How Do Perceptions of Local Neighborhood Relate to Adolescents' Walking and Cycling?

Perceptions of the Neighborhood Environment and Children's Afterschool Moderate-to-Vigorous Physical Activity

Previous research suggests the neighborhood environment may be an important influence on children's physical activity (PA) behaviors; however, findings are inconsistent. The purpose of this study was to further understand the relationship between perceptions of the neighborhood environment and children's afterschool moderate-to-vigorous PA. Utilizing a structural equation modeling technique, we tested a conceptual model linking parent and child perceptions of the neighborhood environment, parent support for PA, and child outdoor PA with children's afterschool moderate-to vigorous PA. We found that child perception of the neighborhood environment and outdoor PA were positively associated with afterschool moderate-to-vigorous PA. In addition, parent support for PA positively influenced children's outdoor PA. The neighborhood environment and outdoor activity appear to play an influential role on children's afterschool PA behaviors.

Influence of the built environment on pedestrian route choices of adolescent girls

We examined the influence of the built environment on pedestrian route selection among adolescent girls. Portable global positioning system units, accelerometers, and travel diaries were used to identify the origin, destination, and walking routes of girls in San Diego, CA and Minneapolis, MN. We completed an inventory of the built environment on every street segment to measure the characteristics of routes taken and not taken. Route-level variables covering four key conceptual built environment domains (Aesthetics, Destinations, Functionality, and Safety) were used in the analysis of route choice. Shorter distance had the strongest positive association with route choice, while the presence of a greenway or trail, higher safety, presence of sidewalks, and availability of destinations along a route were also consistently positively associated with route choice at both sites. The results suggest that it may be possible to encourage pedestrians to walk farther by providing high quality and stimulating routes.

Does parental accompaniment when walking or cycling moderate the association between physical neighbourhood environment and active transport among 10-12 year olds?

OBJECTIVES

To assess whether associations between neighbourhood environmental features and frequency of children's active trips per week are moderated by frequency of parental accompaniment when walking/cycling.

DESIGN

Cross-sectional survey

METHODS

Children aged 10-12 years (n=677) were recruited from 19 schools in Melbourne, Australia. Parents reported the number of walking/cycling trips/week usually made by their child to eight local destinations. Environmental variables (i.e. number of cul-de-sacs, intersections, public open spaces (POS) defined as reserves or parks, sport and recreation POS, sport options, population density, length of busy roads and length of walking/cycling tracks) within an 800m buffer around participants' homes were objectively assessed with a Geographic Information System. Associations between neighbourhood features and frequency of active trips were assessed using multilevel linear regressions. Moderating effects of regular parental accompaniment when walking/cycling were examined.

RESULTS

Parental co-participation in walking and cycling was positively associated with frequency of overall walking/cycling trips. Number of intersections, sport and recreation POS, sport options and population density were positively associated with walking/cycling trips. Only one significant interaction was found; a positive association was found between intersection density and walking/cycling trips among children whose parents did not cycle with them while it was not associated among others.

CONCLUSIONS

Building supporting and safe neighbourhood environments is needed to support children's active travel behaviours to improve real and perceived safety concerns and provide relevant infrastructure and destinations, regardless of whether or not parents accompany children during walking and cycling. Although little evidence of moderation was found, future research should include co-participation in a broader range of walking behaviours.

Perceived barriers to children's active commuting to school: a systematic review of empirical, methodological and theoretical evidence

Active commuting to school (ACS) may increase children's daily physical activity and help them maintain a healthy weight. Previous studies have identified various perceived barriers related to children's ACS. However, it is not clear whether and how these studies were methodologically sound and theoretically grounded. The purpose of this review was to critically assess the current literature on perceived barriers to children's ACS and provide recommendations for future studies. Empirically based literature on perceived barriers to ACS was systematically searched from six databases. A methodological quality scale (MQS) and a theory utilization quality scale (TQS) were created based on previously established instruments and tailored for the current review. Among the 39 studies that met the inclusion criteria, 19 (48.7%) reported statistically significant perceived barriers to child's ACS. The methodological and theory utilization qualities of reviewed studies varied, with MQS scores ranging between 7 and 20 (Mean =12.95, SD =2.95) and TQS scores from 1 to 7 (Mean =3.62, SD =1.74). A detailed appraisal of the literature suggests several empirical, methodological, and theoretical recommendations for future studies on perceived barriers to ACS. Empirically, increasing the diversity of study regions and samples should be a high priority, particularly in Asian and European countries, and among rural residents; more prospective and interventions studies are needed to determine the causal mechanism liking the perceived factors and ACS; future researchers should include policy-related barriers into their inquiries. Methodologically, the conceptualization of ACS should be standardized or at least well rationalized in future studies to ensure the comparability of results; researchers' awareness need to be increased for improving the methodological rigor of studies, especially in regard to appropriate statistical analysis techniques, control variable estimation, multicollinearity testing, and reliability and validity reporting. Theoretically, future researchers need to first ground their investigations in theoretical foundations; efforts should be devoted to make sure theories are used thoroughly and correctly; important theoretical constructs, in particular, need to be conceptualized and operationalized appropriately to ensure accurate measurement. By reviewing what has been achieved, this review offered insights for more sophisticated ACS studies in the future.

Crime and perceptions of safety in the home neighborhood are independently associated with physical activity among 11-15 year olds

OBJECTIVE

To determine whether perceptions of neighborhood safety and measures of neighborhood crime are independently associated within physical activity in youth.

METHODS

The study sample consisted of 14,125 youths in grades 6-10 (ages 11-15) who participated in the nationally representative cross-sectional 2009/10 Canadian Health Behaviour in School-Aged Children Survey. Participants responded to four questions about how safe their home neighborhood is and reported whether or not they accumulated at least 4h/week of physical activity in their free-time outside of school hours. Crimes against persons was assessed in 1 km radius buffers around participants' homes. Associations were assessed using logistic regression.

RESULTS

After controlling for crime and relevant confounders, the relative odds of being physically active outside of school was 0.52 (95% CI: 0.44-0.62) in youth whose perceptions of neighborhood safety were in the lowest quintile. After controlling for perceptions of safety and relevant confounders, the relative odds of being physically active outside of school was 0.75 (0.60-0.95) in youth from neighborhoods with crimes against persons scores in the highest quintile.

CONCLUSIONS

Within this large sample of 11-15 year olds, perceptions and objective measures of neighborhood safety and crime were independently associated with physical activity in free-time outside of school.

How might we increase physical activity through dog walking?: A comprehensive review of dog walking correlates

BACKGROUND

Physical inactivity and sedentary behaviour are major threats to population health. A considerable proportion of people own dogs, and there is good evidence that dog ownership is associated with higher levels of physical activity. However not all owners walk their dogs regularly. This paper comprehensively reviews the evidence for correlates of dog walking so that effective interventions may be designed to increase the physical activity of dog owners.

METHODS

Published findings from 1990-2012 in both the human and veterinary literature were collated and reviewed for evidence of factors associated with objective and self-reported measures of dog walking behaviour, or reported perceptions about dog walking. Study designs included cross-sectional observational, trials and qualitative interviews.

