, physical inactivity and higher levels of overweight and obesity, too many settings are not conducive to physical activity and/or are not safe and walkable. In the knowledge that there are multiple challenges to redress the low levels of physical activity seen in many parts of the world, this paper provides some examples of opportunities for healthy living (HL) in a built environment characteristic of an increasingly urbanized world. Particular foci include opportunities for HL fostered in child-friendly cities, in which walkability is high, and active transport is encouraged and supported.

Individual, social, and physical environmental factors related to changes in walking and cycling for transport among older adults: A longitudinal study

To date, no longitudinal studies examined the change in walking and cycling for transport as distinct outcomes over time and investigated the predictors of those changes. Therefore, this present study examined the change in odds of engagement in walking and cycling for transport as distinct outcomes among Belgian older adults over a three-year follow-up period, and examined factors (i.e. socio-demographics, psychosocial, perceived social and physical environmental characteristics) related to these changes in engaging in walking and cycling for transport. Against our expectations, we found significantly higher odds of engaging in cycling for transport among older adults at follow-up compared to baseline and no significant differences in the odds of engaging in walking for transport. Interventions should assist older adults to increase their self-efficacy towards PA, their perceived benefits of PA, and their perception of land use mix diversity in their neighborhood in order to increase the engagement in walking/cycling for transport over time, or help to decrease their perceived barriers towards PA or their perception to have a lot of physical barriers to walk/cycle in their neighborhood. Future longitudinal studies with larger samples are warranted investigating interaction effects between different predictors at various levels to find out which factors can be further integrated into active transport interventions in older adults.

Perceived Social and Built Environment Correlates of Transportation and Recreation-Only Bicycling Among Adults

Introduction

Research on perceptions of environmental factors in relation to transportation and recreation bicycling is limited in the United States. We explored the association between perceived social and built environment factors with total, transportation, and recreation bicycling in a sample of adult bicyclists in Austin, Texas, and Birmingham, Alabama. The objective of this study was to examine the relationship between perceived social and built environment factors and domain-specific bicycling in a sample of adult bicyclists.

Methods

Adults aged 18 to 65 who rode a bicycle at least once in the past year completed an internet-based survey that was developed for this study to specifically assess correlates of bicycling; the study was conducted from October 2016 through January 2017. Perceived environmental factors assessed were residential density, traffic safety, destination, connectivity, safety from crime, aesthetics, and bicycle infrastructure. Multivariable logistic regression models were used to estimate the association of each perceived environmental factor (tertile 1, lowest; tertile 3, highest) with recreation-only and transportation bicycling. Effect modification of the relation between environmental factors and bicycling outcomes by sex was also examined.

Results

The final analytic sample size was 801 participants. All environmental factors examined, including residential density, traffic safety, destinations, connectivity, aesthetics, bicycle infrastructure, and safety from crime showed significantly direct associations with transportation bicycling. Traffic safety, destinations, aesthetics, and bicycle infrastructure showed significant direct and inverse associations with recreation-only bicycling. Effect modification by sex was identified with residential density; a significant direct association with recreation-only bicycling was seen among women.

Conclusion

These findings illustrate that bicycling for transportation is associated with different perceived environmental factors than is recreation-only bicycling, with some significant modification by sex. Comprehensive tools that assess the perceived environment for bikeability in the United States are warranted.

An exploratory analysis of the interactions between social norms and the built environment on cycling for recreation and transport

Background

There is growing evidence of the public health benefits of promoting cycling. The ways that the built environment and perceived social norms independently influence cycling participation is well established. However, whether these factors interact to influence cycling participation has not been examined. Such research is important because understanding the effect of multiple socio-ecological factors and the interactions between them is needed to guide the development of interventions and strategies to increase cycling participation. Therefore, the aim of this study is to explore the interactive effects of the built environment and perceived social norms on transport and recreational cycling.

Methods

Data was collected using a self-administered online questionnaire from 228 office workers in Metropolitan Melbourne, Australia. Measures used in previous research were employed to assess self-reported transport and recreation cycling in the last week, perceptions of neighbourhood built environment, perceived social norms towards cycling, and objective land-use mix, residential density and street connectivity of the suburbs in which participants lived and work. Multiple binary logistic regression analyses were conducted to explore the interactive effects of the built environment and perceived social norms on transport and recreation cycling. All interactive effects were considered significant at p < 0.10.

Results

There was a significant interactive effect between the workplace built environment and perceived group norm on transport cycling (p = 0.06). There were no other significant interactive effects observed between components of the built environment and perceived social norms on transport or recreational cycling.

Conclusions

The interactive effect found in this study provides some evidence that the workplace built environment interacts with perceived group norms to influence cycling for transport. Positive perceptions of the workplace built environment, such as showers and secure bike racks, can somewhat compensate for the negative influence of when cycling is considered less of a norm among, family, friend or colleagues. However, the findings of this study did not support that the neighbourhood built environment and perceived social norms interact to influence cycling for recreation or transport. These findings contribute to the knowledge of how multiple factors may reciprocate to influence individual’s decision to cycle. More research into the interactive effects of socio-ecological factors is warranted.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6075-4) contains supplementary material, which is available to authorized users.

Inactive lifestyles in peri-urban Australia: A qualitative examination of social and physical environmental determinants

ISSUE ADDRESSED

Australians living in peri-urban areas are insufficiently active, sedentary and experience poorer health than people in major cities. There are health benefits attributable to active lifestyles that could contribute to the improved health and well-being of this population. To support the adoption of active lifestyles, it is important to understand the unique context in which behaviour occurs.

METHODS

The aim of this study was to identify characteristics of the social and physical peri-urban environment that may impact active lifestyles. Semi-structured interviews were conducted in peri-urban southern Queensland. Data were analysed by thematic analysis.

RESULTS

The natural environment, weather, distance, accessibility and walkability were features of the physical environment relevant to active lifestyles. Social factors included social capital and crime. Activity-supportive characteristics (eg, community spirit) were identified, in addition to active lifestyle barriers (eg, lack of public transport).

