Built environmental correlates of cycling for transport across Europe

Are bicycle streets cyclist-friendly? Micro-environmental factors for improving perceived safety when cycling in mixed traffic

A bicycle street is a mixed traffic street where motor vehicles are forced to adapt their speed to bicycle traffic, for example by encouraging cycling in the middle of the street using centered bicycle lanes. The objective safety of cyclists increases with lower vehicle speeds and fewer motor vehicles. Despite this, cyclists' perception of their safety is often reduced in mixed traffic streets. Subjective unsafety and risk constitute a major barrier to increased cycling. This study investigates how the design of the micro-environment of bicycle streets can improve cyclists' perceived safety in mixed traffic. A quasi-experimental survey in which 371 participants rated their perceived safety in photo-manipulated bicycle streets was conducted. 52% of the participants were male, the mean age was 43 (20-77) years, and 76% reported that they cycle 4-5 days a week or more. The focus was on evaluating micro-environmental factors such as different designs of centered bicycle lanes, road markings, signs, traffic volume, and parked cars. It is concluded that the micro-environment has important effects on the perceived safety of cyclists. Important gains in subjective safety can be achieved with fairly simple design efforts. Many participants felt safe when there were clearly demarcated red-colored bicycle lanes in the center of the street accompanied by road markings for cyclists. The strongest effect, however, comes from reducing traffic volume. Most participants felt safe in micro-environments in which the traffic volume had been reduced, including those where no design changes had been made. Important differences between different groups of cyclists were also found.

Cyclists' exposure to air pollution, noise, and greenery: a population-level spatial analysis approach

Urban travel exposes people to a range of environmental qualities with significant health and wellbeing impacts. Nevertheless, the understanding of travel-related environmental exposure has remained limited. Here, we present a novel approach for population-level assessment of multiple environmental exposure for active travel. It enables analyses of (1) urban scale exposure variation, (2) alternative routes' potential to improve exposure levels per exposure type, and (3) by combining multiple exposures. We demonstrate the approach's feasibility by analysing cyclists' air pollution, noise, and greenery exposure in Helsinki, Finland. We apply an in-house developed route-planning and exposure assessment software and integrate to the analysis 3.1 million cycling trips from the local bike-sharing system. We show that especially noise exposure from cycling exceeds healthy thresholds, but that cyclists can influence their exposure by route choice. The proposed approach enables planners and individual citizens to identify (un)healthy travel environments from the exposure perspective, and to compare areas in respect to how well their environmental quality supports active travel. Transferable open tools and data further support the implementation of the approach in other cities.

An ecosystem service perspective on urban nature, physical activity, and health

Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants.

How Is Urban Greenness Spatially Associated with Dockless Bike Sharing Usage on Weekdays, Weekends, and Holidays?

Dockless bike sharing plays an important role in residents’ daily travel, traffic congestion, and air pollution. Recently, urban greenness has been proven to be associated with bike sharing usage around metro stations using a global model. However, their spatial associations and bike sharing usage on public holidays have seldom been explored in previous studies. In this study, urban greenness was obtained objectively using eye-level greenness with street-view images by deep learning segmentation and overhead view greenness from the normalized difference vegetation index (NDVI). Geographically weighted regression (GWR) was applied to fill the research gap by exploring the spatially varying association between dockless bike sharing usage on weekdays, weekends, and holidays, and urban greenness indicators as well as other built environment factors. The results showed that eye-level greenness was positively associated with bike sharing usage on weekdays, weekends, and holidays. Overhead-view greenness was found to be negatively related to bike usage on weekends and holidays, and insignificant on weekdays. Therefore, to promote bike sharing usage and build a cycling-friendly environment, the study suggests that the relevant urban planner should pay more attention to eye-level greenness exposure along secondary roads rather than the NDVI. Most importantly, planning implications varying across the study area during different days were proposed based on GWR results. For example, the improvement of eye-level greenness might effectively promote bike usage in northeastern and southern Futian districts and western Nanshan on weekdays. It also helps promote bike usage in Futian and Luohu districts on weekends, and in southern Futian and southeastern Nanshan districts on holidays.