RESULTS

There is good evidence that the strength of the dog-owner relationship, through a sense of obligation to walk the dog, and the perceived support and motivation a dog provides for walking, is strongly associated with increased walking. The perceived exercise requirements of the dog may also be a modifiable point for intervention. In addition, access to suitable walking areas with dog supportive features that fulfil dog needs such as off-leash exercise, and that also encourage human social interaction, may be incentivising.

CONCLUSION

Current evidence suggests that dog walking may be most effectively encouraged through targeting the dog-owner relationship and by providing dog-supportive physical environments. More research is required to investigate the influence of individual owner and dog factors on 'intention' to walk the dog as well as the influence of human social interaction whilst walking a dog. The effects of policy and cultural practices relating to dog ownership and walking should also be investigated. Future studies must be of a higher quality methodological design, including accounting for the effects of confounding between variables, and longitudinal designs and testing of interventions in a controlled design in order to infer causality.

Patterns and correlates of physical activity among middle-aged employees: a population-based, cross-sectional study

OBJECTIVES

The purpose of this study was to determine the level, pattern and correlates (socio-demographic, lifestyle and work-related) of physical activity among middle-aged employees in Croatia.

MATERIAL AND METHODS

In this cross-sectional study the data were collected using a household interview on a random sample of 766 middle-aged employees (52% female) living in Croatia. The International Physical Activity Questionnaire (IPAQ-long) was used to assess physical activity. An additional questionnaire was used to collect data on socio-demographic, lifestyle and work-related correlates.

RESULTS

The median (95% CI) total physical activity for the whole sample was 78.7 (69.1-88.3) MET-hours/week. Most physical activity was accumulated in the domain of work (26.4 (20.3-32.5) MET-hours/week) or in domestic activities (19.2(17.8-20.7) MET-hours/week), whilst a significantly lower physical activity was found in the transport (3.3 (2.9-3.7) MET-hours/week) and leisure-time domains (6.5 (5.7-7.3) MET-hours/week). The multiple regression analysis showed an inverse relationship between educational level and the size of settlements with the domestic-related and total physical activity (β range: -0.11 to -0.22; p < 0.01). Among lifestyle correlates, only alcohol consumption was positively related to the total physical activity (β = 0.12; p < 0.01), while the perceived level of stress outside work was the only one, which was inversely associated with the work-related (β = -0.09; p < 0.01) and leisure-time physical activity (β = -0.10; p < 0.01).

CONCLUSIONS

Middle-aged employees in Croatia accumulate most of their daily physical activity in the work and domestic domains. Analysis of the relationship between physical activity and potential socio-demographic, lifestyle, and work-related correlates indicated that physical activity promotional activities should be primarily focused on males, employees living in smaller settlements and those with higher educational levels. The correlates of physical activity among middle-aged employees seem to be domain-specific. Therefore, future studies in this area should consider assessing physical activity in each domain separately.

Understanding the relationship between dog ownership and children's physical activity and sedentary behaviour

BACKGROUND

Dog ownership is a catalyst for physical activity in adults. Given 50-70% of Australian households with children have a dog, dog-facilitated physical activity may be an effective way to increase physical activity and decrease child obesity.

OBJECTIVE

We hypothesized that children with a family dog walk more, are more physically active and are more likely to achieve recommended levels of weekly physical activity compared with children who do not have a dog.

METHOD

Cross-sectional data from the Western Australian TRravel, Environment, and Kids project (TREK) were analyzed for 1218 children aged 10-12 years. Individual and environment factors, child physical activity, walking, screen use, sedentary behaviour and dog ownership status was collected from child and parent questionnaires. Children's height and weight were measured.

RESULTS

Approximately 60% of children had a family dog. Dog ownership was associated with, on average, 29 more minutes of walking and 142 more minutes of physical activity per week (P ≤ 0.01). After adjustment, children with a dog were 49% more likely to achieve the recommended level of weekly physical activity (420 min) and 32% more likely to have walked in their neighbourhood in the last week, compared with non-dog owners (P ≤ 0.05). These relationships varied by gender. Dog ownership was not associated with screen use or weight status.

CONCLUSIONS

Dog ownership was associated with walking and physical activity, but not screen use or weight status. Within dog-owning families, the promotion of walking and active play with a dog may be a strategy to increase children's physical activity.

A cross-sectional study of frequency and factors associated with dog walking in 9-10 year old children in Liverpool, UK

Background

Owning a pet dog could potentially improve child health through encouraging participation in physical activity, through dog walking. However, evidence to support this is limited and conflicting. In particular, little is known about children’s participation in dog walking and factors that may be associated with this. The objective of this study was to describe the participation of children in dog walking, including their own and those belonging to somebody else, and investigate factors associated with regular walking with their own pet dog.

Methods

Primary school children (n=1021, 9–10 years) from a deprived area of Liverpool were surveyed during a ‘fitness fun day’ as part of the SportsLinx project. The ‘Child Lifestyle and Pets’ survey included questions about pet ownership, pet attachment, and dog walking. Multivariable logistic regression models were used to investigate factors associated with walking any dog, or their own dog, several times a day or more, including level of attachment to the dog, dog type, and sociodemographic factors.

Results

Overall, 15.4% of children reported walking with any dog (their own or belonging to a friend or family member) ≥ once daily, 14.1% several times a week, 27.6% ≤ once a week, and 42.8% never. Dog owning children (37.1% of the population) more often reported dog walking ‘several times a week or more’ (OR=12.30, 95% CI=8.10-18.69, P<0.001) compared to those without a dog, but were less likely to report other walking without a dog. The majority (59.3%) of dog owning children indicated that they usually walked their dog, with 34.6% reporting that they walked their dog ≥ once daily. Attachment score was highly associated with the child reporting walking their dog (lower score=higher attachment; OR=0.93, 95% CI=0.89-0.96, P<0.001). There was no evidence that gender, ethnicity, sibling status or deprivation score was associated with dog walking. Children that reported owning Pit Bulls were more likely to report friends walking with their dog than those owning non-Pit bull types (OR=10.01, 95% CI=1.52-65.76, P=0.02, respectively).

Conclusions

Promotion of supervised walking of suitable pet dogs may be an opportunity for increasing physical activity in 9–10 year old children. The identification of stronger attachment to dogs regularly walked is similar to findings in adult studies.

The associations of perceived neighborhood disorder and physical activity with obesity among African American adolescents

Background

According to recent research studies, the built and socioeconomic contexts of neighborhoods are associated with African American adolescents’ participation in physical activity and obesity status. However, few research efforts have been devoted to understand how African American adolescents’ perceptions of their neighborhood environments may affect physical activity behaviors and obesity status. The objective of the current study was to use a perceived neighborhood disorder conceptual framework to examine whether physical activity mediated the relationship between perceived neighborhood disorder and obesity status among African American adolescents.

