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Abstract
PURPOSE OF REVIEW To review the literature on built environment interventions to increase active travel, focusing on work since 2000 and on methodological choices and challenges affecting studies. RECENT FINDINGS Increasingly, there is evidence that built environment interventions can lead to more walking or cycling. Evidence is stronger for cycling than for walking interventions, and there is a relative lack of evidence around differential impacts of interventions. Some of the evidence remains methodologically weak, with much work in the 'grey' literature. While evidence in the area continues to grow, data gaps remain. Greater use of quasi-experimental techniques, improvements in routine monitoring of smaller schemes, and the use of new big data sources are promising. More qualitative research could help develop a more sophisticated understanding of behaviour change.
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Heinen E, Harshfield A, Panter J, Mackett R, Ogilvie D. Does exposure to new transport infrastructure result in modal shifts? Patterns of change in commute mode choices in a four-year quasi-experimental cohort study. JOURNAL OF TRANSPORT & HEALTH 2017; 6:396-410. [PMID: 29034171 PMCID: PMC5633011 DOI: 10.1016/j.jth.2017.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Intervention studies suggest that changing the built environment may encourage a modal shift from car travel towards active travel. However, little is known about the detail of patterns of changes in travel behaviour. METHOD Adult commuters working in Cambridge (UK) completed annual questionnaires between 2009 and 2012. Commuting was assessed using a validated seven-day travel-to-work record. The intervention consisted of the opening of a guided busway with a path for walking and cycling in 2011. Exposure to the intervention was defined as the negative of the square root of the shortest road distance from home to the busway. We investigated the association between exposure to the intervention and specific modal shifts and patterns of change, along with individual mode choice patterns over the entire four-year period. RESULTS Five groups of patterns of change were found in our in-depth explorations: (1) no change, (2) a full modal shift, (3) a partial modal shift, (4) non-stable but patterned behaviour, and (5) complicated or apparently random patterns. A minority of participants had a directed change of either a full modal shift or, more commonly, a partial modal shift, whereas a large proportion showed a highly variable pattern. No significant associations were found between exposure to the intervention and specific modal shifts or patterns of change. CONCLUSION Our analyses revealed a large diversity in (changes in) travel behaviour patterns over time, and showed that the intervention did not result in one specific pattern of behaviour change or produce only full modal shifts. These insights are important for improving the measurement of travel behaviour, improving our understanding of how changes in travel behaviour patterns occur, and fully capturing the potential impacts of interventions.
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Affiliation(s)
- Eva Heinen
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
- University of Leeds, Institute for Transport Studies, Faculty of Environment, LS2 9JT Leeds, United Kingdom
| | - Amelia Harshfield
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
- The Primary Care Unit, Institute of Public Health, University of Cambridge, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR, United Kingdom
| | - Jenna Panter
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
| | - Roger Mackett
- Centre for Transport studies, University College London, Gower Street, London WC1E6BT, United Kingdom
| | - David Ogilvie
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
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A Complete Street Intervention for Walking to Transit, Nontransit Walking, and Bicycling: A Quasi-Experimental Demonstration of Increased Use. J Phys Act Health 2016; 13:1210-1219. [PMID: 27334024 DOI: 10.1123/jpah.2016-0066] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Complete streets require evaluation to determine if they encourage active transportation. METHODS Data were collected before and after a street intervention provided new light rail, bike lanes, and better sidewalks in Salt Lake City, Utah. Residents living near (<800 m) and far (≥801 to 2000 m) from the street were compared, with sensitivity tests for alternative definitions of near (<600 and <1000 m). Dependent variables were accelerometer/global positioning system (GPS) measures of transit trips, nontransit walking trips, and biking trips that included the complete street corridor. RESULTS Active travel trips for Near-Time 2 residents, the group hypothesized to be the most active, were compared with the other 3 groups (Near-Time 1, Far-Time 1, and Far-Time 2), net of control variables. Near-Time 2 residents were more likely to engage in complete street transit walking trips (35%, adjusted) and nontransit walking trips (50%) than the other 3 groups (24% to 25% and 13% to 36%, respectively). Bicycling was less prevalent, with only 1 of 3 contrasts significant (10% of Near-Time 2 residents had complete street bicycle trips compared with 5% of Far-Time 1 residents). CONCLUSIONS Living near the complete street intervention supported more pedestrian use and possibly bicycling, suggesting complete streets are also public health interventions.