Development and Validation of a Google Street View Pedestrian Safety Audit Tool

BACKGROUND

Assessing aspects of intersections that may affect the risk of pedestrian injury is critical to developing child pedestrian injury prevention strategies, but visiting intersections to inspect them is costly and time-consuming. Several research teams have validated the use of Google Street View to conduct virtual neighborhood audits that remove the need for field teams to conduct in-person audits.

METHODS

We developed a 38-item virtual audit instrument to assess intersections for pedestrian injury risk and tested it on intersections within 700 m of 26 schools in New York City using the Computer-assisted Neighborhood Visual Assessment System (CANVAS) with Google Street View imagery.

RESULTS

Six trained auditors tested this instrument for inter-rater reliability on 111 randomly selected intersections and for test-retest reliability on 264 other intersections. Inter-rater kappa scores ranged from -0.01 to 0.92, with nearly half falling above 0.41, the conventional threshold for moderate agreement. Test-retest kappa scores were slightly higher than but highly correlated with inter-rater scores (Spearman rho = 0.83). Items that were highly reliable included the presence of a pedestrian signal (K = 0.92), presence of an overhead structure such as an elevated train or a highway (K = 0.81), and intersection complexity (K = 0.76).

CONCLUSIONS

Built environment features of intersections relevant to pedestrian safety can be reliably measured using a virtual audit protocol implemented via CANVAS and Google Street View.

Adapting the SPOTLIGHT Virtual Audit Tool to assess food and activity environments relevant for adolescents: a validity and reliability study

Background

Physical inactivity and unhealthy diet are key behavioral determinants underlying obesity. The neighborhood environment represents an important arena for modifying these behaviors, and hence reliable and valid tools to measure it are needed. Most existing virtual audit tools have been designed to assess either food or activity environments deemed relevant for adults. Thus, there is a need for a tool that combines the assessment of food and activity environments, and which focuses on aspects of the environment relevant for youth.

Objective

The aims of the present study were: (a) to adapt the SPOTLIGHT Virtual Audit Tool (S-VAT) developed to assess characteristics of the built environment deemed relevant for adults for use in an adolescent population, (b) to assess the tool’s inter- and intra-rater reliability, and (c) to assess its criterion validity by comparing the virtual audit to a field audit.

Methods

The tool adaptation was based on literature review and on results of a qualitative survey investigating how adolescents perceived the influence of the environment on dietary and physical activity behaviors. Sixty streets (148 street segments) in six neighborhoods were randomly selected as the study sample. Two raters assessed the inter- and intra-rater reliability and criterion validity, comparing the virtual audit tool to a field audit. The results were presented as percentage agreement and Cohen’s kappa (κ).

Results

Intra-rater agreement was found to be moderate to almost perfect (κ = 0.44–0.96) in all categories, except in the category aesthetics (κ = 0.40). Inter-rater agreement between auditors ranged from fair to substantial for all categories (κ = 0.24–0.80). Criterion validity was found to be moderate to almost perfect (κ = 0.56–0.82) for most categories, except aesthetics and grocery stores (κ = 0.26–0.35).

Conclusion

The adapted version of the S-VAT can be used to provide reliable and valid data on built environment characteristics deemed relevant for physical activity and dietary behavior among adolescents.

A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence

INTRODUCTION

Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and quality of life, and injuries in the Canadian adult population.

METHODS

From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectively-measured built environment and health conditions in Canadian adults. Studies under-taken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features.

RESULTS

Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic condi-tions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for associations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found.

CONCLUSION

Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limitations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice.

