Happiness in motion: emotions, well-being, and active school travel

Applying the multiphase optimization strategy to evaluate the feasibility and effectiveness of an online road safety education intervention for children and parents: a pilot study

BACKGROUND

Reports of children's engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents.

METHODS

Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses.

RESULTS

Main intervention feasibility findings include positive and critical feedback on the program's content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the "wheeling safety and skills" module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the 'wheeling safety and skills' module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component.

CONCLUSION

The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children's road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the "wheeling safety and skills" module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples.

WORD COUNT

9,391 (excludes abstract, tables, figures, abbreviations, and references).

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.

Validating the Perceived Active School Travel Enablers and Barriers - Child (PASTEB-C) questionnaire

OBJECTIVES

Presently, child-specific tools and instruments related to active school travel (AST) are lacking. This methodological shortcoming often contributes to suboptimal AST behaviour evaluations and intervention programming. The aim of this paper was to develop and validate a theoretically informed child-specific scale regarding multiple perceived barriers and enablers known to impact children's participation in AST.

STUDY DESIGN

Mixed methods.

METHODS

A mixed-methods and multistudy scale development approach featuring the application of social-ecological theory, a validation pilot study (n = 80), and test-retest study (n = 96) was conducted in collaboration with children in Ontario, Canada. In tandem with completing cognitive interviews and online surveys, multiple analyses, including a qualitative thematic analysis, along with weighted Cohen's kappa, Cronbach's alpha, and confirmatory factor analysis were undertaken.

RESULTS

Qualitative analyses of the developed tool addressed face validity concerns related to the response options and definitions of terms used. Following the reliability analyses of 40 items, two confirmatory factor analyses were run to assess the construct validation of perceived AST barriers and enablers, and resulted in the development of the 24-item Perceived Active School Travel Enablers and Barriers - Child (PASTEB-C) questionnaire.

CONCLUSION

The developed PASTEB-C questionnaire may be used to inform the programming and development of AST interventions, as well as conduct child-specific AST research.

Motivation and Basic Psychological Needs Satisfaction in Active Travel to Different Destinations: A Cluster Analysis with Adolescents Living in Germany

Active travel in adolescence contributes to improved health outcomes. Self-Determination Theory suggests that motivation and basic psychological needs influence travel behavior. Person-centered approaches can examine interrelationships of these constructs underlying travel behavior. The aim of this study was to investigate (i) which clusters can be identified in adolescents, (ii) whether clusters explain overall active travel behavior, (iii) whether clusters were associated with travel mode to various destinations or distance, and (iv) whether differences across clusters appear regarding sex/gender, age, and weight status. The sample included 517 (263 male, 254 female) adolescents from Germany, aged 11-15. Self-organizing maps analysis identified six clusters from nine input variables: intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, amotivation, autonomy satisfaction, competence satisfaction, and relatedness satisfaction. The most beneficial cluster regarding active travel demonstrated highest basic psychological needs satisfaction and autonomous motivation with low controlled motivation and amotivation. The most vulnerable cluster was characterized by generally low levels of motivation except for external regulation and amotivation. Clusters were not associated with distance to school, friends/relatives, shopping facilities, or leisure facilities. The findings support the importance of high quality and high quantity of motivation for active travel in adolescents.

How the Built Environment Moderates Gender Gap in Active Commuting to Schools

This study investigates the influences of built environmental (BE) factors, network design, and sociodemographic factors on active school travel (AST). Although numerous studies have explored these relationships, this study is trying to assess this issue with a focus on gender differences. Data from a cross-sectional sample of children from first to sixth grades from 16 public primary schools exclusive for girls and boys (N = 1260) in Shiraz collected in November 2019 was used. The analysis of the data revealed that, on average, boys are more willing to walk than girls, but that the boys' tendency to walk is less elastic with respect to distance. Moreover, it is shown that street connectivity for all distance thresholds has a positive relationship with walking level, but the street network choice parameter decreases the chance of walking within an 800 metre threshold. It is demonstrated the need to take gender differences into account in local planning policies to promote AST in a developing country context.

