Is active travel associated with greater physical activity? The contribution of commuting and non-commuting active travel to total physical activity in adults

Success and Challenges of Community Bicycle Advocacy Organizations in Reaching Underserved Populations

INTRODUCTION

Bicycling, as forms of recreation and travel, offers many positive physical and mental health benefits, though there are still many disparities in bicycling rates among underserved populations in the United States. Community bicycling advocacy organizations/coalitions promote and advocate for increased bicycling; however, have been shown to have a lack of organizational capacity for equitable programming to diverse populations (racial/ethnic minorities, women, low-income, LGBTQ+ communities, youth). The purpose of this study was to understand the current practices for providing underserved populations bicycling programming among advocacy organizations and to find major barriers and helpful tools for equitable programming.

METHODS

This was conducted in a volunteer sample of U.S. bicycle advocacy organizations. An interview (n = 23) assessed organizational function, successful programs, and barriers to reaching underserved populations.

RESULTS

Several themes emerged from the interviews. Participants stated that the lack of organizational leadership and member diversity, along with a lack of trust with underserved communities, presented major barriers to providing equitable programming. Partnering with other community organizations that place an emphasis on serving diverse populations was noted to have potential for increasing successful programming by allocating resources and connections.

CONCLUSION

Although barriers exist for bicycle advocacy organizations when attempting to reach underserved and diverse populations, groups should focus on creating successful and diverse partnerships to increase the capacity for providing equitable programming.

Distinct patterns of adult transport-related physical activity (TRPA) behaviour exist independent of the TRPA behaviours of childhood: the childhood determinants of adult health study

BACKGROUND

Transport-related physical activity (TRPA) is recognised as a potential means of increasing total physical activity participation that may yield substantial health benefits. Public health campaigns focusing on promoting TRPA from a young age aim to develop life-long healthy habits. However, few studies have examined how TRPA changes across the lifecourse and whether childhood TRPA levels influence those observed later in life.

METHODS

Using the Australian Childhood Determinants of Adult Health study (baseline, 1985), latent class growth mixture modelling with adjustment for time-varying covariates was performed using four timepoints (ranging from 7 to 49 years) to assess behavioural patterns and retention of TRPA across the lifecourse. As child and adult adjusted TRPA measures could not be harmonised, trajectories of adult TRPA (n = 702) were instead identified, and log-binomial regression analysis was performed to determine whether childhood levels of TRPA (high/medium/low) influenced these trajectories.

RESULTS

Two stable groups of adult TRPA trajectories were identified: persistently low (n = 520; 74.2%), and increasingly high TRPA (n = 181; 25.8%). There was no significant relationship between childhood TRPA levels and patterns in adulthood (relative risk of high childhood TRPA yielding high adult TRPA trajectory membership = 1.06; 95% confidence interval = 0.95-1.09).

CONCLUSION

This study found childhood TRPA levels were not associated with TRPA patterns in adulthood. These findings suggest that while TRPA in childhood may have health, social, and environmental benefits, it does not appear to impact adult TRPA directly. Therefore, further intervention is required beyond childhood to promote the implementation of healthy TRPA behaviours into adulthood.

Gender differences in active travel in major cities across the world

There is lack of literature on international comparison of gender differences in the use of active travel modes. We used population-representative travel surveys for 19 major cities across 13 countries and 6 continents, representing a mix of cites from low-and-middle income (n = 8) and high-income countries (n = 11). In all the cities, females are more likely than males to walk and, in most cities, more likely to use public transport. This relationship reverses in cycling, with females often less likely users than males. In high cycling cities, both genders are equally likely to cycle. Active travel to access public transport contributes 30-50% of total active travel time. The gender differences in active travel metrics are age dependent. Among children (< 16 years), these metrics are often equal for girls and boys, while gender disparity increases with age. On average, active travel enables one in every four people in the population to achieve at least 30 min of physical activity in a day, though there is large variation across the cities. In general, females are more likely to achieve this level than males. The results highlight the importance of a gendered approach towards active transport policies. Such an approach necessitates reducing road traffic danger and male violence, as well as overcoming social norms that restrict women from cycling.

Street Experiments and COVID-19: Challenges, Responses and Systemic Change

Cities have introduced street experiments, among others, in order to cope with the urgent health challenges caused by the COVID-19 pandemic. They are primarily intended to allow people to move safely in urban spaces according to physical distancing requirements. It has been suggested that street experiments have the potential to not only respond to pressing needs, but to also trigger systemic change in mobility. This paper explores urban case studies and demonstrates how pandemic-induced street experiments provide a solution to specific challenges to mobility and public space. There are, however, issues concerning equity and citizen participation. Finally, we find that pandemic-induced street experiments have a higher acceptance among the public and authorities, a more permanent character and a greater embeddedness in long-term planning agendas. The paper concludes that the pandemic stimulated the introduction of street experiments and fostered their potential to enable systemic change in urban mobility.

Odds of self-reported minor cycle crashes with conventional and electric assisted cycles adjusted for cycling frequency in Dutch and Belgian adults a retrospective study

BACKGROUND

Cycling for transportation and recreation is gaining in popularity, especially in older age groups. The rise in electric assisted cycles (EAC) may also have a role to play in this. With an increase in the number of cyclists comes an increase in the prevalence of cycle crashes. However, there is a lack of knowledge on EAC crashes and crash studies including cycle use data. An important question is also whether the high number of serious road injuries among older cyclists, is due to increased risk or more serious consequences in the event of a crash.

STUDY AIM

To compare the odds of reporting a cycle crash on a conventional (CC) against electrically assisted cycle (EAC), while controlling for age, gender, BMI, impairments while cycling, cycling frequency and region of residence.

METHODS

A 12-month retrospective cross-sectional survey-based study, including male and female cyclists aged 40+ years, was conducted in Belgium and the Netherlands. Socio-demographics, physical and mental impairments while cycling (such as lower reaction time), crash details and cycling frequency data were collected. Cyclists were grouped into CC, EAC or both (CC + EAC) based on the type of cycle they used during the study period. Logistic regression models were used to calculate the odds of reporting a cycle crash. Main and interaction effects were studied.

RESULTS

1,919 cyclists were included in the data analysis (63.2 ± 11.1 years; 50% women). 319 (17% of the total sample) cyclists reported a crash in the previous 12 months, of which 36% were EAC crashes. Those reporting a crash were significantly younger compared to those not reporting a crash. The following significant main effects were observed: those cycling on an EAC had a higher odds of reporting a cycle crash compared to those cycling on a CC (OR = 1.41, 95% CI = 1.01-1.97); cyclists in the category average and high on mental impairments while cycling had a higher odds of reporting a cycle crash compared to those in the category low (OR = 1.72, 95% CI = 1.23-2.40 and OR = 3.49, 95% CI = 2.51-4.90, respectively); higher cycling frequency is related to higher odds of reporting a cycle crash (OR = 3.25, 95% CI = 2.25-4.90). A significant interaction effect was observed between age category and gender (OR = 1.93, 95% CI = 1.15-3.26). Post-hoc tests revealed that men in the younger age category (40-64 years) had the highest probability (18.95%) of reporting a cycle crash, whereas men in the oldest age category (65+ years) had the lowest probability (9.99%) of reporting a cycle crash. No significant difference between age categories in women was observed.

CONCLUSION

This study indicates that within a cohort of middle aged and older adults living in regions with high to low cycling modal shares, cycle type, mental impairments while cycling, cycling frequency and region of residence play a significant role in the odds of reporting a (minor) cycle crash. Men in the age category 40-64 years have a significantly higher probability of reporting a cycle crash compared to men of 65+ years. Safety campaigns and instructions should pay particular attention to men in the age category 40-64 years and those with a mental impairment while cycling.