Physical Impairments Disrupt the Association Between Physical Activity and Loneliness: A Longitudinal Study

This study explores the association between physical activity (PA), loneliness, and the presence of physical chronic impairments among single older adults. A longitudinal study (N = 575; mean age 76 ± 8 years) was conducted. The association between self-reported weekly minutes of moderate to vigorous PA, loneliness, and presence of physical impairments was assessed with multilevel analyses at baseline, 3 months, and 6 months. Improvements in moderate to vigorous PA were associated with decreases in loneliness (B = −0.09, SE = 0.04, p = .020); this association became nonsignificant when including the presence of physical impairments in the analyses (p = .824), which in itself was positively associated with loneliness (B = 0.51, SE = 0.10, p < .001). Findings indicate that physical impairments have a larger influence on loneliness than the level of PA. Interventions targeting PA and loneliness should tailor specifically to physical impairments.

Associations of neighbourhood safety with leisure-time walking and cycling in population subgroups: The HELIUS study

To create neighbourhood environments that encourage physical activity, it is important to know which neighbourhood characteristics are most influential. We examined the association of neighbourhood safety with leisure-time walking and cycling in the population at large, as well as in some subgroups in terms of sex, age, ethnicity and socio-economic position. We used data of 19,914 participants (18-70 years) from a study in Amsterdam, the Netherlands. Leisure-time walking and cycling in minutes/week were assessed with standard questionnaire. Geographic Information System techniques were used to examine neighbourhood safety (range = 1-10). Multilevel linear regression analyses showed positive associations between safety and walking (B = 7.9, 95% CI = -6.2-21.9) and cycling (B = 14.8, 95% CI = 2.5-27.1), but only the association with cycling was statistically significant. Higher safety levels were significantly associated with more cycling in women and individuals of Turkish and Moroccan origin. Stronger evidence is needed to inform policies to stimulate walking and cycling by improving neighbourhood safety.

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

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

Age, sex and other correlates with active travel walking and cycling in England: Analysis of responses to the Active Lives Survey 2016/17

Active travel (walking or cycling for transport) can generate personal and environmental benefits. We determined the frequency of participation in walking or cycling active travel by age and sex, as well as used multivariate analysis to find correlations with many other factors using a large cross-sectional 2016/17 survey of people living in England. Walking and cycling active travel were explored separately. Most respondents reported no active travel, but at least 25% of people under age 45 met activity recommendations only from active travel. Otherwise, (unlike other types of physical activity) active travel declined consistently with increased age. Men reported much more cycling active travel than women, who were more likely to do any active travel walking and therefore more likely to meet activity guidelines from just active travel walking. Lower levels of disability, fewer children in household, and working full time increased active travel. Season was sometimes relevant. BMI, personal-effectiveness, deprivation and rurality had mixed relationships with types of active travel. Understanding differences in correlates for cycling vs. walking active travel could help tailor local promotion programmes for each. The analysis suggests that motivators and barriers for active travel greatly by age.

Cyclists’ Multiple Environmental Urban Exposures—Comparing Subjective and Objective Measurements

Citizens in urban areas are exposed to multiple environmental stressors like noise, heat, and air pollution, with impact on human health. There is a great deal of evidence that connects human health, objective environmental exposure, and place of residence. However, little is known about subjective and objective multiple personal exposures while being mobile. To address this research gap, this paper presents results from a mixed-methods exploratory study with cyclists in the City of Leipzig, Germany. In the summer of 2017, cyclists (n = 66) wore a unique combination of sensors that measured particle number counts (PNC), noise, humidity, temperature, geolocation, and the subjective perception of each exposure on everyday routes for one week (n = 730). A smartphone application was developed to question participants about their perception of subjective exposure. The data were analyzed with three aims: (i) to compare the multiple exposure profiles of the cyclists, (ii) to contrast the objective data and subjective individual perception, and (iii) to examine the role of route decision-making and awareness of health impacts for healthier route choices. The results indicate distinct differences between the exposure profiles of cyclists. Over 80% of the cyclists underestimated their exposure to noise and air pollution. Except for heat, no significant associations between the objective and subjective data were found. This reveals an exposure awareness gap that needs to be considered in urban health planning and risk communication. It is argued that knowledge about health impacts and route characteristics plays a crucial role in decision-making about route choices. The paper concludes with suggestions to harness smart sensing for exposure mitigation and research in health geography.