Desplazamiento activo en adolescentes: importancia de las barreras percibidas y el acompañamiento

El presente estudio tiene como objetivo conocer el valor predictivo de la edad, el acompañamiento, y las barreras físicas y psicosociales en el desplazamiento activo. Participaron un total de 1325 estudiantes procedentes de centros educativos de Educación Primaria y Educación Secundaria de la Comunidad Autónoma de Extremadura (España), con edades comprendidas entre los 10-17 años (M =12.1; DT= 1.60). Los estudiantes cumplimentaron información sobre el modo, distancia, tiempo y acompañamiento a través del cuestionario PACO, y de las barreras percibidas para el desplazamiento activo mediante la escala BATACE. Los resultados revelaron una importante incidencia del acompañamiento, la distancia y las barreras psicosociales percibidas para la realización de desplazamiento activo hacia el colegio (R2 = .53; p = 0.00). Se concluye en la importancia de la distancia hasta el centro educativo, las barreras psicosociales, y el acompañamiento como elementos más importantes en la realización de desplazamiento activo.

Eine Perspektive von Grundschulkindern auf Bedingungsfaktoren der aktiven und eigenständigen Mobilität – eine qualitative Studie

Nur wenige Kinder erreichen die Bewegungsempfehlungen der Weltgesundheitsorganisation und profitieren von den gesundheitlichen Effekten der körperlichen Aktivität. Die Förderung nicht-organisierter Bewegungsaktivitäten, wie die aktive und eigenständige Mobilität, ist ein relevanter Ansatzpunkt für Interventionen zur Bewegungsförderung bei Kindern im Grundschulalter. Ziel der vorliegenden Studie war es, hinderliche und förderliche Faktoren für die eigenständige und aktive Mobilität auf dem Schulweg zu identifizieren, aus welchen geeignete Interventionsmaßnahmen abgeleitet werden können.

Im Rahmen der Studie wurden zwölf Grundschulkinder im Alter von acht bis zehn Jahren qualitativ anhand der Photovoice-Methode zu ihrem Schulweg befragt. Basierend auf dem sozial-ökologischen Modell wurden individuelle, soziale und physische Einflussfaktoren aus den Daten extrahiert. Insbesondere die elterliche Erlaubnis, eine mangelnde fahrrad- und fußgängerfreundliche Infrastruktur und rücksichtslose motorisierte Verkehrsteilnehmer*innen hindern Kinder an einem aktiven und eigenständigen Zurücklegen des Schulwegs.

Anhand der Studie wurden vielfältige Faktoren auf unterschiedlichen sozial-ökologischen Ebenen identifiziert, welche in Interventionsmaßnahmen zur Förderung eines aktiven und eigenständigen Schulwegs berücksichtigt werden sollten. Zudem sollten Verbesserungsvorschläge der Grundschüler*innen zur Ermöglichung eines aktiven und eigenständigen Schulwegs in der Stadtplanung und -entwicklung kritisch reflektiert und berücksichtigt werden, um kindgerechte Umwelten zu schaffen.

Relevant Variables in the Stimulation of Psychological Well-Being in Physical Education: A Systematic Review

This study is based on the need to explore the different strategies and interventions that seek to develop psychological well-being (PW) in scholars (children and adolescents aged 9–19 years) through physical education and school sports by bearing in mind other variables that can extensively facilitate PW in these students. This study analyzed 504 research works published between 2010 and 2020, and 23 were selected for this review because they met the inclusion criteria. The results showed that the most studied variables were: motivation, academic performance, teaching climate in physical education (PE) teaching styles, parents’ relationships and school environment. The literature review carried out in this study reveals the need to consider PW with other relevant variables, and the importance of doing so from a community approach, in which all systems (parents, school and government) are active participants, and contribute to generate a positive environment for all. Finally, school professionals should be aware of the need to stimulate their students’ PW because government organizations should be interested in promoting such a policy in this population.

Do Active Commuters Feel More Competent and Vital? A Self-Organizing Maps Analysis in University Students

University students represent a population that faces high risks regarding physical inactivity. Research suggests that a regular engagement in physical activity (PA) may be more likely established when it leads to the experience of subjective vitality. Subjective vitality, in turn, is more likely achieved through physical activities that individuals feel competent in, and that take place in natural outdoor environments. An activity that may fulfill these conditions is active commuting to and from university (ACU). To examine whether and in which form ACU can combine this promising pattern of aspects, a person-oriented analysis was conducted. The sample contained 484 university students (59.3% females). Leisure-time PA, ACU by walking, ACU by cycling, subjective vitality, PA-related competence and body mass index were included as input variables in a self-organizing maps analysis. For both female and male university students, the identified clusters indicated that students who intensively engaged in ACU did not exhibit subjective vitality levels above average. Consistently, they did not show elevated levels of PA-related competence, which suggests that ACU does not support the perception of their physical abilities. Considerations regarding urban university environments lacking sufficient natural elements finally add to the conclusion that engaging in ACU does not suffice to establish a vitality-supportive and thus sustainable PA behavior. Additionally, the identified clusters illustrate a large heterogeneity regarding the interaction between leisure-time PA, body mass index and subjective vitality.

