Association between daily physical activity and neighborhood environments

Objectively measuring the association between the built environment and physical activity: a systematic review and reporting framework

Background

Objective measures of built environment and physical activity provide the opportunity to directly compare their relationship across different populations and spatial contexts. This systematic review synthesises the current body of knowledge and knowledge gaps around the impact of objectively measured built environment metrics on physical activity levels in adults (≥ 18 years). Additionally, this review aims to address the need for improved quality of methodological reporting to evaluate studies and improve inter-study comparability though the creation of a reporting framework.

Methods

A systematic search of the literature was conducted following the PRISMA guidelines. After abstract and full-text screening, 94 studies were included in the final review. Results were synthesised using an association matrix to show overall association between built environment and physical activity variables. Finally, the new PERFORM (’Physical and Environmental Reporting Framework for Objectively Recorded Measures’) checklist was created and applied to the included studies rating them on their reporting quality across four key areas: study design and characteristics, built environment exposures, physical activity metrics, and the association between built environment and physical activity.

Results

Studies came from 21 countries and ranged from two days to six years in duration. Accelerometers and using geographic information system (GIS) to define the spatial extent of exposure around a pre-defined geocoded location were the most popular tools to capture physical activity and built environment respectively. Ethnicity and socio-economic status of participants were generally poorly reported. Moderate-to-vigorous physical activity (MVPA) was the most common metric of physical activity used followed by walking. Commonly investigated elements of the built environment included walkability, access to parks and green space. Areas where there was a strong body of evidence for a positive or negative association between the built environment and physical activity were identified. The new PERFORM checklist was devised and poorly reported areas identified, included poor reporting of built environment data sources and poor justification of method choice.

Conclusions

This systematic review highlights key gaps in studies objectively measuring the built environment and physical activity both in terms of the breadth and quality of reporting. Broadening the variety measures of the built environment and physical activity across different demographic groups and spatial areas will grow the body and quality of evidence around built environment effect on activity behaviour. Whilst following the PERFORM reporting guidance will ensure the high quality, reproducibility, and comparability of future research.

GPS-based activity space exposure to greenness and walkability is associated with increased accelerometer-based physical activity

INTRODUCTION

Built and natural environments may provide opportunities for physical activity. However, studies are limited by primarily using residential addresses to define exposure and self-report to measure physical activity. We quantified associations between global positioning systems (GPS)-based activity space measures of environmental exposure and accelerometer-based physical activity.

METHODS

Using a nationwide sample of working female adults (N = 354), we obtained seven days of GPS and accelerometry data. We created Daily Path Area activity spaces using GPS data and linked these activity spaces to spatial datasets on walkability (EPA Smart Location Database at the Census block group level) and greenness (satellite vegetation at 250 m resolution). We utilized generalized additive models to examine nonlinear associations between activity space exposures and accelerometer-derived physical activity outcomes adjusted for demographic characteristics, socioeconomic factors, and self-rated health.

RESULTS

Higher activity space walkability was associated with higher levels of moderate-vigorous physical activity, and higher activity space greenness was associated with greater numbers of steps per week. No strong relationships were observed for sedentary behavior or light physical activity. Highest levels of moderate-vigorous physical activity were observed for participants with both high walkability and high greenness in their activity spaces.

CONCLUSION

This study contributes evidence that higher levels of physical activity occur in environments with more dense, diverse, and well-connected built environments, and with higher amounts of vegetation. These data suggest that urban planners, landscape architects, and policy makers should implement and evaluate environmental interventions to encourage higher levels of physical activity.

Correlation between Campus-Built Environment and Physical Fitness in College Students in Xi’an—A GIS Approach

Background: This research aimed to investigate the correlation between students’ physical fitness and campus-built environment, which could put forward some suggestions for the construction of a campus environment. Method: Four colleges in Xi’an were regarded as special “semi-closed” spaces. Combined with ArcGIS and SPSS, the correlation between the built environment of colleges and the students’ physical fitness test results in 2019 was analyzed (n = 1498). Results: regarding the men questioned in this research, there was a significant correlation between street connectivity and vital capacity, grip strength, 50 m running, 1000 m running, a significant correlation between land use mix and vital capacity, sit-and-reach, pull-up, grip strength, a significant correlation between green space per capita and vital capacity, grip strength, 50 m running, and a significant correlation between walk score and vital capacity, pull-up, grip strength, and 50 m running. Regarding the women questioned in this research, there was a significant correlation between street connectivity and vital capacity, grip strength, 50 m running, 800 m running, curl-up, a significant correlation between land use mix and vital capacity, sit-and-reach, curl-up, grip strength, 800 m running, a significant correlation between green space per capita and vital capacity, grip strength, curl-up, sit-and-reach, and a significant correlation between walk score and vital capacity, curl-up, grip strength, and 800 m running. Conclusion: the built environment on campus can indirectly affect the physical fitness of college students. Increasing the number of intersections and short connections of campus streets, ensuring that the green space of the campus meets the standards, and reasonably arranging the site selection of buildings are conducive to improving the physical fitness of students.

