Systematic review of interventions for promoting active school transport

Where and how to invest in greenspace for optimal health benefits: a systematic review of greenspace morphology and human health relationships

Research on the relationship between greenspace morphology and health is a growing field that informs the spatial design of greenspace to enhance health outcomes. This study reviews the current progress, methodologies, and knowledge gaps in this area. From a database search of 272 940 English articles and 39 053 Chinese articles up to April 18, 2024, we identified 22 and 7 studies on the topic for further evaluation. Predominantly cross-sectional and neighbourhood-scale analyses were conducted using land cover maps ranging from 0·25 to 100 meters in resolution. Six primary characteristics of greenspace morphology have been studied, including size, shape, fragmentation, connectedness, aggregation, and diversity. While associations between greenspace morphology and health outcomes have been observed, both their reliability and generalisability remain suggestive due to ecological study designs and heterogeneity among studies. Future research should prioritise individual-level prospective cohorts and intervention studies. Exploring mechanisms linking greenspace morphology and health, determining optimal map resolution, and distinguishing it from greenness magnitude in statistical analysis is essential. This evidence is crucial for health-promoting greenspace planning and should be routinely integrated into urban epidemiological research.

Effectiveness of an Ecological Model-Based Active Transport Education Program on Physical and Mental Health in High School Students (MOV-ES Project): Study Protocol for a Randomized Controlled Trial

The United Nations, through its 2030 Agenda and Sustainable Development Goals, advocates for the establishment of conducive environments for physical activity, following the ecological model. In line with this initiative, active transportation emerges as an accessible, cost-effective, and sustainable approach to augmenting daily physical activity levels. This study protocol endeavors to assess the impact of an active transportation education program rooted in the ecological model on the physical and mental well-being of high school students. Drawing upon scientific insights, we hypothesize that a 16-week active transportation intervention will lead to a 3% reduction in average body fat percentage and a noteworthy enhancement in executive function (including inhibition, cognitive flexibility, and working memory), physical fitness (comprising cardiorespiratory fitness and muscle strength), and mental health (encompassing mood disorders and cognitive functioning). If this intervention proves effective, it could offer a viable solution for the school community, especially in reducing congestion within the school environment. The study protocol aims to evaluate the impact of an active transportation educational program based on the ecological model on the physical and mental well-being of high school students. Three high schools located in the urban area of Talca, Chile, will be randomly selected (one public, one privately subsidized, and one private non-subsidized). Each high school will be randomly assigned an experimental group (n = 30) and a control group (n = 30; without intervention). The experimental groups will receive an active transportation educational intervention during their physical education classes for four months (60 to 90 min sessions, once a week), while the control group will receive no intervention. The primary outcome will provide information on body composition and executive function. Secondary outcomes will include objective physical activity level, physical fitness, mental well-being, academic achievement, health-related quality of life, perception of environmental urban features, physical activity barriers, and adherence to active transportation. It is expected that the results of the MOV-ES Project will transcend the physical health of schoolchildren and will have an impact on the school community, especially by decongesting the school environment.

Children's active school transportation: an international scoping review of psychosocial factors

BACKGROUND

Over the last decades, the prevalence of AST has decreased significantly. Barriers to active school transport (AST) have been extensively examined in the literature, while psychosocial factors that facilitate AST have received less attention. To our best knowledge, there are currently no reviews on this subject. Therefore, the objective of this review was to scope the literature and identify published research about psychosocial factors related to AST.

METHODS

Systematic searches conducted in PubMed, Web of Science, TRID, Scopus, and ERIC resulted in a total of 1933 publications, and 77 of them were considered eligible for this review.

RESULTS

The results of the included articles were categorised into four psychosocial factors: confidence in ability, attitudes, social support, and social norms, which were all generally positively related to AST, with a few exceptions.

CONCLUSION

The findings of this review indicate that these psychosocial factors may be important to consider when developing interventions and highlight that both children and parents should be involved in the process. This knowledge can serve as a valuable guide for developing interventions to promote AST. However, the evidence base supporting these psychosocial factors requires further investigation to fully understand how and when to incorporate them to maximise AST efficacy.

Active Commuting to School among Spanish Preschool Children: A Temporal Change Study between 2013 and 2017

BACKGROUND

Active commuting to school may increase the total daily physical activity and achieve health benefits among preschool children. Rates of active commuting to school among Spanish children and adolescents have been widely analysed, while the rates of active commuting to school among Spanish preschool children are unknown.

AIM

The main objective of this study was to examine the changes in the rates of active commuting to school in a sample of Spanish preschool children between 3 and 6 years old from 2013 to 2017.

METHODS

Data were found from five studies carried out across Spain. The study sample comprised 4787 preschool children (4.59 ± 0.77 years old; 51% males). The overall changes in active commuting to school were assessed using multilevel logistic regression analysis.

RESULTS

The rates of active commuting to school in Spanish preschool children are around 52%, and the active commuting to school rates have stayed stable throughout the period assessed (odds ratio from 0.40 to 0.58, all p > 0.05).

CONCLUSION

In preschool children, the present study obtained a favourable result on active commuting to school, showing a pattern stability in the examined period similar to other ages. It will be of great importance to promote this behaviour to obtain high levels of active commuting to school.

Associations between school-level environment and individual-level factors of walking and cycling to school in Canadian youth

Identifying individual-level and school-level correlates of walking and cycling to school remains a public health priority as only one in four Canadian youth actively travels to school. This study aimed to estimate the prevalence of Canadian youth in grades 6 to 10 who walk, cycle, or use motorised transport to go to school, and to examine if school neighbourhood walkability, neighbourhood-level and individual-level correlates are associated with mode of transportation to school. Data come from the 2017/2018 Health Behaviour in School-aged Children study. The walkability of the schools' neighbourhood was measured using the Canadian Active Living Environments (Can-ALE) index. We observed that only 22.4% and 4.2% of youth walked and cycled to school, respectively. Most (73.4%) used motorised transport to school, including 53.2% of youth who lived less than 5 minutes from school. Schools located in neighbourhoods with higher Can-ALE classes (i.e., higher walkability) were positively associated with walking to school. No statistically significant association between school walkability and cycling to school was observed. Individual-level socioeconomic status (SES) was associated with walking, but not cycling, to school. Conversely, neighbourhood-level SES was associated with cycling, but not with walking, to school. Correlates of walking to school differed from those for cycling to school, suggesting that different approaches to promoting active transportation are needed.

Contribution of active commuting to and from school to device-measured physical activity levels in young people: A systematic review and meta-analysis

OBJECTIVE

To analyze the contribution of active commuting to and from school (ACS) to device-measured light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) levels in young people aged 6 to 18 years old, as well as, in both trip directions (i.e., home-school, school-home).

METHODS

This systematic review was conducted according to the PRISMA statement, and five different databases were used for the systematic search (PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library) using PECO strategy.

RESULTS

A total of 14 studies met all the eligibility criteria, which compile 7127 participants. The overall ACS weighted LPA was 19.55 min (95% CI: 3.84-35.26; I2  = 99.9%, p < 0.001) and 68.74 min (95% CI: 6.09-131.39; z = 2.15, p = 0.030) during the home-school and school-home trips, respectively. For MVPA, the overall ACS weighted MVPA was 8.98 min (95% CI: 5.33-12.62; I2  = 99.95%, p < 0.001) during the home-school trip and 20.07 min (95% CI: 13.62-26.53; I2  = 99.62%, p < 0.001) during the school-home trip.

CONCLUSION

ACS may contribute about 48% of the PA recommendations in young people on school days if both trip directions are actively performed. Therefore, future studies aimed at increasing daily PA levels in young population should focus on promoting students' ACS. PROSPERO registration number: CRD42020162004A.

Active School Commuting in School Children: A Narrative Review of Current Evidence and Future Research Implications

Active school commuting (ASC) has been proposed as a practical way to inculcate positive physical activity habits in children. This paper reviews the current evidence regarding ASC among children, highlights advances in research techniques and existing limitations in the field, and outlines future implications for research and promotion. A comprehensive literature search was conducted to identify English language studies on ASC among children aged 6-12 years, followed by a narrative review. ASC has witnessed a global decline, despite evidence of its contribution to physical activity levels. Context-dependent factors such as commuting distance and parental safety concerns are consistently identified as key determinants of ASC. Several promising interventions have been identified. Despite the limitations in intervention scope and quality, notable advancements in research techniques, such as multilevel regression and agent-based modelling, have been identified. Effective promotion of ASC to tackle childhood physical inactivity requires collaborative efforts among schools, parents, and the government, and should be tailored to address multilevel determinants within the local context. Future research should leverage recent advancements in research techniques to develop effective promotion strategies, while considering the context-dependent nature of ASC behaviours and addressing existing limitations, including the lack of standardised definitions and limited geographical and age coverage.