Active commuting through natural environments is associated with better mental health: Results from the PHENOTYPE project

BACKGROUND

Commuting routes with natural features could promote walking or cycling for commuting. Commuting through natural environments (NE) could have mental health benefits as exposure to NE can reduce stress and improve mental health, but there is little evidence. This study evaluates the association between NE and commuting, whether active or not, and the association between commuting (through NE), whether active or not, and mental health. We also evaluate the moderating effect of NE quality on the association between NE commuting and mental health.

METHODS

This cross-sectional study was based on adult respondents (n = 3599) of the Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe (PHENOTYPE) project. Data were collected in four European cities in Spain, the Netherlands, Lithuania and the United Kingdom. Data on commuting behavior (active commuting at least one day/week, daily NE commuting) and mental health were collected with questionnaires. Associations were estimated with multilevel analyses including random intercepts at city- and neighborhood level.

RESULTS

Adjusted multilevel analyses showed that daily NE commuters were more often active commuters (OR 1.42; 95% CI 1.19, 1.70). There was no association between active commuting and mental health, but daily NE commuters had on average a 2.74 (95% CI 1.66, 3.82) point higher mental health score than those not commuting through NE. The association with mental health was stronger among active commuters (4.03, 95% CI 2.13, 5.94) compared to non-active commuters (2.21; 95% CI 0.90, 3.51) when daily commuting through NE, but NE quality did not have a moderating effect.

CONCLUSIONS

Daily NE commuting was associated with better mental health, especially for active commuters. Daily NE commuters were likely to be active commuters. Active commuting itself was not associated with mental health. These findings suggest that cities should invest in commuting routes with nature for cycling and walking.

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

Background

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

Methods

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

Results

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

Conclusions

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

Electronic supplementary material

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

The role of the natural and built environment in cycling duration in the Netherlands

Background

Cycling for transportation has the potential to contribute to an increase in people’s physical activity levels. A growing body of evidence links the natural and the built environment to cycling. Whereas previous studies were mostly done within one city or one region, the present study covers the whole of the Netherlands, allowing an investigation of whether associations between environmental characteristics and cycling are context-specific. The study examines the extent to which objectively measured natural and built environment characteristics contribute to cycling duration in the Netherlands, as well as the differential effect of environmental characteristics on cycling duration by municipality size.

Methods

Our sample from the Dutch National Travel Survey 2010–2014 comprised 110,027 people aged 20–89 years, residing in 3163 four-digit postal code areas, nested within 387 municipalities across the whole of the Netherlands. Multilevel Tobit regression models were fitted to assess the associations between the natural and the built environment with average daily cycling duration (in minutes), while adjusting for individual and household characteristics. Interaction effects of natural and built environment characteristics and municipality size on cycling duration were also investigated.

Results

Higher address density, more bus stops, and shorter distance from home to the nearest train station were positively related to cycling duration. Respondents were more likely to cycle on days with higher temperatures, less wind, and less precipitation. Interaction tests showed that increased street density and address density were less cycling-promotive in small urban areas compared to medium or large cities. On the other hand, the positive association between number of bus stops and cycling duration was weaker in the largest and medium-sized cities compared to small urban and rural areas.

Conclusions

Interactions suggest that relations between environmental characteristics and cycling duration are context-specific (i.e., dependent on circumstances that differ between highly urbanized and less urbanized areas). Our findings need to be replicated in other countries to gain more insight into the interplay between environmental factors and municipality size.

