Six-year trend in active commuting to school in Spanish adolescents. The AVENA and AFINOS Studies

Associations of active commuting to school in childhood and physical activity in adulthood

This study examined whether active commuting to school in childhood and adolescence predicted active commuting to work and overall physical activity (PA) in adulthood. Participants from the Young Finns Study (N = 2436) were aged 9-18 years in 1980 and followed up until 2018/2020. Their commuting modes to school were assessed with a self-reported questionnaire in 1980. Adulthood PA was assessed through self-reports regarding commuting modes to work (2001-2018), leisure-time physical activity (LTPA) (2001-2018), and objectively measured daily steps (2007-2018/2020). Associations between childhood commuting and adulthood PA were evaluated using regression analyses and multilevel models. Demographic, socioeconomic and environmental covariates were adjusted for in the analyses. Active commuting to school in childhood contributed favourably to LTPA in 2001 (B = .38, p < .001), in 2007 (B = .35, p < .001), and in 2018 (B = .28, p < .01). Active commuting in childhood was associated with higher number of daily aerobic steps (B = 299.00, p = .03) and daily aerobic steps during weekdays in 2011 (B = 312.15, p = .03). In 2018, active commuting associated favourably with daily aerobic steps (B = 370.42, p < .01), daily aerobic steps during weekdays (B = 347.65, p = .01), daily steps during weekends (B = 628.49, p = .02), and daily aerobic steps during weekends (B = 402.69, p = .03). Covariate adjustments attenuated the associations excluding the one between active commuting and LTPA in 2007 (B = .36, p = .01) and daily steps during weekends in 2018 (B = 782.25, p = .04). Active commuting to school in childhood might be one of the PA modes that contribute to PA in adulthood and is therefore encouraged to be promoted from an early age.

Secular trends in physical activity in adolescents: A systematic review

Objective

One in five adolescents has been estimated to perform sufficient physical activity (PA), thus potentially indicating that PA among adolescents has declined. This systematic review was aimed at reporting and summarizing the available knowledge regarding PA secular trends in adolescents over time.

Methods

Seven databases were consulted (Web of Science, Scopus/Elsevier, Medline/PubMed, ScienceDirect, Lilacs, Physical Education Index, and SPORTDiscus), and 1809 studies were examined. According to the PRISMA guidelines, relevant research on secular PA trends in adolescents was screened for inclusion in a narrative synthesis. The risk of bias in the articles included was also assessed.

Results

Forty-three studies with data collected between 1969 and 2018 met the inclusion criteria, and data from high-income countries predominated. PA was estimated predominantly by self-reporting, except in seven studies, and diverse contexts and domains were analyzed. Increased PA was reported in 16 studies (from 2.9% to 43.5%), decreased PA was reported in 15 studies (-2.5% to -69.5%), and no change was reported in 22 studies (-12.0% to 14.4%).

Conclusions

Although PA has increased in some countries, very little information is available in low- and middle-income countries. Efforts should support studies on PA trends in adolescents from economically disadvantaged countries.

Active school commuting in adolescents from 28 countries across Africa, the Americas, and Asia: a temporal trends study

BACKGROUND

Evidence examining trends in active school commuting among adolescents are mainly single-country studies, and principally focused on high-income countries. Thus, the present study aims to examine temporal trends in adolescents' active school commuting and to examine if there are differences in such trends by sex. We used nationally representative samples of 28 countries, which were predominantly low- and middle-income countries (LMICs), covering 5 different WHO regions.

METHODS

Data from the Global School-based Student Health Survey 2004-2017 were analyzed in 177,616 adolescents [mean (SD) age: 13.7 (1.0) years; 50.7% girls]. Active school commuting was self-reported (frequency of walking or riding a bike to and from school in the past 7 days). The prevalence and 95%CI of active school commuting (i.e., ≥ 3 days/week) was calculated for the overall sample and by sex for each survey. Crude linear trends in active school commuting were assessed by linear regression models. Interaction analyses were conducted to examine differing trends among boys and girls.

RESULTS

Trends in active school commuting were heterogeneous across countries, with results showing stable patterns for the majority (16/28), decreasing trends for some (7/28) and increasing trends over time for a few (5/28). The majority of countries showed no differences in active school commuting trends between girls and boys.

CONCLUSIONS

The quantification of changes in adolescents' active school commuting over time, together with a deeper understanding of local determinants for such behaviors will provide valuable evidence to inform the development of tailored and context-specific actions.

Desplazamiento activo en adolescentes: importancia de las barreras percibidas y el acompañamiento

El presente estudio tiene como objetivo conocer el valor predictivo de la edad, el acompañamiento, y las barreras físicas y psicosociales en el desplazamiento activo. Participaron un total de 1325 estudiantes procedentes de centros educativos de Educación Primaria y Educación Secundaria de la Comunidad Autónoma de Extremadura (España), con edades comprendidas entre los 10-17 años (M =12.1; DT= 1.60). Los estudiantes cumplimentaron información sobre el modo, distancia, tiempo y acompañamiento a través del cuestionario PACO, y de las barreras percibidas para el desplazamiento activo mediante la escala BATACE. Los resultados revelaron una importante incidencia del acompañamiento, la distancia y las barreras psicosociales percibidas para la realización de desplazamiento activo hacia el colegio (R2 = .53; p = 0.00). Se concluye en la importancia de la distancia hasta el centro educativo, las barreras psicosociales, y el acompañamiento como elementos más importantes en la realización de desplazamiento activo.

Analysis of Variables That Influence the Walkability of School Environments Based on the Delphi Method

Walkability is determined the presence or absence of factors such as quality sidewalks, pedestrian crossings, traffic, etc. The ability to walk to the school environment may be one of the variables that promotes active commuting levels. The aim of this study was to examine the walkability of school environments using the Delphi method. This study used the Delphi method to measure the walkability. A total of 18 experts were selected. First, a list of variables was designed by the control group and sent three times to the experts. Later, the items were analyzed qualitatively and quantitatively to test the consensus of the experts. The list of variables that influence walkability showed a good consensus among the experts at the end of the process. This list was formed by 48 items and organized in six factors: traffic and safety (eleven items), signage (eight items), sidewalk (ten items), transport consistency (five items), activity (five items), and finally, urban planning (nine items). The experts agreed on the need to analyze the environments of educational centers and measure the variables that affect walkability. This study has identified the most important barriers. In the future, a measurement instrument should be developed that allows centers to be compared with others in terms of their levels of walkability. Moreover, it might be a resource for more policies to be developed with the aim to promote active commuting to school.