Exploring Perceived and Objective Measures of the Neighborhood Environment and Associations with Physical Activity among Adults: A Review and a Meta-Analytic Structural Equation Model

There is an urgent need to understand factors that promote physical activities (PA) because it is one of the modifiable risk factors for global mortality. None of the previous reviews considered both perceived and objective characteristics of the same environment. The first aim was to review the literature on studies investigating the relationship between PA behavior of adults and perceived and objective physical environment measures. The second aim was to verify the potential mediational role of the perceived measure in the relationship between the objective measure of the environment and PA using meta-analytic SEM. Only 15 studies reported a relationship between PA and both environmental measures. One of the most studied characteristics of the physical environment is the accessibility to recreational/PA facilities. Both objective and subjective measures of accessibility to PA facilities are associated with PA. Meta-SEM results suggest a significant effect of the objective accessibility to facilities on PA behavior (β = 0.15) and on the perceived measure (β = 0.10), but the indirect effect was not significant. No significant effect was found for the perceived measure on PA, suggesting that individuals' level of awareness about their environments may have played a role. This prompts a need to create awareness campaigns.

The association between spatial access to physical activity facilities within home and workplace neighborhoods and time spent on physical activities: evidence from Guangzhou, China

BACKGROUND

Urban residents from the developing world have increasingly adopted a sedentary lifestyle and spend less time on physical activities (PA). Previous studies on the association between PA facilities and individuals' PA levels are based on the assumption that individuals have opportunities to use PA facilities within neighborhoods all day long, ignoring the fact that their willingness and opportunities to use nearby facilities depend on how much discretionary time (any time when people have a choice what to do) they have. Further, scant attention has been paid to the influence of PA facilities within both residential and workplace neighborhoods in the dense urban context. To address the above research gaps, this study investigated the links between the spatial access to PA facilities within home/workplace neighborhoods and time spent on PA among working adults, focusing on whether results were different when different measures of accessibility were used and whether participants' discretionary time over a week affected their time spent on PA.

METHOD

This study used data from a questionnaire survey (n = 1002) in Guangzhou between June and July 2017 and point of interest (POI) data from online mapping resources. Outcome variables included the amount of time spent on physical activity/moderate and vigorous intensity physical activity (PA/MVPA) over the past week. Home/workplace neighborhoods were measured as different distance buffers (500 m circular buffers, 1000 m circular buffers, and 1080 m network buffers) around each respondent's home/workplace. Spatial access to PA facilities was measured using two indicators: the counts of PA facilities and proximity to PA facilities within home/workplace neighborhoods. The amount of discretionary time was calculated based on activity log data of working day/weekend day from the Guangzhou questionnaire survey, and regression models were used to examine relationships between the spatial access of PA facilities, the time spent on PA/MVPA, and the amount of discretionary time, adjusted for covariates. Associations were stratified by gender, age, education, and income.

RESULTS

Using different measures of accessibility (the counts of and proximity to PA facilities) generated different results. Specifically, participants spent more time on PA/MVPA when they lived in neighborhoods with more PA facilities and spent more time on MVPA when worked in closer proximity to PA facilities. A larger amount of discretionary time was associated with more time spent on PA/MVPA, but it did not strengthen the relationship between access to PA facilities and PA/MVPA time. In addition, relationships between access to PA facilities and PA levels varied by gender, age, education, and income.

CONCLUSION

This study contributes to the knowledge of PA-promoting environments by considering both the home and workplace contexts and by taking into account the temporal attributes of contextual influences. Policymakers and urban planners are advised to take into account the workplace context and the temporal variability of neighborhood influences when allocating public PA facilities and public spaces.

Built environment correlates of physical activity in low- and middle-income countries: A systematic review

Insufficient physical activity (PA) is the fourth major risk factor for many non-communicable diseases and premature mortality worldwide. Features of the built environment (BE) play a considerable role in determining population PA behaviors. The majority of evidence for PA-BE relationships comes from high-income countries and may not be generalizable to low- and middle-income countries (LMICs). We aim to systematically review the literature and assess the associations between perceived and/or objective BE characteristics and PA domains in LMICs. This review adopted a systematic search strategy for English language articles published between January 2000 and June 2019 from four electronic databases-Medline, Embase, Web of Science and PubMed-adhering to the PRISMA guidelines. Studies addressing the associations between self-reported and/or objective BE and PA were only included if they were conducted in LMICs, according to the World Bank classification list. Articles investigating PA-BE relationships across any age groups were included, and all study designs were eligible, except for qualitative studies and reviews. Thirty-three studies were included for evidence synthesis. Cross-sectional studies were the most prevailing study design (97%), revealing a notable gap in longitudinal PA-BE research in LMICs. A majority of the BE factors were not associated with different PA domains while others (e.g., density, proximity to services, aesthetics) exhibited an inconsistent association. Land-use mix diversity was positively associated with transport PA and the presence of recreation facilities resulted in an increase in PA during leisure-time. Increased safety from crime at night consistently increased total PA and walking levels. Research exploring the associations between BE attributes and PA behaviors in LMICs appears to be limited and is primarily cross-sectional. Longitudinal research studies with objective measures are needed for inferring well-grounded PA-BE causal relationships and informing the design of evidence-based environmental interventions for increasing PA levels in LMICs.

Does the Connectivity of Urban Public Green Space Promote Its Use? An Empirical Study of Wuhan

A high greenness level can enhance green space use and outdoor physical activity. However, rapid urbanization and high-density development have led to the loss or fragmentation of green space, especially urban public green space (PGS). With the aim of increasing the health benefits from PGS, some planners and researchers suggest connecting existing PGSs to encourage urban residents to use the PGS, and thus, to improve public health. Does this suggestion stand with robustness? By taking 42 sub-districts in the inner area of Wuhan as the study objects, this paper examines the correlation between the connectivity of PGS and its use. We also explore how the characteristics of PGS and the facilities/functions in the neighboring areas influence this relationship by using Location Based Service data (WeChat-Yichuxing data), point of interest (POI) data, and remote-sensing image, etc. Using Regression Analysis, we found that there is no high correlation between PGS use and its connectivity. The possible causes might be attributed to the fact that PGS use is profoundly influenced by multifaceted competing impact factors, and no one can stand dominantly. It is interesting to see that the density of companies is positively, but slightly, related to PGS use.