The Association of Urban Greenness and Walking Behavior: Using Google Street View and Deep Learning Techniques to Estimate Residents' Exposure to Urban Greenness

Many studies have established that urban greenness is associated with better health outcomes. Yet most studies assess urban greenness with overhead-view measures, such as park area or tree count, which often differs from the amount of greenness perceived by a person at eye-level on the ground. Furthermore, those studies are often criticized for the limitation of residential self-selection bias. In this study, urban greenness was extracted and assessed from profile view of streetscape images by Google Street View (GSV), in conjunction with deep learning techniques. We also explored a unique research opportunity arising in a citywide residential reallocation scheme of Hong Kong to reduce residential self-selection bias. Two multilevel regression analyses were conducted to examine the relationships between urban greenness and (1) the odds of walking for 24,773 public housing residents in Hong Kong, (2) total walking time of 1994 residents, while controlling for potential confounders. The results suggested that eye-level greenness was significantly related to higher odds of walking and longer walking time in both 400 m and 800 m buffers. Distance to the closest Mass Transit Rail (MTR) station was also associated with higher odds of walking. Number of shops was related to higher odds of walking in the 800 m buffer, but not in 400 m. Eye-level greenness, assessed by GSV images and deep learning techniques, can effectively estimate residents’ daily exposure to urban greenness, which is in turn associated with their walking behavior. Our findings apply to the entire public housing residents in Hong Kong, because of the large sample size.

Systematic review of the use of Google Street View in health research: Major themes, strengths, weaknesses and possibilities for future research

We systematically reviewed the current use of Google Street View (GSV) in health research and characterized major themes, strengths and weaknesses in order to highlight possibilities for future research. Of 54 qualifying studies, we found that most used GSV to assess the neighborhood built environment, followed by health policy compliance, study site selection, and disaster preparedness. Most studies were conducted in urban areas of North America, Europe, or New Zealand, with few studies from South America or Asia and none from Africa or rural areas. Health behaviors and outcomes of interest in these studies included injury, alcohol and tobacco use, physical activity and mental health. Major strengths of using GSV imagery included low cost, ease of use, and time saved. Identified weaknesses were image resolution and spatial and temporal availability, largely in developing regions of the world. Despite important limitations, GSV is a promising tool for automated environmental assessment for health research. Currently untapped areas of health research using GSV include identification of sources of air, soil or water pollution, park design and usage, amenity design and longitudinal research on neighborhood conditions.

Activating Childcare Environments for All Children: the Importance of Children's Individual Needs

Characteristics of the physical childcare environment are associated with children’s sedentary behavior (SB) and physical activity (PA) levels. This study examines whether these associations are moderated by child characteristics. A total of 152 1- to 3-year-old children from 22 Dutch childcare centers participated in the study. Trained research assistants observed the physical childcare environment, using the Environment and Policy Assessment Observation (EPAO) protocol. Child characteristics (age, gender, temperament and weight status) were assessed using parental questionnaires. Child SB and PA was assessed using Actigraph GT3X+ accelerometers. Linear regression analyses including interaction terms were used to examine moderation of associations between the childcare environment and child SB and PA. Natural elements and portable outdoor equipment were associated with less SB and more PA. In addition, older children, boys and heavier children were less sedentary and more active, while more use of childcare and an anxious temperament were associated with more SB. There were various interactions between environmental factors and child characteristics. Specific physical elements (e.g., natural elements) were especially beneficial for vulnerable children (i.e., anxious, overactive, depressive/withdrawn, overweight). The current study shows the importance of the physical childcare environment in lowering SB and promoting PA in very young children in general, and vulnerable children specifically. Moderation by child characteristics shows the urgency of shaping childcare centers that promote PA in all children, increasing equity in PA promotion in childcare.