From motorised to active travel: using GPS data to explore potential physical activity gains among adolescents

Background

A high proportion of adolescents worldwide are not doing enough physical activity for health benefits. Replacing short motorised trips with walking or cycling has the potential to increase physical activity at the population level. This study aimed to estimate the proportion of short distance motorised trips that could be replaced with walking or cycling, and the potential physical activity gains by sociodemographic and trip characteristics.

Methods

Data were from a subsample of the NEighbourhood Activity in Youth (NEArbY) study conducted among adolescents in Melbourne. A total of 217 adolescents with at least one motorised trip completed a survey and wore a Global Positioning Systems (GPS) device for eight consecutive days. Classification of travel modes were based on speed. GPS data points were geocoded in ArcGIS. Motorised trips within walkable (1.3 km) and cyclable (4.2 km) distances were identified (threshold based on 80^th percentile of walking and cycling trip distances among Victorian adolescents), and the additional physical activity minutes that could be accrued by replacing walkable or cyclable motorised trip to active trips were quantified. Multilevel linear regression was used to assess differences in physical activity minutes gain by sociodemographic and trip characteristics.

Results

A total of 4,116 motorised trips were made. Of these, 17% were walkable and 61% were cyclable. Replacing motorised trips by walking and cycling resulted in estimated gains of six minutes and 15 min of physical activity per day, respectively.

Conclusion

The sizable proportion of replaceable trips and potential physical activity gains from this shift calls for attention to improve safe and connected infrastructure to support active travel.

The Effect of a School-Based Intervention on Children’s Cycling Knowledge, Mode of Commuting and Perceived Barriers: A Randomized Controlled Trial

The low rates of active commuting to/from school in Spain, especially by bike, and the wide range of cycling interventions in the literature show that this is a necessary research subject. The aims of this study were: (1) to assess the feasibility of a school-based cycling intervention program for adolescents, (2) to analyse the effectiveness of a school-based cycling intervention program on the rates of cycling and other forms of active commuting to/from school (ACS), and perceived barriers to active commuting in adolescents. A total of 122 adolescents from Granada, Jaén and Valencia (Spain) participated in the study. The cycling intervention group participated in a school-based intervention program to promote cycling to school during Physical Education (PE) sessions in order to analyse the changes in the dependent variables at baseline and follow up of the intervention. Wilcoxon, Signs and McNemar tests were undertaken. The association of the intervention program with commuting behaviour, and perceived barriers to commuting, were analysed by binary logistic regression. There were improvements in knowledge at follow-up and the cycling skill scores were medium-low. The rates of cycling to school and active commuting to/from school did not change, and only the “built environment (walk)” barrier increased in the cycling group at follow-up. School-based interventions may be feasibly effective tools to increase ACS behaviour, but it is necessary to implement a longer period and continue testing further school-based cycling interventions.

Role of Sociodemographic Variables and the Mother's Active Behavior on Active Commuting to School in Children and Adolescents

The main objective of the current study was to analyze how parents' sociodemographic characteristics, mode of commuting and physical activity (PA) act as indicators of active commuting to school (ACS) in their children and adolescents. A total of 684 paired parents (52.8% mothers) and their respective offspring (33.7% girls) were included. The participants self-reported their sociodemographic characteristics, mode of commuting, and PA. Logistic regression analyses were performed using a stepwise approach, including, as indicators, parental characteristics, mode of commuting and PA. The main outcome was child and adolescent ACS. The odds ratio (OR) and R² of Nagelkerke were obtained for each step. Parental sociodemographic characteristics were greater indicators of child ACS than the parental mode of commuting and PA. In children, the greatest predictive variables of ACS explained 38% of the variance and were as follows: car availability (OR = 0.24), father's educational level (OR = 0.47), mother's educational level (OR = 1.95), mother's active commuting to work (OR = 4.52) and mother's salary/month (OR = 0.67). In adolescents, the greatest predictive variables of ACS explained 40% of the variance and were as follows: socioeconomic level (OR = 0.43) and father's active commuting (OR = 10.6). In conclusion, sociodemographic factors are better indicators of ACS than parents' physical activity and active commuting to work.

Development and Initial Validation of the PILCAST Questionnaire: Understanding Parents' Intentions to Let Their Child Cycle or Walk to School

Children generally do not meet the recommendation of 60 min of daily physical activity (PA); therefore, active school transportation (AST) is an opportunity to increase PA. To promote AST, the involvement of parents seems essential. Using the theory of planned behavior (TPB), the aim was to develop and validate the PILCAST questionnaire to understand parents’ intentions to let their child cycle or walk to school. Cross-sectional sampling was performed, where 1024 responses were collected from parents. Confirmatory factor analysis indicated acceptable fit indices for the factorial structure according to the TPB, comprising 32 items grouped in 11 latent constructs. All constructs showed satisfying reliability. The regression analysis showed that the TPB explained 55.3% of parents’ intentions to let the child cycle to school and 20.6% regarding walking, increasing by a further 18.3% and 16.6%, respectively, when past behavior was added. The most influential factors regarding cycling were facilitating perceived behavioral control, positive attitudes, subjective and descriptive norms, and for walking, subjective and descriptive norms. The PILCAST questionnaire contributes to a better understanding of the psychological antecedents involving parents’ decisions to let their child cycle or walk to school, and may therefore provide guidance when designing, implementing and evaluating interventions aiming to promote AST.