Application of machine learning to predict transport modes from GPS, accelerometer, and heart rate data

BACKGROUND

There has been an increased focus on active transport, but the measurement of active transport is still difficult and error-prone. Sensor data have been used to predict active transport. While heart rate data have very rarely been considered before, this study used random forests (RF) to predict transport modes using Global Positioning System (GPS), accelerometer, and heart rate data and paid attention to methodological issues related to the prediction strategy and post-processing.

METHODS

The RECORD MultiSensor study collected GPS, accelerometer, and heart rate data over seven days from 126 participants living in the Ile-de-France region. RF models were built to predict transport modes for every minute (ground truth information on modes is from a GPS-based mobility survey), splitting observations between a Training dataset and a Test dataset at the participant level instead at the minute level. Moreover, several window sizes were tested for the post-processing moving average of the predicted transport mode.

RESULTS

The minute-level prediction rate of being on trips vs. at a visited location was 90%. Final prediction rates of transport modes ranged from 65% for public transport to 95% for biking. Using minute-level observations from the same participants in the Training and Test sets (as RF spontaneously does) upwardly biases prediction rates. The inclusion of heart rate data improved prediction rates only for biking. A 3 to 5-min bandwidth moving average was optimum for a posteriori homogenization.

CONCLUSION

Heart rate only very slightly contributed to better predictions for specific transport modes. Moreover, our study shows that Training and Test sets must be carefully defined in RF models and that post-processing with carefully chosen moving average windows can improve predictions.

Active Commuting to University Is Positively Associated with Physical Activity and Perceived Fitness

Background: Fitness is a powerful marker of health associated with physical activity (PA) in university students. However, insufficient PA is a serious health concern among university students. Active commuting provides an opportunity for increased PA levels. Therefore, the aims of this study were (a) to describe the mode of commuting, PA and fitness in university students; (b) to analyze the associations of mode of commuting with PA and fitness; and c) to analyze the relationship between mode of commuting, PA recommendations and fitness. Methods: This was a cross-sectional study. A total of 1257 university students (52.4% women) participated (22.4 ± 5.6 years old). Results: Public commuting was the main mode to and from university. Active and public commuters were more likely to meet the PA recommendations and reported higher muscular strength than those using private commuting. Active and public commuters who met PA recommendations present the highest fitness in most of its components. Conclusions: Achieving the PA recommendations was more relevant than adopting an active mode of commuting in order to have better fitness. Further research targeting a broader understanding of the mode of commuting, PA levels and fitness in university students is needed.

Active commuting, commuting modes, and the risk of diabetes: 14-year follow-up data from the Hisayama Study

Aims/Introduction

We aimed to investigate the association of active commuting (cycling or walking to work), as well as the association of the individual commuting modes, with the risk of diabetes in a prospective cohort of community‐dwelling adults in Japan.

Material and Methods

A total of 1,270 residents aged 40–79 years were followed up for a median of 14 years. Active commuting was defined as either cycling or walking to work. A Cox proportional hazards model was used to examine the association of active commuting with the risk of diabetes. Associations for different forms of active commuting (cycling, walking and mixed modes of cycling or walking with non‐active components) were also examined.

Results

During the follow‐up period, 191 participants developed diabetes. Active commuting was associated with a lower risk of diabetes than non‐active commuting after adjustment for potential confounders (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.31–0.92). With regard to the commuting modes, the risk of diabetes was significantly lower in individuals who commuted by cycling alone (HR 0.46, 95% CI 0.22–0.98), and tended to be lower in individuals who commuted by walking alone (HR 0.14, 95% CI 0.02–1.02) compared with that in individuals with non‐active commuting. Meanwhile, no significant associations were observed for the mixed mode of walking and non‐active commuting (HR 1.69, 95% CI 0.77–3.71).

Conclusions

Active commuting, particularly that consisting exclusively of cycling or walking, was associated with a reduced risk of diabetes. Our findings support a public health policy that promotes the choice of active commuting for the prevention of diabetes.

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.

Translation, cultural adaptation and validation of the basic psychological needs satisfaction in active commuting to and from school (BPNS-ACS) scale in Polish students

BACKGROUND

To promote active commuting to and from school, it is pertinent to understand the motivational factors that influence the choice of this form of transportation.

OBJECTIVE

Translation, cultural adaptation and analysis of the factor structure as well as psychometric properties of the Basic Psychological Needs and Satisfaction in Active Commuting to and from School (BPNS-ACS) scale among Polish students and examination of the distribution of the scale scores according to gender, mode of commuting to and from school and the frequency of using bicycle for this purpose.

MATERIAL AND METHODS

Data from 475 Polish students aged 11-18, including 53.9% of girls were analysed. The Confirmatory Factor Analysis of the Polish version of the BPNS-ACS, U Mann-Whitney and Kruskal Wallis H tests were performed.

RESULTS

The BPNS-ACS consists of 12 items forming three dimensions: autonomy, competence and relatedness need satisfaction. The scale has acceptable psychometric properties: χ2(51)=195.424 (p ˂ 0.001); χ2/df=3.832; CFI=0.944, TLI=0.927, RMSEA=0.077 (90%CI 0.066-0.089), AIC=249.424, BIC=361.833, GFI=0.937, AGFI=0.904. BPNC-ACS scores on factors corresponding to the three basic psychological needs differ based on gender, mode of commuting to and from school and the frequency of cycling to or from school.

CONCLUSIONS

Further exploration of the function of basic psychological needs in active commuting to and from school among Polish adolescents may be conducted using an adapted version of the BPNS-ACS scale.

Lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 pandemic in Japan

AIMS/INTRODUCTION

This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Japan.

MATERIALS AND METHODS

We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID-19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model.

RESULTS

Leisure time and other outside physical activities were decreased in one-quarter of patients during the COVID-19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15).

CONCLUSIONS

A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID-19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.

Cycle-network expansion plan in Oslo: Modeling cost-effectiveness analysis and health equity impact

Physical inactivity is the leading cause of non-communicable diseases, and further research on the cost-effectiveness of interventions that target inactivity is warranted. Socioeconomic status is vital in this process. We aim to evaluate the cost-effectiveness of a cycle-network expansion plan in Oslo compared to the status quo by income quintiles. We applied a Markov model using a public payer perspective. Health outcomes were measured by quality-adjusted life years (QALYs) gained from the prevention of coronary heart disease, stroke, type 2 diabetes, and cancer. We measured equity impact by the concentration index and social welfare using the achievement index. We conducted sensitivity analyses. The intervention was generally more costly and more effective than the status quo. Incremental cost per QALY falls with income quintile, ranging from $10,098 in the richest quintile to $23,053 per QALY gained in the poorest quintile. The base-case intervention increased health inequality. However, a scenario targeting low-income quintiles reduced inequality and increased social welfare. In conclusion, the cycle-network expansion is likely to be cost-effective, but with equity concerns. If decision makers care about health inequalities, the disadvantaged groups could be targeted to produce more equitable and socially desirable outcomes instead of a uniform intervention across income quintiles.

Validity of a Global Positioning System-Based Algorithm and Consumer Wearables for Classifying Active Trips in Children and Adults

OBJECTIVE

To investigate the convergent validity of a global positioning system (GPS)-based and two consumer-based measures with trip logs for classifying pedestrian, cycling, and vehicle trips in children and adults.