Methods

The data were obtained from a cross-sectional study that examined social and cultural barriers and facilitators of physical activity among African American adolescents. The study included a sample of 101 African American adolescents age 12 to 16 years and their parents who were recruited from the Birmingham, Alabama metropolitan area. The primary outcome measure was obesity status which was classified using the International Obesity Task Force cut off points. Moderate-to-vigorous physical activity was assessed via accelerometry. Perceived neighborhood disorder was assessed using the Perceived Neighborhood Disorder Scale. Mediation models were used to examine whether the relationship between neighborhood disorder and obesity status was mediated by physical activity.

Results

Perceived neighborhood disorder was significantly and positively related to obesity status and moderate-to-vigorous physical activity was inversely associated with obesity status. However, there was no evidence to support a significant mediating effect of moderate-to-vigorous physical activity on the relationship between neighborhood disorder and obesity status.

Conclusion

Future studies should longitudinally assess perceived neighborhood disorder characteristics and childhood adiposity to examine the timing, extent, and the mechanisms by which perceived neighborhood disorder characteristics increase the risk of obesity.

Factors influencing whether children walk to school

Few studies have simultaneously evaluated multiple levels of influence on whether children walk to school. A large cohort of 4338 subjects from 10 communities was used to identify the determinants of walking through (1) a one-level logistic regression model for individual-level variables and (2) a two-level mixed regression model for individual and school-level variables. Walking rates were positively associated with home-to-school proximity, greater age, and living in neighborhoods characterized by lower traffic density. Greater land use mix around the home was, however, associated with lower rates of walking. Rates of walking to school were also higher amongst recipients of the Free and Reduced Price Meals Program and attendees of schools with higher percentage of English language learners. Designing schools in the same neighborhood as residential districts should be an essential urban planning strategy to reduce walking distance to school. Policy interventions are needed to encourage children from higher socioeconomic status families to participate in active travel to school and to develop walking infrastructures and other measures that protect disadvantaged children.

Understanding contextual barriers, supports, and opportunities for physical activity among Mexican-origin children in Texas border colonias: a descriptive study

BACKGROUND

The increasing numbers of colonias along the U.S.-Mexico border are characterized by disproportionately poor families of Mexican-origin, limited access to resources and health services, and heightened risk for obesity and diabetes. Despite consistent evidence supporting physical activity (PA) in prevention of chronic diseases, many individuals of Mexican-origin, including children, fail to meet PA recommendations. Environmental influences on PA, founded in ecological and social cognitive perspectives, have not been examined among children living in colonias. The purpose of this study was to identify and better understand (1) household and neighborhood environmental PA resources/supports, (2) perceived barriers to engaging in PA, and (3) PA offerings, locations, and transportation characteristics for Mexican-origin children living in colonias.

METHODS

Data for this study were collected by promotora-researchers (indigenous community health workers trained in research methods) using face-to-face interviews conducted in Spanish. The sample consists of 94 mother-child dyads from Texas border colonias in Hidalgo County. Interviews included questionnaire items addressing PA barriers, household and neighborhood environmental support assessments conducted with each dyad, and open-ended questions that were coded to identify availability and locations of PA opportunities and transportation options. Descriptive statistics were calculated and differences between genders, birth countries, and BMI categories of children were determined using chi-square tests.

RESULTS

All children were of Mexican-origin. The most frequently reported barriers were unleashed dogs in the street, heat, bad weather, traffic, no streetlights, and no place like a park to exercise. Prominent locations for current PA included schools, home, and parks. Common PA options for children were exercise equipment, running, playing, and sports. Environmental assessments identified exercise equipment (bicycles/tricycles, balls, etc.…), paved/good streets, yard/patio space, and social norms as the most frequent household or neighborhood resources within these colonias. Differences in PA barriers, options, and environmental resources for genders, birth countries, and BMI categories were detected.

CONCLUSIONS

This study suggests that PA environmental resources, barriers, and opportunities for colonias children are similar to previous studies and distinctively unique. As expected, built resources in these communities are limited and barriers exist; however, knowledge of PA opportunities and available PA resources within colonias households and neighborhoods offers insight to help guide future research, policy, and PA initiatives.

Understanding the drive to escort: a cross-sectional analysis examining parental attitudes towards children's school travel and independent mobility

BACKGROUND

The declining prevalence of Active School Transportation (AST) has been accompanied by a decrease in independent mobility internationally. The objective of this study was to compare family demographics and AST related perceptions of parents who let their children walk unescorted to/from school to those parents who escort (walk and drive) their children to/from school. By comparing these groups, insight was gained into how we may encourage greater AST and independent mobility in youth living in the Greater Toronto and Hamilton Area, Canada.

METHODS

This study involved a cross-sectional design, using data from a self-reported questionnaire (n =1,016) that examined parental perceptions and attitudes regarding AST. A multinomial logistic regression analysis was used to explore the differences between households where children travelled independently to school or were escorted.

RESULTS

Findings revealed that unescorted children were: significantly older, the families spoke predominantly English at home, more likely to live within one kilometer from school, and their parents agreed to a greater extent that they chose to reside in the current neighborhood in order for their child to walk to/from school. The parents of the escorted children worried significantly more about strangers and bullies approaching their child as well as the traffic volume around school.

CONCLUSIONS

From both a policy and research perspective, this study highlights the value of distinguishing between mode (i.e., walking or driving) and travel independence. For policy, our findings highlight the need for planning decisions about the siting of elementary schools to include considerations of the impact of catchment size on how children get to/from school. Given the importance of age, distance, and safety issues as significant correlates of independent mobility, research and practice should focus on the development and sustainability of non-infrastructure programs that alleviate parental safety concerns.

Urban environment and children's active lifestyle: softGIS revealing children's behavioral patterns and meaningful places

PURPOSE

To determine the relationship between (1) urban structure characteristics, (2) children's environmental experiences and active behavioral patterns, and (3) perceived health and body mass index (BMI).

DESIGN

Cross-sectional study.

SETTING

City of Turku, western coast of Finland, 175,000 inhabitants. Average residential density of the studied settings was 17 housing units per hectare, proportion of green structure 43%, and proportion of population under 15 years old 17%.

SUBJECTS

One thousand eight hundred thirty seven fifth (10-12 years old) and seventh (13-15 years old) graders from 54 schools in Turku.

MEASURES

Self-reported behavioral patterns (activity of school travel mode, territorial range, mobility licenses, and distance to meaningful places) and environmental experiences (localized meaningful places, likability index, environmental fears) were gathered on the basis of locality with an Internet-based softGIS method. Self-reported BMI, perceived health, and daily symptoms were also queried. Geographic information system-based measures of urban structure (residential density, proportion of green structure, proportion of children), calculated within a 500-m buffer of each respondent's home, were used as independent variables.

ANALYSIS

Mainly logistic regression analysis.

RESULTS

After controlling for gender, age, and neighborhood socioeconomic status (proportion of academically educated), residential density was significantly associated with active travel mode to school and short distances to the meaningful places of children. The proportions of green structure and children had an association with nonactive transport, long distance to meaningful places, and small territorial range. We also found significant associations between active school travel mode and reduced risk of being overweight when controlled for gender and age but not when the proportion of academically educated was also controlled. The negative association between likability index and daily symptoms and positive association with perceived health remained significant after controlling for all three background variables. The only urban structure variable directly associated with good perceived health was the proportion of green structure around the child's home.