Gender-specific social and environmental correlates of active travel to school in four European countries: the HBSC Study

Introduction

Despite the health benefits, a large proportion of girls and boys in Europe do not travel to school actively. A better understanding of the correlates associated with this behavior could guide interventions. This study examines perceived social and environmental correlates of active travel to school (ACTS) from the 2017/18 Health Behavior in School-Aged Children (HBSC) survey in four European countries, with a special emphasis on gender differences (n = 22,023).

Methods

Logistic regression was conducted to analyze associations between the perceived importance of each correlate and ACTS behavior for 11-, 13-, and 15-year-old girls and boys from Germany, Czechia, Poland, and Slovakia. All models were adjusted for age, family affluence, and meeting World Health Organization recommendations for moderate-to-vigorous physical activity.

Results

Rates of ACTS significantly differed between girls and boys. In Czechia, 65% of girls and boys traveled to school actively, followed by Slovakia (61.4% girls and 58.4% boys), Poland (57.7% girls and 60.2% boys), and Germany (42.6% girls and 48.6% boys). Girls were less likely to actively travel to school compared to boys (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.87-0.97). Increasing age (OR: 0.95, 95% CI: 0.93-0.97) and a greater distance to school index (OR: 0.89, 95% CI: 0.88-0.90) were both negatively associated with ACTS. The perceived importance of living closer to school and of road and neighborhood safety was positively associated with ACTS, with a stronger association in boys than in girls for neighborhood safety. On the contrary, the perceived importance of having people to walk with was negatively associated with ACTS, with a stronger association in girls (OR: 0.74, 95% CI: 0.65-0.84) than in boys (OR: 0.77, 95% CI: 0.66-0.88).

Discussion

This study provides insights into perceived social and environmental correlates associated with ACTS behavior. Future research should include gender-specific perceptions and more in-depth investigations of correlates encouraging ACTS, especially considering social aspects, safety issues, and the structuring of the environment in different cultural settings.

Association of Walking and Biking to School Policies and Active Commuting to School in Children

BACKGROUND

Active commuting to school (ACS) can be an important source of physical activity for children. Schools are an important setting for policy-related ACS promotion. The purpose of this study was to examine the association between school policies and ACS, and to assess whether this relation varied by grade.

METHODS

This cross-sectional study used data from schools recruited to the Safe Travel Environment Evaluation in Texas School study (n = 94). The percent of trips made by active travel modes was measured through tallies among third to fifth grade classrooms from 5 school districts in Central Texas in 2018-2019. School ACS policies and practices were measured through 8 survey items aggregated into a score. Linear mixed effects models were used to assess the association between policies and ACS.

RESULTS

School health policy surveys and ACS data were collected from 69 elementary schools. An average of 14.6% of trips to/from school was made using active travel modes. Schools with higher numbers of policies had significantly higher percentages of students using active travel modes (P = .03), and for each additional policy, the predicted percentage of trips made by active travel modes was 1.46% higher. There was a significant interaction effect between school policy and grade, with stronger correlations among higher grades (P = .002).

CONCLUSIONS

Results from this study demonstrate a correlation between the school policies designed to support walking and biking and ACS. Results from this study can be used to justify the use of school-based policy interventions to promote ACS.

Active school commuting in adolescents from 28 countries across Africa, the Americas, and Asia: a temporal trends study

BACKGROUND

Evidence examining trends in active school commuting among adolescents are mainly single-country studies, and principally focused on high-income countries. Thus, the present study aims to examine temporal trends in adolescents' active school commuting and to examine if there are differences in such trends by sex. We used nationally representative samples of 28 countries, which were predominantly low- and middle-income countries (LMICs), covering 5 different WHO regions.

METHODS

Data from the Global School-based Student Health Survey 2004-2017 were analyzed in 177,616 adolescents [mean (SD) age: 13.7 (1.0) years; 50.7% girls]. Active school commuting was self-reported (frequency of walking or riding a bike to and from school in the past 7 days). The prevalence and 95%CI of active school commuting (i.e., ≥ 3 days/week) was calculated for the overall sample and by sex for each survey. Crude linear trends in active school commuting were assessed by linear regression models. Interaction analyses were conducted to examine differing trends among boys and girls.

RESULTS

Trends in active school commuting were heterogeneous across countries, with results showing stable patterns for the majority (16/28), decreasing trends for some (7/28) and increasing trends over time for a few (5/28). The majority of countries showed no differences in active school commuting trends between girls and boys.

CONCLUSIONS

The quantification of changes in adolescents' active school commuting over time, together with a deeper understanding of local determinants for such behaviors will provide valuable evidence to inform the development of tailored and context-specific actions.

Association between the Duration of the Active Commuting to and from School, and Cognitive Performance in Urban Portuguese Adolescents

This study aimed to analyze the differences between active commuting to school (ACS) and non-ACS in cognitive performance (CP), and the association of ACS duration with CP. This cross-sectional study included 370 adolescents (males n = 170), with a mean age of 15.28 ± 2.25 years. CP was assessed through an interview, and ACS, extracurricular physical activity, and socioeconomic status was assessed by self-report. Body composition was assessed using the FitnessGram test battery. One in two adolescents did ACS (51.6%). ACS was associated with boys (53.9%), younger adolescents (14.91 ± 2.15 vs. 15.69 ± 2.29), those having school social support (55.0%), and those doing one or more extracurricular physical activities (53.6%), compared to non-ACS participants (p < 0.05). The analysis of covariance, after controlling for age, sex, school social support, and participation in extracurricular physical activity, showed an effect of ACS on the total cognitive score (F_(2,362) = 3.304, p < 0.05). The CP was higher in adolescents with more than 30 min of ACS than non-ACS (p < 0.05). The influence of ACS duration can be seen in the dimensions of inductive reasoning (ß = 0.134, t = 2.587, p < 0.05) and working memory (ß = 0.130, t = 2.525, p < 0.05). The role of ACS for CP, as well as guidelines for future research, are discussed.

Psychosocial and environmental determinants of active transport to school in Austrian rural communities: a cross-sectional study among schoolchildren and their parents

Background

Active transport to school (ATS) is an effective health-promoting intervention to integrate physical activity into children’s everyday lives. While previous studies have examined environmental and behavioural determinants on ATS in urban areas, evidence on rural areas is rare.

Method

This study examined whether environmental and psychosocial characteristics are associated with ATS in two rural communities in Austria. Participants from four schools (two primary / two secondary schools) returned a self-reported questionnaire on individual and environmental determinants of ATS consisting of one section for parents and one for children, with 382 of the 467 total responses being included in the analysis.

Results

Bivariate analyses showed a significant association of psychosocial characteristics of parents and children (intention, attitude, social norm, perceived behavioural control: p < 0.001), one environmental item (walking and cycling network: p ≤ 0.001) as well as distance and duration for walking to/from school between ATS. In a multiple regression model, the chances of participating in ATS were higher among children who have higher perceived behavioural control, walk between 5 to 10 minutes to school, and whose parents have a higher commitment to ATS.

Conclusions

Future initiatives to enhance ATS in rural areas should focus on the control beliefs of parents and children, and should involve parents in order to increase parents’ commitment to ATS. Additionally, measures should explore the effects of active transport promotion in the context of public transport and school buses. Above all, further opportunities for ATS should be considered in spatial and community planning.