METHODS

Participants (N = 34) wore a Qstarz GPS tracker, Fitbit Alta, and Garmin vivosmart 3 on multiple days and logged their outdoor pedestrian, cycling, and vehicle trips. Logged trips were compared with device-measured trips using the Personal Activity Location Measurement System (PALMS) GPS-based algorithms, Fitbit's SmartTrack, and Garmin's Move IQ. Trip- and day-level agreement were tested.

RESULTS

The PALMS identified and correctly classified the mode of 75.6%, 94.5%, and 96.9% of pedestrian, cycling, and vehicle trips (84.5% of active trips, F1 = 0.84 and 0.87) as compared with the log. Fitbit and Garmin identified and correctly classified the mode of 26.8% and 17.8% (22.6% of active trips, F1 = 0.40 and 0.30) and 46.3% and 43.8% (45.2% of active trips, F1 = 0.58 and 0.59) of pedestrian and cycling trips. Garmin was more prone to false positives (false trips not logged). Day-level agreement for PALMS and Garmin versus logs was favorable across trip modes, though PALMS performed best. Fitbit significantly underestimated daily cycling. Results were similar but slightly less favorable for children than adults.

CONCLUSIONS

The PALMS showed good convergent validity in children and adults and were about 50% and 27% more accurate than Fitbit and Garmin (based on F1). Empirically-based recommendations for improving PALMS' pedestrian classification are provided. Since the consumer devices capture both indoor and outdoor walking/running and cycling, they are less appropriate for trip-based research.

A national and sub-national metaregression of the trend of insufficient physical activity among Iranian adults between 2001 and 2016

Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor Surveillance (STEPS) in Iran. We estimated the physical activity status of Iranian adults from 2006 to 2016 after adjusting for years of schooling, urbanization percentage, and wealth index. We used the spatiotemporal model to interpolate and extrapolate the IPA prevalence for the years in-between the series and from 2001 to 2006, respectively. We used the data of 177,910 participants from six STEPS surveys and found that the national prevalence of IPA had steadily increased over the course of 16 years and had almost doubled in this time period (23.1% in 2001 to 55.4% in 2016). The increase was persistent across all age and gender strata and in every province. Moreover, IPA was more prevalent among women than their male peers regardless of their age category or province of residence. The prevalence of IPA in Khuzestan (highest prevalence) was almost double compared to that in Lorestan (lowest prevalence) in 2016. The IPA prevalence increased considerably and almost doubled in 16 years among Iranian adults, particularly women. Policies need to target IPA as a high priority contributing to the burden of Non-communicable diseases.

Individual Characteristics Associated with Active Travel in Low and High Income Groups in the UK

Active travel (AT) has gained increasing attention as a way of addressing low levels of physical activity. However, little is known regarding the relationship between income and AT. The aim of this study was to investigate characteristics associated with undertaking AT in an adult population and by low- and high-income groups. Data collected from the Physical Activity and the Rejuvenation of Connswater (PARC) study in 2017 were used. Participants were categorised into socio-economic groups according to their weekly household income, and were categorised as participating in ‘no’ AT or ‘some’ AT and ‘sufficient’ AT. Multivariable logistic regression explored characteristics associated with AT in the full cohort, and the low- and high-income groups separately. Variables associated with AT in the low-income group were body mass index (BMI), physical activity self-efficacy, marital status, long term illness, difficulty walking and housing tenure. For the high-income group, BMI, marital status, housing tenure and education were associated with AT. For both income groups, there were consistent positive associations with the action/maintenance phase of the stage of change model across all AT categories. The findings suggest that population sub-groups may benefit from targeted initiatives to support engagement in AT and prevent further widening of inequalities.

Estimating walking and bicycling in Canada and their road collision fatality risks: The need for a national household travel survey

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Canadian Community Health Survey captures more bicycling/walking than the census.

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Across data sources, walking more common among women than men.

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Men had higher risk of a fatality than women for bicycling and walking.

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Both data sources have key limitations for measuring bicycling and walking.

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Implementing a national household travel survey should be a priority in Canada.

Canada does not conduct a national household travel survey, resulting in a data gap on walking and bicycling. These data are key to surveillance of physical activity and health, as well as in epidemiological injury risk calculations. This study explored the use of available national data sources, the Canadian census and the Canadian Community Health Survey (CCHS), to tally walking and bicycling and examine trends in fatality risk. Estimates of the percentage and number of Canadians walking or bicycling to work were calculated for 1996–2016 using the census. The CCHS was used to estimate the number and proportion of Canadians walking or bicycling for leisure (2000–2014) and to work or school (2008–2014). We combine these data with National Collision Database data on the number of pedestrian and bicyclist fatalities (1999–2017) and compare trends in fatality risk over time using each dataset. Across all data sources, walking was more common among women, while bicycling was more common among men. Men were at higher fatality risk than women. These results should be interpreted with caution given limitations this study identifies in census and CCHS data, including narrow definitions for bicycling behaviour, lack of detail regarding amount of use, and inconsistency of questions asked over time. A national household travel survey should be a priority for public health purposes in Canada.

Health Impacts of Urban Bicycling in Mexico

Background: Bicycling has been associated with health benefits. Local and national authorities have been promoting bicycling as a tool to improve public health and the environment. Mexico is one of the largest Latin American countries, with high levels of sedentarism and non-communicable diseases. No previous studies have estimated the health impacts of Mexico’s national bicycling scenarios. Aim: Quantify the health impacts of Mexico urban bicycling scenarios. Methodology: Quantitative Health Impact Assessment, estimating health risks and benefits of bicycling scenarios in 51,718,756 adult urban inhabitants in Mexico (between 20 and 64 years old). Five bike scenarios were created based on current bike trends in Mexico. The number of premature deaths (increased or reduced) was estimated in relation to physical activity, road traffic fatalities, and air pollution. Input data were collected from national publicly available data sources from transport, environment, health and population reports, and surveys, in addition to scientific literature. Results: We estimated that nine premature deaths are prevented each year among urban populations in Mexico on the current car-bike substitution and trip levels (1% of bike trips), with an annual health economic benefit of US $1,897,920. If Mexico achieves similar trip levels to those reported in The Netherlands (27% of bike trips), 217 premature deaths could be saved annually, with an economic impact of US $45,760,960. In all bicycling scenarios assessed in Mexico, physical activity’s health benefits outweighed the health risks related to traffic fatalities and air pollution exposure. Conclusion: The study found that bicycling promotion in Mexico would provide important health benefits. The benefits of physical activity outweigh the risk from traffic fatalities and air pollution exposure in bicyclists. At the national level, Mexico could consider using sustainable transport policies as a tool to promote public health. Specifically, the support of active transportation through bicycling and urban design improvements could encourage physical activity and its health co-benefits.

Changes in physical activity and sedentary behaviours from before to during the COVID-19 pandemic lockdown: a systematic review

OBJECTIVE

In March 2020, several countries banned unnecessary outdoor activities during COVID-19, commonly called 'lockdowns. These lockdowns have the potential to impact associated levels of physical activity and sedentary behaviour. Given the numerous health outcomes associated with physical activity and sedentary behaviour, the aim of this review was to summarise literature that investigated differences in physical activity and sedentary behaviour before vs during the COVID-19 lockdown.

DESIGN DATA SOURCES AND ELIGIBILITY CRITERIA

Electronic databases were searched from November 2019 to October 2020 using terms and synonyms relating to physical activity, sedentary behaviour and COVID-19. The coprimary outcomes were changes in physical activity and/or sedentary behaviour captured via device-based measures or self-report tools. Risk of bias was measured using the Newcastle-Ottawa Scale.