Active travel behaviour in the family environment: protocol for the mixed-methods cross-sectional ARRIVE study

INTRODUCTION

Active travel is an important source of physical activity and a primary contributor to overall health among adolescents. To understand and promote active travel behaviour in adolescents, developing a more robust understanding of the predictors of active travel and its associated decision-making processes is needed. Situated within a theoretical socioecological framework for adolescent travel behaviour, the mixed-methods Active tRavel behavioR in the famIly enVironmEnt study aims to quantitatively assess the influence of several predictors of adolescent travel behaviour, and to qualitatively understand the associated decision-making processes of both adolescents and parents.

METHODS AND ANALYSIS

Our mixed-methods approach will feature online surveys and semistructured interviews. The online questionnaire, developed in accordance with a theoretical framework of adolescent active travel, will examine adolescent travel behaviour with respect to four different destinations while controlling for multiple relevant individual, social and physical environment factors. To enable the comparison of adolescent and parental perspectives, the questionnaire will be answered by a representative sample of German adolescents (11-15 years old) and their parents.Our semistructured interviews, likewise framed based on the central tenets of the theoretical framework of adolescent active travel, will seek to explore the decision-making process of families regarding travel mode choice via conducting interviews with each member (ie, father, mother, adolescent). To investigate travel decision-making processes, adolescents and their parents will be invited to talk about trips they undertook using both active and passive transport modes during the last week. Thematic analyses will be conducted to highlight the central concerns, priorities and values of participants' decision-making processes.

ETHICS AND DISSEMINATION

This study has received ethical approval from the ethics commission of the Friedrich-Alexander-University Erlangen-Nuremberg. Study results will be disseminated at scientific conferences and published in peer-reviewed journals. Additionally, study findings will be made publicly available to relevant health, policy, and research stakeholders and groups.

Segmenting children’s active school travel behaviour: insights on caregivers’ perceived risks and social norms

Purpose

Active school travel (AST) programmes aim to change commuting behaviour to improve children's physical and mental health. However, very limited health education programmes for children use segmentation to create tailored solutions that understand the specific characteristics of each group of children and their caregivers in order to yield better results. The aim of this study is to use a statistical segmentation analysis (two-step cluster analysis) to gain insights on the examination of specific groups to design future health education interventions and campaigns that can improve children's health.

Design/methodology/approach

Guided by the Ecological and Cognitive Active Commuting (ECAC) framework, a market segmentation analysis was performed. An online survey was designed to collect data from caregivers of children between 5 and 12 years attending school and responsible for taking the child to and/or from school in Victoria and Queensland, Australia. Using 3,082 responses collected from Australian caregivers of primary school children, a two-step cluster analysis was performed.

Findings

Analysis revealed the most important variables for group formation were previous child walking behaviour, distance from school and caregiver income. Perceived risk of the physical environment was the most important psychographic segmentation variable for group formation, followed by social norms. Four distinct groups with different characteristics were identified from the analysis.

Originality/value

This is the first study that applies the ECAC framework to perform market segmentation in the AST context. Results revealed four market segments that demand different tailored solutions. Findings shed light on how to better design AST interventions and campaigns to promote children's health using segmentation techniques.

Perceived neighbourhood safety moderates the relationship between active school travel and health-related quality of life

There is a dearth of studies examining associations between active school travel and children's health-related quality of life. Additionally, studies have not examined how perceived neighbourhood characteristics may moderate these associations. This study aims to examine the relationship between regular active school travel, children's physical and psychosocial health-related quality of life, and the potential moderating effects of their perceived neighbourhood safety (interpersonal and traffic). This cross-sectional study used data from Ontario schoolchildren (aged 8-14) as part of the Spatial Temporal Environment and Activity Monitoring (STEAM) Project. Results showed no significant direct relationship between regular active school travel and children's physical or psychosocial functioning; but the relationships were moderated by perceived neighbourhood safety. Regular active school travelers with high levels of perceived neighbourhood interpersonal safety, had higher physical and psychosocial functioning than regular active school travelers with low levels of perceived neighbourhood interpersonal safety. Additionally, at higher levels of perceived neighbourhood traffic safety, regular active school travelers had higher psychosocial functioning than regular active school travelers with lower perceived neighbourhood traffic safety. Interventions promoting active school travel should consider the environments through which children will be traveling.

