Socio-ecological predictors of the uptake of cycling for recreation and transport in adults: results from the RESIDE study

A systematic review on the associations between the built environment and adult's physical activity in global tropical and subtropical climate regions

BACKGROUND

Physical inactivity is a major public health concern, exacerbated in countries with a (sub)tropical climate. The built environment can facilitate physical activity; however, current evidence is mainly from North American and European countries with activity-friendly climate conditions. This study explored associations between built environment features and physical activity in global tropical or subtropical dry or desert climate regions.

METHODS

A systematic review of four major databases (Web of Science, Scopus, PubMed, and SportDISCUS) was performed. To be included, studies had to investigate associations between perceived or objective built environment characteristics and adult's physical activity and had to be conducted in a location with (sub)tropical climate. Each investigated association was reported as one case and results were synthesized based upon perceived and objectively assessed environment characteristics as well as Western and non-Western countries. Study quality was evaluated using a tool designed for assessing studies on built environment and physical activity.

RESULTS

Eighty-four articles from 50 studies in 13 countries with a total of 2546 built environment-physical activity associations were included. Design (connectivity, walking/cycling infrastructure), desirability (aesthetics, safety), and destination accessibility were the built environment characteristics most frequently associated with physical activity across the domains active transport, recreational physical activity, total walking and cycling, and moderate-to-vigorous physical activity, particularly if multiple attributes were present at the same time. Very few studies assessed built environment attributes specifically relevant to physical activity in (sub)tropical climates. Most studies were conducted in Western countries, with results being largely comparable with non-Western countries. Findings were largely generalizable across gender and age groups. Results from natural experiments indicated that relocating to an activity-friendly neighborhood impacted sub-groups differently.

CONCLUSIONS

Built environment attributes, including destination accessibility, connectivity, walking and cycling infrastructure, safety, and aesthetics, are positively associated with physical activity in locations with (sub)tropical climate. However, few studies focus on built environment attributes specifically relevant in a hot climate, such as shade or indoor recreation options. Further, there is limited evidence from non-Western countries, where most of the urban population lives in (sub)tropical climates. Policy makers should focus on implementing activity-friendly environment attributes to create sustainable and climate-resilient cities.

Is the built-environment at origin, on route, and at destination associated with bicycle commuting? A gender-informed approach

There is limited evidence on the gender differences and location-specific built-environment factors associated with bicycling in Latin American cities. This study aimed to assess commuting in Bogotá by (1) analyzing the gender-specific trend of the standardized number of bicycle commuters during 2005-2017; and (2) assessing the socio-demographic, community, built-environment and natural factors associated with bicycle commuting stratified by gender. This secondary-data analysis included data from the Household Travel Surveys and Multipurpose Surveys to calculate the number of bicycle commuters per habitant from 2005 to 2017 by gender. We assessed the socio-demographic and built-environment factors fitting generalized additive models stratified by gender using the 2015 Household Travel Survey. Although both women and men increased the standardized number of bicycle commuters, male commuters show a steeper trend than women, evidencing the widening gender gap in bicycle commuting over time. Bicycle commuting was negatively associated with household motor vehicle ownership, steeper terrain slope, longer commute distance, and scarce low-stress roads at trip origin and route. Among women, the availability of bike paths at the trip destination was positively associated with bicycling, while age and being a student were negatively associated with bicycling. Among men, living in areas with the lowest socio-economic status was positively associated with bicycling, while having a driver's license and living close to bus rapid transit stations were negatively associated with bicycling. In conclusion, bicycle and transport infrastructure play different roles in commuting by bicycle by gender and trip stages (origin - route - destination).

Socio-Ecological Predictors of Frequent Bike Share Trips: Do Purposes Matter?

Using bike share could increase physical activity and improve health. This study used the social-ecological model to identify predictors of frequent bike share trips for different purposes. Participants residing in the U.S. were recruited via Amazon Mechanical Turk (MTurk). Self-report trip purposes were used to group participants into using bike share for commuting only (n = 260), social/entertainment only (n = 313), exercise only (n = 358), dual or triple-purpose (n = 501), and purposes other than commuting, social/entertainment, and exercise (n = 279). Results showed that at the intrapersonal level, perceived use of bike share to be helpful for increasing physical activity was a significant predictor for all groups, except for the other purpose group. Adjusting outdoor activity based on air quality was a significant predictor for the dual or triple-purpose group. At the interpersonal level, having four or more friends/family using bike share was a significant predictor for the other purpose group. At the community level, distance to the nearest bike share within acceptable range was a significant predictor for social/entertainment and dual or triple-purpose groups. The findings suggest that it is important to consider factors at multiple levels for predicting bike share usage. Moreover, health educators and policy makers should adopt different strategies for promoting bike share usage based on trip purposes.