Nutrition and Physical Activity Behavior in 11-14-Year-Old Schoolchildren in Serbia

Regular physical activity and healthy diet have a significant positive impact on children’s health. Lack of physical activity increases the risk of various diseases, while obesity has become an alarming health problem worldwide. The aim of this study is to investigate the patterns of physical activity and diet among 11–14-year-old school children in Serbia. The sample included 623 primary school children, of whom 333 were boys (53.45%) and 290 were girls (46.55%). The children were also divided according to their age/grade: fifth grade/11 years (24.40% (n = 152; M = 84, F = 68)), sixth grade/12 years (25.68% (n = 160; M = 91, F = 69)), seventh grade/13 years (26.81% (n = 167; M = 83, F = 84)) and eighth grade/14 years (23.11% (n = 144; M = 75, F = 69)). Children’s lifestyle was assessed using two subscales of questionnaires based on the Health-Promoting Lifestyle Profile model II. The Mann–Whitney U test showed no statistically significant difference between boys and girls in the variables Nutrition (p = 0.81) and Physical Activity (p = 0.91). The Kruskal–Wallis test was applied and showed no statistically significant differences between children of different ages, regardless of gender, in the variable Nutrition (p = 0.63). However, differences were evident in the variable Physical Activity (p < 0.001), with the highest mean scores recorded in 12- and 13-year-old children and the lowest in 14-year-old children. Additionally, no statistically significant differences were found among boys as a function of age in the variables Nutrition (p = 0.55) and Physical Activity (p = 0.15), nor among girls in the variable Nutrition (p = 0.43), but in the variable Physical Activity (p = 0.01). In general, it can be concluded that the older primary school children have relatively satisfactory dietary and physical activity habits, but that these behaviors decrease with age, especially the level of physical activity. There is a need for better and more effective education of children about the benefits and importance of proper nutrition and regular physical activity.

Trends in active commuting to school from 2003 to 2017 among children and adolescents from Germany: the MoMo Study

BACKGROUND

Inactivity in children and adolescents is a global issue requiring interventions that target different domains of physical activity, such as active transport. The aim of this study was to assess the prevalence, historical trends and socio-demographic correlates of active commuting to school (ACS) in a nationwide sample of girls and boys from Germany.

METHODS

Data of commuting behaviour and socio-demographic factors were collected, covering three measurement points from 2003 to 2017. The MoMo Study derived its data from a representative sample of children and adolescents aged 4-17 years who answered a questionnaire (N = 11 387). Statistically significant differences between Baseline, Wave 1 and Wave 2 were determined via 95% confidence intervals (CIs) for complex samples.

RESULTS

Overall, ACS decreased from 84.4% at the first measurement point to 78.3% in the third measurement point. The proportion of cases in which children opted for passive modes of commuting increased predominantly in those aged 4-5 years, in children with a low-to-medium socio-economic status, and in children residing in small- or medium-sized towns. No gender differences were found in active commuting. The results of multinomial logistic regression identified age, migration background and residential area as correlates of walking for boys. For girls, the likelihood of walking, cycling and taking public transport instead of opting for motorized transport increased with age.

CONCLUSIONS

Intervention programmes to increase active transport in children and adolescents should target different age groups and also consider parental influence in determining the child's choice of transport mode.

Individual and social factors associated with active commuting to school in 4-6 years old Spanish children

To examine the prevalence of active commuting to school (ACS) in 4 to 6 year old children and individual and social factors associated with it. Cross-sectional study including 1,159 children from Cuenca and Ciudad Real (Castilla-La Mancha, Spain). ACS, population area, and socioeconomic status (SES) were self-reported by parents. Body mass index and cardiorespiratory fitness (CRF) were measured using standard procedures. Binary logistic regression models were used to assess the strength of association between the mode of commuting (ACS/no-ACS) and individual (weight status and CRF) and social (population area and SES) factors. Forty-six percent of the children ACS. The probability of ACS was greater in boys and girls from families of low/medium-low SES and in girls who lived in urban areas. ACS was not associated with weight status and CRF. Effective interventions need to be promoted, especially in children from families of high SES and those living in rural areas.

Children and Parental Barriers to Active Commuting to School: A Comparison Study

The main objectives of this study were: to compare the barriers to active commuting to and from school (ACS) between children and their parents separately for children and adolescents; and to analyze the association between ACS and the children’s and parents’ barriers. A total of 401 child–parent pairs, from Granada, Jaén, Toledo and Valencia, self-reported, separately, their mode of commuting to school and work, respectively, and the children’s barriers to ACS. T-tests and chi-square tests were used to analyze the differences by age for continuous and categorical variables, respectively. Binary logistic regressions were performed to study the association between ACS barriers of children and parents and ACS. Both children and adolescents perceived higher physical and motivational barriers and social support barriers towards ACS than their parents (all p < 0.05). Additionally, the parents perceived higher distance, traffic safety, convenience, built environment, crime-related safety and weather as barriers towards ACS, than their children (all p < 0.05). Moreover, a higher perception of barriers was related to lower ACS. The results of our study showed the necessity of attenuating the perceptions of children and their parents in order to increase ACS. This is relevant to develop interventions in the specific contexts of each barrier and involving both populations.

12-Year Trends in Active School Transport across Four European Countries-Findings from the Health Behaviour in School-Aged Children (HBSC) Study

Active school transport (AST) is a source of daily physical activity uptake. However, AST seems to have decreased worldwide over recent decades. We aimed to examine recent trends in AST and associations with gender, age, family affluence, and time to school, using data from the Health Behaviour in School-Aged Children (HBSC) study collected in 2006, 2010, 2014, and 2018 in the Czech Republic, Norway, Scotland, and Wales. Data from 88,212 students (11, 13 and 15 years old) revealed stable patterns of AST from 2006 to 2018, apart from a decrease in the Czech Republic between 2006 and 2010. For survey waves combined, walking to and from school was most common in the Czech Republic (55%) and least common in Wales (30%). Cycling was only common in Norway (22%). AST differed by gender (Scotland and Wales), by age (Norway), and by family affluence (everywhere but Norway). In the Czech Republic, family affluence was associated with change over time in AST, and the effect of travel time on AST was stronger. The findings indicate that the decrease in AST could be levelling off in the countries considered here. Differential associations with sociodemographic factors and travel time should be considered in the development of strategies for AST.

A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study

This manuscript describes the rationale and protocol of a school-based randomized controlled trial called “Cycling and Walk to School” (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1–2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.