CONCLUSIONS

Despite activity-supportive social and environmental characteristics, most participants reported inactive lifestyles. The barriers to active lifestyles in peri-urban environments may negate these activity-supportive features. Some barriers are difficult to modify (eg, distance and accessibility). However, some may be alleviated through the adoption of activity-supportive policy and urban design (eg, pedestrian mobility infrastructure). SO WHAT?: Strategies to support active lifestyles in peri-urban environments must take into account unmodifiable contextual barriers, whilst encouraging utilisation of existing activity-supportive infrastructure and resources. The enhancement of activity-supportive environments through improved neighbourhood walkability and the usability of public transport may encourage some peri-urban residents to undertake more active forms of transport and recreational physical activity.

Racial and ethnic differences in perceived safety barriers to walking, United States National Health Interview Survey - 2015

Barriers to safe walking may prevent people from being physically active, and previous reports have identified differences in barriers to safe walking across racial and ethnic groups. The purpose of this research was to determine the role demographic characteristics play on racial/ethnic differences in perceived barriers to safe walking and determine if racial/ethnic differences vary by urban/rural residence and Census region. Participants in the 2015 National Health Interview Survey Cancer Control Supplement (n = 31,433 adults ≥18 years) reported perceived barriers to safe walking (traffic, crime, and animals) and demographic characteristics. Urban/rural residence and Census region were based on home addresses. We calculated adjusted prevalence of barriers by race/ethnicity using logistic regression; geographic differences in barriers across racial/ethnic groups were examined via interaction terms. After adjustment for demographic characteristics, non-Hispanic blacks (blacks) and Hispanics reported crime and animals as barriers more frequently than non-Hispanic whites (whites) (crime: blacks, 22.2%; Hispanics, 16.7%; whites, 9.0%; animals: blacks, 18.0%; Hispanics, 12.4%; whites, 8.5%). Racial/ethnic differences in perceived crime as a barrier were more pronounced in the Northeast and Midwest than in the South and West. Urban-dwelling blacks (all regions) and Hispanics (Midwest and South) reported animals as barriers more frequently than whites. Racial/ethnic differences in perceived barriers to safe walking remained after adjusting for demographic characteristics and varied by geographic location. Addressing perceived crime and animals as barriers to walking could help reduce racial/ethnic differences in physical activity, and several barriers may need to be assessed to account for geographic variation.

Exploring Neighborhood Environments and Active Commuting in Chennai, India

Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, poor enforcement of traffic rules and regulations, air pollution, and overcrowding. This cross-sectional study investigated associations between home neighborhood environment characteristics and active commuting in Chennai, India. Adults (N = 370, 47.2% female, mean age = 37.9 years) were recruited from 155 wards in the metropolitan area of Chennai in southern India between January and June 2015. Participants self-reported their usual mode of commute to work, with responses recoded into three categories: (1) multi-modal or active commuting (walking and bicycling; n = 56); (2) public transit (n = 52); and (3) private transport (n = 111). Environmental attributes around participants’ homes were assessed using the Neighborhood Environment Walkability Scale for India (NEWS-India). Associations between environmental characteristics and likelihood of active commuting and public transit use were modeled using logistic regression with private transport (driving alone or carpool) as the reference category, adjusting for age, gender, and household car ownership. Consistent with other international studies, participants living in neighborhoods with a mix of land uses and a transit stop within a 10-minute walk from home were more likely to use active commuting (both p < 0.01). Land-use mix was significantly associated with the use of public transit compared to private transport (adjusted odds ratio (aOR) = 5.2, p = 0.002). Contrary to findings in high-income countries, the odds of active commuting were reduced with improved safety from crime (aOR = 0.2, p = 0.003), aesthetics (aOR = 0.2, p = 0.05), and street connectivity (aOR = 0.2, p = 0.003). Different environmental attributes were associated with active commuting, suggesting that these relationships are complex and may distinctly differ from those in high-income countries. Unexpected inverse associations of perceived safety from crime and aesthetics with active commuting emphasize the need for high-quality epidemiologic studies with greater context specificity in the study of physical activity in LMICs. Findings have public health implications for India and suggest that caution should be taken when translating evidence across countries.

Relationships between the neighborhood environment and depression in older adults: a systematic review and meta-analysis

ABSTRACTBackground:While depression is a growing public health issue, the percentage of individuals with depression receiving treatment is low. Physical and social attributes of the neighborhood may influence the level of depressive symptoms and the prevalence of depression in older adults.

METHODS

This review systematically examined the literature on neighborhood environmental correlates of depression in older adults. Findings were analyzed according to three depression outcomes: depressive symptoms, possible depression, and clinical depression. Based on their description in the article, environmental variables were assigned to one of 25 categories. The strength of evidence was statistically quantified using a meta-analytical approach with articles weighted for sample size and study quality. Findings were summarized by the number of positive, negative, and statistically non-significant associations by each combination of environmental attribute - depression outcome and by combining all depression outcomes.

RESULTS

Seventy-three articles met the selection criteria. For all depression outcomes combined, 12 of the 25 environmental attribute categories were considered to be sufficiently studied. Three of these, neighborhood socio-economic status, collective efficacy, and personal/crime-related safety were negatively associated with all depression outcomes combined. Moderating effects on associations were sparsely investigated, with 52 articles not examining any. Attributes of the physical neighborhood environment have been understudied.

CONCLUSION

This review provides support for the potential influence of some neighborhood attributes on population levels of depression. However, further research is needed to adequately examine physical attributes associated with depression and moderators of both social and physical neighborhood environment attribute - depression outcome associations.

Preferences of Tourists for the Service Quality of Taichung Calligraphy Greenway in Taiwan

This study explores preferences for a set of attributes that characterize the recreational value of Calligraphy Greenway, the most notable greenbelt in Taichung City, Taiwan. As an urban green space, the Calligraphy Greenway has its own recreational attributes and visitors’ preferences. This study uses the choice experiment method to determine visitors’ preference levels for five major attributes to improve the recreational quality. On average, each visitor visited there 9.15 times in the past year and spent 2.37 h per visit. Of the five recreational attributes, satisfaction with recreational activity opportunities had the highest score and satisfaction with cultural landscape resources had the lowest score. The importance is ranked in the order of recreational service quality, total recreational cost, environmental landscape resources, cultural landscape resources and recreational activity opportunities. Considering difference of groups, female visitors were more concerned with cost and activities but male visitors were more concerned with service quality and natural/cultural landscape resources. Local visitors were more concerned with cost and activities but non-local visitors were more concerned with environmental/cultural landscape resources. Both were concerned with service quality. Based on the results, this study makes the following recommendations: cultural landscape resources and quality of recreational services and facilities should be improved and more complete interpretative educational guidance should be provided to increase visitors’ willingness to visit. Additionally, it is suggested to set up various districts to cater for preferences of different visitor groups.