CONCLUSION

Moderate urban density seems to have child-friendly characteristics such as an ability to promote active school journeys and to guarantee a short distance to meaningful places. The studied Finnish children expressed very few environmental fears, and the possibilities for them to independently use the opportunities of the urban environment were very high. The limitation of the study was that the socioeconomic background variables were extracted from register-based geographic grid data rather than from respondents. More refined measures of urban structure are also needed in future studies.

How does perceived risk mediate associations between perceived safety and parental restriction of adolescents' physical activity in their neighborhood?

Background

There is evidence that adolescence is a critical period of decline in physical activity. However, adolescents may have limited opportunities to be physically active outdoors if their parents are concerned about neighborhood safety and restrict their adolescent’s physical activity within their neighborhood. Pathways that lead to parental restriction of adolescents’ physical activity (constrained behavior) are under-researched. This study aimed to examine perceived risk as a potential mediator of associations between perceived safety/victimization and constrained behavior.

Methods

Cross-sectional study of adolescents (43% boys) aged 15–17 years (n = 270) in Melbourne, Australia. Parents reported perceived safety (road safety, incivilities and personal safety) and prior victimization in their neighborhood, perceived risk of their children being harmed and whether they constrained their adolescent’s physical activity. Constrained behavior was categorized as ‘avoidance’ or ‘defensive’ behavior depending on a whether physical activity was avoided or modified, respectively, due to perceived risk. MacKinnon’s product-of-coefficients test of mediation was used to assess potential mediating pathways between perceived safety/victimization and constrained behavior.

Results

For girls only, perceived risk was a significant mediator of associations between perceived road safety and avoidance/defensive behavior, and between perceived incivilities, perceived personal safety, victimization and defensive behavior.

Conclusions

Associations between perceived safety/victimization and constrained behavior are complex. Findings may guide the design of interventions that aim to improve actual and perceived levels of safety and reduce perceptions of risk. This is of particular importance for adolescent girls among whom low and declining levels of physical activity have been observed worldwide.

The neighborhood social environment and body mass index among youth: a mediation analysis

Background

This study aimed to examine associations between aspects of the neighborhood social environment and body mass index (BMI) in youth both cross-sectionally and prospectively; and whether this association was mediated by physical activity, screen-time and sedentary time.

Methods

Data were collected in 2004 and 2006 in high and low socio-economic areas of Melbourne, Australia. In 2004, 185 children aged 8-9 years (47% boys) and 359 children aged 13-15 years (45% boys) participated. Parents reported their perceptions of aspects of the social environment (i.e. social networks and social trust/cohesion), and physical activity (i.e. time spent outdoors by their children; and their younger children's walking and cycling trips) and screen-time (i.e. TV viewing, computer use). The older children self-reported their walking and cycling trips and their screen-time. All children wore an accelerometer to objectively assess outside-school hours moderate- to-vigorous physical activity and sedentary time. BMI was calculated from height and weight measured in 2004 and 2006. Multilevel linear regression analyses were conducted to examine associations between the social environment and BMI. Mediation analyses using the products of coefficient method were conducted to determine whether associations between the social environment and BMI were mediated by the time spent in a range of physical activity and sedentary behaviors.

Results

Cross-sectional and prospective regression analyses showed that a more positive social network and higher social trust/cohesion was related to lower BMI among children. There was no evidence that time spent in physical activity or sedentary behaviors mediated this relation, despite significant associations between social networks and screen-time and between screen-time and BMI.

Conclusions

The findings suggest that the neighborhood social environment may be important for preventing overweight and obesity in children. Further research investigating the mechanisms through which the neighborhood social environment exerts its effect on BMI is needed.

Look who's walking: social and environmental correlates of children's walking in London

A substantial literature examines the social and environmental correlates of walking to school but less addresses walking outside the school commute. Using travel diary data from London, we examined social and environmental correlates of walking: to school; outside the school commute during term time; and during the summer and weekends. Living in a household without a car was associated with all journey types; 'Asian' ethnicity was negatively associated with walking for non-school travel; environmental factors were associated with non-school journeys, but not the school commute. Interventions aiming to increase children's active travel need to take account of the range of journeys they make.

Health-related behavior as a mechanism behind the relationship between neighborhood social capital and individual health--a multilevel analysis

Background

Although various studies have found a positive association between neighborhood social capital and individual health, the mechanism explaining this direct effect is still unclear. Neighborhood social capital is the access to resources that are generated by relationships between people in a friendly, well-connected and tightly knit neighborhood community. We expect that the resources generated by cohesive neighborhoods support and influence health -improving behaviors in daily life. We identify five different health-related behaviors that are likely to be affected by neighborhood social capital and test these behaviors separately as mediators.

Methods

The data set pertaining to individual health was taken from the 'health interview' in the 'Second Dutch national survey of general practice' (DNSGP-2, 2002). We combine these individual-level data with data from the 'Dutch housing demand survey' (WBO, 1998 and WoON, 2002) and statistical register information (1995-1999). Per neighborhood 29 WBO respondents, on average, had answered questions regarding social capital in their neighborhood. These variables have been aggregated to the neighborhood level by an ecometric methodology. In the main analysis, in which we tested the mediation, multilevel (ordered) logistic regressions were used to analyze 9253 adults (from the DNSGP-2 data set) from 672 Dutch neighborhoods. In the Netherlands, on average, neighborhoods (4-digit postcodes) comprise 4,000 inhabitants at highly variable population densities. Individual- and neighborhood-level controls have been taken into account in the analyses.

Results

In neighborhoods with a high level of social capital, people are more physically active and more likely to be non-smokers. These behaviors have positive effects on their health. The direct effect of neighborhood social capital on health is significantly and strongly reduced by physical activity. This study does not support nutrition and sleep habits or moderate alcohol intake as possible explanations of the effects of neighborhoods on health.

Conclusions

This study is one of the first to test a mechanism explaining much of the direct effect of small-area social capital on individual health. Neighborhood interventions might be most successful at improving health if they stimulate both social interaction and physical activity.

Active commuting to school among adolescents in Ho Chi Minh City, Vietnam: change and predictors in a longitudinal study, 2004 to 2009

BACKGROUND

Active commuting (walking or cycling) to/from school is an important part of the overall physical activity levels of children but is on the decline in many countries. Data for adolescents on mode of transportation to and from school are limited for low- and middle-income countries, including Vietnam.

PURPOSE

This paper aims to describe the changes in the prevalence of active commuting to and from school, and to examine prospectively the predictors of active commuting, among adolescents from Ho Chi Minh City (HCMC).

METHODS

The data are from a 5-year cohort study from 2004 of a representative sample of 759 adolescents from 18 schools in HCMC. Data were obtained at five annual assessments using validated questionnaires to capture commuting behaviors, socioeconomic and demographic factors, individual and family characteristics, and physical and social environmental factors. Height and weight were measured by trained staff using standardized guidelines. Generalized linear latent and mixed models with a hierarchic approach were used to analyze the data in 2011.

