Longer afterschool active commutes and the travel environment of middle schools in Shenzhen, China

The Associations of Active Travel to School With Physical Activity and Screen Time Among Adolescents: Do Individual and Parental Characteristics Matter?

Little is known about the relationship of active travel to school (ATS) with physical activity (PA) and screen time (ST) by individual and parental characteristics among adolescents, especially in China. To address the research gap, this study aimed to explore the difference of sex, age, living environment, parental occupation and education level in the relationship of ATS with PA and ST among students of grades 7–12 (aged 10–18 years) using cross-sectional data. In 13 cities of Hubei province, China, students from 39 public schools were recruited to engage in the survey. In total, 5,898 students (response rate = 89.6%) were invited into this study. Participants were required to report their ATS (including its types), PA and ST as well as sociodemographic information using a validated questionnaire. Descriptive analyses were used to report the information of all variables. Regression models were used to analyse the relationships of ATS and its types with PA and ST. In a total of 4,128 participants (boys: 50.9%; younger adolescents: 61.9%) included in the final analysis, the proportion of those with ATS was 47.3%. Regarding the types of ATS, walking accounted for over 30%, while cycling was 13.2%. Participants with ATS were more likely to have sufficient PA (OR = 1.26, 95% CI: 1.14–1.39), especially among boys, younger adolescents and those with lower parental education level. However, ATS was not associated with ST (OR = 0.94, 95% CI: 0.86–1.01). Participants with cycling had a higher odds ratio of being physically active (OR for cycling = 1.47, 95% CI: 1.27–1.70; OR for walking = 1.18, 95% CI: 1.06–1.32). The association of ATS types with PA and ST differed by gender, age, living environment and parental educational level as well as occupations. ATS may be a useful approach to increase PA among adolescents, but this should be explained by individual and parental characteristics.

Access to public transport and childhood obesity: A systematic review

The lack of access to public transport is generally considered to be a risk factor for childhood obesity by discouraging active transport and thus physical activity. To explore the association between access to public transport and childhood obesity, we have conducted a systematic literature search in the Cochrane Library, PubMed, and Web of Science for studies published before January 1, 2019. A total of 25 cross-sectional and two longitudinal studies conducted in 10 countries were identified. Inconsistent findings were identified arising from a great variety of sample characteristics, definitions of exposure (ie, access to public transport), and outcome variables (eg, obesity), and analysis methods. While over half of the studies showed null associations between access to public transport and childhood obesity, we have observed more positive than negative associations among the rest of the studies. These observations suggest that an increased level of access to public transport may have a health-promoting effect and hence prevent the development of childhood obesity. However, this conclusion needs to be further corroborated in future research on the basis of large-sample health surveys, in situ observations, and comparative analyses among different study areas.

Street connectivity, physical activity, and childhood obesity: A systematic review and meta-analysis

Street connectivity, as a neighbourhood built environmental factor, may affect individual physical activity (PA) and subsequently weight status. However, these associations remain inconclusive. This study aimed to systematically review the association between street connectivity and childhood obesity. A literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before January 1, 2019. All original studies that investigated the association between street connectivity and weight-related behaviours or outcomes among children and adolescents were included. Forty-seven articles were identified, including eight longitudinal and 41 cross-sectional studies conducted in eight countries. The sample size ranged from 88 to 46 813. Street intersection density (SID), measured by Geographic Information Systems in 36 studies and reported in 13 studies, was the main indicator used to represent street connectivity. Forty-four studies examined the association between SID and weight-related behaviours, including overall PA (n = 15), moderate-to-vigorous PA (n = 13), active transport (n = 12), dog walking (n = 1), walking (n = 1), sedentary behaviours (n = 2), and TV viewing (n = 1). Fifteen studies focused on the association between SID and weight-related outcomes. Overall, evidence from this systematic review and meta-analyses suggested a positive association between street connectivity and PA. However, it was difficult to draw a conclusion on the association between street connectivity and BMI. More longitudinal evidence is needed to confirm the causal association between street connectivity and weight status.

Active commute to school: does distance from school or walkability of the home neighbourhood matter? A national cross-sectional study of children aged 10-11 years, Scotland, UK

OBJECTIVES

To study the extent to which home-to-school distance and neighbourhood walkability were associated with self-reported active travel to school (ATS) (eg, walking, cycling), and to explore how distance moderates the effect of walkability on ATS, among 10-11 years old.

DESIGN

Cross-sectional study.

SETTING

Data were collected between May 2015 and May 2016 in partnership with the Growing Up in Scotland Study, a nationally representative longitudinal cohort study.

PARTICIPANTS

713 children (male (n=330) and female (n=383) 10-11 years old) from Studying Physical Activity in Children's Environments across Scotland.

PRIMARY AND SECONDARY OUTCOME MEASURES

Children who actively travelled to/from school categorised as active all (100% of ATS) and active 60%+ (at least 60% of ATS); home-to-school road/path network distance (<0.5 km, 0.5 to <1 km, 1 to <1.5 km, 1.5 to <2 km, 2 km+); home neighbourhood walkability (i.e., composite measure of road/path intersection density and dwelling density) (in quintiles).

RESULTS

Distance and walkability were both associated with ATS. The likelihood of ATS for all or most journeys decreased with increasing distance. Compared with 'most' walkable areas (Q1), the odds of active all were significantly lower within least walkable areas (Q5 OR 0.45, 95% CI 0.21 to 0.99), and odds of active 60%+ were significantly less in Q2-Q5 (lowest odds Q5 OR 0.20, 95% CI 0.07 to 0.47). Regarding walkability and distance interactions, for all distance categories, higher walkability increased the probability of ATS (for most school journeys).

CONCLUSION

Walkability was positively associated with ATS within all distance categories, with the relationship between walkability and ATS more complex than the clear-cut association between distance and ATS. A more walkable environment had a larger effect on the probability of reaching the 60% threshold of school journeys using ATS than the probability of always travelling in an active manner. Investment is needed in existing less walkable neighbourhoods to provide infrastructure to support opportunities for children's ATS.