Comparing food environment and food purchase in areas with low and high prevalence of obesity: data from a mapping, in-store audit, and population-based survey

Our study aimed to compare key aspects of the food environment in two low-income areas in the city of Campinas, São Paulo State, Brazil: one with low and the other with high prevalence of obesity. We compared the availability of retail food establishments, the types of food sold, and the residents' eating habits. Demographic and socioeconomic data and eating habits were obtained from a population-based health survey. We also analyzed local food environment data collected from remote mapping of the retail food establishments and audit of the foods sold. For comparison purposes, the areas were selected according to obesity prevalence (body mass index - BMI ≥ 30kg/m²), defined as low prevalence (< 25%) and high prevalence (> 45%). Only 18 out of the 150 points of sale for food products sold fruits and vegetables across the areas. Areas with high obesity prevalence had more grocery stores and shops specialized in fruits and vegetables, as well as more supermarkets that sold fruits and vegetables. With less schooling, residents in the areas with high obesity prevalence reported purchasing food more often in supermarket chains and specialized shops with fruits and vegetables, although they consumed more sodas when compared with residents of areas with low obesity prevalence. Our results suggest interventions in low-income areas should consider the diverse environmental contexts and the interaction between schooling and food purchase behaviors in settings less prone to healthy eating.

Objectively measured access to recreational destinations and leisure-time physical activity: Associations and demographic moderators in a six-country study

Within the growing body of research linking neighbourhood environmental attributes with physical activity, associations between recreational destinations and non-walking leisure-time physical activity (LTPA) are rarely studied, and to date, not across multiple cities. We examined six potential associations of objectively-measured access to private recreational facilities (e.g., fitness centres, swimming pools) and parks with adults' non-walking LTPA (e.g., swimming, cycling, tennis), using data gathered with consistent methods from adults living in international cities with a range of environment attributes. The potential effects of socio-demographic moderators and between-city variations were also examined. Data from 6725 adults from 10 cities (6 countries) were gathered. Adults were more likely to engage in non-walking LTPA if they had a greater number of private recreational facilities within 0.5 or 1 km of the home, particularly in women, and if they lived closer to a park. The amount of non-zero LTPA was only associated (positively) with the number of recreational facilities within 1 km. Relationships between amount of LTPA and park proximity appear complex, with likely contextual and cultural differences. Improving access to private recreational facilities could promote non-walking LTPA, especially in women.

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.

Laboratory-Assessed Markers of Cardiometabolic Health and Associations with GIS-Based Measures of Active-Living Environments

Active-living-friendly environments have been linked to physical activity, but their relationships with specific markers of cardiometabolic health remain unclear. We estimated the associations between active-living environments and markers of cardiometabolic health, and explored the potential mediating role of physical activity in these associations. We used data collected on 2809 middle-aged adults who participated in the Canadian Health Measures Survey (2007⁻2009; 41.5 years, SD = 15.1). Environments were assessed using an index that combined GIS-derived measures of street connectivity, land use mix, and population density. Body mass index (BMI), systolic blood pressure (SBP), hemoglobin A1c, and cholesterol were assessed in a laboratory setting. Daily step counts and moderate-to-vigorous intensity physical activity (MVPA) were assessed for seven days using accelerometers. Associations were estimated using robust multivariable linear regressions adjusted for sociodemographic factors that were assessed via questionnaire. BMI was 0.79 kg/m² lower (95% confidence interval (CI) -1.31, -0.27) and SBP was 1.65 mmHg lower (95% CI -3.10, -0.20) in participants living in the most active-living-friendly environments compared to the least, independent of daily step counts or MVPA. A 35.4 min/week difference in MPVA (95% CI 24.2, 46.6) was observed between residents of neighborhoods in the highest compared to the lowest active-living-environment quartiles. Cycling to work rates were also the highest in participants living in the highest living-environment quartiles (e.g., Q4 vs. Q1: 10.4% vs. 4.9%). Although active-living environments are associated with lower BMI and SBP, and higher MVPA and cycling rates, neither daily step counts nor MVPA appear to account for environment⁻BMI/SBP relationships. This suggests that other factors not assessed in this study (e.g., food environment or unmeasured features of the social environment) may explain this relationship.

The association between objective measures of residence and worksite neighborhood environment, and self-reported leisure-time physical activities: The Aichi Workers' Cohort Study

The possible effects of a neighborhood's built environment on physical activity have not been studied in Asian countries as much as in Western countries. The present study cross-sectionally examined the relationship between geographic information system (GIS) measured residence and worksite neighborhood walkability, and the number of parks/green spaces and sports facilities within a 1 km radius of home and workplace, with self-reported leisure-time habitual (3–4 times per week or more) walking and moderate-to-vigorous intensity habitual exercise among local government workers aged 18 to 64 years living in an urban-suburban area of Aichi, Japan in 2013. A single-level binomial regression model was used to estimate the multivariable odds ratios (ORs) and 95% confidence intervals (95% CIs). Of the 1959 male and 884 female participants, 288 (15%) and 141 (16%) reported habitual walking, respectively, and 18% and 17% reported habitual exercise, respectively. Compared with women who resided in neighborhood with a walkability index of 4–30, those living in an area with that of 35–40 were significantly more likely to engage in leisure-time habitual exercise (multivariable OR: 1.70, 95% CI: 1.08–2.68). Marginally significant positive associations were found between leisure-time habitual exercise and the residential neighborhood's number of parks/green spaces among women, as well as the number of sports facilities among men. In conclusion, a residential neighborhood environment characterized by higher walkability may contribute to the initiation or maintenance of moderate-to-vigorous intensity leisure-time exercise among working women living in an urban-suburban area of Japan.