Do neighbourhood characteristics matter in understanding school children’s active lifestyles? A cross-region multi-city comparison of Glasgow, Edinburgh and Hong Kong

Many studies have explored the influence of individual and neighbourhood factors on active school travel (AST), this novel study is the first to examine how AST and formal extracurricular activities are associated with children’s active lifestyles. The aims of this study were to (a) create an active lifestyle variable (ALIFE) measured in terms of total weekly minutes of AST and extracurricular activities, and (b) explore how ALIFE is associated with different attributes at the individual, household and neighbourhood levels, and how these relationships differ for children aged 10 and 11 years old across the three cities: Glasgow, Edinburgh and Hong Kong. We found environmental factors to be important indicators of lower AST, for example greater parking facility density. The most substantial contribution to children’s overall ALIFE was household income, those from the lowest household group having almost 2 h less ALIFE per-week than those from the highest income.

How Do Urban Environments Affect Young People's Mental Health? A Novel Conceptual Framework to Bridge Public Health, Planning, and Neurourbanism

Childhood and adolescence are crucial periods for mental and social development. Currently, mental illness among young people is a global epidemic, and rates of disorders such as depression and anxiety are rising. Urban living, compared with rural living, is linked with a higher risk of serious mental illness, which is important because the world is urbanizing faster than ever before. Urban environments and their landscapes, designs, and features influence mental health and well-being. However, no conceptual frameworks to date have detailed the effect of urban environments on young people's mental health, and few studies have considered the growing role of digital and social media in this relationship, leading to calls for the development of holistic approaches to describe this relationship. This article synthesizes existing knowledge on urban places (both built and natural environments) and mental health in the public health and urban planning literature and examines the emerging field of neurourbanism (a multidisciplinary study of the effect of urban environments on mental health and brain activity) to enhance current practice and research. We developed 2 novel conceptual frameworks (1 research-oriented, 1 practice-oriented), adapted from Bronfenbrenner's socioecological model, that focus on the relationship between urban environments and young people's mental health. We added a digital and social media contextual level to the socioecological model, and we applied a multilayer concept to highlight potential cross-field interactions and collaborations. The proposed frameworks can help to guide future practice and research in this area.

Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.

Strategies and effects of school-based interventions to promote active school transportation by bicycle among children and adolescents: a systematic review

BACKGROUND

Promoting cycling to school may benefit establishing a lifelong physical activity routine. This systematic review aimed to summarize the evidence on strategies and effects of school-based interventions focusing on increasing active school transport by bicycle.

METHODS

A literature search based on "PICo" was conducted in eight electronic databases. Randomized and non-randomized controlled trials with primary/secondary school students of all ages were included that conducted pre-post measurements of a school-based intervention aimed at promoting active school travel by bicycle and were published in English between 2000 and 2019. The methodological quality was assessed using the "Effective Public Health Practice Project" tool for quantitative studies. Applied behavior change techniques were identified using the "BCT Taxonomy v1". Two independent researchers undertook the screening, data extraction, appraisal of study quality, and behavior change techniques.

RESULTS

Nine studies investigating seven unique interventions performed between 2012 and 2018 were included. All studies were rated as weak quality. The narrative synthesis identified 19 applied behavior change techniques clustered in eleven main groups according to their similarities and a variety of 35 different outcome variables classified into seven main groups. Most outcomes were related to active school travel and psychosocial factors, followed by physical fitness, physical activity levels, weight status, active travel and cycling skills. Four studies, examining in total nine different outcomes, found a significant effect in favor of the intervention group on bicycle trips to school (boys only), percentage of daily cycling trips to school, parental/child self-efficacy, parental outcome expectations, moderate-to-vigorous intensity physical activity (total, from cycling, before/after school), and total basic cycling skills. Seven of these outcomes were only examined in two studies conducting the same intervention in children, a voluntary bicycle train to/from school accompanied by adults, including the following clustered main groups of behavior change techniques: shaping knowledge, comparison of behavior, repetition and substitution as well as antecedents.

CONCLUSIONS

The applied strategies in a bicycle train intervention among children indicated great potential to increase cycling to school. Our findings provide relevant insights for the design and implementation of future school-based interventions targeting active school transport by bicycle.