Active commuting to school among 36,781 Spanish children and adolescents: A temporal trend study

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term.

Psychometric Characteristics of a Commuting-to-School Behaviour Questionnaire for Families

The purposes of this study were: (a) to describe the patterns of modes of commuting to school (children) and to work (parents) separated by gender and age, (b) to validate the questions on children’s mode of commuting to and from school according to their parents, and (c) to analyse the reliability of a family questionnaire focused on commuting to school behaviours. A total of 611 parents (mean age: 43.28 ± 6.25 years old) from Granada (Spain) completed “Family commuting-to-school behaviour” questionnaire in two sessions separated by 14 days, (2016 and 2018). The validation between family and children’s questions was assessed using the Kappa and Spearman correlation coefficients, and the test–retest reliability within the family questions was assessed using the Kappa and the weighted Kappa. The children’s modes of commuting to school (mean age: 11.44 ± 2.77 years old) were mainly passive (57.7% to school) while parents’ modes of commuting to work were mainly active (71.6%). The validity of the mode of commuting was significant with high Kappa and Spearman coefficients. The test–retest reliability presented a good agreement for the mode of commuting to school in children, distance and time to school, and the mode of commuting to work in parents, while the questions on acceptable distance to walk or cycle to school showed a moderate to good agreement. The “Family commuting-to-school behaviour” questionnaire could be a useful tool to assess the mode of commuting of children, distance and time to school for researchers and practitioners.

Different neighborhood walkability indexes for active commuting to school are necessary for urban and rural children and adolescents

BACKGROUND

Literature focusing on youth has reported limited evidence and non-conclusive associations between neighborhood walkability measures and active commuting to and from school (ACS). Moreover, there is a lack of studies evaluating both macro- and micro-scale environmental factors of the neighborhood when ACS is analyzed. Likewise, most studies on built environment attributes and ACS focus on urban areas, whereas there is a lack of studies analyzing rural residential locations. Moreover, the relationship between built environment attributes and ACS may differ in children and adolescents. Hence, this study aimed to develop walkability indexes in relation to ACS for urban and rural children and adolescents, including both macro- and micro-scale school-neighborhood factors.

METHODS

A cross-sectional study of 4593 participants from Spain with a mean age of 12.2 (SD 3.6) years was carried out. Macro-scale environmental factors were evaluated using geographic information system data, and micro-scale factors were measured using observational procedures. Socio-demographic characteristics and ACS were assessed with a questionnaire. Several linear regression models were conducted, including all the possible combinations of six or less built environment factors in order to find the best walkability index.

RESULTS

Analyses showed that intersection density, number of four-way intersections, and residential density were positively related to ACS in urban participants, but negatively in rural participants. In rural children, positive streetscape characteristics, number of regulated crossings, traffic calming features, traffic lanes, and parking street buffers were also negatively related to ACS. In urban participants, other different factors were positively related to ACS: number of regulated crossings, positive streetscape characteristics, or crossing quality. Land use mix acted as a positive predictor only in urban adolescents. Distance to the school was a negative predictor on all the walkability indexes. However, aesthetic and social characteristics were not included in any of the indexes.

CONCLUSIONS

Interventions focusing on improving built environments to increase ACS behavior need to have a better understanding of the walkability components that are specifically relevant to urban or rural samples.

Objective Measures to Assess Active Commuting Physical Activity to School in Young People: A Systematic Review Protocol and Practical Considerations

There are no systematic reviews that have identified the existing studies assessing active commuting physical activity (PA) to and from (to/from) school using objective measures, as well as the contribution of both walking and cycling to/from school to PA levels. To fill this gap in the literature, this systematic review will aim (a) to identify existing studies that assess active commuting PA to/from school with objective measures in young people and to examine the contribution of walking and cycling to/from school to PA levels, and (b) to propose an appropriate methodology and practical considerations to assess active commuting PA to/from school based on the studies identified. The review protocol was registered in PROSPERO (CRD42020162004). We will conduct a systematic search up to 2020 in five databases: PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library. Both the risk of bias and the quality of the identified studies will be evaluated through different instruments according to the design of each study. This systematic review will help to choose the most appropriate objective measures to assess active commuting PA to/from school and to promote walking and cycling to/from school to increase PA levels.

Relationship between the average slope in the active commuting to and from school and fitness in adolescents: the mediator role of fatness

Active commuting to and from school (ACS) has been recognized as a potential tool to improve physical fitness. Thus, this study aims to test the relationships between the average slope in the ACS and physical fitness, as well as to verify the mediator role of fatness in the relationship between average slope and physical fitness. A total of 257 participants, 137 boys and 120 girls, from 22 schools belonged to first and second High School grades participated in this study. Based on self-reported measure and Google Earth, participants were grouped into the active commuter (number of trips was ≥5, and the time of the trip was ≥15 min), mixed commuter (number of weekly trips was <5, and the time spent on the trip was <15 min) and passive commuter groups (those who reported traveling regularly by car, motorcycle, or bus). Specifically, in the active commuter group, a positive association between the average slope in the ACS with fatness was found, which in turn was positively related to strength lower limbs and cardiorrespiratory fitness. The average slope was not significantly associated with physical fitness indicators. Furtheremore, fatness did not mediate the relathionship between average slope and physical fitness. This research concluded positive associations between average slope and the body fat in the ACS. The tendency of findings signal that the average slope should be taken into account along with the distance, time and frequency of the active commuting.

A Conceptual Framework for Modelling Safe Walking and Cycling Routes to High Schools

Active transport to or from school presents an opportunity for adolescents to engage in daily physical activity. Multiple factors influence whether adolescents actively travel to/from school. Creating safe walking and cycling routes to school is a promising strategy to increase rates of active transport. This article presents a comprehensive conceptual framework for modelling safe walking and cycling routes to high schools. The framework has been developed based on several existing relevant frameworks including (a) ecological models, (b) the “Five Es” (engineering, education, enforcement, encouragement, and evaluation) framework of transport planning, and (c) a travel mode choice framework for school travel. The framework identifies built environment features (land use mix, pedestrian/cycling infrastructure, neighbourhood aesthetics, and accessibility to local facilities) and traffic safety factors (traffic volume and speed, safe road crossings, and quality of path surface) to be considered when modelling safe walking/cycling routes to high schools. Future research should test this framework using real-world data in different geographical settings and with a combination of tools for the assessment of both macro-scale and micro-scale built environment features. To be effective, the modelling and creation of safe routes to high schools should be complemented by other interventions, including education, enforcement, and encouragement in order to minimise safety concerns and promote active transport.