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Residential neighborhood walkability was associated with exercise habits of women.

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No features of residential neighborhood were related to walking habits in both sexes.

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No association was found for worksite neighborhood environmental features.

Perceived Environmental Factors Associated with Obesity in Libyan Men and Women

Background: There is a lack of research pertaining to the links between built environment attributes and obesity in adults in the Eastern Mediterranean Region. In the Libyan context, no previous studies have been conducted to investigate this relationship. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and obesity among Libyan men and women. The prevalence of overweight and obesity was also assessed. Methods: A cross-sectional study design was used for the population-based survey in Benghazi, Libya. A multi-stage cluster sampling technique was used to select Libyan adults from the Benghazi electoral register. The Physical Activity Neighbourhood Environment Scale (PANES) was used to measure participants’ perception of neighbourhood environmental factors. Using the Tanita BC-601 Segmental Body Composition Monitor and a portable stadiometer, anthropometric measurements were taken at a mutually agreeable place by qualified nurses. Results: Four hundred and one Libyan adults were recruited (78% response rate). Participants were aged 20–65 years, 63% were female, and all had lived in Benghazi for over 10 years. The prevalence of obesity and overweight was 42.4% and 32.9% respectively. A significant association was found between BMI and 6 neighbourhood environment attributes, specifically: street connectivity, unsafe environment and committing crimes at night, and neighbourhood aesthetics. For men only, these were: access to public transport, access to recreational facilities, and unsafe environment and committing crimes during the day. The attribute ‘residential density zones’ was only significant for women. Conclusions: The study suggests that Libyan people are at risk of living in neighbourhoods with unsupportive environmental features of physical activity, which are likely to promote obesity of both genders. The findings of this study could inform Libyan health policies about interventions in the obesogenic environments that might slow the obesity epidemic and contain the public health crisis. This study suggests that further research is needed, within the Libyan context, to explore the impact of the neighbourhood environment attributes on contributing to increased obesity.

The Relationship between the Neighborhood Built Environment and Active Transportation among Adults: A Systematic Literature Review

Active transportation (AT) has aroused great interest in recent years as it may benefit public health and reduce the dependency on cars. This article aims to summarize recent findings on the relationship between the objectively measured built environment and AT among adults, to examine if different study designs may generate different results, and to provide directions for future research. A systematic literature review of journal articles from different databases was conducted. Fifty-one articles published between 2005 and 2017 were identified, and twelve built environment factors were extracted. The results showed that residential density, land use mix, street connectivity, retail land use, walkability, sidewalk, and access to destinations had a convincing positive relationship with walking for transport. Regarding cycling for transport, while street connectivity and bike lane showed a convincing positive relationship, neighborhood aesthetics and access to destinations showed a convincing negative relationship. Studies that use different analyzed geographic units and different measurements of AT may generate different results, so choosing suitable geographic units and measurement of AT is necessary to reduce the mismatch in the relationships. In addition, we need more longitudinal studies, more studies on cycling for transport, and more studies in countries outside North America and Australasia.

Which environmental factors most strongly influence a street's appeal for bicycle transport among adults? A conjoint study using manipulated photographs

Background

Micro-environmental factors (specific features within a streetscape), instead of macro-environmental factors (urban planning features), are more feasible to modify in existing neighborhoods and thus more practical to target for environmental interventions. Because it is often not possible to change the whole micro-environment at once, the current study aims to determine which micro-environmental factors should get the priority to target in physical environmental interventions increasing bicycle transport. Additionally, interaction effects among micro-environmental factors on the street’s appeal for bicycle transport will be determined.

Methods

In total, 1950 middle-aged adults completed a web-based questionnaire consisting of a set of 12 randomly assigned choice tasks with manipulated photographs. Seven micro-environmental factors (type of cycle path, speed limit, speed bump, vegetation, evenness of the cycle path surface, general upkeep and traffic density) were manipulated in each photograph. Conjoint analysis was used to analyze the data.

Results

Providing streets with a cycle path separated from motorized traffic seems to be the best strategy to increase the street’s appeal for adults’ bicycle transport. If this adjustment is not practically feasible, micro-environmental factors related to safety (i.e. speed limit, traffic density) may be more effective in promoting bicycle transport than micro-environmental factors related to comfort (i.e. evenness of the cycle path surface) or aesthetic (i.e. vegetation, general upkeep). On the other hand, when a more separated cycle path is already provided, micro-environmental factors related to comfort or aesthetic appeared to become more prominent.

Conclusions

Findings obtained from this research could provide advice to physical environmental interventions about which environmental factors should get priority to modify in different environmental situations.

Trial registration

The study was approved by the Ethics Committee of the Ghent University Hospital. Trial registration: B670201318588. Registered at 04/10/2013. http://www.ugent.be/ge/nl/faculteit/raden/ec

Electronic supplementary material

The online version of this article (doi:10.1186/s12942-016-0058-4) contains supplementary material, which is available to authorized users.

Neighbourhood walkability, daily steps and utilitarian walking in Canadian adults

OBJECTIVES

To estimate the associations of neighbourhood walkability (based on Geographic Information System (GIS)-derived measures of street connectivity, land use mix, and population density and the Walk Score) with self-reported utilitarian walking and accelerometer-assessed daily steps in Canadian adults.