Living liveable? RESIDE's evaluation of the "Liveable Neighborhoods" planning policy on the health supportive behaviors and wellbeing of residents in Perth, Western Australia

BACKGROUND

The RESIDential Environments (RESIDE) project is a unique longitudinal natural experiment designed to evaluate the health impacts of the "Liveable Neighbourhoods" planning policy, which was introduced by the Western Australian government to create more walkable suburbs.

OBJECTIVES

To summarize the RESIDE evidence of the impact of the planning policy on a range of health-supportive behaviours and wellbeing outcomes and to assess the consistency and direction of the estimates of associations.

METHODS

An audit of 26 RESIDE research papers (from 2003 to 2012) identified the number of positive associations (statistically significant and consistent with policy expectations), negative associations (statistically significant and inconsistent with policy expectations), and null findings from multiple-exposure models between objective and perceived measures of 20 policy design requirements and 13 health-supportive behaviors and wellbeing outcomes.

RESULTS

In total 332 eligible estimates of associations (n = 257 objective measures and n = 75 perceived measures) were identified. Positively significant findings were detected for: 57% of walking estimates with objectively measured policy design features (negative = 3%; null = 40%) (n = 115) and 54% perceived measures (negative = 0%; null = 33%) (n = 27); 42% of sense of community estimates with objectively measured of policy design features (negative = 8%; null = 50%) (n = 12) and 61% perceived measures (negative = 8%; null = 31%) (n = 13); 39% of safety or crime-related estimates with objectively measured of policy design features (negative = 22%; null = 39%) (n = 28) and 100% perceived measures (n = 7). All (n = 4) estimates for mental health outcomes with objectively measured policy-related design features were positively significant.

CONCLUSIONS

The synthesis of findings suggests that new suburban communities built in accordance with the "Liveable Neighbourhoods" policy have the potential to encourage health supportive behaviors and wellbeing outcomes including transport and recreation walking, and to create neighborhoods with a stronger sense of community where residents may feel safer.

China's green future and household solid waste: Challenges and prospects

China is facing the dual challenge of economic development and environment protection. Recently, Shanghai (tier-1 city) implemented the pilot project of household solid waste (HSW) management and expects to execute a similar project in 45 cities across China by 2020. The current research's aim is to examine the pilot project's progress by comparing it with existing HSW management practice in other cities. From a theoretical perspective, a socio-ecological framework is used to examine citizens' HSW sorting behavior (HSWSB), which is further mapped based on the theory of planned behavior to enrich the findings. A total of 1409 citizen responses are utilized to generalize the findings. The study concludes that replicating tier-1 practices in other cities could produce unsatisfactory results. The regulatory environment should focus on comparatively long-lasting citizen behavior change by designing a citizen-centric approach (i.e., awareness campaigns) related to ecological concerns (i.e., climate change) because it could define the future of HSWSB practice in Chinese society.

Local walking and cycling by residents living near urban motorways: cross-sectional analysis

Background

Everyday activities, such as walking or cycling, may be a feasible and practical way to integrate physical activity into everyday life. Walking and cycling for transport or recreation in the area local to a person’s home may have additional benefits. However, urban planning tends to prioritise car use over active modes. We explored the cross-sectional association between living near an urban motorway and local walking and cycling.

Methods

In 2013, residents living in an area (a) near a new urban motorway (M74), (b) near a longstanding urban motorway (M8), or (c) without a motorway, in Glasgow, Scotland, were invited to complete postal surveys assessing local walking and cycling journeys and socio-demographic characteristics. Using adjusted regression models, we assessed the association between motorway proximity and self-reported local walking and cycling, as well as the count of types of destination accessed. We stratified our analyses according to study area.