RESULTS

The results show a remarkable decrease in the prevalence of active commuting in adolescents from 27.8% in 2004 to 19.6% in 2009. Male students, from the least-wealthy families, living in suburban areas, close to school, studying at schools in less-wealthy districts, were more likely to actively commute.

CONCLUSIONS

In the context of an epidemic of childhood and adolescent obesity in urban Vietnam, the decline in active commuting over the 5 years of this study highlights the need for development of urban physical environments favorable for active commuting and education campaigns to promote active commuting in adolescents.

Increasing Children’s Physical Activity

Background. Efforts to increase the prevalence of children’s active school transport require evidence to inform the development of comprehensive interventions. This study used a multilevel ecological framework to investigate individual, social, and environmental factors associated with walking to and from school among elementary school-aged children, stratified by gender. Method. Boys aged 10 to 13 years ( n = 617) and girls aged 9 to 13 years ( n = 681) attending 25 Australian primary schools located in high or low walkable neighborhoods completed a 1-week travel diary and a parent/child questionnaire on travel habits and attitudes. Results. Boys were more likely (odds ratio [OR] = 3.37; p < .05) to walk if their school neighborhood had high connectivity and low traffic and less likely to walk if they had to cross a busy road (OR = 0.49; p < .05). For girls, confidence in their ability to walk to or from school without an adult (OR = 2.03), school encouragement (OR = 2.43), scheduling commitments (OR = 0.41), and parent-perceived convenience of driving (OR = 0.24) were significantly associated ( p < .05) with walking. Irrespective of gender and proximity to school, child-perceived convenience of walking (boys OR = 2.17 and girls OR = 1.84) and preference to walk to school (child perceived, boys OR = 5.57, girls OR = 1.84 and parent perceived, boys OR = 2.82, girls OR = 1.90) were consistently associated ( p < .05) with walking to and from school. Conclusion. Although there are gender differences in factors influencing children walking to and from school, proximity to school, the safety of the route, and family time constraints are consistent correlates. These need to be addressed if more children are to be encouraged to walk to and from school.

Food choices in recreation facilities: operators' and patrons' perspectives

PURPOSE

Recreation facilities (RFs) provide physical activity environments; however, unhealthy food choices are abundant there. This needs assessment was conducted to determine patrons' satisfaction with food and purchasing preferences while at RFs, reasons for purchasing certain foods, and inclination for other options. Also assessed were RF operators' receptiveness to and perspectives on the feasibility of providing healthy foods.

METHODS

A previously developed and piloted paper-and-pencil survey was administered to a cross-section of 269 adult patrons of local RFs. Seven operators participated in a previously developed researcher-administered survey.

RESULTS

Among patrons, 52.2% were satisfied with RF food choices, although 59.2% and 68.8% reported not purchasing any RF food or beverages from the snack bar or vending machines, respectively. Patrons who were dissatisfied and did not purchase food and beverages noted the abundance of unhealthy choices, poor food quality and variety, and expense as reasons. All operators were interested in and receptive to healthy food options at their RFs, but expressed concerns about poor sales of existing healthier options. All operators indicated the importance of knowing what patrons would purchase.

CONCLUSIONS

The RF operators and most patrons were interested in and receptive to healthier food options at RFs. Developing, implementing, and evaluating a pilot RF healthy-food intervention are next steps.

Neighborhood environment and physical activity among youth a review

CONTEXT

Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people.

EVIDENCE ACQUISITION

A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years.

EVIDENCE SYNTHESIS

Papers were categorized by design features, sample characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated.

CONCLUSIONS

Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access/proximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan.

Park-based physical activity among children and adolescents

BACKGROUND

Availability of parks is associated with higher levels of physical activity among children and adolescents. Few studies examine actual park use and park-based physical activity in these populations.

PURPOSE

This study examined associations among individual, park, and neighborhood environmental characteristics and children's and adolescent's park-based physical activity.

METHODS

Data were collected in 2007 on 2712 children in 20 randomly selected parks in Durham NC. The System for Observing Play and Recreation in Communities (SOPARC) provided measures of physical activity. Hierarchic regression analysis assessed associations among individual, park, and neighborhood environmental characteristics and children's park-based physical activity. Data were analyzed in 2010.

RESULTS

Of the 2712 children observed, 34.2% and 13.2% were engaged in walking or vigorous physical activity. Environmental features of parks were associated with activity levels whereas neighborhood characteristics were not. Physical activity was negatively associated with gender (girls) (p=0.003); presence of a parent (p<0.0001); presence of nonparental adult (p=0.006); and an interaction involving the 0-5 years age group and style of play (p=0.017). Higher level of physical activity was associated with presence of other active children (p<0.0001); courts (e.g., basketball); and an interaction between number of recreation facilities and formal activities (p=0.004).

CONCLUSIONS

These social factors and design features should be considered in order to stimulate higher levels of park-based physical activity among children and adolescents.

Correlates of park-based physical activity among children in diverse communities: results from an observational study in two cities

PURPOSE

This study examined correlates of park-based physical activity (PA) among children in neighborhood parks.

DESIGN

Direct observation was used to assess PA among children.

SETTING

Public parks in Tampa, Florida (n=10), and Chicago, Illinois (n=18), from low income and high income and racially/ethnically diverse communities. Subjects. Children (n=3410), coded as anyone who appeared to be 10 years or younger, observed at parks in Tampa and Chicago.

MEASURES

Physical activity was measured by a modified version of the System for Observing Play and Leisure Among Youth (SOPLAY).

ANALYSIS

Descriptive statistics and multilevel regression models were used in data analysis.

RESULTS

At the activity observation level, children's PA was positively related to temperature and unstructured activities in Tampa and Chicago parks. Among park activity area predictors, type of activity area was significantly related to PA. In Tampa, more PA was observed on courts, and less PA was observed in shelter areas compared with open space areas. In Chicago, less PA was observed on courts and fields compared with open space areas. Neighborhood income was associated with lower PA in Tampa parks. Neighborhood race/ethnicity was not a significant predictor of children's PA in either city.

CONCLUSIONS

Children's PA was linked to modifiable social and environmental features within parks. Strategies to increase PA among children in parks should promote courts, playgrounds, informal activities, and free play.

Longitudinal changes in active transportation to school in Canadian youth aged 6 through 16 years

BACKGROUND

Concern has been raised regarding the increased prevalence of physical inactivity among children. Active transportation, such as walking and cycling to school, is an opportunity for children to be physically active.

OBJECTIVE

To identify the sociodemographic predictors of active transportation to schools across time among school-aged children participating in the Canadian National Longitudinal Survey of Children and Youth (NLSCY).

METHODS

The sample included 7690 school-aged children attending public schools who were drawn from cycle 2 (1996 and 1997) of the Canadian NLSCY. Data were collected through interviews with the person most knowledgeable about the child. Parents were asked how their child usually gets to school. Responses were dichotomized into active (walking or bicycling) or inactive (school bus, public transit, is driven, or multiple) modes. Using 3 waves of data from the Canadian NLSCY (1996-2001), we estimated the effect of sociodemographic factors on the likelihood of active transportation to school across time using random-effects models.