TRIAL REGISTRATION

This systematic review has been registered in the international prospective register of systematic reviews "PROSPERO" at (registration number: CRD42019125192 ).

Association between Active Travel to School and Depressive Symptoms among Early Adolescents

Background: Although much evidence has demonstrated the positive relationship of active school travel (AST) and physical health, little is known about the relationship of AST and mental health indicators among early adolescents, especially in Chinese populations. Thus, this study aimed to investigate the relationship of AST with depressive symptoms and its sex as well as age difference among early adolescents from Shanghai urban areas, China. Methods: 6478 adolescents (mean age = 13.6) in urban area were recruited, of whom boys accounted for 46.2%. A self-reported questionnaire in Chinese was used to collect data on AST and depressive symptoms, and other control variables. Multivariable logistic regression analyses were used to explore the relationships of AST with depressive symptoms. Results: Of all included participants, 53.2% of adolescents reported being active in AST without sex difference. The prevalence of depressive symptoms was 19.2% without sex difference. AST was associated with reporting no depressive symptoms in adolescents (adjusted OR = 1.20, 95%CI: 1.06–1.36). However, the relationship was significant in boys (adjusted OR = 1.34, 95%CI: 1.11–1.60), in those who were grade 8 (adjusted OR = 1.25, 95%CI: 1.01–1.55) and 9 (adjusted OR = 1.29, 95%CI: 1.01–1.65) adolescents. Conclusions: AST may play an important role in preventing depressive symptoms among early adolescents. However, the relationship of AST with depressive symptoms differed by sex and age. More research is encouraged to explore the mechanism linking AST and depressive symptoms among adolescents, especially in different contexts.

Can I Sustain My Happiness? A Review, Critique and Research Agenda for Economics of Happiness

Human beings want to live in a state of happiness and prosperity, but happiness is important not just for the well-being of individuals but for the well-being of society. To ensure the maximization of happiness, it is necessary to consider more than just money, and rather include the right understanding of happiness at the individual level, the family level, the society level, and the environmental (nature) level. This paper contributes to the existing body of knowledge by consolidating the findings of the literature; grouping those into major themes and sub-themes; describing the mechanisms based on the empirical papers by highlighting the independent, dependent, control, and moderating variables, to study the causal relationships between variables under study; proposing an agenda for future research; and informing the policymakers about decisions influencing the human happiness level through legislative rules and regulations. Our results suggest prioritizing the conceptualization of happiness while computing the happiness level at the individual or collective levels. Furthermore, the study recommends governments to establish the conditions enabling individuals to report happiness independently from the political pressure to answer strategically for impressive happiness level figures at the macro level.

Active Commuting to School, Physical Activity, and Behavior Problems Among Third-Grade Children

BACKGROUND

We examined factors associated with active commuting to school and the relationships of active commuting and physical activity to child- and teacher-reported internalizing and externalizing behavior problems in a sample of third graders.

METHODS

The study sample consisted of 13,166 third graders enrolled in the Early Childhood Longitudinal Study Kindergarten Class of 1998-1999. "Active" commuters were children who walked to school and "passive" commuters were those who took the bus or were driven. Linear analyses evaluated differences in behavior problems by school commute, physical activity, and sports team participation after adjusting for sociodemographic, regional, and neighborhood factors.

RESULTS

Overall, 11% of children actively commuted. Type of commute differed by sociodemographics, region, urbanicity, school type, and neighborhood safety. Active commuters had less general physical activity participation and sports team participation. Commuting type and general physical activity were not associated with behavior problems, but sports team participation was associated with fewer child-reported internalizing and externalizing behaviors as well as fewer teacher-reported internalizing behaviors.

CONCLUSIONS

Our findings demonstrate the ongoing need for creating and maintaining physical activity programs (such as sports teams) among school-aged children to optimize children's overall health and well-being.

Effectiveness of active school transport interventions: a systematic review and update

Background

Active school transport (AST) is a promising strategy to increase children’s physical activity. A systematic review published in 2011 found large heterogeneity in the effectiveness of interventions in increasing AST and highlighted several limitations of previous research. We provide a comprehensive update of that review.