Community perceptions of the implementation and impact of an intervention to improve the neighbourhood physical environment to promote walking for transport: a qualitative study

BACKGROUND

Using community engagement approaches to develop and deliver interventions targeting small-scale physical environmental improvements in neighbourhoods is a potential strategy for increasing walking for transport. This study aimed to qualitatively assess community perceptions of the implementation and impact of the Fitter for Walking (FFW) intervention, which encouraged communities to work together to improve the street environment on local routes and promote walking for transport.

METHODS

From 155 FFW community projects, nineteen were selected to take part in a focus group/interview using specified criteria: geographical area; level of community involvement; intervention activities; and project progress. Participants were invited to take part via the project coordinator or lead member of the community group. A written guide was used to initiate and direct discussions through key topics. Deductive and inductive approaches were used to analyse the data and identify key themes relating to the barriers and facilitators for implementation and the perceived impact of the intervention.

RESULTS

Fourteen focus groups and five interviews were conducted with 86 community members. Themes were identified in relation to barriers (poor area reputation and regeneration areas; engaging the local community; and working with local authorities) and facilitators (provision of a coordinator/facilitator; strong local partnerships; and using a range of communication and engagement activities) for programme implementation. Participants perceived the main impacts to be improved physical and social environments. Increases in walking for transport were rarely specifically commented on, but participants did report increased street use.

CONCLUSIONS

Community perspectives provided important insights into the barriers and facilitators for the implementation of the FFW intervention and its' potential impacts. Using community engagement approaches can lead to perceived improvements in the physical and social environment resulting in increased street use, which may lead to increases in walking for transport in the longer-term. Recommendations are provided for researchers, practitioners and policy makers in planning and delivering future interventions. Future research should determine optimal implementation strategies, investigate the relative importance of improving physical environments, social environments and using individual behaviour change strategies, and determine how physical and social environments interact to maximise intervention impact on walking for transport.

Sub-population differences in the relationship between the neighborhood environment and Latinas' daily walking and vehicle time

BACKGROUND

Over 60% of Latinas report not meeting moderate to vigorous physical activity (MVPA) guidelines of 150 minutes/week. Ecological models of health posit that intrapersonal and environmental factors interact with one another to influence physical activity. Understanding their interactions in relation to transportation behaviors may inform interventions to increase Latinas' physical activity.

PURPOSE

To 1) objectively estimate walking and vehicle time in Latinas, 2) examine the association of, and interactions between, intrapersonal (socio-demographics and weight status) and neighborhood environmental correlates with objective daily walking and vehicle time.

METHODS

A subsample of Latinas (n=87) participating in a health intervention wore an accelerometer and GPS device for at least two valid wear days at baseline. The Personal Activity Location and Measurement System (PALMS) software estimated daily walking and vehicle time. Participants' anthropometrics were measured, and they completed a survey assessing socio-demographic characteristics and perceived neighborhood environment. Generalized linear mixed models examined main effects and interactions of four intrapersonal and five environmental factors on daily walking and vehicle time.

RESULTS

On average, participants walked 16 min/day and spent 69 min/day in a vehicle. Overweight/obesity was negatively associated with walking time (p=.04) and positively associated with vehicle time (p=0.01). Household income was positively associated with vehicle time (p=0.02). For daily walking time, two interactions were significant: perceived access to destinations X household income (p=0.01), and perceived sidewalk maintenance X acculturation (p= 0.01). For daily vehicle time, two interactions were significant: perceived access to destinations X weight status (p<0.001), and perceived safety from crime X education (p=0.01).

CONCLUSION

Latinas participated in relatively low walking time and high amounts of vehicle time. Findings suggest intrapersonal sub-group differences in the association of the neighborhood environment with walking and vehicle time. Improving neighborhood environments to promote walking and reduce vehicle time may help improve Latinas' overall physical activity.

Characteristics of the environmental microscale and walking and bicycling for transportation among adults in Curitiba, Paraná State, Brazil

The aim of this study was to analyze the association between the characteristics of the built and social and environmental microscale and walking and bicycling for transportation in adults in Curitiba, Paraná State, Brazil. A cross-sectional study was performed in 2009 with a household survey that included 1,419 adults. Objective evaluation of environment was performed on the resident's street segments, using an instrument for systematic observation consisting of six dimensions: "land use", "public transportation", "streetscape", "conditions and aesthetics", "places for walking and bicycling", and "social environment". The score for each dimension was obtained as the sum of positive items related to physical activity. The items for "public transportation" (≥ 1 items) and "places for walking and bicycling on the streets" (≥ 3 items) were dichotomized, while the scores for the other items were classified in tertiles. Walking and bicycling for transportation were assessed with the International Physical Activity Questionnaire (IPAQ). The data were analyzed using multilevel Poisson regression. Medium "streetscape" score was inversely associated with walking ≥ 150min/week (PR = 0.60; 95%CI: 0.40-0.91; VPC = 12%) and bicycling (PR = 0.54; 95%CI: 0.29-0.99; VPC = 60%). In conclusion, only "streetscape" was associated with walking and bicycling for transportation in adults.

Environmental Supports for Physical Activity, National Health Interview Survey-2015

INTRODUCTION

The Guide to Community Preventive Services recommends combined built environment approaches to increase physical activity, including new or enhanced transportation infrastructure (e.g., sidewalks) and land use and environmental design interventions (e.g., close proximity of local destinations). The aim of this brief report is to provide nationally representative estimates of two types of built environment supports for physical activity: near-home walkable infrastructure and destinations, from the 2015 National Health Interview Survey.

METHODS

Adults (n=30,453) reported the near-home presence of walkable transportation infrastructure (roads, sidewalks, paths, or trails where you can walk; and whether most streets have sidewalks) and four walkable destination types (shops, stores, or markets; bus or transit stops; movies, libraries, or churches; and places that help you relax, clear your mind, and reduce stress). The prevalence of each, and the count of destination types, was calculated (in 2017) and stratified by demographic characteristics.

RESULTS

Overall, 85.1% reported roads, sidewalks, paths, or trails on which to walk, and 62.6% reported sidewalks on most streets. Among destinations, 71.8% reported walkable places to relax; followed by shops (58.0%); transit stops (53.2%); and movies, libraries, or churches (47.5%). For most design elements, prevalence was similar among adults aged 18-24 and 25-34 years, but decreased with age >35 years. Adults in the South reported a lower prevalence of all elements compared with those in other Census regions.