DESIGN

A cross-sectional analysis of data collected as part of the Canadian Health Measures Survey (2007-2009).

SETTING

Home neighbourhoods (500 m polygonal street network buffers around the centroid of the participant's postal code) located in Atlantic Canada, Québec, Ontario, the Prairies and British Columbia.

PARTICIPANTS

5605 individuals participated in the survey. 3727 adults (≥18 years) completed a computer-assisted interview and attended a mobile clinic assessment. Analyses were based on those who had complete exposure, outcome and covariate data (n=2949).

MAIN EXPOSURE MEASURES

GIS-derived walkability (based on land use mix, street connectivity and population density); Walk Score.

MAIN OUTCOME MEASURES

Self-reported utilitarian walking; accelerometer-assessed daily steps.

RESULTS

No important relationship was observed between neighbourhood walkability and daily steps. Participants who reported more utilitarian walking, however, accumulated more steps (<1 h/week: 6613 steps/day, 95% CI 6251 to 6975; 1 to 5 h/week: 6768 steps/day, 95% CI 6420 to 7117; ≥6 h/week: 7391 steps/day, 95% CI 6972 to 7811). There was a positive graded association between walkability and odds of walking ≥1 h/week for utilitarian purposes (eg, Q4 vs Q1 of GIS-derived walkability: OR=1.66, 95% CI 1.31 to 2.11; Q3 vs Q1: OR=1.41, 95% CI 1.14 to 1.76; Q2 vs Q1: OR=1.13, 95% CI 0.91 to 1.39) independent of age, sex, body mass index, married/common law status, annual household income, having children in the household, immigrant status, mood disorder, perceived health, ever smoker and season.

CONCLUSIONS

Contrary to expectations, living in more walkable Canadian neighbourhoods was not associated with more total walking. Utilitarian walking and daily steps were, however, correlated and walkability demonstrated a positive graded relationship with utilitarian walking.

Perceived and Objective Measures of Neighborhood Walkability and Physical Activity among Adults in Japan: A Multilevel Analysis of a Nationally Representative Sample

Although associations between a person’s neighborhood and their health have been studied internationally, most studies have been limited to a few cities or towns. Therefore, we used a nationally representative sample to explore whether perceived and objective neighborhood walkability was associated with the physical activity of residents. Data were analyzed from the Japanese General Social Surveys of 2010 (n = 2395; 1114 men and 1281 women). Perceived walkability was scored using factor analysis for the respondents’ perceptions of neighborhood conditions, while objective walkability was measured using the geographic information system approach. Finally, multilevel logistic regression analysis was performed to examine whether neighborhood walkability was associated with the frequency of leisure-time physical activity (LTPA) among respondents. We found that perceived walkability was positively associated with the frequency of LTPA (odds ratio of the highest quartile was 1.53 (1.14–2.05) compared with the lowest quartile); however, objective walkability showed no association. When stratified by gender, an association between perceived walkability and LTPA was observed among women, but only a marginally significant association was present between objective walkability and LTPA among men. We conclude that the association between neighborhood walkability and LTPA can be partially generalized across Japan.

Associations between neighbourhood walkability and daily steps in adults: a systematic review and meta-analysis

Background

Higher street connectivity, land use mix and residential density (collectively referred to as neighbourhood walkability) have been linked to higher levels of walking. The objective of our study was to summarize the current body of knowledge on the association between neighbourhood walkability and biosensor-assessed daily steps in adults.

Methods

We conducted a systematic search of PubMed, SCOPUS, and Embase (Ovid) for articles published prior to May 2014 on the association between walkability (based on Geographic Information Systems-derived street connectivity, land use mix, and/or residential density) and daily steps (pedometer or accelerometer-assessed) in adults. The mean differences in daily steps between adults living in high versus low walkable neighbourhoods were pooled across studies using a Bayesian hierarchical model.

Results

The search strategy yielded 8,744 unique abstracts. Thirty of these underwent full article review of which six met the inclusion criteria. Four of these studies were conducted in Europe and two were conducted in Asia. A meta-analysis of four of these six studies indicates that participants living in high compared to low walkable neighbourhoods accumulate 766 more steps per day (95 % credible interval 250, 1271). This accounts for approximately 8 % of recommended daily steps.

Conclusions

The results of European and Asian studies support the hypothesis that higher neighbourhood walkability is associated with higher levels of biosensor-assessed walking in adults. More studies on this association are needed in North America.

Association between perceived urban built environment attributes and leisure-time physical activity among adults in Hangzhou, China

BACKGROUND

Neighborhood built environment may influence residents' physical activity, which in turn, affects their health. This study aimed to determine the associations between perceived built environment and leisure-time physical activity in Hangzhou, China.

METHODS

1440 participants aged 25-59 were randomly selected from 30 neighborhoods in three types of administrative planning units in Hangzhou. International Physical Activity Questionnaire long form and NEWS-A were used to obtain individual-level data. The China Urban Built Environment Scan Tool was used to objectively assess the neighborhood-level built environment. Multi-level regression was used to explore the relationship between perceived built environment variables and leisure-time physical activities. Data was collected in Hangzhou from June to December in 2012, and was analyzed in May 2013.

RESULTS

Significant difference between neighborhood random variations in physical activity was identified (P=0.0134); neighborhood-level differences accounted for 3.0% of the variability in leisure-time physical activity. Male residents who perceived higher scores on access to physical activity destinations reported more involvement in leisure-time physical activity. Higher scores on perception of esthetic quality, and lower on residential density were associated with more time in leisure-time walking in women.