A GIS-Based Method for Analysing the Association Between School-Built Environment and Home-School Route Measures with Active Commuting to School in Urban Children and Adolescents

In the current call for a greater human health and well-being as a sustainable development goal, to encourage active commuting to and from school (ACS) seems to be a key factor. Research focusing on the analysis of the association between environmental factors and ACS in children and adolescents has reported limited and inconclusive evidence, so more knowledge is needed about it. The main aim of this study is to examine the association between different built environmental factors of both school neighbourhood and home-school route with ACS of children and adolescents belonging to urban areas. The ACS level was evaluated using a self-reported questionnaire. Built environment variables (i.e., density of residents, street connectivity and mixed land use) within a school catchment area and home-school route characteristics (i.e., distance and pedestrian route directness—PRD) were measured using a geographic information system (GIS) and examined together with ACS levels. Subsequently, the association between environmental factors and ACS was analysed by binary logistic regression. Several cut-off points of the route measures were explored using receiver operating characteristic (ROC) curves. In addition, the PRD was further studied regarding different thresholds. The results showed that 70.5% of the participants were active and there were significant associations between most environmental factors and ACS. Most participants walked to school when routes were short (distance variable in children: OR = 0.980; p = 0.038; and adolescents: OR = 0.866; p < 0.001) and partially direct (PRD variable in children: OR = 11.334; p < 0.001; and adolescents: OR = 3.513; p < 0.001), the latter specially for children. Mixed land uses (OR = 2.037; p < 0.001) and a high density of street intersections (OR = 1.640; p < 0.001) clearly encouraged adolescents walking and slightly discouraged children walking (OR = 0.657, p = 0.010; and OR = 0.692, p = 0.025, respectively). The assessment of ACS together with the environmental factors using GIS separately for children and adolescents can inform future friendly and sustainable communities.

School Neighbourhood Built Environment Assessment for Adolescents' Active Transport to School: Modification of an Environmental Audit Tool and Protocol (MAPS Global-SN)

School neighbourhood built environments (SN-BE) can influence adolescents' active transport to school habits. Typically, SN-BE assessment has involved micro-scale (i.e., environmental audits) or macro-scale (Geographic Information Systems (GIS)) assessment tools. However, existing environmental audits are time/resource-intensive and not specific to school neighbourhoods, while GIS databases are not generally purposed to include micro-scale data. This study evaluated the inter-rater reliability and feasibility of using a modified audit tool and protocol (Microscale Audit of Pedestrian Streetscapes Global-School Neighbourhood (MAPS Global-SN)) to assess the SN-BE of twelve secondary schools in Dunedin, New Zealand. Correlations between MAPS Global-SN and GIS measures of the SN-BE were also examined. Specifically, MAPS Global-SN audit and GIS spatial analysis (intersection density, residential density, land use mix, walkability) was conducted within a 0.5 km street-network buffer-zone around all twelve schools. Based on investigator and expert consultation, MAPS Global-SN included eight modifications to both auditing processes and items. Inter-rater reliability data was collected from two independent auditors across two schools. The feasibility of a condensed audit protocol (auditing one side of each street segment in the neighbourhood, compared to both sides) was also assessed. Results indicated the modified MAPS Global-SN tool had good to excellent inter-rater reliability and the condensed MAPS Global-SN audit protocol appeared to sufficiently represent the micro-scale SN-BE. Results also highlighted the complementary nature of micro- and macro-scale assessments. Further recommendations for SN-BE assessment are discussed.

Active Commuting, Physical Activity, and Sedentary Behaviors in Children and Adolescents from Spain: Findings from the ANIBES Study

Active commuting (AC) has been proposed as a great opportunity to increase physical activity level (PA) in children and adolescents. The aim of the present study is to determine the associations between AC (walk and cycle commuting) and non-AC (motor vehicle commuting) with PA levels, and with AC and sedentarism in Spanish children and adolescents. A representative Spanish sample of 424 children and adolescents (38% females) was involved in the ANIBES (Anthropometry, Dietary Intake and Lifestyle in Spain) Study in 2013. Data on the levels of AC, non-AC, PA, and sedentarism were obtained using the International Physical Activity Questionnaire for adolescents. Stepwise backward univariate generalized linear and linear regression models were performed. In girls, walking was associated with playground PA, moderate PA, and moderate to vigorous PA (MVPA) (β = 0.007, p < 0.05; both β = 0.007, p < 0.01), respectively. In boys, walking was associated with all PA levels (p < 0.05); while cycling was related to moderate PA and MVPA (both β = 0.007, p < 0.05). A negative significant association was observed between AC and time spent studying without Internet use in boys (β = −0.184, p < 0.05). Commuting by walking contributes to increased daily PA in both sexes, whereas cycling was only related to moderate PA and MVPA in boys. Sedentary behaviors are not related to AC, but studying without Internet use was negatively associated with AC in boys.

Parental barriers to active transport to school: a systematic review

OBJECTIVES

We aimed to systematically review parental barriers towards children and adolescents' active transport to school (ATS) in the scientific literature and to provide a categorization of the barriers identified in the studies.

METHODS

A search was conducted through seven online databases, from the beginning of the database to March 2018.

RESULTS

A total of 27 of the identified studies met the inclusion criteria. The main parental barriers reported by parents of children (21 studies) were built environment, traffic safety, distance, crime-related safety and social support. The main parental barriers reported by parents of adolescents (6 studies) were built environment (street connectivity), distance, traffic safety and physical and motivation barriers. The parental barriers associated with ATS were mainly related to the built environment and traffic safety.

CONCLUSIONS

It is crucial to involve parents through interventions to reduce the perception of safety and to increase awareness of the importance of ATS. In addition, these strategies should be complemented by environmental changes performed by local governments.