CONCLUSIONS

Many U.S. adults report walkable built environment elements near their home; future efforts might target areas with many older adult residents or those living in the South.

Cross-sectional interactions between quality of the physical and social environment and self-reported physical activity in adults living in income-deprived communities

Background

Understanding the environmental determinants of physical activity in populations at high risk of inactivity could contribute to the development of effective interventions. Socioecological models of activity propose that environmental factors have independent and interactive effects of physical activity but there is a lack of research into interactive effects.

Objectives

This study aimed to explore independent and interactive effects of social and physical environmental factors on self-reported physical activity in income-deprived communities.

Methods

Participants were 5,923 adults in Glasgow, United Kingdom. Features of the social environment were self-reported. Quality of the physical environment was objectively-measured. Neighbourhood walking and participation in moderate physical activity [MPA] on ≥5 days/week was self-reported. Multilevel multivariate logistic regression models tested independent and interactive effects of environmental factors on activity.

Results

‘Social support’ (walking: OR:1.22,95%CI = 1.06–1.41,p<0.01; MPA: OR:0.79,95%CI = 0.67–0.94,p<0.01), ‘social interaction’ (walking: OR:1.25,95%CI = 1.10–1.42,p<0.01; MPA: OR:6.16,95%CI = 5.14–7.37,p<0.001) and ‘cohesion and safety’ (walking: OR:1.78,95%CI = 1.56–2.03,p<0.001; MPA: OR:1.93,95%CI = 1.65–2.27,p<0.001), but not ‘trust and empowerment’, had independent effects on physical activity. ‘Aesthetics of built form’ (OR:1.47,95%CI = 1.22–1.77,p<0.001) and ‘aesthetics and maintenance of open space’ (OR:1.32, 95%CI = 1.13–1.54,p<0.01) were related to walking. ‘Physical disorder’ (OR:1.63,95%CI = 1.31–2.03,p<0.001) had an independent effect on MPA. Interactive effects of social and physical factors on walking and MPA were revealed.

Conclusions

Findings suggest that intervening to create activity-supportive environments in deprived communities may be most effective when simultaneously targeting the social and physical neighbourhood environment.

Transport and public health in China: the road to a healthy future

Transportation-related risk factors are a major source of morbidity and mortality in China, where the expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside increased use of motorised transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect on air quality, but persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet and to famously congested roads. Urban design favours motorised transport, and physical activity and its associated health benefits are hindered by poor urban infrastructure. Transport emissions of greenhouse gases contribute substantially to regional and global climate change, which compound public health risks from multiple factors. Despite these complex challenges, technological advances and innovations in planning and policy stand to make China a leader in sustainable, healthy transportation.

Applying a Treatment Effects Model to Investigate Public Amenity Effect on Physical Activity of the Elderly

The increasing elderly population puts significant health, economic, and social burdens on society. Physical activity is one of the most cost-effective ways to maintain the health of the elderly. This study adopts a treatment effects model to investigate the causal relationship between environment attributes and physical activity among the elderly, while taking endogeneity into account. The data were collected from 274 participants by face-to-face interviews in Taichung, Taiwan. Performing physical activity regularly in parks is the most important measure of the amount of physical activity by the elderly. Providing sufficient and accessible parks in metropolitan residential neighborhoods could be one of the most cost-effective ways to promote physical activity for the elderly living in midsize Asian cities.

Perceived neighborhood environmental attributes associated with leisure-time and transport physical activity in Mexican adults

Environmental factors have been associated with specific physical activity domains, including leisure-time and transport physical activity, in some high income countries. Few studies have examined the environmental correlates for domain-specific physical activity in low-and middle-income countries, and results are inconsistent. We aimed to estimate the associations between perceived environment and self-reported leisure-time walking, moderate-to-vigorous leisure-time physical activity and transport physical activity among adults living in Cuernavaca, Mexico. A population-based study of adults 20 to 64years old was conducted in Cuernavaca, Mexico in 2011 (n=677). Leisure and transport physical activity was measured using the International Physical Activity Questionnaire - Long Form. Perceptions of neighborhood environment were obtained by questionnaire. Hurdle regression models estimated the association between environmental perceptions and participation and time spent in each physical activity domain. High perceived aesthetics were positively correlated with participation and time spent in leisure-time walking and moderate-to-vigorous physical activity. SES differences existed for aesthetics in relation to participation in leisure-time walking. Participation in transport physical activity was positively associated with easy access to large parks, while closer distance to large parks was a negative correlate for participation and time-spent in this physical activity domain. Results suggest that perceived environmental characteristics related with physical activity are domain specific. High perceived aesthetics were an important correlate for leisure-time activities among Mexican adults, suggesting that policy strategies aimed at improving this environmental perception may be warranted. Patterns of associations between environmental correlates and transport physical activity differed from those reported in commonly studied high income countries.

"Can we walk?" Environmental supports for physical activity in India

India is currently facing a non-communicable disease epidemic. Physical activity (PA) is a preventative factor for non-communicable diseases. Understanding the role of the built environment (BE) to facilitate or constrain PA is essential for public health interventions to increase population PA. The objective of this study was to understand BEs associations with PA occurring in two major life domains or life areas-travel and leisure-in urban India. Between December 2014 and April 2015, in-person surveys were conducted with participants (N=370; female=47.2%) in Chennai, India. Perceived BE characteristics regarding residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking and bicycling, aesthetics, traffic safety, and safety from crime were measured using the adapted Neighborhood Environment Walkability Scale-India (NEWS-India). Self-reported PA was measured the International Physical Activity Questionnaire. High residential density was associated with greater odds of travel PA (aOR=1.9, 95% CI=1.2, 3.2). Land use mix-diversity was positively related to travel PA (aOR=2.1, 95%CI=1.2, 3.6), but not associated with leisure or total PA. The aggregate NEWS-India score predicted a two-fold increase in odds of travel PA (aOR=1.9, 95% CI=1.1, 3.1) and a 40% decrease in odds of leisure PA (aOR=0.6, 95% CI=0.4, 1.0). However, the association of the aggregated score with leisure PA was not significant. Results suggest that relationships between BE and PA in low-and-middle income countries may be context-specific, and may differ markedly from higher income countries. Findings have public health implications for India suggesting that caution should be taken when translating evidence across countries.