CONCLUSIONS

The present study demonstrated that perceived urban built environment attributes significantly correlate with leisure-time physical activity in Hangzhou, China.

Positive Action for Today's Health (PATH): Sex differences in walking and perceptions of the physical and social environment

Research indicates that people from low socioeconomic and ethnic minority backgrounds disproportionately fail to meet the weekly national recommendations for physical activity. Perceptions of environmental factors may be significant barriers to walking in communities experiencing high rates of crime and poverty and may impact women and men differently. The present study investigated sex differences in the impact of perceptions of the environment and overall neighborhood quality on walking in an underserved population. Participants were 195 African American women and 95 African American men. Baseline data indicated that women reported greater concerns about safety, poorer perceptions of aesthetics, and lower neighborhood satisfaction than men. Regression analyses showed that perceptions of access to places for walking significantly predicted walking for both women and men and that sex moderated the effect of neighborhood satisfaction. These results suggest that interventions focused on building accessibility to places for walking while also addressing social environmental concerns are needed in high crime communities.

Neighbourhood walkability, leisure-time and transport-related physical activity in a mixed urban-rural area

Objectives. To develop a walkability index specific to mixed rural/suburban areas, and to explore the relationship between walkability scores and leisure time physical activity. Methods. Respondents were geocoded with 500 m and 1,000 m buffer zones around each address. A walkability index was derived from intersections, residential density, and land-use mix according to built environment measures. Multivariable logistic regression models were used to quantify the association between the index and physical activity levels. Analyses used cross-sectional data from the 2007-2008 Canadian Community Health Survey (n = 1158; ≥18 y). Results. Respondents living in highly walkable 500 m buffer zones (upper quartiles of the walkability index) were more likely to walk or cycle for leisure than those living in low-walkable buffer zones (quartile 1). When a 1,000 m buffer zone was applied, respondents in more walkable neighbourhoods were more likely to walk or cycle for both leisure-time and transport-related purposes. Conclusion. Developing a walkability index can assist in exploring the associations between measures of the built environment and physical activity to prioritize neighborhood change.

Impact of participant incentives and direct and snowball sampling on survey response rate in an ethnically diverse community: results from a pilot study of physical activity and the built environment

Community-wide efforts to encourage healthy behaviours must respond to the needs of existing neighbourhoods, especially those where low physical activity (PA) is associated with social, economic, and cultural challenges. This study reports on the effect of direct and snowball sampling strategies and financial incentive levels on the response rates of a built environment and PA survey in a predominately urban, low-SES new-immigrant community. Women residing in the Jane-Finch neighbourhood of Toronto, Ontario were selected to participate by quasi-random sampling, yielding a response rate of 41.5%. The survey completion rate per contact attempt increased 2-fold when incentives were increased from $10 to $20 and a further threefold following the increase from $20 to $30. Snowball sampled respondents were older, less likely to have full-time employment, and had lower educational attainment than directly sampled participants. With appropriate incentives, face-to-face contact, and snowball sampling, survey-based research is feasible within a low-SES, high minority population.

Environmental and individual correlates of various types of physical activity among community-dwelling middle-aged and elderly Japanese

Recent studies have suggested the importance of the neighborhood environment in determining the specific type of physical activity. However, few studies on this topic have been undertaken in Japan. This study examined the association of three types of physical activity and their associations with individual and neighborhood environmental factors among middle-aged and elderly Japanese. Participants were 2,449 adults aged 40–69 living in Fujisawa city who had undergone health checkups and responded to our survey by mail. Individual factors, the International Physical Activity Questionnaire (long form), and its environmental module acted as inputs to the study. The adjusted odds ratios (ORs) of high levels of moderate-to-vigorous intensity leisure-time physical activity (LTPA), walking for active recreation, and transportation were calculated in relation to individual and neighborhood environmental factors through multiple logistic regression models. Not working and good self-rated health were significantly associated with a higher level of each physical activity outcome. According to the adjusted ORs, higher educational attainment, higher economic status, good access to exercise facilities, and owning motor vehicles were associated with longer LTPA time. However, different sets of factors were associated with longer walking times for recreation and transportation. The results suggest that diverse individual and neighborhood environmental characteristics are associated with different physical activity outcomes. Therefore, customizing environments to become activity-friendly is necessary to increase physical activity effectively among middle-aged and elderly Japanese.

Association between physical activity and neighborhood environment among middle-aged adults in Shanghai

Objective. To determine the perceived neighborhood environment (NE) variables that are associated with physical activity (PA) in urban areas in China. Methods. Parents of students at two junior high schools in Shanghai, one downtown and the other in the suburbs, were recruited to participate in the study. They completed an International Physical Activity Questionnaire (IPAQ) and Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) survey. Participant physical activity was also objectively measured using accelerometers. Results. Participants from downtown areas were more positively associated with transportation PA and leisure-time PA than respondents living in the suburbs. Residential density was found to be a significant positive predictor of recreational or leisure-based PA. Street connectivity was negatively associated with leisure time PA for respondents. Moderate-vigorous PA was found to be negatively associated with traffic safety. There were no significant associations between environmental factors and transportation PA. Women had higher levels of moderate-vigorous PA than men. Conclusions. The results of this study demonstrate that residential density, street connectivity, and traffic safety have a significant impact on Chinese middle-aged adults' PA, suggesting urban planning strategies for promoting positive public health outcomes.