Changing Primary School Children's Engagement in Active School Travel Using Safe Routes to School Interventions: A Rapid Realist Review

Safe Routes to School (SR2S) interventions have been implemented in many economically developed countries to improve children's engagement in Active School Travel (AST). Evaluations have highlighted inconsistencies in SR2S intervention outcomes, raising questions as to how, why, and under what contextual conditions these interventions work. This review used a Rapid Realist Review (RRR) methodology to build, test, and refine an overarching program theory that unpicks the contextual factors and underlying mechanisms influencing children's engagement in AST. From the 45 included documents, 16 refined Context-Mechanism-Outcome Configurations (CMOCs) were developed and clustered into three partial program theories (i.e., implementor/implementation, child, and parent), with the associated mechanisms of: (1) School Reliance; (2) School Priority; (3) Fun; (4) Pride; (5) Perceived Safety; (6) Distrust; (7) Convenience; (8) Perceived Capabilities; and (9) Reassurance. The overarching program theory delineates the pathways between intervention implementation, children's motivation, parental decision-making, and children's engagement in AST. The findings suggest SR2S interventions can motivate children to engage in AST, but whether this motivation is translated into engagement is determined by parental decision-making. This review is novel for highlighting that many of the factors influencing parental decision-making are contextually driven and appear to be unaddressed by the current suite of SR2S intervention strategies. The review additionally highlights the complexity of parental perceptions of safety, with the traffic and the road environment shaping only part of this multidimensional mechanism. Practitioners and policymakers need to tailor SR2S interventions to local contexts to better influence parental decision-making for children's engagement in AST.

An evaluation of primary schools and its accessibility using GIS techniques: a case study of Prayagraj district, India

The spatial analysis of primary schools is needed to ensure that they meet standards set by the Government of India. Therefore, mapping of Prayagraj district primary schools is carried out in this research work. The spatial analysis of schools is performed using various parameters that include: literacy rate, student gender ratio, teacher taught ratio, and students' toilets ratio. Several problems were revealed in the GIS based analysis of schools by highlighting their locations on the map. The results identify the location of all those schools where there is a need to take corrective measures. Further, the route analysis between home and school is handled in this research work. Sometimes, commutation is the sole criteria in the selection of a school. Therefore, optimal path analysis has been performed based on three parameters, i.e. population density, traveling distance and traveling time. A combined weight function is also given to find the optimal path. This work will help people to select the best possible path based upon their requirements. There is often a requirement to reach all the schools to distribute the goods or other physical monitoring activities. This work gave the optimal route to visit all the schools by using the Travelling Salesman Problem (TSP). School accessibility results obtained in this research through TSP will assist in choosing the best possible route. This will help the government identify locations where new roads need to be constructed to have road connectivity.

The Effect of a School-Based Intervention on Children’s Cycling Knowledge, Mode of Commuting and Perceived Barriers: A Randomized Controlled Trial

The low rates of active commuting to/from school in Spain, especially by bike, and the wide range of cycling interventions in the literature show that this is a necessary research subject. The aims of this study were: (1) to assess the feasibility of a school-based cycling intervention program for adolescents, (2) to analyse the effectiveness of a school-based cycling intervention program on the rates of cycling and other forms of active commuting to/from school (ACS), and perceived barriers to active commuting in adolescents. A total of 122 adolescents from Granada, Jaén and Valencia (Spain) participated in the study. The cycling intervention group participated in a school-based intervention program to promote cycling to school during Physical Education (PE) sessions in order to analyse the changes in the dependent variables at baseline and follow up of the intervention. Wilcoxon, Signs and McNemar tests were undertaken. The association of the intervention program with commuting behaviour, and perceived barriers to commuting, were analysed by binary logistic regression. There were improvements in knowledge at follow-up and the cycling skill scores were medium-low. The rates of cycling to school and active commuting to/from school did not change, and only the “built environment (walk)” barrier increased in the cycling group at follow-up. School-based interventions may be feasibly effective tools to increase ACS behaviour, but it is necessary to implement a longer period and continue testing further school-based cycling interventions.

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.

Effects of Large-Scale Municipal Safe Routes to School Infrastructure on Student Active Travel and Physical Activity: Design, Methods, and Baseline Data of the Safe Travel Environment Evaluation in Texas Schools (STREETS) Natural Experiment

Past evaluations of Safe Routes to School (SRTS) programs have been relatively small in scope and have lacked objective measurements of physical activity. A 2016 Mobility Bond in Austin, Texas, USA, allocated USD 27.5 million for infrastructure changes to facilitate active commuting to schools (ACS). The Safe TRavel Environment Evaluation in Texas Schools (STREETS) study aims to determine the health effects of these infrastructure changes. The purpose of this paper is to describe the STREETS study design, methods, and selected baseline results. The STREETS study is comprised of two designs: (1) a serial cross-sectional design to assess changes in ACS prevalence, and (2) a quasi-experimental, prospective cohort to examine changes in physical activity. Differences between study arms (Austin SRTS and comparison) were assessed for school demographics, ACS, and school programs. At baseline, 14.3% of school trips were made by ACS, with non-significant differences between study arms. Only 26% of schools implemented ACS-related programs. Some significant differences across SRTS and comparison schools were identified for several school- and neighborhood-level characteristics. Substantial changes are needed across area schools and neighborhoods to promote optimum ACS. STREETS study longitudinal findings will be critical for informing optimal future implementations of SRTS programs.

Changes in 24-Hour Domain-Specific Movement Behaviors and Their Associations With Children’s Psychosocial Health During the Transition From Primary to Secondary School: A Compositional Data Analysis

Background: Little is known about the influence of 24-hour movement behaviors on children’s psychosocial health when transitioning from primary to secondary school. This study described changes in 24-hour domain-specific movement behavior composition and explored their associations with changes in psychosocial health during this transition. Methods: Data were drawn from the Longitudinal Study of Australian Children. The analytical sample (n = 909) included children who were enrolled in primary school at baseline (2010) and in secondary school at follow-up (2012). Time spent in 8 domains of movement behaviors was derived from the child-completed time-use diaries. Psychosocial health was examined using the self-report version of the Strengths and Difficulties Questionnaires. Analyses included repeated-measures multivariate analysis of variance and compositional regression. Results: Children reported engaging in more social activities and sleeping less over the transition period. Increased time spent in social activities (βilr = −0.06, P = .014) and recreational screen use (βilr = −0.17, P = .003) (relative to other domains) were associated with decreased prosocial behavior in boys. Changes in movement behavior composition were not associated with changes in girls’ psychosocial health. Conclusion: This study found considerable changes in children’s 24-hour movement behavior composition, but a lack of consistent association with changes in psychosocial health during the primary to secondary school transition.

Association of change in the school travel mode with changes in different physical activity intensities and sedentary time: A International Children's Accelerometry Database Study

Our aim was to assess the association between changes in active travel to school and changes in different intensities of physical activity (i.e. moderate - MPA and vigorous - VPA) and time spent sedentary (SED) among adolescents and assess the moderating effect of children's sex, age and weight status. Data from six cohort studies in the International Children's Accelerometry Database were used (4108 adolescents aged 10-13y at baseline, with 1.9±0.7y of follow-up). Participants self-reported travel mode to school at baseline and follow-up. Mutually exclusive categories of change were created using passive (e.g. by car) or active (cycling or walking) forms of transport (active/active, passive/active, active/passive, passive/passive). Multilevel linear regression analyses assessed associations with change in accelerometer-assessed time spent MPA, VPA and SED, adjusting for potential confounders. The moderation of sex, age and weight status was tested though the inclusion of interaction terms in the regression models. Relative to those remaining in active travel (active/active), participants classified as passive/active increased VPA (B: 2.23 min/d; 95%CI: 0.97-3.48), while active/passive (MPA: -5.38min/d; -6.77 to -3.98; VPA: -2.92min/d; -4.06 to -1.78) and passive/passive (MPA: -4.53min/d; -5.55 to -3.50; VPA: -2.84min/d; -3.68 to -2.01) decreased MPA and VPA. There were no associations with SED. An interaction was observed, age group moderated the association with change in VPA: among 12-13y-olds a greater increase in VPA was observed for the passive/active group compared to active/active. Promoting active travel to school can be a strategy to attenuate the decline in physical activity through adolescence.

Users' acceptance of private automated vehicles: A systematic review and meta-analysis

INTRODUCTION

This research systematically reviewed relevant studies on users' acceptance of conditional (Level 3) to full (Level 5) automated vehicles when such vehicles are to be used privately (herein referred to as 'private automated vehicles or private AVs).

METHOD

The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and was undertaken in three databases: APA PsycINFO, Transport Research International Documentation, and Web of Science. Articles were required to focus on individuals' acceptance of private SAE Level 3-5 AVs. Acceptance was defined as individuals' attitudes towards or intentions and/or willingness to use AVs in the future. A total of 2,354 articles were identified in the database search. Thirty-five articles were included in the review, six of which included multiple studies and/or comparison groups.