Reliability of self-report measures of correlates of obesity-related behaviours in Hong Kong adolescents for the iHealt(H) and IPEN adolescent studies

BACKGROUND

This study examined the reliability of measures of correlates of dietary behaviours (DBs), physical activity (PA) and sedentary behaviour (SB) for Hong Kong adolescents.

METHOD

Individual, social and environmental correlates of obesity-related behaviours were assessed twice, 15-27 days apart (average 20 days), via self-administered questionnaires. These questionnaire included measures of decisional balance, self-efficacy, enjoyment and social support related to intake of fruits, vegetables, high-fat foods and sugar-sweetened beverages, PA behaviour and SB. They also included measures of perceived barriers to PA, parental rules related to PA and SB, and environmental correlates of DB, PA and SB. The questionnaires were self-completed outside school hours. A sample of 119 12-17 year old Chinese-speaking secondary school students (60 girls; 59 boys) were recruited from four Hong Kong schools located in areas stratified by walkability and socio-economic status.

RESULTS

The test-retest reliability of the examined measures ranged from poor to excellent (ICC: 0.30-0.99). All measures of correlates of PA and SB had excellent or substantial test-retest reliability, with the exception of self-efficacy for reducing SB (ICC: 0.59). Four of 18 measures of DBs showed moderate, and two poor (ICC < 0.41), test-retest reliability. Evidence of unidimensionality (Cronbach's α ≥ 0.70) was found for 10 of 28 multi-item scales. The evidence for the remaining 18 was either questionable or poor.

CONCLUSIONS

Most of the self-report measures of correlates of obesity-related behaviours used in the iHealt(H) study have acceptable test-retest reliability in Hong Kong adolescents. The factorial structure of several scales needs to be investigated in a larger sample.

Active Transportation on a Complete Street: Perceived and Audited Walkability Correlates

Few studies of walkability include both perceived and audited walkability measures. We examined perceived walkability (Neighborhood Environment Walkability Scale—Abbreviated, NEWS-A) and audited walkability (Irvine–Minnesota Inventory, IMI) measures for residents living within 2 km of a “complete street”—one renovated with light rail, bike lanes, and sidewalks. For perceived walkability, we found some differences but substantial similarity between our final scales and those in a prior published confirmatory factor analysis. Perceived walkability, in interaction with distance, was related to complete street active transportation. Residents were likely to have active transportation on the street when they lived nearby and perceived good aesthetics, crime safety, and traffic safety. Audited walkability, analyzed with decision trees, showed three general clusters of walkability areas, with 12 specific subtypes. A subset of walkability items (n = 11), including sidewalks, zebra-striped crosswalks, decorative sidewalks, pedestrian signals, and blank walls combined to cluster street segments. The 12 subtypes yielded 81% correct classification of residents’ active transportation. Both perceived and audited walkability were important predictors of active transportation. For audited walkability, we recommend more exploration of decision tree approaches, given their predictive utility and ease of translation into walkability interventions.

Complex active travel bout motivations: Gender, place, and social context associations

Active travel bouts are healthy, but bout-specific motives, social, and physical contexts have been poorly characterized. Adults (n= 421 in 2012, 436 in 2013) described their moderate activity bouts over the past week, aided by accelerometry/GPS data integration. Participants viewed maps indicating date, time, and starting and ending locations of their past week moderate-to-vigorous active travel bouts of 3 or more minutes. These prompts helped participants recall their social and physical contexts and motives for the bouts. Three bout motivations were modeled: leisure, transportation, and their "T-L" difference scores (transportation minus leisure scores). Blends of leisure and transportation motives characterized most bouts, even though most studies do not allow participants to endorse multiple motives for their active travel. Bouts were often neighborhood-based. Leisure motives were related to pleasant place perceptions, homes, and exercise places; workplaces were associated with stronger transportation and T-L bout motives. Women's bout motives were more closely associated with place than men's. Our novel method of individual bout assessment can illuminate the social-ecological contexts and experiences of everyday healthy bouts of activity.

Individual and environmental correlates of objectively measured physical activity and sedentary time in adults from Curitiba, Brazil

OBJECTIVES

This study assessed the association of individual and neighborhood environment characteristics and objectively measured physical activity (PA) and sedentary time (ST) in adults from Curitiba, Brazil.

METHODS

A population-based cross-sectional study was conducted through face-to-face household interviews in 2010. The analytic sample included 305 adults aged 20-65 years recruited from 32 census tracts selected according to neighborhood walkability and socioeconomic status. Individual and environmental PA correlates were evaluated through standardized and valid self-reported measures, including the Neighborhood Environment Walkability Scale. Minutes per week of PA and ST were assessed through accelerometry. Multi-level regression models were used in the analyses.

RESULTS

After adjusting for confounders the strongest individual and environmental correlates associated with ST was residential density (B = 0.14; p = 0.008), light-intensity PA was being a father/mother (B = 35.71; p = 0.025) and moderate-to-vigorous PA was sex (B = 0.91; p < 0.001) and number of cars (one car, B = -1.05; two cars, B = -1.14; p < 0.001).

CONCLUSIONS

The associations found with individual and environmental correlates varied accordingly across all outcomes. Future changes in policies and infrastructure should consider the social context of the community and improvements to promote a safer environment in the neighborhood.

Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults

Background

Although research has shown that numerous perceived environmental factors are supportive of physical activity, little is known about their associations with sedentary transport in motorcycle-oriented countries. This study examined the association between perceptions of Taiwan’s environmental factors and urban adults’ motorcycle use.

Methods

Cross-sectional data from 1003 Taiwanese adults aged 20–64 years from three urban cities were collected through telephonic surveys in 2015. Data on motorcycle use, sociodemographic variables, and perceived environmental attributes were obtained. Logistic regression analyses were performed.

Results

In Model 1, adults who perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night were less likely to use motorcycles. In Model 2, in which potential covariates were additionally adjusted for, the same four environmental attributes (perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night; odds ratio [OR] = 0.46, 0.65, 0.63, 0.64, respectively) were significantly associated with motorcycle use.

Conclusion

The investigated perceived environmental factors, which have previously been associated with facilitating active transportation, discourage sedentary modes of transport, such as motorized vehicles.