RESULTS

Sixty six articles met the inclusion criteria and were included in the review (total n=86 981). Changes in physical activity were reported in 64 studies, with the majority of studies reporting decreases in physical activity and increases in sedentary behaviours during their respective lockdowns across several populations, including children and patients with a variety of medical conditions.

CONCLUSION

Given the numerous physical and mental benefits of increased physical activity and decreased sedentary behaviour, public health strategies should include the creation and implementation of interventions that promote safe physical activity and reduce sedentary behaviour should other lockdowns occur.

Physical activity and sedentary behaviour related to transport activity assessed with multiple body-worn accelerometers: the RECORD MultiSensor Study

OBJECTIVES

The study explored the physical activity and sedentary behaviours related to transport activity. The aim was to provide evidence to support public health and transport policies encouraging people to reach daily recommendations of physical activity.

STUDY DESIGN

The study design of this study is a cross-sectional study design.

METHODS

Between 2013 and 2015, the RECORD MultiSensor Study collected data from 155 participants using two accelerometers worn on the thigh and trunk. In addition, data were collected from Global Positioning System (GPS) receivers and a GPS-based mobility survey. Relationships between transport modes and the durations and partition patterns of physical behaviours were established at the trip stage (n = 7692) and trip levels (n = 4683) using multilevel linear models with a random effect at the individual level and taking into account temporal autocorrelation.

RESULTS

Participants travelled for a median of 1 h 45 min per day. Trip stages and trips involving walking, other active modes or public transport were associated with a lower sitting duration and a higher moderate-to-vigorous physical activity (MVPA) duration than trips with a personal motorised vehicle. Using public transport was associated with a lower number of transitions between sedentary behaviours and non-sedentary behaviours, and with a higher number of transitions between non-sedentary behaviours and MVPA than relying on a private motorised vehicle.

CONCLUSIONS

This study is the first to assess the association of transport mode with physical activity and sedentary behaviours captured with thigh- and trunk-worn accelerometers at both the trip stage and trip levels. The results demonstrate that, in addition to active transport modes, encouraging people to use public transport increases physical activity and reduces sedentary time.

Cumbersome but desirable-Breaking the code of everyday cycling

Introduction

Cycling for transport could integrate physical activity (PA) into daily routines and potentially increase total PA levels. However, for parents with young children, most factors affecting transport mode choice tend to facilitate car use. Greater insight is necessary into reasons for (not) using sustainable transport modes in parents with young children. Therefore, the objective of this study was to explore the experiences, including motives, perceptions, attitudes, and norms, of parents of young children by using an e-bike, a longtail bike, and a traditional bike for everyday travel to the workplace, kindergarten, and the grocery store during the autumn, winter, and spring, in nine months.

Methods

Semistructured focus group interviews were conducted with 18 parents of young children residing in southern Norway. Parents were recruited through Facebook announcements and direct contact with kindergartens, selected organisations, and companies in the Kristiansand municipality. Data were analysed by systematic text condensation by using NVivo V.11.

Results

Participants’ experiences were summarised by three main themes: ‘cycling is cumbersome’, ‘cycling reflects the desirable me’, and ‘breaking the cycling code’. Time use, planning, logistics, wet and cold weather, long distances, and no cycling habit were frequently mentioned barriers, and the most notable facilitator was the children’s attitude towards cycling. In general, children loved to cycle and preferred cycling to driving. Additionally, the freedom and independence of cycling were emphasised and valued.

Conclusion

In challenging weather conditions, parents of young children may experience cycling as cumbersome but desirable, and bike access could increase the feasibility of daily cycling.

Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study

Background

Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.

Objectives

The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.

Design

The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.

Setting

East Village, London, UK.

Participants

A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.

Intervention

The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.

Main outcome measure

Change in objectively measured daily steps from baseline to follow-up.

Methods

Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.

Results

A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.

Conclusions

Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).

The long-term impact of restricting cycling and walking during high air pollution days on all-cause mortality: Health impact Assessment study

Regular active commuting, such as cycling and walking to and from the workplace, is associated with lower all-cause mortality through increased physical activity (PA). However, active commuting may increase intake of fine particles (PM_2.5), causing negative health effects. The purpose of this study is to estimate the combined risk of PA and air pollution for all-cause mortality among active commuters who, on days with high PM_2.5 levels, switch to commuting by public transportation or work from home. Towards this purpose, we developed a Health Impact Assessment model for six cities (Helsinki, London, Sao Paulo, Warsaw, Beijing, New Delhi) using daily, city-specific PM_2.5 concentrations. For each city we estimated combined Relative Risk (RR) due to all-cause mortality for the PA benefits and PM_2.5 risks with different thresholds concentrations. Everyday cycling to work resulted in annual all-cause mortality risk reductions ranging from 28 averted deaths per 1000 cyclists (95% confidence interval (CI): 20-38) in Sao Paolo to 12 averted deaths per 1000 cyclists (95% CI: 5-19) in Beijing. Similarly, for everyday walking, the reductions in annual all-cause mortality ranged from 23 averted deaths per 1000 pedestrians (95 CI: 16-31) in Sao Paolo to 10 averted deaths per 1000 pedestrians (95%CI: 5-16) in Beijing. Restricting active commuting during days with PM_2.5 levels above specific air quality thresholds would not decrease all-cause mortality risk in any examined city. On the contrary, all-cause mortality risk would increase if walking and cycling are restricted in days with PM_2.5 concentrations below 150 μg/m³ in highly polluted cities (Beijing, New Delhi). In all six cities, everyday active commuting reduced all-cause mortality when benefits of PA and risk or air pollution were combined. Switching to working from home or using public transport on days with high air pollution is not expected to lead to improved all-cause mortality risks.

Physical activity accrued as part of public transport use in England

BACKGROUND

Walking and cycling for transport (active travel) is an important source of physical activity with established health benefits. However, levels of physical activity accrued during public transport journeys in England are unknown.

METHODS

Using the English National Travel Survey 2010-14 we quantified active travel as part of public transport journeys. Linear regression models compared levels of physical activity across public transport modes, and logistic regression models compared the odds of undertaking 30 min a day of physical activity.

RESULTS

Public transport users accumulated 20.5 min (95% confidence interval=19.8, 21.2) a day of physical activity as part of public transport journeys. Train users accumulated 28.1 min (26.3, 30.0) with bus users 16.0 min (15.3, 16.8). Overall, 34% (32%, 36%) of public transport users achieved 30 min a day of physical activity in the course of their journeys; 21% (19%, 24%) of bus users and 52% (47%, 56%) of train users.

CONCLUSION

Public transport use is an effective way to incorporate physical activity into daily life. One in three public transport users meet physical activity guidelines suggesting that shifts from sedentary travel modes to public transport could dramatically raise the proportion of populations achieving recommended levels of physical activity.

Association between Different Modes of Travelling and Adiposity in Chilean Population: Findings from the Chilean National Health Survey 2016-2017

BACKGROUND

Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile.

AIM

To investigate the associations between different types of travelling and markers of obesity in the Chilean adult population.

METHODS

5411 participants from the Chilean National Health Survey 2016-2017 (CNHS) were included in this study. Active travel was assessed using a questionnaire. Car commuters, public transport (PT), walking and cycling were the four forms of travelling assessed. Bodyweight, body mass index and waist circumference were used as markers of adiposity.