RESULTS

Most studies (n = 31) applied self-reported measures to assess user acceptance together with a range of psychosocial factors predicting such acceptance. The meta-analytic correlations revealed that perceived behavioral control, perceived benefits/usefulness, perceived ease of use, and subjective/social norms had significant positive pooled relationships with attitudes and intentions. Trust and sensation seeking also had significant positive pooled correlations with intentions, while knowledge of AVs had a significant and negative pooled correlation with intentions. Age did not show any significant pooled relationship with attitudes, intentions, or willingness.

CONCLUSIONS

The findings obtained from the systematic review and meta-analysis provide support for psychosocial models to aid understanding of users' acceptance of private AVs. Practical applications: Examining acceptance of AVs after participants have experienced these vehicles on closed tracks or open roads would advance contemporary knowledge of users' intentions to use these vehicles in the future. Further, experiencing these vehicles firsthand may also help with addressing any perceived barriers reducing acceptance of future use of private AVs.

Effects of school-based before-school physical activity programmes on children's physical activity levels, health and learning-related outcomes: a systematic review

OBJECTIVE

To review and evaluate the impact of school-based, before-school physical activity (PA) programmes on children's PA levels, health and learning-related outcomes.

DESIGN

Systematic review.

DATA SOURCES

PubMed, PsycINFO, Scopus, Embase and ERIC were searched in January 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: (1) Original research published in English, (2) sample included typically developing school-age children and/or adolescents, (3) examined school-based PA programmes delivered before school, (4) included a comparator and (5) reported associations with PA, physical health, learning-related and/or psychosocial outcomes. Studies examining before-school active transport or sport were excluded.

RESULTS

Thirteen articles representing 10 studies were included (published 2012-2020); seven conducted in primary schools. Programmes ranged between 3 weeks and 6 months, primarily operating daily and for 25-40 min. One study examined a programme informed by theory; six incorporated fidelity measures. Data synthesis, considering consistency of findings, showed indeterminate associations for the domains of physical health, learning-related and psychosocial outcomes. Among subdomains, synthesis showed positive associations with before-school and daily PA, cardiorespiratory and muscular fitness, readiness to learn and an inverse association with adiposity. Risk of bias was high/serious or insufficiently detailed across studies and outcome domains, except PA, which included moderate-risk studies.

CONCLUSION

There is limited available evidence on school-based, before-school PA programmes, with some positive associations at domain and subdomain levels. Continued research is justified to understand the role of before-school programmes for facilitating PA. Future research should follow recommended practice for intervention design and process evaluation, and address under-represented contexts, including secondary schools.

PROSPERO REGISTRATION NUMBER

CRD42020181108.

Development and Initial Validation of the PILCAST Questionnaire: Understanding Parents' Intentions to Let Their Child Cycle or Walk to School

Children generally do not meet the recommendation of 60 min of daily physical activity (PA); therefore, active school transportation (AST) is an opportunity to increase PA. To promote AST, the involvement of parents seems essential. Using the theory of planned behavior (TPB), the aim was to develop and validate the PILCAST questionnaire to understand parents’ intentions to let their child cycle or walk to school. Cross-sectional sampling was performed, where 1024 responses were collected from parents. Confirmatory factor analysis indicated acceptable fit indices for the factorial structure according to the TPB, comprising 32 items grouped in 11 latent constructs. All constructs showed satisfying reliability. The regression analysis showed that the TPB explained 55.3% of parents’ intentions to let the child cycle to school and 20.6% regarding walking, increasing by a further 18.3% and 16.6%, respectively, when past behavior was added. The most influential factors regarding cycling were facilitating perceived behavioral control, positive attitudes, subjective and descriptive norms, and for walking, subjective and descriptive norms. The PILCAST questionnaire contributes to a better understanding of the psychological antecedents involving parents’ decisions to let their child cycle or walk to school, and may therefore provide guidance when designing, implementing and evaluating interventions aiming to promote AST.

Mediation role of residential density on the association between perceived environmental factors and active commuting to school in Brazilian adolescents

The objective of this study was to verify whether residential density and connectivity between streets are mediators on the association between perceived environmental factors and active commuting to school (ACS) in Brazilian adolescents. This is a cross-sectional study with a random sample of 1,130 adolescents (52.7% girls) aged between 14 to 20 years, from Porto Alegre, Rio Grande do Sul State, Brazil. Adolescents' self-reported their usual mode of commuting to and from school using a questionnaire and the perceived environmental attributes by Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Residential density and connectivity between streets were measured by gographic information systems (GIS), within 1km road network buffers around the participant's residential address. Regression models were fitted according to mediation analyses procedures. The results showed that residential density is a mediator on the association between ACS and perceived environmental factors, including land-use mix diversity (IE = 0.114; 95%CI: 0.130, 0.311; 32% mediation), neighborhood recreation facilities (IE = 0.064; 95%CI: 0.034, 0.105; 15% mediation), and access to services (IE = 0.045; 95%CI: 0.006, 0.104; 14% mediation). Connectivity between streets did not correlate with ACS, thus it was not tested in the mediation model. In conclusion, residential density is a mediator on the relationship between perceived environmental factors and ACS.

The evidence for the impact of policy on physical activity outcomes within the school setting: A systematic review

BACKGROUND

Despite the well-established health benefits of physical activity (PA) for young people (aged 4-19 years), most do not meet PA guidelines. Policies that support PA in schools may be promising, but their impact on PA behavior is poorly understood. The aim of this systematic review was to ascertain the level and type of evidence reported in the international scientific literature for policies within the school setting that contribute directly or indirectly to increasing PA.

METHODS

This systematic review is compliant with Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Six databases were searched using key concepts of policy, school, evaluation, and PA. Following title and abstract screening of 2323 studies, 25 progressed to data synthesis. Methodological quality was assessed using standardized tools, and the strength of the evidence of policy impact was described based on pre-determined codes: positive, negative, inconclusive, or untested statistically.

RESULTS

Evidence emerged for 9 policy areas that had a direct or indirect effect on PA within the school setting. These were whole school PA policy, physical education, sport/extracurricular PA, classroom-based PA, active breaks/recess, physical environment, shared use agreements, active school transport, and surveillance. The bulk of the evidence was significantly positive (54%), 27% was inconclusive, 9% was significantly negative, and 11% was untested (due to rounding, some numbers add to 99% or 101%). Frequency of evidence was highest in the primary setting (41%), 34% in the secondary setting, and 24% in primary/secondary combined school settings. By policy area, frequency of evidence was highest for sport/extracurricular PA (35%), 17% for physical education, and 12% for whole school PA policy, with evidence for shared use agreements between schools and local communities rarely reported (2%). Comparing relative strength of evidence, the evidence for shared use agreements, though sparse, was 100% positive, while 60% of the evidence for whole school PA policy, 59% of the evidence for sport/extracurricular PA, 57% of the evidence for physical education, 50% of the evidence for PA in classroom, and 50% of the evidence for active breaks/recess were positive.

CONCLUSION

The current evidence base supports the effectiveness of PA policy actions within the school setting but cautions against a "one-size-fits-all" approach and emphasizes the need to examine policy implementation to maximize translation into practice. Greater clarity regarding terminology, measurement, and methods for evaluation of policy interventions is needed.

12-Year Trends in Active School Transport across Four European Countries-Findings from the Health Behaviour in School-Aged Children (HBSC) Study

Active school transport (AST) is a source of daily physical activity uptake. However, AST seems to have decreased worldwide over recent decades. We aimed to examine recent trends in AST and associations with gender, age, family affluence, and time to school, using data from the Health Behaviour in School-Aged Children (HBSC) study collected in 2006, 2010, 2014, and 2018 in the Czech Republic, Norway, Scotland, and Wales. Data from 88,212 students (11, 13 and 15 years old) revealed stable patterns of AST from 2006 to 2018, apart from a decrease in the Czech Republic between 2006 and 2010. For survey waves combined, walking to and from school was most common in the Czech Republic (55%) and least common in Wales (30%). Cycling was only common in Norway (22%). AST differed by gender (Scotland and Wales), by age (Norway), and by family affluence (everywhere but Norway). In the Czech Republic, family affluence was associated with change over time in AST, and the effect of travel time on AST was stronger. The findings indicate that the decrease in AST could be levelling off in the countries considered here. Differential associations with sociodemographic factors and travel time should be considered in the development of strategies for AST.

A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study

This manuscript describes the rationale and protocol of a school-based randomized controlled trial called “Cycling and Walk to School” (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1–2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.