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Prins RG, Panter J, Heinen E, Griffin SJ, Ogilvie DB. Causal pathways linking environmental change with health behaviour change: Natural experimental study of new transport infrastructure and cycling to work. Prev Med 2016; 87:175-182. [PMID: 26946367 PMCID: PMC4893020 DOI: 10.1016/j.ypmed.2016.02.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/08/2016] [Accepted: 02/26/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mechanisms linking changes to the environment with changes in physical activity are poorly understood. Insights into mechanisms of interventions can help strengthen causal attribution and improve understanding of divergent response patterns. We examined the causal pathways linking exposure to new transport infrastructure with changes in cycling to work. METHODS We used baseline (2009) and follow-up (2012) data (N=469) from the Commuting and Health in Cambridge natural experimental study (Cambridge, UK). Exposure to new infrastructure in the form of the Cambridgeshire Guided Busway was defined using residential proximity. Mediators studied were changes in perceptions of the route to work, theory of planned behaviour constructs and self-reported use of the new infrastructure. Outcomes were modelled as an increase, decrease or no change in weekly cycle commuting time. We used regression analyses to identify combinations of mediators forming potential pathways between exposure and outcome. We then tested these pathways in a path model and stratified analyses by baseline level of active commuting. RESULTS We identified changes in perceptions of the route to work, and use of the cycle path, as potential mediators. Of these potential mediators, only use of the path significantly explained (85%) the effect of the infrastructure in increasing cycling. Path use also explained a decrease in cycling among more active commuters. CONCLUSION The findings strengthen the causal argument that changing the environment led to changes in health-related behaviour via use of the new infrastructure, but also show how some commuters may have spent less time cycling as a result.
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Affiliation(s)
- R G Prins
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
| | - J Panter
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - E Heinen
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - S J Griffin
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - D B Ogilvie
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Humphreys DK, Panter J, Sahlqvist S, Goodman A, Ogilvie D. Changing the environment to improve population health: a framework for considering exposure in natural experimental studies. J Epidemiol Community Health 2016; 70:941-6. [PMID: 27056683 PMCID: PMC5390281 DOI: 10.1136/jech-2015-206381] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 03/18/2016] [Indexed: 11/30/2022]
Abstract
There is renewed optimism regarding the use of natural experimental studies to generate evidence as to the effectiveness of population health interventions. Natural experimental studies capitalise on environmental and policy events that alter exposure to certain social, economic or environmental factors that influence health. Natural experimental studies can be useful for examining the impact of changes to ‘upstream’ determinants, which may not be amenable to controlled experiments. However, while natural experiments provide opportunities to generate evidence, they often present certain conceptual and methodological obstacles. Population health interventions that alter the physical or social environment are usually administered broadly across populations and communities. The breadth of these interventions means that variation in exposure, uptake and impact may be complex. Yet many evaluations of natural experiments focus narrowly on identifying suitable ‘exposed’ and ‘unexposed’ populations for comparison. In this paper, we discuss conceptual and analytical issues relating to defining and measuring exposure to interventions in this context, including how recent advances in technology may enable researchers to better understand the nature of population exposure to changes in the built environment. We argue that when it is unclear whether populations are exposed to an intervention, it may be advantageous to supplement traditional impact assessments with observational approaches that investigate differing levels of exposure. We suggest that an improved understanding of changes in exposure will assist the investigation of the impact of complex natural experiments in population health.
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Affiliation(s)
- David K Humphreys
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Jenna Panter
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Shannon Sahlqvist
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Cambridge, UK Centre for Physical Activity and Nutrition Research (C-PAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Anna Goodman
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Cambridge, UK Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - David Ogilvie
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Cambridge, UK
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Heinen E, Ogilvie D. Variability in baseline travel behaviour as a predictor of changes in commuting by active travel, car and public transport: a natural experimental study. JOURNAL OF TRANSPORT & HEALTH 2016; 3:77-85. [PMID: 27200265 PMCID: PMC4861037 DOI: 10.1016/j.jth.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/06/2015] [Accepted: 11/13/2015] [Indexed: 05/03/2023]
Abstract
PURPOSE To strengthen our understanding of the impact of baseline variability in mode choice on the likelihood of travel behaviour change. METHODS Quasi-experimental analyses in a cohort study of 450 commuters exposed to a new guided busway with a path for walking and cycling in Cambridge, UK. Exposure to the intervention was defined using the shortest network distance from each participant's home to the busway. Variability in commuter travel behaviour at baseline was defined using the Herfindahl-Hirschman Index, the number of different modes of transport used over a week, and the proportion of trips made by the main (combination of) mode(s). The outcomes were changes in the share of commute trips (i) involving any active travel, (ii) involving any public transport, and (iii) made entirely by car. Variability and change data were derived from a self-reported seven-day record collected before (2009) and after (2012) the intervention. Separate multinomial regression models were estimated to assess the influence of baseline variability on behaviour change, both independently and as an interaction effect with exposure to the intervention. RESULTS All three measures of variability predicted changes in mode share in most models. The effect size for the intervention was slightly strengthened after including variability. Commuters with higher baseline variability were more likely to increase their active mode share (e.g. for HHI: relative risk ratio [RRR] for interaction 3.34, 95% CI 1.41, 7.89) and decrease their car mode share in response to the intervention (e.g. for HHI: RRR 7.50, 95% CI 2.52, 22.34). CONCLUSIONS People reporting a higher level of variability in mode choice were more likely to change their travel behaviour following an intervention. Future research should consider such variability as a potential predictor and effect modifier of travel and physical activity behaviour change, and its significance for the design and targeting of interventions.