RESULTS

Compared to car travellers, body weight, WC and BMI levels were lower for PT walking and cycling travellers. The odds for obesity (Odds ratio (OR): 0.41 (95% CI: 0.28; 0.61 p ≤ 0.001) were lower for walking and the odds (OR: 0.56 (95%CI: 0.35; 0.89 p = 0.014) for central obesity were significantly lower for cyclist in comparison to car travellers. Additionally, participation in any form of active travel (walking or cycling) was low, with only 20.9% of the population reporting being active travellers.

CONCLUSION

Active travel, such as walking and cycling, was associated with lower adiposity levels in the Chilean adult population. Promoting active travel could be a feasible strategy to tackle the high prevalence of obesity and physical inactivity in the Chilean population.

Cycle training and factors associated with cycling among adolescents in England

BACKGROUND

Cycling has the potential to encourage physical activity as well as advancing societal goals such as reducing carbon emissions; encouraging cycling is therefore a policy goal in many contexts. We analysed individual level data from the whole of England on factors associated with cycling among adolescents, including cycle training delivered by the age of 11 years in primary schools.

METHODS

Data came from the nationally representative Millennium Cohort Study collected when participants were aged 13-15 years (adolescents). We assessed frequency of cycling at least once per week (regular cycling) and used logistic regression to assess how this differed across characteristics including demographic, health and environmental factors, as well as receiving cycle training ('Bikeability') in primary school.

RESULTS

We found that 21.0% of adolescents cycled at least once per week. In fully adjusted analyses, this was more common among boys than girls (32.5% vs. 9.4%, p < 0.001), and those in rural areas than urban areas (24.9% vs. 20.3%, p < 0.001). Adolescents in areas with higher prevalence of adult cycle commuting were more likely to cycle regularly (26.1% in high cycling areas vs. 19.3% in low cycling areas, p < 0.001). Participants offered cycle training in primary school were not more likely to cycle regularly as adolescents (21.7% vs. 22.3%, p = 0.528).

DISCUSSION

Approximately one in five adolescents in England cycles regularly, although being offered cycle training in primary school was not linked to greater cycling. Many of the factors associated with adolescent cycling are similar to those for adults and adolescents are more likely to cycle in areas with higher levels of adult cycling.

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on mode of travel (ENABLE London study, a natural experiment)

BACKGROUND

Interventions to encourage active modes of travel (walking, cycling) may improve physical activity levels, but longitudinal evidence is limited and major change in the built environment / travel infrastructure may be needed. East Village (the former London 2012 Olympic Games Athletes Village) has been repurposed on active design principles with improved walkability, open space and public transport and restrictions on residential car parking. We examined the effect of moving to East Village on adult travel patterns.

METHODS

One thousand two hundred seventy-eight adults (16+ years) seeking to move into social, intermediate, and market-rent East Village accommodation were recruited in 2013-2015, and followed up after 2 years. Individual objective measures of physical activity using accelerometry (ActiGraph GT3X+) and geographic location using GPS travel recorders (QStarz) were time-matched and a validated algorithm assigned four travel modes (walking, cycling, motorised vehicle, train). We examined change in time spent in different travel modes, using multilevel linear regresssion models adjusting for sex, age group, ethnicity, housing group (fixed effects) and household (random effect), comparing those who had moved to East Village at follow-up with those who did not.

RESULTS

Of 877 adults (69%) followed-up, 578 (66%) provided valid accelerometry and GPS data for at least 1 day (≥540 min) at both time points; half had moved to East Village. Despite no overall effects on physical activity levels, sizeable improvements in walkability and access to public transport in East Village resulted in decreased daily vehicle travel (8.3 mins, 95%CI 2.5,14.0), particularly in the intermediate housing group (9.6 mins, 95%CI 2.2,16.9), and increased underground travel (3.9 mins, 95%CI 1.2,6.5), more so in the market-rent group (11.5 mins, 95%CI 4.4,18.6). However, there were no effects on time spent walking or cycling.

CONCLUSION

Designing walkable neighbourhoods near high quality public transport and restrictions on car usage, may offer a community-wide strategy shift to sustainable transport modes by increasing public transport use, and reducing motor vehicle travel.

Active Commuting and Depression Symptoms in Adults: A Systematic Review

Physical activity (PA) is suggested to have a protective effect against depression. One way of engaging in PA is through active commuting. This review summarises the literature regarding the relationship between active commuting and depression among adults and older adults. A systematic review of studies published up to December 2019, performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was conducted using three databases (PubMed, Scopus, and Web of Science). A total of seven articles were identified as relevant. The results from these studies were inconsistent. Only two presented a significant relationship between active commuting and depression symptoms. In those two studies, switching to more active modes of travel and walking long distances were negatively related to the likelihood of developing new depressive symptoms. In the other five studies, no significant association between active travel or active commuting and depression was found. The relationship between active commuting and depression symptoms in adults is not clear. More studies on this topic are necessary in order to understand if active commuting can be used as a public health strategy to tackle mental health issues such as depression.

Trends in Transportation Modes and Time among Chinese Population from 2002 to 2012

Giving the rising trends in obesity and chronic diseases in China, strategies to increase physical activity are important. Transport-related activity is a substantial source of physical activity and can be easily incorporated into the daily lives. It is a key social factor of health, which can help improve people’s mental and physical health and decrease environmental pollution. However, little is known about recent trends in transportation modes and time in China. Between 2002 and 2010–2012, information about transportation behaviors of Chinese population aged 15 years or older were collected within two Chinese Nutrition and Health Surveys. A stratified multistage cluster sampling method was conducted to select participants. Sociodemographic information, transportation modes, and time were collected during face-to-face interviews. The study included 82,377 (mean age 41.2 years) and 143,075 (mean age 48.7 years) participants in the 2002 and 2010–2012 surveys respectively. The weighted prevalence of active transportation (including walking and cycling) decreased from 83.8% in 2002 to 54.3% in 2010–2012 (p < 0.001). During the same period, the number of participants using public transportation (including taking the bus, subway, or shuttle bus) has doubled (7.5% and 15.7%, respectively, for 2002 and 2010–2012, (p < 0.001)), and the proportion of inactive transportation (including driving or taking a car, motorcycle, taxi, or electric bicycle) more than tripled. Concurrently, the transportation time almost doubled with an increase of 25.9 min over the 10 years (p < 0.001). The prevalence of active transportation increased with age. Participants with higher family income and education reported a lower prevalence of active transportation. Females were more likely to use active transportation (OR (95% CI): 4.41 (4.14–4.70) and 2.50 (2.44–2.57), respectively, for 2002 and 2010–2012, where males were the reference). Before the prevalence of active transportation and physical activity gets lower, there is a need for the public health sector and the transport and land use sector to work together to develop related policies and initiatives with the aim of promoting active transportation and public transportation to increase the levels of physical activity and to decrease the risks of chronic diseases.

Combining sensor tracking with a GPS-based mobility survey to better measure physical activity in trips: public transport generates walking

Background

Policymakers need accurate data to develop efficient interventions to promote transport physical activity. Given the imprecise assessment of physical activity in trips, our aim was to illustrate novel advances in the measurement of walking in trips, including in trips incorporating non-walking modes.

Methods

We used data of 285 participants (RECORD MultiSensor Study, 2013–2015, Paris region) who carried GPS receivers and accelerometers over 7 days and underwent a phone-administered web mobility survey on the basis of algorithm-processed GPS data. With this mobility survey, we decomposed trips into unimodal trip stages with their start/end times, validated information on travel modes, and manually complemented and cleaned GPS tracks. This strategy enabled to quantify walking in trips with different modes with two alternative metrics: distance walked and accelerometry-derived number of steps taken.