Systematic review of active transportation to school in youth – an update from Brazil’s Report Card

ABSTRACT The aim of this study was to update a systematic review on the use of active transportation to school in Brazilian children and adolescents. All studies were extracted from the LILACS; BIREME; SCIELO and MEDLINE. The search was carried out on manuscripts published in the period 2018-2019. The descriptors were used in Portuguese, English and Spanish. In overall, 8 manuscripts were included in this systematic review, with 1 presenting data from three periods (2009, 2012 and 2015). The study data were obtained between 2009 and 2015 and the age group found between 7 to 19 years old. Of the selected articles, 2 presented national data, 1 from the north, 2 from the northeast, 1 from the southeast and 2 from the south of Brazil. The use of active transportation was superior to passive transportation on 6 occasions and its use was common in boys than in girls (4 of 6 articles). The use of active transportation is still more common than passive transportation in most Brazilian regions, although some cities have the opposite. The results suggest that the prevalence of active transportation is higher in boys than girls. Public policies must be created to favor the use of active transportation among Brazilian youth.

Interventions Aiming to Promote Active Commuting in Children and Adolescents: An Evaluation From a Sex/Gender Perspective

Active commuting (AC) provides numerous health benefits and is one way to improve physical activity in children and adolescents. Boys are more likely to use active transport modes than girls. Girls and boys benefit differently from interventions that promote AC. The aim of this systematic review is to evaluate the effects of interventions on girls and boys and to appraise the extent to which previous studies have taken sex/gender into account. Eleven electronic databases were searched to identify all relevant randomized and non-randomized controlled trials based on a priori defined eligibility criteria. Two independent reviewers screened the literature for eligibility and assessed risk of bias. Semiquantitative analyses were conducted to evaluate the effects of intervention effects by taking sex/gender aspects into account. To evaluate sex/gender considerations in interventional studies, a recently developed sex/gender checklist was applied. Twelve studies were included that examined intervention effects on AC in girls and boys. Three intervention studies showed significant effects in increasing AC, with one study favoring girls, one favoring boys, and another focusing on a single sex/gender (only girls). According to the checklist, the overall sex/gender rating highlighted a lack of information in sex/gender consideration. Studies with and without significant effects indicated no differences in the sex/gender checklist. The results indicate that sex/gender is not considered adequately in primary interventional research on AC. To evaluate the effectiveness of intervention in boys and girls, detailed analyses of sex/gender are required, and better reporting about sex/gender-specific intervention content is necessary. In future health research to promote AC, sex/gender should be systematically taken into account.

Primary prevention of overweight and obesity in adolescents: An overview of systematic reviews

The aim of this overview of systematic reviews was to summarize evidence from up-to-date reviews of the effectiveness of interventions aimed at preventing overweight and obesity in adolescents aged 10 to 19 years. We searched nine databases for systematic reviews published between January 2008 and November 2019. We used A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 to assess the quality of reviews, excluding those of critically low quality, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool to grade the certainty of included evidence. We included 13 reviews. Three reviews focused on dietary behaviour, six on physical activity, and four on both types of behaviours. Individual-oriented and school-based interventions dominated. Results across reviews showed little or no effect on body mass index, or physical activity levels of adolescents, whereas results from a couple of reviews suggest possibly beneficial effects of public health interventions on dietary behaviours (i.e., consumption of sugar-sweetened beverages). The certainty of evidence was low to very low for all outcomes. Overall, the evidence base for the effect of primary interventions to prevent overweight and obesity in adolescents is weak. In particular, there is a lack of reviews assessing the impact of environmental interventions targeting adolescents, and reviews addressing social inequality are virtually absent from this body of literature.

Physical Activity Recommendations for Segments of School Days in Adolescents: Support for Health Behavior in Secondary Schools

School physical activity (PA) is an indispensable part of daily PA, the foundation for developing lifelong PA and fitness, and an easy way to gain physical and health literacy. School PA is equally important for understanding the continuity of physical and mental health, even in broader psychosocial aspects. Regarding long-term outcomes, significant attention has been paid to the determination of daily and weekly recommendations for adolescent PA. However, comprehensive approaches suggesting recommendations for PA in segments of the school day are rare. This study aimed to (a) provide a rationale for PA recommendations in segments of school days and incorporate it into generally accepted PA recommendations, and (b) promote radical changes in the educational process toward a healthy school lifestyle through PA recommendations in segments of school days. The results of research conducted in 98 secondary schools in the Czech Republic and 104 secondary schools in Poland from 2009 to 2017 were used in this study. In total, 3,860 boys and 5,237 girls from the Czech Republic and 3,052 boys and 3,329 girls from Poland, all aged 15-19, participated. We recommended at least 2,000 steps (or 10 min of moderate-to-vigorous PA) for the before school segment and at least 6,000 steps (or 30 min of moderate-to-vigorous PA) for the after-school segment. For the time spent at school, we further recommended at least 500 steps/h (alternatively, at least 3,000 steps/school time), 20 min of moderate-to-vigorous PA (≥3METs or 60% HRmax), and at least one HRsubmax/max response to significant stress during PA to mitigate educational stress and high levels of sedentary behavior in schools. PA should account for at least 25% of school time, even on days with no scheduled physical education lessons. We propose using PA recommendations in segments of school days to achieve positive changes in the educational process and school lifestyle. Acceptance of PA recommendations in segments of school days theories on physical education could help refine and concretize demands for changes in PA and lifestyle in secondary schools. In practice, it could support the creation of innovative and comprehensive school PA programs. Future research should focus on obtaining evidence in support for adolescent PA by applying PA recommendations in segments of school days.

The Moderating Effect of Distance on Features of the Built Environment and Active School Transport

Despite growing research supporting the impact of the built environment on active school transport (AST), distance persists as the most powerful predictor of walking and biking to school. There is a need to better understand how environmental features interact with distance to affect AST, and whether the influence of environmental factors persist across different distance thresholds. Multilevel models using cluster-robust standard errors were used to examine for interactions between objectively measured macroscale environmental features and several reported distances from home to school (up to ¼, ¼ up to ½, ½ up to 1, 1+ miles) on the likelihood of parent reported AST for children grades 3-8 (n = 2751) at 35 schools who completed a Safe Routes to School Parent Survey about Walking and Biking to School (SRTS Parent Survey). An interaction between both intersection density and food-related land use with distance was observed. The likelihood of AST decreased as intersection density and distance increased (i.e., 31.0% reduced odds among those living within ¼ mile compared to 18.2% using ½-1-mile criterion). The likelihood of using AST were reduced as food-related land use and distance increased (i.e., 43.67% reduced odds among those living under ¼ mile compared to 19.83% reduced odds among those living ½-1 mile). Programs and infrastructure improvements focused on overcoming environmental barriers to promote AST may be most effective when targeting neighborhoods within ¼ mile of schools.

Objective Measures to Assess Active Commuting Physical Activity to School in Young People: A Systematic Review Protocol and Practical Considerations

There are no systematic reviews that have identified the existing studies assessing active commuting physical activity (PA) to and from (to/from) school using objective measures, as well as the contribution of both walking and cycling to/from school to PA levels. To fill this gap in the literature, this systematic review will aim (a) to identify existing studies that assess active commuting PA to/from school with objective measures in young people and to examine the contribution of walking and cycling to/from school to PA levels, and (b) to propose an appropriate methodology and practical considerations to assess active commuting PA to/from school based on the studies identified. The review protocol was registered in PROSPERO (CRD42020162004). We will conduct a systematic search up to 2020 in five databases: PubMed, Web of Science, SPORTdiscuss, Cochrane Library, and National Transportation Library. Both the risk of bias and the quality of the identified studies will be evaluated through different instruments according to the design of each study. This systematic review will help to choose the most appropriate objective measures to assess active commuting PA to/from school and to promote walking and cycling to/from school to increase PA levels.