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Affiliation(s)
- Eva Heinen
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
- Delft University of Technology, Faculty of Technology, Policy & Management, Department of Transport & Logistics, Jaffalaan 5, 2628 BX Delft, The Netherlands
| | - David Ogilvie
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom
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Impact of New Transport Infrastructure on Walking, Cycling, and Physical Activity. Am J Prev Med 2016; 50:e45-53. [PMID: 26585051 PMCID: PMC4712020 DOI: 10.1016/j.amepre.2015.09.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 09/14/2015] [Accepted: 09/21/2015] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Walking and cycling bring health and environmental benefits, but there is little robust evidence that changing the built environment promotes these activities in populations. This study evaluated the effects of new transport infrastructure on active commuting and physical activity. STUDY DESIGN Quasi-experimental analysis nested within a cohort study. SETTING/PARTICIPANTS Four hundred and sixty-nine adult commuters, recruited through a predominantly workplace-based strategy, who lived within 30 kilometers of Cambridge, United Kingdom and worked in areas of the city to be served by the new transport infrastructure. INTERVENTION The Cambridgeshire Guided Busway opened in 2011 and comprised a new bus network and a traffic-free walking and cycling route. Exposure to the intervention was defined using the shortest distance from each participant's home to the busway. MAIN OUTCOME MEASURES Change in weekly time spent in active commuting between 2009 and 2012, measured by validated 7-day recall instrument. Secondary outcomes were changes in total weekly time spent walking and cycling and in recreational and overall physical activity, measured using the validated Recent Physical Activity Questionnaire. Data were analyzed in 2014. RESULTS In multivariable multinomial regression models--adjusted for potential sociodemographic, geographic, health, and workplace confounders; baseline active commuting; and home or work relocation-exposure to the busway was associated with a significantly greater likelihood of an increase in weekly cycle commuting time (relative risk ratio=1.34, 95% CI=1.03, 1.76) and with an increase in overall time spent in active commuting among the least active commuters at baseline (relative risk ratio=1.76, 95% CI=1.16, 2.67). The study found no evidence of changes in recreational or overall physical activity. CONCLUSIONS Providing new sustainable transport infrastructure was effective in promoting an increase in active commuting. These findings provide new evidence to support reconfiguring transport systems as part of public health improvement strategies.
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Ogilvie D, Panter J, Guell C, Jones A, Mackett R, Griffin S. Health impacts of the Cambridgeshire Guided Busway: a natural experimental study. PUBLIC HEALTH RESEARCH 2016. [DOI: 10.3310/phr04010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundImproving transport infrastructure to support walking and cycling on the journey to and from work – active commuting – could help to promote physical activity and improve population health.AimsTo assess whether or not investment in new high-quality transport infrastructure was associated with an increase in active commuting; wider health impacts of changes in travel behaviour; determinants of the use and uptake of active commuting; and how changes in travel behaviour were distributed in the population and related to the wider social context.DesignThe Commuting and Health in Cambridge study, comprising a quasi-experimental cohort study combined with both nested and supplementary in-depth quantitative and qualitative studies.SettingCambridgeshire, UK.ParticipantsA cohort of 1143 adults living within 30 km of Cambridge, working in the city and recruited in 2009; and a separate sample of 1710 users intercepted on the Cambridgeshire Guided Busway in 2012.InterventionThe Cambridgeshire Guided Busway, comprising a new bus network using 22 km of guideway (segregated bus track) accompanied by a traffic-free path for pedestrians and cyclists, opened in 2011.Main outcome measureChange in time spent in active commuting from 2009 to 2012, using a self-reported measure validated using georeferenced combined heart rate and movement sensor data.MethodsA delay from 2009 to 2011 in completing the intervention entailed some changes to the original design and attrition of the cohort. A period of methodological and observational research on active commuting preceded the evaluation, which was based on a quasi-experimental cohort analysis together with the intercept and qualitative data. A graded measure of each participant’s exposure to the intervention, based on the proximity of the busway to his or her home, served as the basis for controlled comparisons.ResultsCommuting practices were complex and shaped by various changeable social and environmental factors. Walking and cycling were often incorporated into longer commuting journeys made predominantly by car or public transport. In multivariable multinomial regression analyses, exposure to the intervention was associated with a greater likelihood of a large increase in the proportion of commuting