RESULTS

Longitudinal analyses indicated that as children aged, the likelihood of using active transportation to school increased, peaked at the age of 10 years, and then decreased. Urban settings (odds ratio [OR]: 3.66 [95% confidence interval (CI): 3.23-4.15]), households with inadequate income (OR: 1.21 [95% CI: 1.06-1.38]), living with 1 parent (OR: 1.46 [95% CI: 1.29-1.65]), and having an older sibling living at home (OR: 1.14 [95% CI: 1.04-1.25]) were significant predictors of active transportation to school at baseline and carried through across time.

CONCLUSIONS

Understanding the factors that influence active transportation may support its adoption by children, which in turn may contribute to meeting physical activity guidelines.

Neighborhood incivilities, perceived neighborhood safety, and walking to school among urban-dwelling children

BACKGROUND

Walking to school is an important source of physical activity among children. There is a paucity of research exploring environmental determinants of walking to school among children in urban areas.

METHODS

A cross-sectional secondary analysis of baseline data (2007) from 365 children in the "Multiple Opportunities to Reach Excellence" (MORE) Study (8 to 13 years; Mean 9.60 years, SD 1.04). Children and caregivers were asked about walking to school and perceived safety. Objective measures of the environment were obtained using a validated environmental neighborhood assessment.

RESULTS

Over half (55.83%) of children reported walking to school most of the time. High levels of neighborhood incivilities were associated with lower levels of perceived safety (OR: 0.39, 95% CI: 0.21 to 0.72). Living on a block above the median in incivilities was associated with a 353% increase in odds of walking to school (OR: 3.53; 95% CI: 1.68 to 7.39).

CONCLUSIONS

Children residing in neighborhoods high in incivilities are more likely to walk to school, in spite of lower levels of perceived safety. As a high proportion of children residing in disadvantaged neighborhoods walk to school, efforts should be directed at minimizing exposure to neighborhood hazards by ensuring safe routes to and from school.

Reliability and validity of psychosocial and environmental correlates measures of physical activity and screen-based behaviors among Chinese children in Hong Kong

Background

Insufficient participation in physical activity and excessive screen time have been observed among Chinese children. The role of social and environmental factors in shaping physical activity and sedentary behaviors among Chinese children is under-investigated. The purpose of the present study was to assess the reliability and validity of a questionnaire to measure child- and parent-reported psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong.

Methods

A total of 303 schoolchildren aged 9-14 years and their parents volunteered to participate in this study and 160 of them completed the questionnaire twice within an interval of 10 days. Intraclass correlation coefficients (ICCs), kappa statistics, and percent agreement were performed to evaluate test-retest reliability of the continuous and categorical variables, respectively. Exploratory factor analyses (EFAs) were conducted to assess convergent validity of the emergent scales. Cronbach's alpha and ICCs were performed to assess internal and test-retest reliability of the emergent scales. Criterion validity was assessed by correlating psychosocial and environmental measures with self-reported physical activity and screen-based behaviors, measured by a validated questionnaire.

Results

Reliability statistics for both child- and parent-reported continuous variables showed acceptable consistency for all of the ICC values greater than 0.70. Kappa statistics showed fair to perfect test-retest reliability for the categorical items. Adequate internal consistency and test-retest reliability were observed in most of the emergent scales. Criterion validity assessed by correlating psychosocial and environmental measures with child-reported physical activity found associations with physical activity in the self-efficacy scale (r = 0.25, P < 0.05), the peer support for physical activity scale (r = 0.25, P < 0.05) and home physical activity environmental (r = 0.14, P < 0.05). Children's screen-based behaviors were associated with the family support for physical activity scale (r = -0.22, P < 0.05) and parental role modeling of TV (r = 0.12, P = 0.053).

Conclusions

The findings provide psychometric support for using this questionnaire for examining psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong. Further research is needed to develop more robust measures based on the current questionnaire, especially for peer influence on physical activity and parental rules on screen-based behaviors.

Youth physical activity resource use and activity measured by accelerometry

OBJECTIVES

To examine whether use of physical activity resources (eg, parks) was associated with daily physical activity measured by accelerometry.

METHODS

One hundred eleven adolescents completed a travel diary with concurrent accelerometry. The main exposure was self-reported use of a physical activity resource (none /1+ resources). The main outcomes were total minutes spent in daily (1) moderate-vigorous physical activity and (2) vigorous physical activity.

RESULTS

Using a physical activity resource was significantly associated with total minutes in moderate-vigorous physical activity. African Americans and males had significantly greater moderate-vigorous physical activity.

CONCLUSIONS

Results from this study support the development and use of physical activity resources.

Built environmental correlates of walking and cycling in Dutch urban children: results from the SPACE study

This study examined built environmental correlates of children’s walking and cycling behavior. Four hundred and forty-eight children from 10 Dutch neighborhoods completed a seven-day physical activity diary in which the number of walking and cycling trips for transportation, to school, and for recreation were assessed. The associations between observed built environmental characteristics and children’s walking and cycling behavior were examined with multivariate linear regression analyses. The results showed that built environmental correlates of children’s walking and cycling behavior differ by purpose and by commuting mode implying a behavior-specific approach for interventions and for future, preferably prospective, studies.

Neighborhood and physical activities of Portuguese adolescents

Background

This study examines associations between perceptions of neighbourhood environment and physical activity and sports within Portuguese adolescents.

Methods

The sample consisted of 4,877 individuals of both genders, with an average age of 14 years. The instrument used was the Health Behavior School-aged Children questionnaire.

Results

Perceptions of the neighbourhood being unsafe for children to play and having no place to spend leisure time were associated with lower levels of exercise among adolescents. The perceptions of the neighbourhood being unsafe for children to play (OR = 1.3, p < .005) and the fact of not having a place to spend leisure time (OR = 1.3, p < .005) p < .005) were associated with lower levels of exercise among adolescents. The perception of these variables is associated to a lower probability of exercising. The neighbourhood characteristics are more important to the practice of outdoor sports than of indoor sports.

Conclusion

The perceptions of the neighbourhood may influence adolescent's physical activity and sports, in different ways.

Encouraging walking for transport and physical activity in children and adolescents: how important is the built environment?