Active or Passive Commuter? Discrepancies in Cut-off Criteria among Adolescents

Active commuting to school has health implications for young people. Previous research has shown the need to consistently define the concept of “active commuter”, given that assessment as well as comparison between studies may be hindered by current discrepancies in frequency criteria. Using a sample of 158 Spanish students (12th–13th grade, 60.8% girls), the current study aimed to compare several cut-off criteria to rigorously identify the frequency of weekly active trips to school in order to categorize adolescents as active or passive commuters, and to analyze whether the threshold living distance to school is associated with the different trip cut-off criteria. Percentages of active commuters ranged from 75% to 88.6%, varying significantly depending on the cut-off criteria (5–10 active trips/week) used. The results also support the need to be stricter in the selection of a cut-off criterion when the distance to the school becomes shorter. Our findings highlight the importance of following a standard criterion to classify individuals as active or passive commuters, considering the characteristics of the context in which each study is conducted.

Objective Measurement of the Mode of Commuting to School Using GPS: A Pilot Study

Background and objectives: Active commuting to school (ACS) is a promising strategy to increase the daily physical activity (PA) in youths. However, more studies are required to objectively quantify the mode of commuting to school, as well as the health impact of this behavior. Thus, the aims of this study were: (1) to objectively determine the mode of commuting to school using GPS; (2) to quantify the sedentary time, PA levels, energy expenditure, and the steps derived from each mode of commuting; and (3) to analyze the associations between ACS trips and sedentary time, PA, energy expenditure, and steps. Participants and Methods: A total of 180 trips to school were detected, which corresponded to 18 adolescents (12 girls, mean age = 15 ± 0.0 years old). Mode of commuting to school was detected using a novel method merging GPS data in the Personal Activity Location Measurement System (PALMS), whereas sedentary time, PA levels, energy expenditure, and steps were objectively evaluated through accelerometry. Logistic regressions were used to analyze the associations of these variables with walking trips. Results: A total of 115 trips were recorded. Most trips were performed by walk (49.5%), followed by vehicle (39.1%) and mixed transport (11.3%). In the active school trips, youths were less likely to spend minutes in sedentary behaviors (OR: 0.481, p = 0.038), a higher increase on Metabolic-Equivalent of Task (METs) (OR: 5.497, p = 0.013), and greater steps (OR: 1.004, p = 0.029) than in the passive school trips (both active and passive modes were objectively measured). Conclusions: ACS (mainly walking) contribute to higher METs and steps in adolescents. GPS could be an appropriate method to objectively evaluate the PA variables related to the ACS trips.

Influence of distance, area, and cultural context in active commuting: Continental and insular children

Commuting by walking or cycling is a way to increase physical activity levels. The objective of this article was to determine the modes of commuting to school and the distance and time of the way to school among children from Easter Island and from the mainland (Valparaíso), in Chile. A total of 666 children and adolescents aged 10 to 18 years old (208 from Easter Island and 458 from Valparaíso) participated and completed a valid questionnaire including data about age, gender, usual commuting mode to and from school, distance, and travel time. There are important differences in the mode of commuting between students of Valparaíso and Easter Island. Private transport is more commonly used in Valparaíso than in Easter Island (p<0.001). Furthermore, it was observed that cycling and public transportation are not used as mode of commuting in Valparaíso and Easter Island respectively. Students from Easter Island, who travel more distance and during more time, are more active than students from Valparaíso (going 24.8% and 17.6%; from: 61% and 28.8% respectively). This situation is influenced by the geographic context of the island, the distances from home to school, and the type of commuting, which fosters the level of active commuting. On the other hand, the passive modes of commuting to school are higher in the mainland urban setting of Valparaíso. It is necessary to study the diverse contexts of the Easter Island population, but, for now, the rural setting of Easter Island seems to be associated with a greater level of active commuting to school.

Built Environment, Psychosocial Factors and Active Commuting to School in Adolescents: Clustering a Self-Organizing Map Analysis

Although the built environment and certain psychosocial factors are related to adolescents' active commuting to and from school (ACS), their interrelationships have not been explored in depth. This study describes these interrelationships and behavioral profiles via a self-organizing map (SOM) analysis. The sample comprised 465 adolescents from the IPEN (International Physical Activity and the Environment Network) Adolescent study in Valencia, Spain. ACS, barriers to ACS, physical self-efficacy, social support and sociodemographics were measured by questionnaire. Street-network distance to school, net residential density and street intersection density were calculated from the Geographic Information System. The clustering of the SOM outcomes resulted in eight areas or clusters. The clusters which correspond to the lowest and highest ACS levels were then explored in depth. The lowest ACS levels presented interactions between the less supportive built environments (i.e., low levels of residential density and street connectivity in the neighborhood and greater distances to school) and unfavorable psychosocial variables (i.e., low values of physical self-efficacy and medium social support for ACS) and good access to private motorized transport at home. The adolescents with the lowest ACS values exhibited high ACS environment/safety and planning/psychosocial barrier values. Future interventions should be designed to encourage ACS and change multiple levels of influence, such as individual, psychosocial and environmental factors.

Physical and spatial assessment of school neighbourhood built environments for active transport to school in adolescents from Dunedin (New Zealand)

Adolescent active transport to school (ATS) is influenced by demographic, social, environmental and policy factors. Yet, the relationship between school neighbourhood built environment (SN-BE) and adolescents' ATS remains largely unexplored. This observational study examined associations between observed, objectively-measured and perceived SN-BE features and adolescents' ATS in Dunedin (New Zealand). Adolescents' perception of safety of walking to school was the strongest correlate of ATS among adolescents living ≤ 2.25 km of school, whereas assessed micro- and macro-scale SN-BE features were not significantly correlated with ATS. Adolescents' perceptions of walking safety should be considered as a part of comprehensive efforts to encourage ATS.