School and Family Environment is Positively Associated with Extracurricular Physical Activity Practice among 8 to 16 Years Old School Boys and Girls

Extracurricular physical activity in children and adolescents can help achieve compliance with the World Health Organization (WHO) recommendations for physical activity. The purpose of this study was to evaluate factors in school and family environments of children and adolescents in Spain that could be related to the practice of extracurricular physical activity. Multistage random cluster sampling was conducted to include 128 schools with the participation of 10,096 students between the ages of 7 and 16. Participants completed the survey of sports habits designed by the National Sports Council. The results revealed a higher participation in extracurricular sports activities among boys (OR: 1.67 (1.5–1.9)) and students in primary education (up to 12 years old) (OR: 1.8 (1.7–2.0)). Likewise, a statistically significant relationship (p < 0.005) was observed between families where another family member practiced sports and lower number of screen time hours, improved academic performance, and better self-perceived health. Participation of children and adolescents in extracurricular sports activities seems to be associated with their immediate environment. It is therefore essential to emphasize the importance of establishing physical activity habits from an early age in family and school environments.

School-Based Interventions for Promoting Physical Activity Using Games and Gamification: A Systematic Review Protocol

Games and/or gamification seem to be a promising area for educational and health research. These strategies are being increasingly used for improving health indicators, even in educational settings; however, there is little information about these terms within the school to promote physical activity (PA). Objective: the aim of this study is to describe a systematic review protocol of school-based interventions for promoting PA in pre-schoolers, children, and adolescent students using games and gamification. Methods: This review protocol is registered in International prospective register of systematic reviews (PROSPERO) (CRD42019123521). Scientific databases include PubMed, Web of Science, SportDiscus, Cochrane Library, ERIC, and PsycINFO. A standardized procedure will be executed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol (PRISMA-P) checklist for conducting systematic review protocols and the PICOS (Population, Interventions, Comparators, Outcomes, and Study design) tool to address an appropriate search strategy. Detailed information will be extracted, including a quantitative assessment using effect sizes to compare the interventions and a qualitative assessment using the Evaluation of Public Health Practice Projects (EPHPP) tool. Conclusion: This systematic review protocol contributes to establishing future systematic reviews using games and gamification strategies in school settings in order to examine their effect on PA outcomes among youth. Additionally, an update and clarification on the different terms in the school context have been included.

Associations of the objective built environment along the route to school with children's modes of commuting: A multilevel modelling analysis (the SLIC study)

As active commuting levels continue to decline among primary schoolchildren, evidence about which built environmental characteristics influence walking or cycling to school remains inconclusive and is strongly context-dependent. This study aimed to identify the objective built environmental drivers of, and barriers to, active commuting to school for a multi-ethnic sample of 1,889 healthy primary schoolchildren (aged 5-11) in London, UK. Using cross-sectional multilevel ordered logistic regression modelling, supported by the spatial exploration of built environmental characteristics through cartography, the objective built environment was shown to be strongly implicated in children's commuting behaviour. In line with earlier research, proximity to school emerged as the prime variable associated with the choice for active commuting. However, other elements of the urban form were also significantly associated with children's use of active or passive modes of transport. High levels of accidents, crime and air pollution along the route to school were independently correlated with a lower likelihood of children walking or cycling to school. Higher average and minimum walkability and higher average densities of convenience stores along the way were independently linked to higher odds of active commuting. The significance of the relations for crime, air pollution and walkability disappeared in the fully-adjusted model including all built environmental variables. In contrast, relationships with proximity, traffic danger and the food environment were maintained in this comprehensive model. Black children, pupils with obesity, younger participants and those from high socioeconomic families were less likely to actively commute to school. There is thus a particular need to ensure that roads with high volumes of actively commuting children are kept safe and clean, and children's exposure to unhealthy food options along the way is limited. Moreover, as short commuting distances are strongly correlated with walking or cycling, providing high-quality education near residential areas might incite active transport to school.

Physical fitness disparities among New York City public school youth using standardized methods, 2006-2017

Standardized physical fitness monitoring provides a more accurate proxy for youth health when compared with physical activity. Little is known about the utilization of broad-scale individual-level youth physical fitness testing to explore health disparities. We examined longitudinal trends in population-level fitness for 4^th-12^th grade New York City youth during 2006/7-2016/17 (average n = 510,293 per year). Analyses were performed in 2019. The primary outcome was whether or not youth achieved sex-/age-specific performance levels (called the Healthy Fitness Zone) on the aerobic capacity, muscular strength and muscular endurance tests using the NYC FITNESSGRAM. The Cooper Institute’s most recent Healthy Fitness Zone criteria were applied to all tests and years. Prevalence estimates were weighted, accounted for school clustering, adjusted for student-level sociodemographics, and run by sociodemographic subgroups and year. The overall prevalence for meeting 3 Healthy Fitness Zones increased from 15.5% (95%CI: 13.9%-17.0%) in 2006/7 to 23.3% (95%CI: 22.2%-24.4%) in 2016/17 for students in grades 4–12. Fitness for all student groups increased over time, although Hispanic and non-Hispanic black girls consistently had the lowest prevalence of meeting 3 Healthy Fitness Zones as compared to all other race/sex subgroups. Also, 9^th-12^th graders had a lower prevalence of meeting 3 Healthy Fitness Zones as compared to 4^th-8^th graders. Given forecasted sharp increases in cardiovascular disease prevalence, routine youth fitness surveillance using standardized, criterion referenced methods can identify important fitness disparities and inform interventions.

Active Travel of Czech and Polish Adolescents in Relation to Their Well-Being: Support for Physical Activity and Health

The adoption of active travel (AT) habits in adolescence, supported by positive emotions, increases the chances of a lifelong positive attitude towards AT. The aim of this study was to assess the associations between active travel and well-being (WB), and to estimate the share of AT in weekly physical activity (PA) and its contribution to meeting the weekly PA recommendations in adolescents. The International Physical Activity Questionnaire-long form and the WHO-5 questionnaire were used to assess the level of AT, weekly PA and well-being of 2805 adolescents from 36 Czech and 39 Polish schools. A higher rate of AT is only significantly associated with higher well-being in girls. However, meeting AT recommendations in combination with higher WB increased the likelihood of meeting the weekly PA recommendations in both girls and boys. AT accounts for 22.5% of weekly PA of Czech (Polish 24.2%) boys. Concerning girls, it accounts for 24.9% of weekly PA in the Czech Republic and 24.5% in Poland. Meeting AT recommendations should be part of comprehensive school-based PA programs. State, school and municipal policies in the Central European region should pay more attention to the improvement of WB and the built environment for AT in secondary school adolescents.

Changes in and the mediating role of physical activity in relation to active school transport, fitness and adiposity among Spanish youth: the UP&DOWN longitudinal study

Background

Longitudinal changes in child and adolescent active school transport (AST), and the mediating role of different intensities of daily physical activity (PA) levels in relation to AST and physical fitness and adiposity indicators is unclear. This study aimed to: 1) describe longitudinal changes in AST, light PA (LPA), moderate- to vigorous-intensity PA (MVPA), physical fitness and adiposity indicators over three time-points; and 2) investigate the mediating role of LPA and MVPA levels on associations between AST and physical fitness and adiposity indicators over three time-points among children and adolescents.

Methods

This longitudinal study comprised 1646 Spanish children and adolescents (48.8% girls, mean age 12.5 years ±2.5) at baseline, recruited from schools in Cádiz and Madrid. Mode of commuting to school was self-reported at baseline (T0, 2011–12), 1-year (T1) and 2-year follow-up (T2). PA was assessed using accelerometers. Handgrip strength, standing long jump and cardiorespiratory fitness (CRF) assessed physical fitness. Height, weight, body mass index, waist circumference, and triceps and subscapular skinfold thickness were measured. Multilevel linear regression analyses assessed changes in AST, PA levels, physical fitness and adiposity indicators over three time-points (T0-T1-T2). Additionally, longitudinal path analysis (n = 453; mean age [years] 12.6 ± 2.4) was used to test the mediating effects of LPA and MVPA levels on the association between AST and physical fitness and adiposity indicators.

Results

Multilevel analyses observed decreases in LPA between T0-T1 (β = − 11.27; p < 0.001) and T0-T2 (β = − 16.27; p < 0.001) and decreases in MVPA between T0-T2 (β = − 4.51; p = 0.011). Moreover, changes over time showed increases in handgrip between T0-T1 (β = 0.78; p = 0.028) and T0-T2 (β = 0.81; p = 0.046).

Path analyses showed that AST was directly positively associated with MVPA at T1 (all, β ≈ 0.33; p < 0.001). MVPA at T1 mediated associations between AST and CRF at T2 (β = 0.20; p = 0.040), but not the other outcomes. LPA did not mediate any associations.