In the post-World War II era, there have been dramatic changes to the environment that appear to be having a detrimental impact on the lifestyles and incidental physical activities of young people. These changes are not trivial and have the potential to influence not only physical health, but also mental health and child development. However, the evidence of the impact of the built environment on physical activity to date is inconsistent. This review examines the evidence on the association between the built environment and walking for transport as well as physical activity generally, with a focus on methodological issues that may explain inconsistencies in the literature to date. It appears that many studies fail to measure behaviour-specific environmental correlates, and insufficient attention is being given to differences according to the age of study participants. Higher levels of out-of-school-hours physical activity and walking appear to be significantly associated with higher levels of urban density and neighbourhoods with mixed-use planning, especially for older children and adolescents. Proximate recreational facilities also appear to predict young people's level of physical activity. However, there are inconsistencies in the literature involving studies with younger children. Independent mobility increases with age. For younger children, the impact of the built environment is influenced by the decision-making of parents as the gatekeepers of their behaviour. Cross-cultural differences may also be present and are worthy of greater exploration. As children develop and are given more independent mobility, it appears that the way neighbourhoods are designed - particularly in terms of proximity and connectivity to local destinations, including schools and shopping centres, and the presence of footpaths - becomes a determinant of whether children are able, and are permitted by their parents, to walk and use destinations locally. If older children and adolescents are to enjoy health and developmental benefits of independent mobility, a key priority must be in reducing exposure to traffic and in increasing surveillance on streets (i.e. 'eyes-on-the-street') through neighbourhood and building design, by encouraging others to walk locally, and by discouraging motor vehicle use in favour of walking and cycling. Parents need to be assured that the rights and safety of pedestrians (and cyclists) - particularly child pedestrians and cyclists - are paramount if we are to turn around our 'child-free streets', now so prevalent in contemporary Australian and US cities. There remains a need for more age- and sex-specific research using behaviour- and context-specific measures, with a view to building a more consistent evidence base to inform future environmental interventions.

Individual, social and physical environmental correlates of children's active free-play: a cross-sectional study

BACKGROUND

Children's unstructured outdoor free-play (or active free-play) has the potential to make an important contribution to children's overall physical activity levels. Limited research has, however, examined physical activity in this domain. This study examined associations between individual, social and physical environmental factors and the frequency with which children play in particular outdoor locations outside school hours. This study also investigated whether the frequency of playing in outdoor locations was associated with children's overall physical activity levels.

METHODS

Participants including 8-9 year old children and their parents (n = 187) were recruited from a selection of primary schools of varying socioeconomic status across metropolitan Melbourne, Australia. Parents completed a survey and children's overall physical activity levels were measured by accelerometry. Regression models examined the odds of children playing in various outdoor settings according to particular correlates.

RESULTS

Inverse associations were found between preference for activities not involving physical activity, and the likelihood of children playing in the yard at home on the weekend (OR = 0.65; CI = 0.45,0.95). Positive correlates of children playing in their own street included: parental perceptions that it was safe for their child to play in their street (weekdays [OR = 6.46; CI = 2.84,14.71], weekend days [OR = 6.01; CI = 2.68,13.47]); children having many friends in their neighbourhood (OR = 2.63; CI = 1.21,5.76); and living in a cul-de-sac (weekdays [OR = 3.99; CI = 1.65,9.66], weekend days [OR = 3.49; CI = 1.49,8.16]). Positive correlates of more frequent play in the park/playground on weekdays included family going to the park together on a weekly basis on weekdays (OR = 6.8; CI = 3.4,13.6); and on weekend days (OR = 7.36; CI = 3.6,15.0). No differences in mean mins/day of moderate-vigorous physical activity were found between children in the highest and lowest tertiles for frequency of playing in particular outdoor locations.

CONCLUSION

The presence of friends, safety issues and aspects of the built environment were reported by parents to be associated with children's active free-play in outdoor locations. Future research needs to further examine associations with time spent in active free-play and objectively-measured overall physical activity levels. It is also important to investigate strategies for developing a supportive social and physical environment that provides opportunities for children to engage in active free-play.

Perceived social and physical environmental correlates of physical activity in older adolescents and the moderating effect of self-efficacy

OBJECTIVE

To determine if perceptions of the social and physical environment are associated with active transport and leisure-time sports among Belgian youth and to investigate if this relationship is moderated by self-efficacy.

METHODS

In February-May 2008, 1445 adolescents (17.4+/-0.6 yrs) were recruited in 20 randomly selected Belgian schools. Physical activity, psychosocial, and environmental factors were assessed using validated questionnaires. Moderated multilevel regression analysis was used to examine the association between physical activity and possible correlates.

RESULTS

Social environmental variables (modeling and social support) were positively associated with active transportation and leisure-time sports (p<0.05). Higher land use mix diversity, higher street connectivity, more attractive environments, better access to recreational facilities, and higher emotional satisfaction with the neighborhood were associated with more active transportation (p<0.05). Higher perceived safety from traffic, better access to recreational facilities, more physical activity equipment at home, and fewer electronic devices in the bedroom were associated with more leisure-time sports (p<0.05). Lower perceived safety and poorer access to (recreational) facilities were only associated with lower active transport among youth with lower self-efficacy (p<0.05).

CONCLUSION

Creating more supportive environments could have the potential to affect the physical activity levels of Belgian adolescents with both high and low self-efficacy.

Attitudes, social support and environmental perceptions as predictors of active commuting behaviour in school children

BACKGROUND

Environmental perceptions appear to play a role in determining behaviour in children, although their influence on active commuting remains unclear. This study examines whether attitudes, social support and environmental perceptions are associated with active commuting behaviour in school children and whether these associations are moderated by the distance to school.

METHODS

Data were collected as part of the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people), a cross-sectional study of 2064 children from schools in Norfolk, UK. Data regarding the usual mode of travel to school, attitudes towards and social support for active commuting, perceptions of the neighbourhood and route to school were assessed using questionnaires completed by 2012 children and their parents. Distance to school was estimated using a Geographic Information System and this was used to compare associations between personal and environmental factors and active travel, across different distance categories.

RESULTS

Forty per cent of children reported usually walking to school, with 9% cycling and the remainder using motorised travel. Parental attitudes and safety concerns, the presence of social support from parents and friends and parent-reported neighbourhood walkability were all found to be predictors of active commuting, with children receiving peer and family support and living in supportive environments being more likely to walk or cycle. There was some evidence of a moderating effect of distance whereby attitudes were more important for short distances and safety concerns long.

CONCLUSION

Both attitudinal and environmental perceptions are associated with children's active commuting behaviours. Given the difficulty in modifying attitudes directly, the effect on them of interventions to provide more supportive environments should be evaluated.

The impact of transportation infrastructure on bicycling injuries and crashes: a review of the literature

BACKGROUND

Bicycling has the potential to improve fitness, diminish obesity, and reduce noise, air pollution, and greenhouse gases associated with travel. However, bicyclists incur a higher risk of injuries requiring hospitalization than motor vehicle occupants. Therefore, understanding ways of making bicycling safer and increasing rates of bicycling are important to improving population health. There is a growing body of research examining transportation infrastructure and the risk of injury to bicyclists.

METHODS

We reviewed studies of the impact of transportation infrastructure on bicyclist safety. The results were tabulated within two categories of infrastructure, namely that at intersections (e.g. roundabouts, traffic lights) or between intersections on "straightaways" (e.g. bike lanes or paths). To assess safety, studies examining the following outcomes were included: injuries; injury severity; and crashes (collisions and/or falls).

RESULTS

The literature to date on transportation infrastructure and cyclist safety is limited by the incomplete range of facilities studied and difficulties in controlling for exposure to risk. However, evidence from the 23 papers reviewed (eight that examined intersections and 15 that examined straightaways) suggests that infrastructure influences injury and crash risk. Intersection studies focused mainly on roundabouts. They found that multi-lane roundabouts can significantly increase risk to bicyclists unless a separated cycle track is included in the design. Studies of straightaways grouped facilities into few categories, such that facilities with potentially different risks may have been classified within a single category. Results to date suggest that sidewalks and multi-use trails pose the highest risk, major roads are more hazardous than minor roads, and the presence of bicycle facilities (e.g. on-road bike routes, on-road marked bike lanes, and off-road bike paths) was associated with the lowest risk.