Results

One thousand three hundred forty-three residents (57% female; mean age: 54 years; SD: 16 years) returned questionnaires. There was no overall association between living near an urban motorway and the likelihood of local walking or cycling, or the number of types of local destination accessed by foot or bicycle.

In stratified analyses, for those living in the area around the new M74 motorway, increasing residential proximity to the motorway was associated with lower likelihood of local recreational walking and cycling (OR 0.63, 95% CI: 0.39 to 1.00) a pattern not found in the area with the longstanding M8 motorway. In the area near the M8 motorway residential proximity was statistically significantly (p = 0.014) associated with a 12% decrease in the number of types of destination accessed, a pattern not found in the M74 study area.

Conclusions

Our findings suggest that associations between living near a motorway and local walking and cycling behaviour may vary by the characteristics of the motorway, and by whether the behaviour is for travel or recreation. The lack of associations seen in the study area with no motorway suggests a threshold effect whereby beyond a certain distance from a motorway, additional distance makes no difference.

Closing the loop: short term impacts on physical activity of the completion of a loop trail in Sydney, Australia

BACKGROUND

In Australia, an estimated 57% of the population do not meet physical activity recommendations for health. The built environment is important for active living, and recreational trails provide safe and pleasant settings for this purpose. However, evidence for positive impacts on physical activity from real world natural experiments is sparse. We describe the impact of transforming a recreational trail into a loop on usage by cyclists and pedestrians and users' physical activity levels.

METHOD

We conducted time series analyses of pre and post-completion (November 2013-July 2015) counts taken from infrared electronic counters of pedestrians and cyclists on two established sections of the trail adjusted for underlying trend, trend change, weather, holidays and trail closures. Chi-square analyses of pre and post-completion visual counts examined change in the distribution of pedestrian/cyclist, adult/child, and male/female users. Descriptive and bivariate analyses of post-completion intercept survey data of 249 trail users were conducted to examine user characteristics and impact on physical activity.

RESULTS

Pedestrian and cyclist counts on established trail sections increased by between 200 and 340% from pre to post-completion. Visual count data showed a significant 7% increase in children (vs adults) using the trail at one site pre to post (p = 0.008). Of previous users, 48% reported doing more physical activity at the trail and this was additional to (not replacing) physical activity done elsewhere. Those users not meeting physical activity recommendations were more likely to report increased total physical activity since the loop was created (55.5% vs 39.2%, p = 0.031). The connected loop nature of the trail and its length was perceived to encourage more and different forms of physical activity.

CONCLUSION

Creating an accessible loop trail away from motorised traffic can lead to increased trail use and potentially total physical activity. The modification to the trail encouraged proportionate and real increases in usage among vulnerable populations such as children and perhaps greater total physical activity especially for people not meeting physical activity recommendations. The findings suggest that the benefits of environmental changes such as these can accrue to those most in need of support for being physically active.

Nature-Based Interventions for Improving Health and Wellbeing: The Purpose, the People and the Outcomes

Engagement with nature is an important part of many people's lives, and the health and wellbeing benefits of nature-based activities are becoming increasingly recognised across disciplines from city planning to medicine. Despite this, urbanisation, challenges of modern life and environmental degradation are leading to a reduction in both the quantity and the quality of nature experiences. Nature-based health interventions (NBIs) can facilitate behavioural change through a somewhat structured promotion of nature-based experiences and, in doing so, promote improved physical, mental and social health and wellbeing. We conducted a Delphi expert elicitation process with 19 experts from seven countries (all named authors on this paper) to identify the different forms that such interventions take, the potential health outcomes and the target beneficiaries. In total, 27 NBIs were identified, aiming to prevent illness, promote wellbeing and treat specific physical, mental or social health and wellbeing conditions. These interventions were broadly categorized into those that change the environment in which people live, work, learn, recreate or heal (for example, the provision of gardens in hospitals or parks in cities) and those that change behaviour (for example, engaging people through organized programmes or other activities). We also noted the range of factors (such as socioeconomic variation) that will inevitably influence the extent to which these interventions succeed. We conclude with a call for research to identify the drivers influencing the effectiveness of NBIs in enhancing health and wellbeing.

Use of Geographic Information Systems in Physical Activity Interventions: a Systematic Review

INTRODUCTION

The promotion of physical activity is inextricably dependent on the environment. This systematic review summarizes studies that used geographic information systems to account for the role of geographic features in the design, implementation, or evaluation of interventions that promoted physical activity.