Results

Compared with GPS-based mobility survey data, algorithm-only processed GPS data indicated that the median distance covered by participants per day was 25.3 km (rather than 23.4 km); correctly identified transport time vs. time at visited places in 72.7% of time; and correctly identified the transport mode in 67% of time (and only in 55% of time for public transport). The 285 participants provided data for 8983 trips (21,163 segments of observation). Participants spent a median of 7.0% of their total time in trips. The median distance walked per trip was 0.40 km for entirely walked trips and 0.85 km for public transport trips (the median number of accelerometer steps were 425 and 1352 in the corresponding trips). Overall, 33.8% of the total distance walked in trips and 37.3% of the accelerometer steps in trips were accumulated during public transport trips. Residents of the far suburbs cumulated a 1.7 times lower distance walked per day and a 1.6 times lower number of steps during trips per 8 h of wear time than residents of the Paris core city.

Conclusions

Our approach complementing GPS and accelerometer tracking with a GPS-based mobility survey substantially improved transport mode detection. Our findings suggest that promoting public transport use should be one of the cornerstones of policies to promote physical activity.

Electronic supplementary material

The online version of this article (10.1186/s12966-019-0841-2) contains supplementary material, which is available to authorized users.

Population health impacts of China's climate change policies

Rapid and wide-ranging reductions in greenhouse gas emissions are required to meet the climate targets agreed upon at the 2015 Paris climate conference. There will be significant transition risks for health, livelihoods, and ecosystems associated with large-scale mitigation, but also opportunities. The aim of this study was to investigate the impacts, positive and negative, of climate policies on population health in China. We review the Intended Nationally Determined Contribution (INDC) that China took to the Paris meeting, link commitments in the INDC to national planning documents relevant to environment and health, and search the literature for Chinese publications on health trade-offs and synergies. Synergies are evident in the measures taken to reduce local air pollution in China: controls on coal burning have materially improved local air quality and benefited health. But there may be risks to health also, depending on how policies are implemented and what safeguards are provided. To date most assessments of the health impacts of climate policies in China have been modelling studies. We recommend work of this kind is complemented by observational research to identify unexpected impacts and vulnerabilities. It will become even more important to undertake this work as emission reductions accelerate to meet the Paris climate targets.

From cars to bikes - The effect of an intervention providing access to different bike types: A randomized controlled trial

Introduction

We aimed to investigate whether providing parents with children in kindergarten with access to different bicycle types could influence (i) travel behavior and cycling amount, and (ii) intrinsic motivation for cycling and psychological constructs related to car use.

Methods

A randomized, controlled trial was conducted in Southern Norway from September 2017 to June 2018. In total 36 parents were recruited and randomly drawn into an intervention (n = 18) or control group (n = 18). The intervention group was in random order equipped with an e-bike with trailer (n = 6), a cargo (longtail) bike (n = 6) and a traditional bike with trailer (n = 6).

Results

At follow-up, more participants from the intervention group (vs. the control group) were classified as cyclists to the workplace (n = 7 (38.9%) vs. n = 1 (5.9%), p = 0.04), but not to the kindergarten (n = 6 (33.3%) vs. n = 2 (11.8%), p = 0.23) or to the grocery store (n = 2 (11.1%) vs. n = 0 (0%), p = 0.49). A significant (p = ≤0.05) increase in cycling frequency (0.1 to 2.0 days/week) from baseline to follow-up was found in the intervention group for all destinations and seasons, except to the grocery store during winter (p = 0.16). A decrease in frequency of car driving (-0.2 to -1.7 days/week) was found to be apparent in terms of travelling to the workplace and the kindergarten for all seasons, yet not to the grocery store for any season (p = 0.15–0.49). The intervention group (vs. the control group) reported significantly higher “intrinsic regulation” for cycling (p = 0.01) at follow-up.

Conclusion

Access to different bike types for parents with children attending kindergarten resulted in overall increased cycling, decreased car use and higher intrinsic motivation for cycling. E-bikes obtained the greatest cycling amount in total, with the smallest sample variability. Hence, providing parents with children in kindergarten with access to e-bikes might result in increased and sustained cycling, also during the winter season.

Longer, More Active Commute, but Still not Very Active: Five-Year Physical Activity and Travel Behavior Change in a University Population

Active travel can support the achievement of recommended levels of physical activity. Monitoring travel behavior of university students and staff provides a useful insight into patterns of regional travel and population level changes in physical activity. This study sought to evaluate current travel and physical activity behaviors in a university population and to determine whether these changed over time. An online survey of travel behavior and physical activity was conducted at the University of Sydney, Australia. The survey was actively promoted for three weeks prior to the release of the survey among staff and students, which asked about travel behavior on a specific day in September 2017. The survey questions were the same as those used in a similar online survey conducted across the University in 2012. In total, 4359 People completed the survey, representing 10.8% of staff and 4.1% of students. Approximately two thirds of survey respondents were students, in both the 2012 and 2017 surveys. Compared with 2012, there was an increase in active travel to the University in 2017 from increased walking and train travel. Compared to 2012, in 2017 there was an increase in average minutes walked by about nine minutes, and less time spent sitting. Trip lengths increased, with 68% of trips taking longer than 30 min in 2017. The amount of time spent in low-moderate levels physical activity increased between 2012 and 2017, potentially related to active travel behavior. Citywide changes towards a system-wide transport fare structure was the biggest change in the transport environment between the two surveys and may have contributed to increased train travel.

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.

Causal evaluation of urban greenway retrofit: A longitudinal study on physical activity and sedentary behavior

Studies of the built environment and physical activity (PA) have primarily been cross-sectional. Evidence on the causal impacts of transportation improvements on PA and sedentary behavior (SB) is lacking. This study assessed the effect of retrofitting an urban greenway on PA and SB in Vancouver, Canada. A sample of 524 participants (median age of 44; 57% female) were divided into experimental and control groups, and the effect of exposure to the greenway was examined by using different distance thresholds. Self-report measures of moderate-to-vigorous PA (MVPA) and SB were collected using the International Physical Activity Questionnaire (IPAQ-SF) before (baseline; 2012-2013) and after (follow-up; 2014-2015) construction of the Comox-Helmcken Greenway in 2013. Mixed-effects models estimated the impacts of greenway on MVPA and SB. For participants living near the greenway (≤300 m), the odds of achieving an average of 20 min of daily MVPA doubled (OR = 2.00; 95% CI = 1.00, 3.98) after the greenway's opening. The odds of being sedentary for >9 h declined by 54% (OR = 0.46; 95% CI = 0.25, 0.85) after opening. PA benefits from the greenway declined with distance from 100 m to 500 m. Reduction in SB was lowest at 100 m and greatest at 300 m. Retrofitting an urban residential neighborhood through greenway interventions can be successful in promoting physical activity while reducing sedentary behavior. Recommendations for future longitudinal research include the use of objective PA measures, studying different neighborhood contexts, collecting more representative samples, and minimizing attrition.

Does Health-Oriented Tourism Contribute to Sustainable Mobility?

Previous research has concentrated on traffic and health-related effects in relation to arrival patterns (e.g., stress in connection with means of transport, travel distance, and time). However, tourist mobility behavior during a vacation and potential health-related associations as well as its correlation with physical activity habits and mobility patterns at home seems to have barely been examined. To address this research gap, the study at hand applied a mixed-method approach in three tourism destinations in Tyrol, Austria. The study examined tourists’ mobility as well as their physical activity at home and at the holiday destination. Results show that the preferred transport mode (arrival and on-site) is the private car, due to its flexibility and comfort. Hotel front desks, as the main information source, determine tourists’ behavioral aspects during a vacation. General mobility routines show differences between everyday life and holiday situations, and physical activity is important for the overall satisfaction of tourists, which proves to be more intense and frequent during a vacation than in everyday life. Seven percent of the tourists participating in the research stated that they had changed their daily mobility behavior after their return, with most of them walking or cycling more often. This study contributes to research in the field of sustainable tourist mobility and physical activity behavior and highlights the necessity for further specific analyses.