CONCLUSION

Evidence is beginning to accumulate that purpose-built bicycle-specific facilities reduce crashes and injuries among cyclists, providing the basis for initial transportation engineering guidelines for cyclist safety. Street lighting, paved surfaces, and low-angled grades are additional factors that appear to improve cyclist safety. Future research examining a greater variety of infrastructure would allow development of more detailed guidelines.

Adolescent place attachment, social capital, and perceived safety: a comparison of 13 countries

In adolescence, children become increasingly independent and autonomous, and spend more time in neighborhood settings away from home. During mid-to-late adolescence, youth often become more critical about the place they live. Their attachment to home and even community may decrease as they explore and develop new attachments to other specific places. The aim of this study is to understand how 15-year-old students from 13 countries perceive their local neighborhood area (place attachment, social capital and safety), and how these different community cognitions are interrelated. We hypothesize that their place attachment predicts safety, and that the relationship is mediated in part by social capital. Result show that, despite cross-cultural differences in neighborhood perceptions, the proposed theoretical model fits robustly across all 13 countries.

Association between neighborhood safety and overweight status among urban adolescents

Background

Neighborhood safety may be an important social environmental determinant of overweight. We examined the relationship between perceived neighborhood safety and overweight status, and assessed the validity of reported neighborhood safety among a representative community sample of urban adolescents (who were racially and ethnically diverse).

Methods

Data come from the 2006 Boston Youth Survey, a cross-sectional study in which public high school students in Boston, MA completed a pencil-and-paper survey. The study used a two-stage, stratified sampling design whereby schools and then 9^th–12^th grade classrooms within schools were selected (the analytic sample included 1,140 students). Students reported their perceptions of neighborhood safety and several associated dimensions. With self-reported height and weight data, we computed body mass index (BMI, kg/m²) for the adolescents based on CDC growth charts. Chi-square statistics and corresponding p-values were computed to compare perceived neighborhood safety by the several associated dimensions. Prevalence ratios (PRs) and 95% confidence intervals (CI) were calculated to examine the association between perceived neighborhood safety and the prevalence of overweight status controlling for relevant covariates and school site.

Results

More than one-third (35.6%) of students said they always felt safe in their neighborhood, 43.9% said they sometimes felt safe, 11.6% rarely felt safe, and 8.9% never felt safe. Those students who reported that they rarely or never feel safe in their neighborhoods were more likely than those who said they always or sometimes feel safe to believe that gang violence was a serious problem in their neighborhood or school (68.0% vs. 44.1%, p < 0.001), and to have seen someone in their neighborhood assaulted with a weapon (other than a firearm) in the past 12 months (17.8% vs. 11.3%, p = 0.025). In the fully adjusted model (including grade and school) stratified by race/ethnicity, we found a statistically significant association between feeling unsafe in one's own neighborhood and overweight status among those in the Other race/ethnicity group [(PR = 1.56, (95% CI: 1.02, 2.40)].

Conclusion

Data suggest that perception of neighborhood safety may be associated with overweight status among urban adolescents in certain racial/ethnic groups. Policies and programs to address neighborhood safety may also be preventive for adolescent overweight.

Where are youth active? Roles of proximity, active transport, and built environment

PURPOSE

This study examined factors related to two sources of physical activity for youth: active use of recreation sites and active transport to recreation sites.

METHODS

Parents of children (n = 87) and matched pairs of parents and adolescents (n = 124 pairs) in three US cities reported on youths' active use of, proximity to, and walking/biking to 12 recreation sites and on neighborhood walkability and safety. Multivariate regression models evaluated factors associated with youths' frequent site use and active transport to sites.

RESULTS

Proximity to the site was associated with frequent use of large parks and public open space. Walking/biking to the site was associated with frequent use of most sites (indoor recreation sites, small and large parks, basketball courts, walking/running tracks, school recreation sites, playgrounds, and public open space). After controlling for proximity and demographic factors, active transport to sites remained significantly associated (P < 0.05) with frequent use of four sites for children (indoor recreation, walking/running tracks, school recreation facilities, and public open space) and all but three sites for adolescents (indoor recreation, playfields/courts, and beach/lake/rivers). Adolescents' active transport to more sites was most positively related to higher perceived traffic safety and to better pedestrian infrastructure and was negatively related to crime threat. Adolescents with driver's licenses walked/biked to recreation sites less often.

CONCLUSIONS

Active transport was strongly associated with the use of multiple recreation sites by children and adolescents, even when accounting for proximity and demographic factors. Adolescents living in neighborhoods with better traffic safety walked/biked to more recreation sites for physical activity. Findings support the need for built environments and transportation policies that facilitate safe, active transport to recreation sites for youth physical activity.

Walking and cycling to school: predictors of increases among children and adolescents

BACKGROUND

Little is known about what happens to active commuting as children get older, and less is known about influences on changes in this behavior. This study examined predictors of increases in children's and adolescents' active commuting (walking or cycling) to/from school over a 2-year period.

METHODS

Participants were initially recruited and assessed in 2001. Follow-up data were collected in 2004 and 2006 and analyzed in 2008. Participants were 121 children (aged 9.1+/-0.34 years in 2004) and 188 adolescents (aged 14.5+/-0.65 years in 2004) from Melbourne, Australia. Parents and adolescents reported their perceptions of individual-level factors and of the neighborhood social and physical environment. Weekly active commuting (walking or cycling) to/from school, ranging from 0 to 10 trips/week was also proxy- or self-reported at the initial measurement and again 2 years later. Logistic regression analyses examined predictors of increases in active commuting over time.

RESULTS

Children whose parents knew many people in their neighborhood were more likely to increase their active commuting (OR=2.6; CI=1.2, 5.9; p=0.02) compared with other children. Adolescents whose parents perceived there to be insufficient traffic lights and pedestrian crossings in their neighborhood were less likely to increase their active commuting over 2 years (OR=0.4; CI=0.2, 0.8; p=0.01), whereas adolescents of parents who were satisfied with the number of pedestrian crossings were more likely to increase their active commuting (OR=2.4; CI=1.1, 5.4; p=0.03) compared with other adolescents.

CONCLUSIONS

Social factors and physical environmental characteristics were the most important predictors of active commuting in children and adolescents, respectively.

Environmental correlates of children's active transportation: a systematic literature review

This systematic review investigated the environmental (physical, economic, socio-cultural and political) correlates of active transportation (AT) among young people aged 5-18 years to better inform the promotion of active living. Greater distance, increasing household income and increasing car ownership are consistently associated with lower rates of AT among children. Having a non-white ethnic background has a convincing positive association with AT. Having recreation facilities and walk or bike paths present are possibly associated with higher rates of AT. Further research requires longitudinal and intervention studies, utilizing multi-level design methodologies and objective measures of environmental attributes.