Features of perceived neighborhood environment associated with daily walking time or habitual exercise: differences across gender, age, and employment status in a community-dwelling population of Japan

OBJECTIVE

Perceived neighborhood environment (NE) is considered a determinant of daily physical activity (PA). However, evidence concerning differences among types of PA, gender, and age is limited. The study purpose was to clarify the association between NE and walking time (WT) or habitual exercise (HE) across gender, age, and employment status in a community-dwelling population of Japan.

METHODS

A questionnaire mail survey with a stratified random 7,515 sampling was conducted in a northeast city in January 2007. Multiple logistic analysis was conducted to examine the associations between seven NE indices and WT or HE across gender, age, and employment status: 20-39 (young-employed), 40-59 (middle-employed), and 60-79 (old-employed or old-unemployed) after adjustment for age and means of transportation.

RESULTS

A total of 3,806 residents (52.4 % females) completed the survey. Traffic and crime safety in old-unemployed males and proximity to service facilities and traffic and crime safety in middle-employed females were significantly associated with a low risk of insufficient WT. Proximity to service facilities in old-employed males, number of service facilities, places for walking, and good view in middle-employed females, and density of dwelling and proximity to service facilities in old-unemployed females were significantly associated with a low risk of non-HE.

CONCLUSIONS

The association between NE and WT or HE differed across type of PA, gender, age, and employment status, and was observed mainly in middle- and old-aged females. The middle- and old-aged female residents' PA possibly were more influenced by their NE, and NE would contribute to promote active living.

A step-defined sedentary lifestyle index: <5000 steps/day

Step counting (using pedometers or accelerometers) is widely accepted by researchers, practitioners, and the general public. Given the mounting evidence of the link between low steps/day and time spent in sedentary behaviours, how few steps/day some populations actually perform, and the growing interest in the potentially deleterious effects of excessive sedentary behaviours on health, an emerging question is "How many steps/day are too few?" This review examines the utility, appropriateness, and limitations of using a reoccurring candidate for a step-defined sedentary lifestyle index: <5000 steps/day. Adults taking <5000 steps/day are more likely to have a lower household income and be female, older, of African-American vs. European-American heritage, a current vs. never smoker, and (or) living with chronic disease and (or) disability. Little is known about how contextual factors (e.g., built environment) foster such low levels of step-defined physical activity. Unfavorable indicators of body composition and cardiometabolic risk have been consistently associated with taking <5000 steps/day. The acute transition (3-14 days) of healthy active young people from higher (>10 000) to lower (<5000 or as low as 1500) daily step counts induces reduced insulin sensitivity and glycemic control, increased adiposity, and other negative changes in health parameters. Although few alternative values have been considered, the continued use of <5000 steps/day as a step-defined sedentary lifestyle index for adults is appropriate for researchers and practitioners and for communicating with the general public. There is little evidence to advocate any specific value indicative of a step-defined sedentary lifestyle index in children and adolescents.

Associations between resident perceptions of the local residential environment and metabolic syndrome

A substantial body of research has arisen concerning the relationships between objective residential area features, particularly area-level socioeconomic status and cardiometabolic outcomes. Little research has explored residents' perceptions of such features and how these might relate to cardiometabolic outcomes. Perceptions of environments are influenced by individual and societal factors, and may not correspond to objective reality. Understanding relations between environmental perceptions and health is important for the development of environment interventions. This study evaluated associations between perceptions of local built and social environmental attributes and metabolic syndrome, and tested whether walking behaviour mediated these associations. Individual-level data were drawn from a population-based biomedical cohort study of adults in Adelaide, South Australia (North West Adelaide Health Study). Participants' local-area perceptions were analysed in cross-sectional associations with metabolic syndrome using multilevel regression models (n = 1, 324). A nonparametric bootstrapping procedure evaluated whether walking mediated these associations. Metabolic syndrome was negatively associated with greater local land-use mix, positive aesthetics, and greater infrastructure for walking, and was positively associated with greater perceived crime and barriers to walking. Walking partially mediated associations between metabolic syndrome and perceived environmental features. Initiatives targeting residents' perceptions of local areas may enhance the utility of environmental interventions to improve population health.

Perceived neighborhood environmental attributes associated with adults' transport-related walking and cycling: Findings from the USA, Australia and Belgium

Background

Active transportation has the potential to contribute considerably to overall physical activity levels in adults and is likely to be influenced by neighborhood-related built environment characteristics. Previous studies that examined the associations between built environment attributes and active transportation, focused mainly on transport-related walking and were conducted within single countries, limiting environmental variability. We investigated the direction and shape of relationships of perceived neighborhood attributes with transport-related cycling and walking in three countries; and examined whether these associations differed by country and gender.

Methods

Data from the USA (Baltimore and Seattle), Australia (Adelaide) and Belgium (Ghent) were pooled. In total, 6,014 adults (20–65 years, 55.7% women) were recruited in high-/low-walkable and high-/low-income neighborhoods. All participants completed the Neighborhood Environmental Walkability Scale and the International Physical Activity Questionnaire. Generalized additive mixed models were used to estimate the strength and shape of the associations.

Results

Proximity to destinations, good walking and cycling facilities, perceiving difficulties in parking near local shopping areas, and perceived aesthetics were included in a ‘cyclability’ index. This index was linearly positively related to transport-related cycling and no gender- or country-differences were observed. The ‘walkability’ index consisted of perceived residential density, land use mix access, proximity of destinations and aesthetics. A non-linear positive relationship with transport-related walking was found. This association was stronger in women than in men, and country-specific associations were identified: the strongest association was observed in Seattle, the weakest in Adelaide. In Ghent, the association weakened at higher levels of walkability.