Evaluation of the implementation of an intervention to improve the street environment and promote walking for transport in deprived neighbourhoods

Background

Levels of physical activity remain low, particularly in deprived areas. Improving the street environment to promote walking for transport using a community engagement approach is a potential strategy to increase physical activity. An understanding of the implementation of this intervention approach is needed to facilitate further research, replication and scale-up. The aim of this study was to evaluate the implementation of the Fitter for Walking (FFW) intervention in deprived neighbourhoods.

Methods

FFW was delivered in five regions of England between August 2008 and March 2012 and aimed to use a community engagement approach to improve the street environment to promote walking for transport. Implementation was assessed in relation to reach; dosage; implementation processes and adaptation; and factors influencing implementation. Three data sources were used: focus groups and face-to-face interviews with coordinators; implementation logs; and participation records.

Results

Reach: 155 community groups participated in FFW engaging 30,230 local residents. Dosage: A wide variety of environmental improvements were implemented by local authorities (LAs) (42 projects) and by communities (46 projects). Examples of LA-led improvements included removal of encroaching vegetation, new/improved pedestrian signage, new dropped kerbs/kerb improvements and new, repaired or improved footpaths. Examples of community-led improvements included planting bulbs, shrubs or bedding plants, clean-up days and litter pick-ups. In 32 projects, no environmental improvements were implemented. Promotional and awareness-raising activities were undertaken in 81 projects. Examples included led walks, themed walks, development of maps/resources to promote improved routes and community events. Processes and adaptation: The need for a planning phase, a preparatory phase, and a delivery phase with a four step process were identified. Adaptability to local context was important. Factors influencing implementation: Five key themes were identified in relation to the barriers and facilitators of implementing FFW: local knowledge and contacts; intervention delivery; coordinator role; working with LAs and other partners; and working with communities.

Conclusions

FFW is one of few reported interventions which have used a community engagement approach to change the street environment to promote walking for transport in deprived neighbourhoods. Delivering these types of interventions is complex and requires considerable resource and time. A set of recommendations and an implementation framework are proposed for future delivery of this and similar types of programme.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4637-5) contains supplementary material, which is available to authorized users.

The observed and perceived neighborhood environment and physical activity among urban-dwelling adults: The moderating role of depressive symptoms

RATIONALE

Physical environmental features of neighborhoods are associated with physical activity, but the influence of mental health factors, such as depression, on these associations is poorly understood.

OBJECTIVE

We examined whether the perceived neighborhood environment mediated associations between the observed neighborhood environment and physical activity, and whether these associations were moderated by depressive symptoms.

METHODS

Data consisted of systematic social observations of 343 neighborhoods and resident surveys. Participants' (N = 2969) mean age was 41.9 ± 16.2 years, 60.2% were female, and 67.9% were non-White. We conducted multiple linear regression and tests for mediation and moderated mediation.

RESULTS

Observed recreation facilities, commercial destinations, physical disorder, and physical deterioration were indirectly associated with walking via perceived neighborhood environment variables. Observed recreation facilities was indirectly and positively associated with leisure-time physical activity via perceived park access, and indirectly and inversely associated with walking and leisure-time physical activity via perceived traffic danger, but only among participants with low depressive symptom scores. Observed recreation facilities was indirectly and inversely associated, and observed physical disorder and physical deterioration were indirectly and positively associated with walking via perceived disorder, but only among participants with high depressive symptom scores.

CONCLUSION

Depressive symptoms affected the strength and direction of associations between the observed neighborhood environment and physical activity via residents' perceptions.

Developing and Validating an Abbreviated Version of the Microscale Audit for Pedestrian Streetscapes (MAPS-Abbreviated)

PURPOSE

Macroscale built environment factors (e.g., street connectivity) are correlated with physical activity. Less-studied but more modifiable microscale elements (e.g., sidewalks) may also influence physical activity, but shorter audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of an abbreviated 54-item streetscape audit tool with multiple measures of physical activity in four age groups.

METHODS

We developed a 54-item version from the original 120-item Microscale Audit of Pedestrian Streetscapes (MAPS). Audits were conducted on 0.25-0.45 mile routes from participant residences toward the nearest nonresidential destination for children (N=758), adolescents (N=897), younger adults (N=1,655), and older adults (N=367). Active transport and leisure physical activity were measured with surveys, and objective physical activity was measured with accelerometers. Items to retain from original MAPS were selected primarily by correlations with physical activity. Mixed linear regression analyses were conducted for MAPS-Abbreviated summary scores, adjusting for demographics, participant clustering, and macroscale walkability.

RESULTS

MAPS-Abbreviated and original MAPS total scores correlated r=.94 The MAPS-Abbreviated tool was related similarly to physical activity outcomes as the original MAPS. Destinations and land use, streetscape and walking path characteristics, and overall total scores were significantly related to active transport in all age groups. Street crossing characteristics were related to active transport in children and older adults. Aesthetics and social characteristics were related to leisure physical activity in children and younger adults, and cul-de-sacs were related with physical activity in youth. Total scores were related to accelerometer-measured physical activity in children and older adults.

CONCLUSION

MAPS-Abbreviated is a validated observational measure for use in research. The length and related cost of implementation has been cited as a barrier to use of microscale instruments, so availability of this shorter validated measure could lead to more widespread use of streetscape audits in health research.

Psychosocial and environmental correlates of active and passive transport behaviors in college educated and non-college educated working young adults

Background

This study aimed to examine potential differences in walking, cycling, public transport and passive transport (car/moped/motorcycle) to work and to other destinations between college and non-college educated working young adults. Secondly, we aimed to investigate which psychosocial and environmental factors are associated with the four transport modes and whether these associations differ between college and non-college educated working young adults.

Methods

In this cross-sectional study, 224 working young adults completed an online questionnaire assessing socio-demographic variables (8 items), psychosocial variables (6 items), environmental variables (10 items) and transport mode (4 types) and duration to work/other destinations. Zero-inflated negative binomial regression models were performed in R.

Results

A trend (p<0.10) indicated that more college educated compared to non-college educated young adults participated in cycling and public transport. However, another trend indicated that cycle time and public transport trips were longer and passive transport trips were shorter in non-college compared to college educated working young adults. In all working young adults, high self-efficacy towards active transport, and high perceived benefits and low perceived barriers towards active and public transport were related to more active and public transport. High social support/norm/modeling towards active, public and passive transport was related to more active, public and passive transport. High neighborhood walkability was related to more walking and less passive transport. Only in non-college educated working young adults, feeling safe from traffic and crime in their neighborhood was related to more active and public transport and less passive transport.