Conclusions

Results from longitudinal path analysis suggest that participation in more AST may help attenuate declines in MVPA that typically occur with age and improve CRF. Therefore, we encourage health authorities to promote AST, as a way to increase MVPA levels and CRF among youth.

"If I know when you will arrive, I will let you walk to school:" The role of information technology

INTRODUCTION

Providing a sense of supervision for parents may facilitate their children's involvement in physical outdoor activities, such as walking to school. Information technology (IT) solutions could bring more parental supervision, which in turn has the potential to enhance the proportion of walking trips to school. This study aimed to examine the role of a proposed hypothetical IT solution that gives parents real-time information about children's entrance to and exit from the school, for the intention of parents letting their children walk to school.

METHOD

A total of 820 questionnaires were distributed among pupils aged 7-9-years across 28 elementary schools to be completed by their parents (82% return rate).

RESULTS

Compared to the group of walking pupils, increased parental intention to let their children walk to school under the proposed solution could be explained by considerably more variables in the group of pupils who did not walk to school. The findings revealed that increased parental intention was higher among the walking pupils compared to the non-walking pupils. For the non-walking pupils, enhancement of walking facilities across the school area could potentiate the use of the proposed solution by the parents, which in turn may increase the proportion of walking on school trips. In addition, boy pupils, the pupils whose parents evaluated walking more favorable, those from lower socioeconomic backgrounds, and those living in close proximity to the school could more likely benefit by shifting from non-walking to walking modes of travel, after implementation of the solution.

Active Commute in Relation to Cognition and Academic Achievement in Children and Adolescents: A Systematic Review and Future Recommendations

Active commuting to school (ACS) is an important source of physical activity among children. Recent research has focused on ACS and its benefits on cognition and academic achievement (AA), factors important for success in school. This review aims to synthesize literature on the relationship between ACS and cognition or AA among children and adolescents. Peer-reviewed articles in PubMed, Web of Science, PsycINFO and Cochrane Library assessing ACS with cognition and/or AA among children, until February 2019, were selected. Twelve studies across nine countries (age range 4–18.5 years) were included. One study used accelerometers, whereas all others used self-report measures of ACS. A wide range of objective assessments of cognitive functioning and AA domains were used. Five among eight studies, and four among six found a positive relationship between ACS and cognitive or AA measure, respectively. Four studies found dose–response relationships, and some studies found sex differences. The quantitative analysis found that ACS was not significantly associated with mathematics score (odds ratio = 1.18; CI = 0.40, 3.48). Findings are discussed in terms of methodological issues, potential confounders, and the strength of the evidence. Future studies should conduct longitudinal studies and use objective measures of ACS to understand this relationship further.

Physical Activity and Commuting to School in Spanish Nine-Year-Old Children: Differences by Gender and by Geographical Environment

Children’s health status is related to their physical activity levels. Active commuting is associated with higher physical activity and reduced risk of all-cause mortality, cardiovascular disease incidence, and diabetes. The objective of this research was to study the levels of physical activity and the commuting to school (active vs. passive) in Spanish nine-year-old children, analyzing the differences by gender and by the geographical environment where they live (rural or urban environment). Accelerometry was used for the measurement of physical activity: Sedentary time (min/day), vigorous physical activity (min/day), moderate to vigorous physical activity (min/day), intensity (counts/min), steps (number). The questionnaire of the European Youth Heart Study (EYHS) was used to determine the geographical environment (city/urban, residential area/outside city, rural/village) and the modes of transport (active: Walking and bicycle, passive: Car, motorcycle, public transport). A total of 455 Spanish nine-year-old children (247 girls and 208 boys) belonging to the EYHS participated in this study. The results showed that boys were significantly more physically active than girls (p ≤ 0.001). Results also showed that active commuting to school was positively correlated with the levels of physical activity (r = 0.324, p ≤ 0.001). The geographical environment influenced the way in which children went to school, being active commuting to school significantly (p ≤ 0.001) less frequent in those children who lived in a rural environment (22.4%) than in those who lived in the city (57.1%) or in a residential area (62.7%). As active commuting to school means increasing levels of physical activity in both sexes, strategies should be implemented in order to encourage active commuting to schools, contributing at the same time to better health and sustainability of future generations.

U.S. active school travel in 2017: Prevalence and correlates

Active transportation to school (ATS), denoting walking and biking, is crucial to promote physical activity for youth. This study uses data from the 2017 National Household Travel Survey (NHTS) to report on the most recent and nationally representative school transportation patterns. Binary logit modeling determines significant factors associated with school travel mode choices. Spatial differences on school mode choices across the US are explored. In 2017 9.6% of the students of 5–17 years old usually walked and 1.1% biked to school. For students who usually walk to school, 77.5% of their school trips were less than one mile and, among usual bikers to school, 82.8% of trips were less than two miles. Student rates of walking to school decreased as the distance to school increased and biking rates peaked when distance to school was between 0.5 and 1 miles. When distance to school was <0.5 miles, walking was the most common mode for urban and rural regions. When the trip was shorter than or equal to one mile, factors such child's school grade, household vehicles per driver, and household income were associated with the decision to walk or bike to school. Other demographic characteristics like race and gender were not significantly related to ATS. While comparison across NHTS years should be viewed with caution due to changes in survey methodology, the decline of ATS rates indicate that more effective and higher reaching efforts for local, regional, and national interventions should be prioritized.

The importance of social capital for young People's active transport and independent mobility in rural Otago, New Zealand

Social capital influences adolescents' licenses for active transport and independent mobility, through parental decision making and safety concerns, and may contribute to increasing adolescents' physical activity. Drawing on 20 parental interviews and 11 focus groups (73 adolescents) from rural New Zealand, this paper shows the importance of social capital and social trust for active transport and independent mobility in an under researched rural context. Change over time in social capital, social trust and parental safety concerns limited adolescents' active transport and independent mobility. Health policy should incorporate social capital measures to increase adolescents' active transport, independent mobility and physical activity.

Objective Measurement of the Mode of Commuting to School Using GPS: A Pilot Study

Background and objectives: Active commuting to school (ACS) is a promising strategy to increase the daily physical activity (PA) in youths. However, more studies are required to objectively quantify the mode of commuting to school, as well as the health impact of this behavior. Thus, the aims of this study were: (1) to objectively determine the mode of commuting to school using GPS; (2) to quantify the sedentary time, PA levels, energy expenditure, and the steps derived from each mode of commuting; and (3) to analyze the associations between ACS trips and sedentary time, PA, energy expenditure, and steps. Participants and Methods: A total of 180 trips to school were detected, which corresponded to 18 adolescents (12 girls, mean age = 15 ± 0.0 years old). Mode of commuting to school was detected using a novel method merging GPS data in the Personal Activity Location Measurement System (PALMS), whereas sedentary time, PA levels, energy expenditure, and steps were objectively evaluated through accelerometry. Logistic regressions were used to analyze the associations of these variables with walking trips. Results: A total of 115 trips were recorded. Most trips were performed by walk (49.5%), followed by vehicle (39.1%) and mixed transport (11.3%). In the active school trips, youths were less likely to spend minutes in sedentary behaviors (OR: 0.481, p = 0.038), a higher increase on Metabolic-Equivalent of Task (METs) (OR: 5.497, p = 0.013), and greater steps (OR: 1.004, p = 0.029) than in the passive school trips (both active and passive modes were objectively measured). Conclusions: ACS (mainly walking) contribute to higher METs and steps in adolescents. GPS could be an appropriate method to objectively evaluate the PA variables related to the ACS trips.

Interventions promoting active transport to school in children: A systematic review and meta-analysis

The systematic review investigated the effectiveness of active travel (AT) interventions on physical activity and fitness in primary school children. The review assessed intervention effectiveness, design, complexity, and study quality. Searches were conducted in five databases on 30/08/2018. Studies with an AT intervention compared to an inactive control, in 4 to 11 year olds, measuring AT or fitness outcomes were included. Two-stage screening identified relevant studies. Relevant data were extracted using Cochrane Extraction Form, Quality Assessment Tool for Quantitative Studies, Active Living by Design model, and intervention Complexity Assessment Tool for Systematic Reviews. Meta-analysis and Cohen's D effect size assessed effectiveness. Seventeen eligible studies were included. Effectiveness assessment found a statistically significant standardised mean difference (SMD) in AT outcomes in favour of the intervention (continuous AT - SMD 0.78 (CI 0.11-1.46); frequency AT - SMD 1.87 (CI 0.88-2.86)). Cohen's D calculation concurred with this finding. Fifteen studies had SMD favouring the intervention - two studies had SMD favouring the control. Sixteen studies received a weak quality rating - one study rated moderate. Active travel shows promise in increasing physical activity in primary school children. The review found walking school buses and educational strategies most effective for increasing relevant outcomes, although overall study quality was weak. Effect size did not associate with the complexity of an intervention, therefore supporting efforts to promote active travel through interventions may be easier to scale. Further intervention studies of greater methodological quality are necessary to confirm these findings due to the limited evidence available.