Cross-sectional and longitudinal analysis of the active commuting behaviors of U.S. Department of the Interior employees

BACKGROUND

Despite evolving evidence of the health and economic benefits of active transportation (AT) to work, few studies have examined the determinants of AT in large organizations with multiple worksites nor how trends in commuting change over time.

METHODS

The data were obtained from the U.S. Department of the Interior Employee Commuting Census of 2010 (n = 23,230), and 2012-2016 (n = 21,725-25,974). The respondents were grouped into four commuting categories: non-active mode, walking, biking, and mixed-mode. Multinomial logistic regression analysis was utilized to examine the correlates of choosing AT to work for the 2010 data. Next, a repeated cross-sectional analysis was completed for all six years of data.

RESULTS

In 2010, AT modes were only chosen by approximately 10% of respondents. Employees who lived farther from work and did not have a public transit station within 0.5 miles from home were generally less likely to choose AT. Respondents working in non-metro workplaces were less likely to bike or take mixed-modes to work, but more likely to walk. Men were more likely to choose AT modes, particularly biking. Respondents aged ≤30 yrs. were less likely to bike than those 31 to 40 yrs., but more likely than those ≥61 yrs. In 2010, the number of respondents that walked was higher, and biked and took mixed-modes was lower when compared to 2016, while the choice to take mixed-modes was higher in 2012 and 2013 when compared to 2016. Daily commuting distances in 2016 tended to be lower than 2010 and 2012, and higher than 2013. However, overall AT choice and commute distance remained reasonably stable over time.

CONCLUSIONS

Respondents who lived close to their workplace and a public transportation station, worked in a metro location, were male and younger were more likely to choose AT modes to work. The results provide insight for the U.S. Department of the Interior and other large organizations to develop intervention strategies that support AT to work. Further research is warranted to understand the concurrent individual, social, and environmental barriers and facilitators for choosing AT to work.

What Psychosocial Factors Determine the Physical Activity Patterns of University Students?

Background: Although levels of physical activity (PA) have been researched, no information on how university students organize their PA across different life domains is available. The purpose of this study is to explore if and how students organize their PA across transport and recreational domains, and to identify the psychosocial factors related to these patterns. Methods: Students from 31 Irish universities completed a supervised online survey measuring participant characteristics, psychosocial factors, and PA. Two-step cluster analysis was used to identify specific PA patterns in students. Binary logistic regressions identified factors associated with cluster membership while controlling for age, sex, household income, and perceived travel time to a university. Results: Analysis was performed on 6951 students (50.7% male; 21.51 [5.55] y). One Low Active cluster emerged. Four clusters containing a form of PA emerged including Active Commuters, Active in University, Active Outside University, and High Active. Increases in motivation and planning improved the likelihood of students being categorized in a cluster containing PA. Conclusion: One size does not fit all when it comes to students PA engagement, with 5 patterns identified. Health professionals are advised to incorporate strategies for increasing students' motivation, action planning, and coping planning into future PA promotion efforts.

Capturing fine-scale travel behaviors: a comparative analysis between personal activity location measurement system (PALMS) and travel diary

Background

Device-collected data from GPS and accelerometers for identifying active travel behaviors have dramatically changed research methods in transportation planning and public health. Automated algorithms have helped researchers to process large datasets with likely fewer errors than found in other collection methods (e.g., self-report travel diary). In this study, we compared travel modes identified by a commonly used automated algorithm (PALMS) that integrates GPS and accelerometer data with those obtained from travel diary estimates.

Methods

Sixty participants, who made 2100 trips during seven consecutive days of data collection, were selected from among the baseline sample of a project examining the travel behavior impact of a new light rail system in the greater Seattle, WA (USA) area. GPS point level analyses were first conducted to compare trip/place and travel mode detection results using contingency tables. Trip level analyses were then performed to investigate the effect of proportions of time overlap between travel logs and device-collected data on agreement rates. Global performance (with all subjects’ data combined) and subject-level performance of the algorithm were compared at the trip level.

Results

At the GPS point level, the overall agreement rate of travel mode detection was 77.4% between PALMS and the travel diary. The agreement rate for vehicular trip detection (84.5%) was higher than for bicycling (53.5%) and walking (58.2%). At the trip level, the global performance and subject-level performance of the PALMS algorithm were 46.4% and 42.4%, respectively. Vehicular trip detection showed highest agreement rates in all analyses. Study participants’ primary travel mode and car ownership were significantly related to the subject-level mode agreement rates.

Conclusions

The PALMS algorithm showed moderate identification power at the GPS point level. However, trip level analyses found lower agreement rates between PALMS and travel diary data, especially for active transportation. Testing different PALMS parameter settings may serve to improve the detection of active travel and help expand PALMS’s applicability in geographically different urbanized areas with a variety of travel modes.

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.

Exploring Neighborhood Environments and Active Commuting in Chennai, India

Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, poor enforcement of traffic rules and regulations, air pollution, and overcrowding. This cross-sectional study investigated associations between home neighborhood environment characteristics and active commuting in Chennai, India. Adults (N = 370, 47.2% female, mean age = 37.9 years) were recruited from 155 wards in the metropolitan area of Chennai in southern India between January and June 2015. Participants self-reported their usual mode of commute to work, with responses recoded into three categories: (1) multi-modal or active commuting (walking and bicycling; n = 56); (2) public transit (n = 52); and (3) private transport (n = 111). Environmental attributes around participants’ homes were assessed using the Neighborhood Environment Walkability Scale for India (NEWS-India). Associations between environmental characteristics and likelihood of active commuting and public transit use were modeled using logistic regression with private transport (driving alone or carpool) as the reference category, adjusting for age, gender, and household car ownership. Consistent with other international studies, participants living in neighborhoods with a mix of land uses and a transit stop within a 10-minute walk from home were more likely to use active commuting (both p < 0.01). Land-use mix was significantly associated with the use of public transit compared to private transport (adjusted odds ratio (aOR) = 5.2, p = 0.002). Contrary to findings in high-income countries, the odds of active commuting were reduced with improved safety from crime (aOR = 0.2, p = 0.003), aesthetics (aOR = 0.2, p = 0.05), and street connectivity (aOR = 0.2, p = 0.003). Different environmental attributes were associated with active commuting, suggesting that these relationships are complex and may distinctly differ from those in high-income countries. Unexpected inverse associations of perceived safety from crime and aesthetics with active commuting emphasize the need for high-quality epidemiologic studies with greater context specificity in the study of physical activity in LMICs. Findings have public health implications for India and suggest that caution should be taken when translating evidence across countries.

The Smart City Active Mobile Phone Intervention (SCAMPI) study to promote physical activity through active transportation in healthy adults: a study protocol for a randomised controlled trial

Background

The global pandemic of physical inactivity represents a considerable public health challenge. Active transportation (i.e., walking or cycling for transport) can contribute to greater total physical activity levels. Mobile phone-based programs can promote behaviour change, but no study has evaluated whether such a program can promote active transportation in adults. This study protocol presents the design and methodology of The Smart City Active Mobile Phone Intervention (SCAMPI), a randomised controlled trial to promote active transportation via a smartphone application (app) with the aim to increase physical activity.