Conclusions

Educational levels should be taken into account when promoting healthy transport behaviors in working young adults. Among non-college educated working young adults, focus should be on increasing active and public transport participation and on increasing neighborhood safety to increase active and public transport use. Among college educated working young adults, more minutes of active transport should be encouraged.

Do associations between objectively-assessed physical activity and neighbourhood environment attributes vary by time of the day and day of the week? IPEN adult study

BACKGROUND

To more accurately quantify the potential impact of the neighbourhood environment on adults' physical activity (PA), it is important to compare environment-PA associations between periods of the day or week when adults are more versus less likely to be in their neighbourhood and utilise its PA resources. We examined whether, among adults from 10 countries, associations between objectively-assessed neighbourhood environment attributes and moderate-to-vigorous physical activity (MVPA) varied by time of the day and day of the week. The secondary aim was to examine whether such associations varied by employment status, gender and city.

METHODS

This cross-sectional study included 6,712 adults from 14 cities across 10 countries with ≥1 day of valid accelerometer-assessed MVPA and complete information on socio-demographic and objectively-assessed environmental characteristics within 0.5 and 1 km street-network buffers around the home. Accelerometer measures (MVPA min/h) were created for six time periods from early morning until late evening/night, for weekdays and weekend days separately. Associations were estimated using generalized additive mixed models.

RESULTS

Time of the day, day of week, gender and employment status were significant moderators of environment-MVPA associations. Land use mix was positively associated with MVPA in women who were employed and in men irrespective of their employment status. The positive associations between MVPA and net residential density, intersection density and land use mix were stronger in the mornings of weekdays and the afternoon/evening periods of both weekdays and weekend days. Associations between number of parks and MVPA were stronger in the mornings and afternoon/evenings irrespective of day of the week. Public transport density showed consistent positive associations with MVPA during weekends, while stronger effects on weekdays were observed in the morning and early evenings.

CONCLUSIONS

This study suggests that space and time constraints in adults' daily activities are important factors that determine the impact of neighbourhood attributes on PA. Consideration of time-specific associations is important to better characterise the magnitude of the effects of the neighbourhood environment on PA. Future research will need to examine the contribution of built environment characteristics of areas surrounding other types of daily life centres (e.g., workplaces) to explaining adults' PA at specific times of the day.

Kernel Density Estimation as a Measure of Environmental Exposure Related to Insulin Resistance in Breast Cancer Survivors

Background: Environmental factors may influence breast cancer; however, most studies have measured environmental exposure in neighborhoods around home residences (static exposure). We hypothesize that tracking environmental exposures over time and space (dynamic exposure) is key to assessing total exposure. This study compares breast cancer survivors' exposure to walkable and recreation-promoting environments using dynamic Global Positioning System (GPS) and static home-based measures of exposure in relation to insulin resistance.Methods: GPS data from 249 breast cancer survivors living in San Diego County were collected for one week along with fasting blood draw. Exposure to recreation spaces and walkability was measured for each woman's home address within an 800 m buffer (static), and using a kernel density weight of GPS tracks (dynamic). Participants' exposure estimates were related to insulin resistance (using the homeostatic model assessment of insulin resistance, HOMA-IR) controlled by age and body mass index (BMI) in linear regression models.Results: The dynamic measurement method resulted in greater variability in built environment exposure values than did the static method. Regression results showed no association between HOMA-IR and home-based, static measures of walkability and recreation area exposure. GPS-based dynamic measures of both walkability and recreation area were significantly associated with lower HOMA-IR (P < 0.05).Conclusions: Dynamic exposure measurements may provide important evidence for community- and individual-level interventions that can address cancer risk inequities arising from environments wherein breast cancer survivors live and engage.Impact: This is the first study to compare associations of dynamic versus static built environment exposure measures with insulin outcomes in breast cancer survivors. Cancer Epidemiol Biomarkers Prev; 26(7); 1078-84. ©2017 AACR.

Construct Validity of the Neighborhood Environment Walkability Scale for Africa

PURPOSE

The development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries.

METHODS

NEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire.

RESULTS

The overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda.

CONCLUSIONS

Of 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.

The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis

BACKGROUND

Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations.

METHODS

Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic).

RESULTS

Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified.

CONCLUSIONS

Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.

The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis

BACKGROUND

Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations.

METHODS

Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic).

RESULTS

Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified.

CONCLUSIONS

Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.

Obesogenic environments: current evidence of the built and food environments

Aims:

Obesity is one of the most significant global health and social problems, with rates rising dramatically over the past few decades. While the basic drivers of obesity are obvious (more energy consumed than expended), the causes are multifactorial and complex. A decade ago, it was suggested that exploring the ways in which the built environment influenced physical activity and dietary behaviours might provide fertile ground for investigation. This article overviews current evidence and, in particular, emergent themes that are of significance for the United Kingdom.

Methods:

This article is based on literature extracted from keyword searching of electronic databases. A timeframe of 2006–2016 was used.

Results:

In the past decade, the research base has grown significantly; while frustratingly some results are still inconclusive or contradictory, it might be argued enough evidence exists to act upon. Themes such as the importance of the journey to school for young people and the multiple environments in which people spend their time are examples of where real progress has been made in the evidence base.

Conclusion:

Progress towards real change in policy and practice may seem slow; however, the opportunities afforded for health and planning professionals to work together provide a step towards the whole systems approaches to tackle obesity that are desperately needed.

Gender and age differences in walking for transport and recreation: Are the relationships the same in all neighborhoods?

INTRODUCTION

Walking as regular physical activity (PA) is central to healthy aging, and environments influence walking. Multilevel neighborhood-based studies that only report average (fixed-effect) walking differences for gender and age implicitly assume that neighborhood environments influence the walking behavior of men and women, and younger and older persons, similarly. This study tests this assumption by examining whether gender and age differences in walking for transport (WfT) and walking for recreation (WfR) are similar or different across neighborhoods.

METHODS

This paper used data from the HABITAT multilevel study, with 7,866 participants aged 42-68 years in 2009 living in 200 neighborhoods in Brisbane, Australia. Respondents reported minutes spent WfT and WfR in the previous week, categorized as: none (0 mins), low (1-59mins), moderate (60-149mins) and high (≥ 150 mins). Multilevel multinomial logistic models were used to estimate average differences in walking by gender and age, followed by random coefficients to examine neighborhood variation in these individual-level relationships.