Systematic review of interventions for promoting active school transport

Active commuting to school has been recognized as a potential avenue to increase physical activity in children and adolescents. However, active commuting to school has declined over time, and interventions are needed to reverse this trend. The main aim in the current study was to update a previous systematic review on interventions focused on active travel to school, following the same methodology and addressing the quality and effectiveness of new studies detected in the more recent scientific literature. A systematic review was conducted to identify intervention studies of active commuting to school published from February 2010 to December 2016. Five electronic databases and a manual search were conducted. Detailed information was extracted, including a quantitative assessment comparing the effect sizes, with Cohen's d, and a qualitative assessment using the Evaluation of Public Health Practice Projects tool. We identified 23 interventions that focused on active commuting to school. Among the 23 interventions, three were randomized control trials, 22 had a pre/post design, and 12 used control groups. Most interventions reported a small effect size on active commuting to school (14/23) (d: from -1.45 to 2.37). The quality assessment was rated as weak in most studies (21/23). Government funding continues investing in public policies to promote active commuting to school. However, even though seven years have passed since the last systematic review, research with high quality designs with randomization, greater sample size, and the use of valid and reliable instruments are needed.

Impact of Distance on Mode of Active Commuting in Chilean Children and Adolescents

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 years were included in this study. Data regarding modes of commuting and commuting distance was collected using a validated questionnaire. Commuting mode was classified as active commuting (walking and/or cycling) or non-active commuting (car, motorcycle and/or bus). Commuting distance expressed in kilometres was categorised into six subgroups (0 to 0.5, 0.6 to 1, 1.1 to 2, 2.1 to 3, 3.1 to 5 and >5 km). Car commuting was the main mode for children (to school 64.9%; from school 51.2%) and adolescents (to school 50.2%; from school 24.7%). Whereas public bus commuting was the main transport used by adolescents to return from school. Only 11.0% and 24.8% of children and adolescents, respectively, walk to school. The proportion of children and adolescents who engage in active commuting was lower in those covering longer distances compared to a short distance. Adolescents walked to and from school more frequently than children. These findings show that non-active commuting was the most common mode of transport and that journey distances may influence commuting modes in children and adolescents.

Sedentary behavior among Spanish children and adolescents: findings from the ANIBES study

Background

An increase of sedentary behaviors far from the Mediterranean lifestyle is happening in spite of the impact on health. The aims of this study were to describe sedentary behaviors in children and adolescents.

Methods

A representative sample of 424 Spanish children and adolescents (38% females) involved in the ANIBES study was analyzed regarding their sedentary behaviors, together with the availability of televisions, computers, and consoles by means of the HELENA sedentary behavior questionnaire.

Results

For the total sample of children, 49.3% during weekdays and 84% during weekends did not meet the recommendation of less than 2 hours of screen viewing per day. The use of TV was higher during weekdays (p < 0.05) and there were significant differences between adolescents and children (16.9 vs. 25.1%, p < 0.05). The use of computer, console games and of internet for non-study reasons was higher during weekends (p < 0.001). Adolescents played more computer games and used more internet for non-study reasons than children during both weekdays and weekends (p < 0.05 and p < 0.001, respectively). The use of internet for academic reasons was lower in children (p < 0.001) than adolescents during weekends; however, no significant differences were found between sexes. In addition, more than 30% of the children and adolescents had at least one electronic device in their bedrooms.

Conclusions

Spanish children and adolescents are not meeting the recommendations regarding the maximum of screen viewing (<2 h/day), especially during the weekend, for all of sedentary behaviors. Urgent strategies and intervention studies are needed to reduce sedentary behavior in young people.

Effects of a school-based intervention on active commuting to school and health-related fitness

Background

Active commuting to school has declined over time, and interventions are needed to reverse this trend. The main objective was to investigate the effects of a school-based intervention on active commuting to school and health-related fitness in school-age children of Southern Spain.

Methods

A total of 494 children aged 8 to 11 years were invited to participate in the study. The schools were non-randomly allocated (i.e., school level allocation) into the experimental group (EG) or the control group (CG). The EG received an intervention program for 6 months (a monthly activity) focused on increasing the level of active commuting to school and mainly targeting children’s perceptions and attitudes. Active commuting to school and health-related fitness (i.e., cardiorespiratory fitness, muscular fitness and speed-agility), were measured at baseline and at the end of the intervention. Children with valid data on commuting to school at baseline and follow-up, sex, age and distance from home to school were included in the final analysis (n = 251). Data was analyzed through a factorial ANOVA and the Bonferroni post-hoc test.

Results

At follow up, the EG had higher rates of cycling to school than CG for boys only (p = 0.04), but not for walking to school for boys or girls. The EG avoided increases in the rates of passive commuting at follow up, which increased in the CG among girls for car (MD = 1.77; SE = 0.714; p = 0.010) and bus (MD = 1.77; SE = 0.714; p = 0.010) modes. Moreover, we observed significant interactions and main effects between independent variables (study group, sex and assessment time point) on health-related fitness (p < 0.05) over the 6-month period between groups, with higher values in the control group (mainly in boys).

Conclusion

A school-based intervention focused on increasing active commuting to school was associated with increases in rates of cycling to school among boys, but not for walking to school or health-related fitness. However, the school-based intervention avoided increases in rates of passive commuting in the experimental group, which were significantly increased in girls of the control group.

Built Environment and Active Transport to School (BEATS) Study: protocol for a cross-sectional study

INTRODUCTION

Active transport to school (ATS) is a convenient way to increase physical activity and undertake an environmentally sustainable travel practice. The Built Environment and Active Transport to School (BEATS) Study examines ATS in adolescents in Dunedin, New Zealand, using ecological models for active transport that account for individual, social, environmental and policy factors. The study objectives are to: (1) understand the reasons behind adolescents and their parents' choice of transport mode to school; (2) examine the interaction between the transport choices, built environment, physical activity and weight status in adolescents; and (3) identify policies that promote or hinder ATS in adolescents.