METHODS

Pubmed, ProQuest/PsycInfo, and Cochrane Library were searched for physical activity interventions that employed geographic information systems. The search was conducted with an algorithm that included 10 geographic, 28 intervention, and 9 physical activity search terms. Data were systematically reviewed using a standardized form based on the PICOS framework (participants, interventions, comparison, outcomes, and study design). Quality of the studies included was independently rated on 14 criteria (Registration number CRD42016046011).

RESULTS

Search yield 12,518 published articles, of which, 19 studies satisfied our inclusion criteria. Proximity to recreational areas and neighborhood walkability were the most common geographic factors measured in studies of physical activity interventions. Interventions focused on supporting physical activity by providing recreational spaces and adequate infrastructure to participants. Fifteen intervention studies assessed socioeconomic environmental factors along with physical environmental factors. Support groups were introduced by 4 of the interventions to offset social environmental barriers in the geographical environment. Given the lack of consistency in measurements of physical activity, and long-term assessments, it was not possible to determine if findings are attributable to the geographic environment or a novelty effect.

CONCLUSION

More research is needed to better understand the physical and social factors within the geographic environment that work as barriers or facilitators of physical activity changes.

From End Treatment to Source Prevention: Socio-Ecological Approaches to Promote Research on the Environment and Non-Communicable Chronic Diseases with Special Reference to China

Globally, the pandemic of non-communicable chronic diseases (NCDs) has become a critical public health problem. Although NCD prevention has been shifting from individual behavioral interventions to broad environmental interventions, it is still necessary to promote research on the environment and NCDs as a whole. Therefore, this conceptual paper aimed to develop a general and novel framework to advance this line of research. The framework uses socio-ecological approaches that emphasize source prevention rather than the end treatment. Specifically, this framework comprehensively covered integrative research approaches, prioritized areas, urgent efforts, innovative methodologies, and improved funding. The framework used China as a typical context, where its public health policies, similar to other nations, still focus on the end treatment of NCDs, placing emphasis on biomedical approaches and technologies. China’s relevant efforts may furnish new insights and approaches concerning NCD prevention, and these efforts may benefit the improvement of global health and well-being. Such social-ecological research efforts can help to accelerate a shift from existing individual interventions to environmental interventions, thereby ultimately achieving the effective source prevention of NCDs in China and around the globe.

Does the Effect of Micro-Environmental Factors on a Street's Appeal for Adults' Bicycle Transport Vary across Different Macro-Environments? An Experimental Study

BACKGROUND

Characteristics of the physical environment can be classified into two broad categories: macro- ("raw" urban planning features influenced on a regional level) and micro- (features specifically within a streetscape influenced on a neighborhood level) environmental factors. In urban planning applications, it is more feasible to modify conditions at the neighborhood level than at the regional level. Yet for the promotion of bicycle transport we need to know whether relationships between micro-environmental factors and bicycle transport depend on different types of macro-environments. This study aimed to identify whether the effect of three micro-environmental factors (i.e., evenness of the cycle path surface, speed limits and type of separation between cycle path and motorized traffic) on the street's appeal for adults' bicycle transport varied across three different macro-environments (i.e., low, medium and high residential density street).

METHODS

In total, 389 middle-aged adults completed a web-based questionnaire consisting of socio-demographic characteristics and a series of choice tasks with manipulated photographs, depicting two possible routes to cycle along. Conjoint analysis was used to analyze the data.

RESULTS

Although the magnitude of the overall effects differed, in each macro-environment (i.e., low, medium and high residential density), middle-aged adults preferred a speed limit of 30 km/h, an even cycle path surface and a hedge as separation between motorized traffic and the cycle path compared to a speed limit of 50 or 70 km/h, a slightly uneven or uneven cycle path surface and a curb as separation or no separation between motorized traffic and the cycle path.

CONCLUSIONS

Our results suggest that irrespective of the macro-environment, the same micro-environmental factors are preferred in middle-aged adults concerning the street's appeal for bicycle transport. The controlled environment simulations in the experimental choice task have the potential to inform real life environmental interventions and suggest that micro-environmental changes can have similar results in different macro-environments.