trips involving any active travel [adjusted relative risk ratio (RRR) 1.80, 95% confidence interval (CI) 1.27 to 2.55], of a large decrease in the proportion of trips made entirely by car (RRR 2.09, 95% CI 1.35 to 3.21), and of an increase in weekly cycle commuting time (RRR 1.34, 95% CI 1.03 to 1.76). There was a mixed pattern of effects at the individual level, with the intervention providing a more supportive environment for active commuting for some and not for others. There was some evidence that the effect was most pronounced among those who reported no active commuting at baseline, and observational evidence suggesting a relationship between active commuting, greater overall physical activity, and improved well-being and weight status.ConclusionsThese findings provide new empirical support and direction for reconfiguring transport systems to improve population health and reduce health inequalities. They should be combined with evidence from research evaluating related environmental changes in other settings, preferably using longer periods of observation and controlled comparisons, to support more generalisable causal inference.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- David Ogilvie
- Medical Research Council Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jenna Panter
- Medical Research Council Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Cornelia Guell
- Medical Research Council Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Andy Jones
- Norwich Medical School and Centre for Diet and Activity Research (CEDAR), University of East Anglia, Norwich, UK
| | - Roger Mackett
- Centre for Transport Studies, University College London, London, UK
| | - Simon Griffin
- Medical Research Council Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Rissel C, Greaves S, Wen LM, Crane M, Standen C. Use of and short-term impacts of new cycling infrastructure in inner-Sydney, Australia: a quasi-experimental design. Int J Behav Nutr Phys Act 2015; 12:129. [PMID: 26444001 PMCID: PMC4596499 DOI: 10.1186/s12966-015-0294-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 09/26/2015] [Indexed: 11/10/2022] Open
Abstract
Background Given increasing investment in new cycling infrastructure, it is important to understand its impacts. The Sydney Transport and Health Study evaluates a new 2.4 km bi-directional separated bicycle path in inner-Sydney. This paper describes the users of the new bicycle path, and examines its short-term impacts upon cycling behaviour and perceptions of the local environment. Methods Data were collected from two bike counts at two intersections on the new bicycle path in the intervention area in 2013 and 2014. On-line surveys collected individual participant data in the intervention area and a similar comparison area before the bicycle path was built (2013), and 12 months later (four months after completion) (n = 512). The data included self-reported cycling behaviour, use of the new bicycle path and perceptions of changes in the local environment. Results Bike counts at two sites on the new bicycle path reported an increase of 23 % and 97 % respectively at 12 months. However, among the participants in the cohort, there was no change in the self-reported weekly frequency of cycling. One in six (approximately 15 %) participants reported using the new bicycle path, with most users (76 %) living in the intervention area. Bicycle path users were most likely to be frequent riders (at least weekly) [adjusted odds ratio (AOR) = 7.50, 95 % CI 3.93–14.31], be a high intensity recreational rider (AOR = 4.38, 95 % CI 1.53–12.54) or a low intensity transport rider (AOR = 2.42, 95 % CI 1.17–5.04) and live closer to the bicycle path (AOR = 1.24, 1.13–1.37). Perceptions that the neighbourhood was more pleasant, that there were more people walking and cycling were significantly higher in the intervention area at 12 months (both P values <0.05). Conclusions Existing cycling behaviour and proximity to the bicycle path were associated with the use of the new bicycle path. Increased use of the new bicycle path as reported by the participants in the intervention area and increased cycling recorded by the bike counts may be due to existing cyclists changing routes to use the new path, and more cyclists from outside the study area using the new path, as study participants did not increase their frequency of cycling. Increases in cycling frequency in the intervention neighbourhood may require a longer lead time, additional promotional activities and further maturation of the Sydney bicycle path network. Key message Understanding how new cycling infrastructure impacts communities can influence the promotion of such infrastructure.
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Affiliation(s)
- Chris Rissel
- Sydney School of Public Health, University of Sydney, Sydney, Australia.
| | - Stephen Greaves
- Institute of Transport and Logistics Studies, University of Sydney, Sydney, Australia.
| | - Li Ming Wen
- Sydney School of Public Health, University of Sydney and Sydney Local Health District, Sydney, Australia.
| | - Melanie Crane
- Sydney School of Public Health, University of Sydney and Sydney Local Health District, Sydney, Australia.
| | - Chris Standen
- Institute of Transport and Logistics Studies, University of Sydney, Sydney, Australia.
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