METHODS AND ANALYSIS

The study will use a mixed-method approach incorporating both quantitative (surveys, anthropometry, accelerometers, Geographic Information System (GIS) analysis, mapping) and qualitative methods (focus groups, interviews) to gather data from students, parents, teachers and school principals. The core data will include accelerometer-measured physical activity, anthropometry, GIS measures of the built environment and the use of maps indicating route to school (students)/work (parents) and perceived safe/unsafe areas along the route. To provide comprehensive data for understanding how to change the infrastructure to support ATS, the study will also examine complementary variables such as individual, family and social factors, including student and parental perceptions of walking and cycling to school, parental perceptions of different modes of transport to school, perceptions of the neighbourhood environment, route to school (students)/work (parents), perceptions of driving, use of information communication technology, reasons for choosing a particular school and student and parental physical activity habits, screen time and weight status. The study has achieved a 100% school recruitment rate (12 secondary schools).

ETHICS AND DISSEMINATION

The study has been approved by the University of Otago Ethics Committee. The results will be actively disseminated through reports and presentations to stakeholders, symposiums and scientific publications.

Physical Activity Patterns of the Spanish Population Are Mostly Determined by Sex and Age: Findings in the ANIBES Study

BACKGROUND

Representative data for the Spanish population regarding physical activity (PA) behaviors are scarce and seldom comparable due to methodological inconsistencies.

AIM

Our objectives were to describe the PA behavior by means of the standardized self-reported International Physical Activity Questionnaire (IPAQ) and to know the proportion of the Spanish population meeting and not meeting international PA recommendations.

MATERIAL AND METHODS

PA was assessed using the IPAQ in a representative sample of 2285 individuals (males, 50.4%) aged 9-75 years and living in municipalities of at least 2,000 inhabitants. Data were analyzed according to: age groups 9-12, 13-17, 18-64, and 65-75 years; sex; geographical distribution; locality size and educational levels.

RESULTS

Mean total PA was 868.8±660.9 min/wk, mean vigorous PA 146.4±254.1 min/wk, and mean moderate PA 398.1±408.0 min/wk, showing significant differences between sexes (p<0.05). Children performed higher moderate-vigorous PA than adolescents and seniors (p<0.05), and adults than adolescents and seniors (p<0.05). Compared to recommendations, 36.2% of adults performed <150 min/week of moderate PA, 65.4% <75 min/week of vigorous PA and 27.0% did not perform any PA at all, presenting significant differences between sexes (p<0.05). A total of 55.4% of children and adolescents performed less than 420 min/week of MVPA, being higher in the later (62.6%) than in the former (48.4%). Highest non-compliance was observed in adolescent females (86.5%).

CONCLUSION

Sex and age are the main influencing factors on PA in the Spanish population. Males engage in more vigorous and light PA overall, whereas females perform more moderate PA. PA behavior differs between age groups and no clear lineal increase with age could be observed. Twenty-seven percent of adults and 55.4% of children and adolescents do not meet international PA recommendations. Identified target groups should be addressed to increase PA in the Spanish population.

Effectiveness of an active commuting school-based intervention at 6-month follow-up

BACKGROUND

Active commuting to school may provide a significant source of physical activity in youth. Previous school-based intervention studies have shown a positive effect on increasing the frequency of active commuting to school in the short-term. However, how the observed effects are after the intervention remains to be investigated. The objective of the present study was to investigate the effects of a school-based intervention on active commuting to school at 6-month follow-up.

METHODS

A total of 494 children ages 8-11 years from 5 primary schools were invited to the study. The schools were non-randomly allocated into control or experimental group. The experimental group received a 6-month programme focused on increasing active commuting to school, while the control group received no intervention. Frequency and mode of commuting to school were measured using a questionnaire at pre-intervention, post-intervention and 6-month follow-up. Children with valid data on commuting to school and provided data for sex, age and distance from home were included in this study (n= 206).

RESULTS

There was a significant difference in the change of number of walk and bike travels per week between groups at 6-month follow-up (Control-Group = -0.4 ± 0.3; Experimental-Group = 0.6 ± 0.2;p = 0.019). Regarding the frequency of mode of commuting, only a change in walking to school was significantly different between the groups at 6-month follow-up (Difference Follow-up-Post-intervention) (Control-Group = -0.6 ± 0.3; Experimental-Group = 0.7 ± 0.2;p = 0.004).

CONCLUSIONS

A 6-month school-based intervention focused on increasing active commuting to school could be effective strategy for increasing the frequency of active commuting to school even beyond the period of intervention.

Changes in Active Commuting to School in Czech Adolescents in Different Types of Built Environment across a 10-Year Period

Active commuting (AC) to school represents a great opportunity to incorporate walking or cycling into adolescents' everyday routine. The objective of the study was to describe changes in AC in Czech adolescents across a 10-year period in different built environments. Data from the 2001 and 2011 Czech Census of Population and Housing were used to examine the mode of transportation taken to school in 6236 adolescents. Changes in AC over time were analyzed for low and high walkable areas separately in two Czech regional cities, Olomouc and Hradec Králové. Between 2001 and 2011, the proportion of adolescents actively commuting to school decreased by 47%, from an absolute rate of 49.1% to 26%. The proportion of active commuters fell in low walkable areas by 61% and in high walkable areas by 39%. The results indicated that adolescents in 2011 were 2.7 times less (OR = 0.365, p < 0.001) likely to actively commute than in 2001. The AC behavior in Czech adolescents has a negative tendency to replicate travel-to-school patterns in adolescents previously described in more developed countries. The findings might serve as a recommendation for municipal policy.

Using an agent-based model to simulate children's active travel to school

Background

Despite the multiple advantages of active travel to school, only a small percentage of US children and adolescents walk or bicycle to school. Intervention studies are in a relatively early stage and evidence of their effectiveness over long periods is limited. The purpose of this study was to illustrate the utility of agent-based models in exploring how various policies may influence children’s active travel to school.

Methods

An agent-based model was developed to simulate children’s school travel behavior within a hypothetical city. The model was used to explore the plausible implications of policies targeting two established barriers to active school travel: long distance to school and traffic safety. The percent of children who walk to school was compared for various scenarios.

Results

To maximize the percent of children who walk to school the school locations should be evenly distributed over space and children should be assigned to the closest school. In the case of interventions to improve traffic safety, targeting a smaller area around the school with greater intensity may be more effective than targeting a larger area with less intensity.

Conclusions

Despite the challenges they present, agent based models are a useful complement to other analytical strategies in studying the plausible impact of various policies on active travel to school.