Active Commuting to University and its Association with Sociodemographic Factors and Physical Activity Levels in Chilean Students

Background and Objectives: Active commuting to and from university (ACU) could be a strategy to increase physical activity levels (PA) and promote health in young university students. We aimed to a) examine the patterns of commuting to university in Chilean students; b) the association between the mode of commuting to and from university and socio-demographic factors and PA-levels. Materials and Methods: A total of 496 university students (21.6 ± 2.4 years old) from two universities from Valparaíso (central coast of Chile) participated in this study. Personal data, home address, socio-economic status, PA, and the usual mode of commuting to and from the university were self-reported by a questionnaire. The commute distances were objectively measured using Google-Maps-software. Associations were examined using binary logistic regressions. Results: The main mode of commuting was by bus (to university: 55.2% vs. from university: 59.3%; p < 0.001). The least used mode was cycling (1.4% to and from university). Students living >5-km from university were less active commuters than those living in closer distances: (2-5 km, odds ratio (OR): 4.424, 95% and 95% confidence intervals (CI): 2.443-8.011, p < 0.001; 2 km, OR: 143.052, 95% CI: 55.154-371.030, p < 0.001). Students with low PA-levels were less active commuters than those with medium (OR: 1.446; 95% CI: 0.864-2.421; p = 0.160) or higher levels (OR: 1.880; 95% CI: 1.880-1.094; p = 0.022). Students who lived between 2 and 5 km, presented a significant association to be active commuters when they showed medium PA-levels (OR: 5.244, 95% CI: 1.358-20.246; p = 0.016). Conclusions: Chilean university students from Valparaíso are mainly passive commuters using public transport as the main mode of commuting to and from university; longer distances from home to the university are associated with low PA levels. ACU in distances between 2-5 km (mainly walking) could contribute to having medium PA-levels in Chilean university students. Thus, promoting the ACU walking to and from the university in such distances could be an effective strategy to increase the overall PA levels in Chilean university students.

Regional disparities in road traffic injury rates involving elementary and junior high school children while commuting among Japan's 47 prefectures between 2004 and 2013

OBJECTIVES

To investigate the extent and patterns of regional disparities of road traffic injury rates involving elementary and junior high school children while commuting among Japan's 47 prefectures.

METHODS

We conducted a cross-sectional ecological study using the national police data for 2004-2013 on the number of children who were killed or seriously injured (KSI) in traffic collisions stratified by prefecture, grade, mode of transport, and purpose of trip (commuting or non-commuting). We calculated stratified KSI rates by dividing the number of KSI cases by the corresponding number of children and presented these rates for the 47 prefectures. Also, for pedestrian elementary school children and cyclist junior high school children, we regressed the KSI rates while commuting by prefecture on the non-commuting KSI rates and the proportion of people who live in the urban, densely inhabited districts.

RESULTS

There were 6463 KSI cases while commuting. The ratios of the highest KSI rate to the lowest KSI rate among prefectures were 12, 30, and 58 for pedestrian elementary school children and pedestrian and cyclist junior high school children, respectively. The non-commuting KSI rates and the proportion of those living in densely inhabited districts were positively and inversely associated with the commuting KSI rates, respectively. The analysis of the residuals of the regression models did not identify prefectures with significantly higher or lower KSI rates while commuting than others.

CONCLUSIONS

There were large inter-prefecture disparities in the KSI rates while commuting, and the disparity was especially large among cyclist junior high school children.

Can High Schools Be an Effective Setting to Promote Healthy Lifestyles? Effects of a Multiple Behavior Change Intervention in Adolescents

PURPOSE

The main aim was to examine the effects of a school-based intervention on multiple health behaviors in adolescents, such as 24-hour movement behaviors (i.e., physical activity, sedentary time, and sleep duration), diet, and substance consumption (i.e., alcohol and tobacco). Another aim was to examine intragender differences in the effectiveness of the programme.

METHODS

A quasi-experimental design was carried out in two secondary schools throughout one academic year. A final sample of 210 students participated: 105 in the control (Mage = 13.07 ± 0.63) and 105 in the experimental school (Mage = 13.05 ± 0.59). A multicomponent school-based intervention was conducted by teachers in the experimental school via curricular (i.e., tutorial action plan, interdisciplinary project, and school break) and extracurricular (i.e., family involvement, institutional and noncurricular activities, and dissemination of health information and events) actions to promote adolescents' healthy lifestyles. Physical activity and sedentary time were measured by accelerometers, and the rest of health behaviors by using self-reported scales.

RESULTS

Experimental school students showed a significant improvement in meeting specific and general combinations of 24-hour movement guidelines, sedentary screen time levels, nap duration, (un)healthy diet scores, breakfast intake, and soft drink consumption compared to both control school students and their baseline values (p >.05). Active commuting and substance consumption rates only showed a significant improvement compared to control school students (p >.05). Although the intervention programme was effective in improving health-related behaviors in both genders, a large effect size was observed in boys.

CONCLUSIONS

Conducting multiple health behavior interventions becomes essential to improve adolescents' healthy lifestyles.

Way2Go! Social marketing for girls' active transportation to school

Active transportation to school (ATS) is a recognized way to increase physical activity (PA). However, girls and young women do not regularly use ATS despite the many documented physical, mental, and community health benefits. Social Marketing (SM) may provide a framework for understanding girls' perspectives of and experience with ATS and inform messages for use in a public health marketing campaign. Focus groups with 79 girls between the ages of 7 and 15 were conducted in Spring 2017 in Victoria, Canada. Transcripts and poster data were initially categorized using the '4Ps' from social marking (Product, Price, Place and Promotion). Participant groups were segmented into three age categories for designing tailored messaging. Thematic analysis revealed elementary school aged participants identified health and fun while middle school participants valued socializing and helping the environment as reasons for engaging in ATS. For secondary school students, ATS was seen as a way to become more independent. All three highlighted fun and enjoyment as important benefits of ATS, and suggested positive and lighthearted messaging. Segmenting into different audiences highlighted how campaign segmentation would resonate with different audiences based on core values and beliefs. Further segmentation of the audience could result in different core values and beliefs held by diverse groups.

Mode of Commuting to School and Its Association with Physical Activity and Sedentary Habits in Young Ecuadorian Students

Active commuting to and from school (ACS) could help to increase daily physical activity levels in youth; however, this association remains unknown in Ecuadorian youth. Thus, the aims of this study were (1) to determine the patterns of commuting to and from school and (2) to analyze the associations between ACS, physical activity (PA), and sedentary habits in Ecuadorian youth. A total of 732 students (65.3% males), aged 10⁻18 years (children = 246, young adolescents = 310, older adolescents = 162) from the central region of Ecuador participated in this study. A self-report questionnaire, including the usual mode and frequency of commuting, distance from home to school (PACO-Questionnaire), and PA and sedentary habits (YAP-Questionnaire), was used. Most of the sample lived ≤2 km from school; however, they were mainly passive commuters (96%). The most common mode of commuting was by car (to school = 43.4%, from school = 31.6%; p < 0.001). Children presented significantly higher scores (0⁻4) in PA outside school and total PA compared with older adolescents (2.20 ± 0.97 vs. 1.97 ± 0.96; p = 0.013 and 2.30 ± 0.76 vs. 2.09 ± 0.74, p = 0.019, respectively), as well as the lowest scores in sedentary habits (1.51 ± 0.65, p < 0.001). PA at school and total PA were positively associated with ACS (OR 3.137; 95% CI, 1.918 to 5.131; p < 0.001, and OR 2.543; 95% CI, 1.428 to 4.527; p = 0.002, respectively). In conclusion, passive modes of transportation were the most frequently used to commute to and from school in young Ecuadorians. PA at school and total PA were positively associated with ACS. Thus, interventions at school setting could be an opportunity to improve PA levels and additionally ACS in youth from the central region of Ecuador.