Methods/design

A two-arm parallel randomised controlled trial will be conducted in Stockholm County, Sweden. Two hundred fifty adults aged 20–65 years will be randomised to either monitoring of active transport via the TRavelVU app (control), or to a 3-month evidence-based behaviour change program to promote active transport and monitoring of active travel via the TRavelVU Plus app (intervention). The primary outcome is moderate-to-vigorous intensity physical activity (MVPA in minutes/day) (ActiGraph wGT3x-BT) measured post intervention. Secondary outcomes include: time spent in active transportation measured via the TRavelVU app, perceptions about active transportation (the Transport and Physical Activity Questionnaire (TPAQ)) and health related quality of life (RAND-36). Assessments are conducted at baseline, after the completed intervention (after 3 months) and 6 months post randomisation.

Discussion

SCAMPI will determine the effectiveness of a smartphone app to promote active transportation and physical activity in an adult population. If effective, the app has potential to be a low-cost intervention that can be delivered at scale.

Trial registration

ClinicalTrials.gov NCT03086837; 22 March, 2017.

Changes in the mode of travel to work and the severity of depressive symptoms: a longitudinal analysis of UK Biobank

Although commuting provides an opportunity for incorporating physical activity into daily routines, little is known about the effect of active commuting upon depressive symptoms. This study aimed to determine whether changes in commute mode are associated with differences in the severity of depressive symptoms in working adults. Commuters were selected from the UK Biobank cohort if they completed ≥2 assessment centre visits between 2006 and 2016. Modes of travel to work were self-reported at each visit. Participants were categorised as 'inactive' (car only) or 'active' commuters (any other mode(s), including walking, cycling and public transport). Transitions between categories were defined between pairs of visits. The severity of depressive symptoms was defined using the two-item Patient Health Questionnaire (PHQ-2). Scores were derived between zero and six. Higher values indicate more severe symptoms. Separate analyses were conducted in commuters who were asymptomatic (zero score) and symptomatic (non-zero score) at baseline. The analytical sample comprised 5474 participants aged 40-75 at baseline with a mean follow-up of 4.65 years. Asymptomatic commuters who transitioned from inactive to active commuting reported less severe symptoms at follow-up than those who remained inactive (β -0.10, 95% CI [-0.20, 0.00]; N = 3145). A similar but non-significant relationship is evident among commuters with pre-existing symptoms (β -0.60, 95% CI [-1.27, 0.08]; N = 1078). After adjusting for transition category, longer commutes at baseline were associated with worse depressive symptoms at follow-up among symptomatic participants. Shifting from exclusive car use towards more active commuting may help prevent and attenuate depressive symptoms in working adults.

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.

School and class-level variations and patterns of physical activity: a multilevel analysis of Danish high school students

Background

There is limited knowledge of physical activity (PA) patterns among high school students. High schools plays an important role as context for the students, but it is uncertain to what extent schools influence student participation in PA during leisure time. The purpose of this study is to describe patterns of PA and assess variations between schools and classes in PA, in a large cohort of Danish high school students.

Methods

Self-reported cross-sectional data came from The Danish National Youth Study, comprising a total of 70,674 students attending 119 different schools and 3213 classes. Multilevel logistic regressions were applied to evaluate the association between socio-demographic variables and patterns of PA, and to assess the impact of schools and classes on PA measures.

Results

Students whose parents have achieved a lower level of education, older students and girls of perceived ethnic minority generally participated less in several forms of PA during leisure time. Substantial variations between schools were observed in terms of participation in PA at school during leisure time and in terms of use of active transportation to and from school. The school-level accounted for 9% (intra-class correlation coefficient (ICC) = 0.09 (95% CI: 0.06–0.11)) and 8% (ICC = 0.08 (95% CI: 0.07–0.11)) of the variation for participation in PA during leisure time and active transportation.

Conclusion

Overall, students whose parents achieved a lower level of education, older students and girls of perceived ethnic minority represent vulnerable groups in relation to participation in several forms of PA during leisure time. The ICCs indicate that schools, in particular, have the potential to influence participation in PA at school during leisure time and active transportation to and from school. Thus, high schools should encourage and facilitate activities aimed at engaging students in PA during leisure time as well as encourage active transportation.

An evaluation of transport mode shift policies on transport-related physical activity through simulations based on random forests

BACKGROUND

Physical inactivity is widely recognized as one of the leading causes of mortality, and transport accounts for a large part of people's daily physical activity. This study develops a simulation approach to evaluate the impact of the Ile-de-France Urban Mobility Plan (2010-2020) on physical activity, under the hypothesis that the intended transport mode shifts are realized.

METHODS

Based on the Global Transport Survey (2010, n = 21,332) and on the RECORD GPS Study (2012-2013, n = 229) from the French capital region of Paris (Ile-de-France), a simulation method was designed and tested. The simulation method used accelerometer data and random forest models to predict the impact of the transport mode shifts anticipated in the Mobility Plan on transport-related moderate-to-vigorous physical activity (T-MVPA). The transport mode shifts include less private motorized trips in favor of more public transport, walking, and biking trips.

RESULTS

The simulation model indicated a mean predicted increase of 2 min per day of T-MVPA, in case the intended transport mode shifts in the Ile-de-France Urban Mobility Plan were realized. The positive effect of the transport mode shifts on T-MVPA would, however, be larger for people with a higher level of education. This heterogeneity in the positive effect would further increase the existing inequality in transport-related physical activity by educational level.

CONCLUSIONS

The method presented in this paper showed a significant increase in transport-related physical activity in case the intended mode shifts in the Ile-de-France Urban Mobility Plan were realized. This simulation method could be applied on other important health outcomes, such as exposure to noise or air pollution, making it a useful tool to anticipate the health impact of transport interventions or policies.

A push for public health: the effect of e-bikes on physical activity levels

Background

Cycling is considered to have a positive effect on public health through increased physical activity. In Norway, the e-bike is seen as a way of getting more people to cycle. However, the motorized assistance of an e-bike potentially eliminates any physical activity associated with its use. It is possible that the assumed health effect of increased cycling is “erased” through a reduction in other physical activities (a substitution effect). In this paper we study the public health effects of e-bikes using a combined cross-sectional and quasi-experimental design. First, we explore the existence of potentially hedonistic values in relation to interest in acquiring an e-bike and, second, we conduct an intervention study of physical activity pre- and post-purchase.

Methods

A sample of 340 people responded to a questionnaire before buying an e-bike and follow-up 4 weeks later, when 45 had bought one. A further 28 (mainly physically inactive) were recruited through a Norwegian NGO. For a comparison group, 1995 people were recruited through the Falck National Register of Bicycle Owners. All respondents were asked about the intensity of their cycling, (kilometres cycled in the previous week), walking and physical activity in addition to cycling as means of transport (days and hours).

Results

A structural equation model showed that hedonistic life values, and general physical activity, were predictive of interest in buying an e-bike. However people who already cycled a lot showed less interest. The trial showed that increased cycling – whether as a mean of transport or exercise –was related to higher levels of total physical activity in both groups compared to a comparison group (one-way ANOVA).

Conclusions

Our findings indicate that in the Norwegian cycle population there is no substantial substitution effect of physical activity with the introduction of an e-bike. The appeal of the e-bike is strongest among those with little existing interest in, or levels of, physical activity. The net effect of the e-bike therefore seems positive from a public health perspective.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4817-3) contains supplementary material, which is available to authorized users.