Do Physical Activity Friendly Neighborhoods Affect Community Members Equally? A Cross-Sectional Study

An activity-friendly environment may increase physical activity (PA) levels and decrease sedentary behavior (SB). This study investigated associations between socio-demographic characteristics, health-related quality of life (HRQoL), perceived environment and objectively measured PA outcomes. Socio-demographic characteristics were assessed using a questionnaire and HRQoL was measured using the EQ-5D. The Neighborhood Environment Walkability Scale (NEWS-A) was used to assess the perceived environment. SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) were measured using the Actigraph GT3X+. Data from 622 Dutch adults were used in multivariate linear regression analyses to investigate associations between NEWS-A and PA outcomes. Analyses were controlled for socio-demographic characteristics and HRQoL. The presence of attractive buildings was associated with less SB (β = −0.086, p < 0.01) and more MVPA (β = 0.118, p < 0.01). Presence of destinations within walking distance was also positively associated with MVPA (β = 0.106, p < 0.01). Less crime was associated with less MVPA (β = 0.092, p < 0.05). Interactions between personal and environmental characteristics showed that the absence of PA-hindering characteristics (e.g., heavy traffic) was associated with less SB and more MVPA, but only for residents with problems regarding pain and usual activities. The presence of PA-facilitating characteristics (e.g., aesthetics and destinations) was associated with less SB, more LPA and more MVPA but only for the more advantaged people in society. Results suggest that to reduce health inequalities, it would be more helpful to remove barriers rather than introduce PA facilitating characteristics.

Do Natural Experiments of Changes in Neighborhood Built Environment Impact Physical Activity and Diet? A Systematic Review

Physical activity and diet are major modifiable risk factors for chronic disease and have been shown to be associated with neighborhood built environment. Systematic review evidence from longitudinal studies on the impact of changing the built environment on physical activity and diet is currently lacking. A systematic review of natural experiments of neighborhood built environment was conducted. The aims of this systematic review were to summarize study characteristics, study quality, and impact of changes in neighborhood built environment on physical activity and diet outcomes among residents. Natural experiments of neighborhood built environment change, exploring longitudinal impacts on physical activity and/or diet in residents, were included. From five electronic databases, 2084 references were identified. A narrative synthesis was conducted, considering results in relation to study quality. Nineteen papers, reporting on 15 different exposures met inclusion criteria. Four studies included a comparison group and 11 were pre-post/longitudinal studies without a comparison group. Studies reported on the impact of redeveloping or introducing cycle and/or walking trails (n = 5), rail stops/lines (n = 4), supermarkets and farmers' markets (n = 4) and park and green space (n = 2). Eight/15 studies reported at least one beneficial change in physical activity, diet or another associated health outcome. Due to limitations in study design and reporting, as well as the wide array of outcome measures reported, drawing conclusions to inform policy was challenging. Future research should consider a consistent approach to measure the same outcomes (e.g., using measurement methods that collect comparable physical activity and diet outcome data), to allow for pooled analyses. Additionally, including comparison groups wherever possible and ensuring high quality reporting is essential.

Contextual influences on physical activity and eating habits -options for action on the community level

Background

This conceptual paper aims to illustrate the ways in which communities are able to advance health improvements on a population level. Outcome measures may include increased physical activity and healthier eating habits in particular, as well as an improved health-related quality of life and social cohesion as more generic outcomes.

Main body

The paper begins by asking initial questions: Why did previous health-specific interventions only show moderate effects on an individual level and mixed effects on a population level? What is the added value of a community-based public health perspective compared to the traditional biomedical perspective when it comes to prevention? Why are we living the way we are living? Why do we eat what we eat? Why do we move the way we move?

Subsequently, we illustrate the broad spectrum of contextual interventions available to communities. These can have geographical and technological as well as economic, political, normative and attitude-specific dimensions. It is shown that communities have a strong influence on health-related contexts and decision-making of adults, adolescents and children. In addition contextual characteristics, effects, mediators, moderators and consequences relevant for health can differ greatly between age groups. Both small-scale settings and overarching sectors possess physical, economic, political and sociocultural characteristics that can be proactively influenced by community decision-makers in the sense of a “health in all policies”-strategy.

Short conclusion

After presenting various interdisciplinary approaches to community-based health interventions, the manuscript closes with the following core message: Successful community-based health promotion strategies consist of multilevel – multicomponent interventions on the micro, meso and macro-level-environments.

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.