Characteristics, cycling patterns, and crash and injury experiences at baseline of a cohort of transport and recreational cyclists in New South Wales, Australia

This paper examines self-reported retrospective data for a 12 month period from 2038 adult cyclists from New South Wales (Australia), and compares cyclists according to whether they self-identify as riding mainly for transport or mainly for recreation. Statistically significant differences were found in the demographic characteristics, cycling patterns, and crash experiences between these two groups of cyclists. Transport cyclists tended to be younger, travel more days per week, and within morning and evening peak hours than recreational cyclists; recreational cyclists were more likely to identify fitness as a purpose for cycling. The proportion of cyclists experiencing a crash or crash-related injury in the previous 12 months was similar for transport and recreational cyclists, but there were differences in crash types and location which likely reflect different cycling environments. Heterogeneity within transport and recreational cyclists was also found, based on self-reported riding intensity. An understanding of the different cycling patterns and experiences of various types of cyclists is useful to inform road safety, transport and health promotion policy.

Invited commentary: Taking advantage of time-varying neighborhood environments

Neighborhood built environment characteristics may encourage physical activity, but previous literature on the topic has been critiqued for its reliance on cross-sectional data. In this issue of the Journal, Knuiman et al. (Am J Epidemiol. 2014;180(5):453-461) present longitudinal analyses of built environment characteristics as predictors of neighborhood transportation walking. We take this opportunity to comment on self-selection, exposure measurement, outcome form, analyses, and future directions. The Residential Environments (RESIDE) Study follows individuals as they relocate into new housing. The outcome, which is neighborhood transportation walking, has several important limitations with regards to public health relevance, dichotomization, and potential bias. Three estimation strategies were pursued: marginal modeling, random-effects modeling, and fixed-effects modeling. Knuiman et al. defend fixed-effects modeling as the one that most effectively controls for unmeasured time-invariant confounders, and it will do so as long as confounders have a constant effect over time. Fixed-effects modeling requires no distributional assumptions regarding the heterogeneity of subject-specific effects. Associations of time-varying neighborhood characteristics with walking are interpreted at the subject level for both fixed- and random-effects models. Cross-sectional data have set the stage for the next generation of neighborhood research, which should leverage longitudinal changes in both place and health behaviors. Careful interpretation is warranted as longitudinal data become available for analysis.

Using simple agent-based modeling to inform and enhance neighborhood walkability

Background

Pedestrian-friendly neighborhoods with proximal destinations and services encourage walking and decrease car dependence, thereby contributing to more active and healthier communities. Proximity to key destinations and services is an important aspect of the urban design decision making process, particularly in areas adopting a transit-oriented development (TOD) approach to urban planning, whereby densification occurs within walking distance of transit nodes. Modeling destination access within neighborhoods has been limited to circular catchment buffers or more sophisticated network-buffers generated using geoprocessing routines within geographical information systems (GIS). Both circular and network-buffer catchment methods are problematic. Circular catchment models do not account for street networks, thus do not allow exploratory ‘what-if’ scenario modeling; and network-buffering functionality typically exists within proprietary GIS software, which can be costly and requires a high level of expertise to operate.

Methods

This study sought to overcome these limitations by developing an open-source simple agent-based walkable catchment tool that can be used by researchers, urban designers, planners, and policy makers to test scenarios for improving neighborhood walkable catchments. A simplified version of an agent-based model was ported to a vector-based open source GIS web tool using data derived from the Australian Urban Research Infrastructure Network (AURIN). The tool was developed and tested with end-user stakeholder working group input.

Results

The resulting model has proven to be effective and flexible, allowing stakeholders to assess and optimize the walkability of neighborhood catchments around actual or potential nodes of interest (e.g., schools, public transport stops). Users can derive a range of metrics to compare different scenarios modeled. These include: catchment area versus circular buffer ratios; mean number of streets crossed; and modeling of different walking speeds and wait time at intersections.

Conclusions

The tool has the capacity to influence planning and public health advocacy and practice, and by using open-access source software, it is available for use locally and internationally. There is also scope to extend this version of the tool from a simple to a complex model, which includes agents (i.e., simulated pedestrians) ‘learning’ and incorporating other environmental attributes that enhance walkability (e.g., residential density, mixed land use, traffic volume).