Conclusions

For cycling, consistent correlates were found in the three countries, but associations were less straightforward for transport-related walking. Moreover, the identified neighborhood environmental correlates were different for walking compared to cycling. In order to further clarify the shape of these associations and reach more specific international guidelines for developing walkable and bikeable neighborhoods, future studies should include even more countries to maximize environmental variability.

Neighborhood built environment and physical activity of Japanese older adults: results from the Aichi Gerontological Evaluation Study (AGES)

BACKGROUND

Although many studies have reported the association between neighborhood built environment (BE) and physical activity (PA), less is known about the associations for older populations or in countries besides the US and Australia. The aim of this paper is to examine the associations for older adult populations in Japan.

METHODS

Our analyses were based on cross-sectional data from the Aichi Gerontological Evaluation Study (AGES), conducted in 2003. The respondents were older adults, aged 65 years or over (n = 9,414), from 8 municipalities across urban, suburban, and rural areas. The frequency of leisure time sports activity and total walking time were used as the outcome variables. Using geographic information systems (GIS), we measured residential density, street connectivity, number of local destinations, access to recreational spaces, and land slope of the respondents' neighborhoods, based on network distances with multiple radii (250 m, 500 m, 1,000 m). An ordinal logistic regression model was used to analyze the association between PA and BE measures.

RESULTS

Population density and presence of parks or green spaces had positive associations with the frequency of sports activity, regardless of the selected buffer zone. The analysis of total walking time, however, showed only a few associations.

CONCLUSIONS

Our findings provide mixed support for the association between PA and the characteristics of BE measures, previously used in Western settings. Some characteristics of the neighborhood built environment may facilitate leisure time sports activity, but not increase the total walking time for Japanese older adults.

The built environment and recreational physical activity among adults in Curitiba, Brazil

OBJECTIVE

To examine the relationship between objective measures of the built environment (BE) and recreational physical activity (PA) in adults from Curitiba, Brazil.

METHOD

A phone survey was carried among a random sample of 1206 people. Walking during leisure time (WLT) and moderate and vigorous recreational PA (MVPA) was measured using IPAQ. Characteristics of the BE were determined in an area of 500 m surrounding respondent's homes. Multivariate logistic regression analysis was used to estimate the associations between recreational PA and BE.

RESULTS

After adjusting for confounders, WLT was associated with area income level US$971.45-3341.64 vs. US$167.05-461.06 (25.7% vs. 11.1% POR=2.5; 95% CI=1.5-4.4), having ≥ 2 gyms vs. none (26.1% vs. 12.7%, POR=1.9; 95% CI=1.2-3.0) and distance to recreation centers, 1769.1-2835.5 km vs. 2835.6-10,212.3 km (22.1% vs. 11.0%, POR=2.3; 95% CI=(1.0-2.5). MVPA was associated with neighborhood income US$971.45-3341.64 vs. US$167.05-461.06 (47.6% vs. 22.0% POR=3.0; 95% CI=1.5-5.9) and having ≥ 2 gyms vs. none (41.7% vs. 26.0%, POR=1.5; 95% CI=1.11-2.1).

CONCLUSION

The presence of some recreational facilities for PA was associated with recommended levels of PA during leisure time in Curitiba, Brazil.

Activity space environment and dietary and physical activity behaviors: a pilot study

This study examined relationships among individual demographics, environmental features (e.g., fast food outlet density, park land use) of residential neighborhoods and activity spaces, and weight-related behaviors (diet, physical activity). Participants' movement was tracked for 7 days using global positioning systems (GPS). Two activity space measures (one standard deviation ellipse, daily path area) were derived from the GPS data. Activity spaces were generally larger than residential neighborhoods; environmental features of residential neighborhoods and activity spaces were weakly associated; and some activity space environmental features were related to dietary behaviors. Activity spaces may provide new insights into environmental influences on obesity-related behaviors.

Association between perceived neighborhood environment and walking among adults in 4 cities in Japan

BACKGROUND

Recent research highlights the importance of environment as a determinant of physical activity; however, evidence among Japanese is sparse. The aim of this study was to examine the association between perceived neighborhood environment and neighborhood walking for multiple purposes among Japanese.

METHODS

We conducted a population-based, cross-sectional study of 1461 Japanese adults (age: 48.2 +/- 14.1 years, men: 44.8%). Neighborhood environment and walking were assessed by a validated questionnaire. The odds ratio of active walkers was calculated in relation to environmental characteristics after adjustment for age, sex, and other potential confounders.

RESULTS

Participants were more likely to walk when they perceived that there was high residential density (odds ratio, 1.47; 95% confidence interval, 1.11-1.96), fair land use mix-diversity (1.37, 1.04-1.81), good walking/cycling facilities (1.56, 1.19-2.04), and attractive aesthetics (1.49, 1.14-1.95). Environmental factors associated with walking differed with respect to the purpose for walking. The environmental characteristics associated with walking for daily errands and with walking for commuting were similar, and included residential density and land use mix. Walking for leisure was associated with walking/cycling facilities, aesthetics, and traffic safety. Stratified analyses showed some sex-specific associations. Among women, there was an unexpected inverse association of leisure walking with both residential density and land use mix-diversity.

CONCLUSIONS

The association between neighborhood environment and walking differed by walking purpose. The results were generally consistent with those of studies conducted in Western countries, except for the association of high residential density and good land use mix-diversity with less leisure walking in women. These results suggest possible targets for environmental interventions to promote walking.