RESULTS

On average, women were more likely to engage in WfR at moderate and high levels (no gender differences found in WfT); and older persons were less likely to do WfT and more likely to do high levels of WfR. These average (Brisbane-wide) relationships varied significantly across neighborhoods.

CONCLUSION

Relationships between gender and walking, and age and walking, are not the same in all neighborhoods, (i.e. the Brisbane average conceals important information) suggesting that neighborhood-level factors differentially influence the walking behaviors of men and women and younger and older persons. Identifying these factors should be a priority for future research.

International comparisons of the associations between objective measures of the built environment and transport-related walking and cycling: IPEN Adult Study

INTRODUCTION

Mounting evidence documents the importance of urban form for active travel, but international studies could strengthen the evidence. The aim of the study was to document the strength, shape, and generalizability of relations of objectively measured built environment variables with transport-related walking and cycling.

METHODS

This cross-sectional study maximized variation of environments and demographics by including multiple countries and by selecting adult participants living in neighborhoods based on higher and lower classifications of objectively measured walkability and socioeconomic status. Analyses were conducted on 12,181 adults aged 18-66 years, drawn from 14 cities across 10 countries worldwide. Frequency of transport-related walking and cycling over the last seven days was assessed by questionnaire and four objectively measured built environment variables were calculated. Associations of built environment variables with transport-related walking and cycling variables were estimated using generalized additive mixed models, and were tested for curvilinearity and study site moderation.

RESULTS

We found positive associations of walking for transport with all the environmental attributes, but also found that the relationships was only linear for land use mix, but not for residential density, intersection density, and the number of parks. Our findings suggest that there may be optimum values in these attributes, beyond which higher densities or number of parks could have minor or even negative impact. Cycling for transport was associated linearly with residential density, intersection density (only for any cycling), and land use mix, but not with the number of parks.

CONCLUSION

Across 14 diverse cities and countries, living in more densely populated areas, having a well-connected street network, more diverse land uses, and having more parks were positively associated with transport-related walking and/or cycling. Except for land-use-mix, all built environment variables had curvilinear relationships with walking, with a plateau in the relationship at higher levels of the scales.

Harnessing Technology and Citizen Science to Support Neighborhoods that Promote Active Living in Mexico

Middle- and low-income countries bear 80 % of the global chronic disease burden. Population-level, multi-sectoral approaches to promoting healthful lifestyles that take into local physical, socioeconomic, and sociocultural characteristics of both the environment and the population are needed. The "Nuestra Voz (Our Voice)" is one such approach that involves neighborhood residents acting as "citizen scientists" to systematically gather information on the barriers and facilitators of physical activity in their neighborhoods and then use their data to collectively advocate for local environmental- and policy-level changes to support active living. We pilot tested this approach in Cuernavaca, Mexico with adults and adolescents. This community-engaged and participatory approach is driven by residents, who utilize a GPS-enabled electronic tablet-based application with simple audio-based instructions to take photographs and record audio narratives of facets of their neighborhood that promote or hinder active living. After collecting these data, the citizen scientists come together in a community meeting and use their data to prioritize realistic, multi-level changes for promoting active living in their neighborhoods. A survey assessed participants' acceptability of the approach. Participating citizen scientists included 32 adults and 9 adolescents. The citizen scientists rated the acceptability of five of the nine acceptability survey items with an average of 4.0 or higher out of 5.0, indicating they thought it was "fun," were comfortable carrying the tablet, were likely to use it again, and would recommend it to friends and family. Items with average scores of less than 4 were all related to safety concerns. The most common barriers reported by citizen scientists using the tablet were poor sidewalk quality, presence of trash, negative characteristics of the streets, unpleasant aesthetics (e.g., graffiti), and presence of parks and recreational facilities. The Our Voice citizen scientist approach using the Discovery Tool has high potential for assisting communities in diverse settings to begin to identify both local barriers to active living as well as potentially useful strategies for promoting physical activity in culturally congruent ways that are appropriate and feasible in the local context.

Measurement of physical activity in urban and rural South African adults: a comparison of two self-report methods

BACKGROUND

Due to the large mortality from inactivity-related non-communicable diseases in low- and middle- income countries, accurate assessment of physical activity is important for surveillance, monitoring and understanding of physical (in)activity epidemiology in many of these countries. Research on relative performance of self-report physical activity instruments commonly used for epidemiological research in Africa have rarely been reported. The present study compared estimates of physical activity measured with the International Physical Activity Questionnaire - Short Form (IPAQ-SF) and the Baecke Physical Activity Questionnaire (BPAQ) among urban and rural black South African adults.

METHODS

Self-reported physical activity data using the IPAQ-SF and BPAQ were collected from a representative sample of 910 urban and rural black South African adults (age = 59.2 ± 9.5 years, 69.7 % women) participating in the 2015 wave of the Prospective Urban and Rural Epidemiological (PURE) study in the North West Province of South Africa. Between-method relationships (pearson correlations [r] and intraclass correlation coefficients [ICCs]) and agreements (Bland-Altman mean difference with 95 % limits of agreement and Kappa coefficient [k]) of IPAQ-SF and BPAQ variables were estimated. Sensitivity and specificity of the BPAQ relative to the IPAQ-SF to classify individuals according to the international guidelines for sufficient physical activity were calculated using chi-square statistics.

RESULTS

Correlations between IPAQ-SF scores and BPAQ indices were small (r = 0.08-0.18; ICCs = 0.09-0.18) for BPAQ leisure and sport indices, moderate-to-large for work index (r = 0.42-0.59; ICCs = 0.40-0.62) and total physical activity index (r = 0.52-0.60; ICCs = 0.36-0.51). Between methods mean difference for total physical activity was large (1.85 unit), and agreement in physical activity classifications was poor to moderate (k = 0.16-0.44). The sensitivity of the BPAQ to identify sufficiently active people from the IPAQ-SF was very good (98 %), but its specificity to correctly classify insufficiently active people was weak (23 %).

CONCLUSION

Notable disparities in physical activity estimates between methods suggest that utilization of IPAQ-SF and BPAQ for surveillance and epidemiology studies in Africa should depend on research questions and population to be studied. Future studies with objective measures are needed to confirm the relative validity between the two instruments.