Methods

Replicating the search of the previous review, we screened the PubMed, Web of Science, Cochrane, Sport Discus and National Transportation Library databases for articles published between February 1, 2010 and October 15, 2016. To be eligible, studies had to focus on school-aged children and adolescents, include an intervention related to school travel, and report a measure of travel behaviors. We assessed quality of individual studies with the Effective Public Health Practice Project quality assessment tool, and overall quality of evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. We calculated Cohen’s d as a measure of effect size.

Results

Out of 6318 potentially relevant articles, 27 articles reporting 30 interventions met our inclusion criteria. Thirteen interventions resulted in an increase in AST, 8 found no changes, 4 reported inconsistent results, and 5 did not report inferential statistics. Cohen’s d ranged from −0.61 to 0.75, with most studies reporting “trivial-to-small” positive effect sizes. Three studies reported greater increases in AST over longer follow-up periods and two Safe Routes to School studies noted that multi-level interventions were more effective. Study quality was rated as weak for 27/30 interventions (due notably to lack of blinding of outcome assessors, unknown psychometric properties of measurement tools, and limited control for confounders), and overall quality of evidence was rated as low. Evaluations of implementation suggested that interventions were limited by insufficient follow-up duration, incomplete implementation of planned interventions, and limited access to resources for low-income communities.

Conclusions

Interventions may increase AST among children; however, there was substantial heterogeneity across studies and quality of evidence remains low. Future studies should include longer follow-ups, use standardized outcome measures (to allow for meta-analyses), and examine potential moderators and mediators of travel behavior change to help refine current interventions.

Trial registration

Registered in PROSPERO: CRD42016033252

Electronic supplementary material

The online version of this article (10.1186/s12889-017-5005-1) contains supplementary material, which is available to authorized users.

Active Travel by Built Environment and Lifecycle Stage: Case Study of Osaka Metropolitan Area

Active travel can contribute to physical activity achieved over a day. Previous studies have examined active travel associated with trips in various western countries, but few studies have examined this question for the Asian context. Japan has high levels of cycling, walking and public transport, similar to The Netherlands. Most studies have focused either on children or on adults separately, however, having children in a household will change the travel needs and wants of that household. Thus, here a household lifecycle stage approach is applied. Further, unlike many previous studies, the active travel related to public transport is included. Lastly, further to examining whether the built environment has an influence on the accumulation of active travel minutes, a binary logistic regression examines the built environment’s influence on the World Health Organization’s recommendations of physical activity. The findings suggest that there is a clear distinction between the urbanized centers and the surrounding towns and unurbanized areas. Further, active travel related to public transport trips is larger than pure walking trips. Females and children are more likely to achieve the WHO recommendations. Finally, car ownership is a strong negative influence.

Are the correlates of active school transport context-specific?

OBJECTIVES

Previous research consistently indicates that children who engage in active school transport (AST) are more active than their peers who use motorized modes (car or bus). However, studies of the correlates of AST have been conducted predominantly in high-income countries and have yielded mixed findings. Using data from a heterogeneous sample of 12 country sites across the world, we investigated the correlates of AST in 9-11-year olds.

METHODS

The analytical sample comprised 6555 children (53.8% girls), who reported their main travel mode to school and the duration of their school trip. Potential individual and neighborhood correlates of AST were assessed with a parent questionnaire adapted from previously validated instruments. Multilevel generalized linear mixed models (GLMM) were used to examine the associations between individual and neighborhood variables and the odds of engaging in AST while controlling for the child's school. Site moderated the relationship of seven of these variables with AST; therefore we present analyses stratified by site.

RESULTS

The prevalence of AST varied from 5.2 to 79.4% across sites and the school-level intra-class correlation ranged from 0.00 to 0.56. For each site, the final GLMM included a different set of correlates of AST. Longer trip duration (that is, ⩾16 min versus ⩽15 min) was associated with lower odds of AST in eight sites. Other individual and neighborhood factors were associated with AST in three sites or less.

CONCLUSIONS

Our results indicate wide variability in the prevalence and correlates of AST in a large sample of children from twelve geographically, economically and culturally diverse country sites. This suggests that AST interventions should not adopt a 'one size fits all' approach. Future research should also explore the association between psychosocial factors and AST in different countries.

Associations Between Active Commuting to School, Body Fat, and Mental Well-being: Population-Based, Cross-Sectional Study in China

PURPOSE

Little is known about patterns of active commuting to school (ACS) among school-aged children in China. This study examines mode of transport to school in China and associations with physical and mental well-being among national representative children.

METHODS

Data came from National Puberty Research Collaboration. Commuting mode to school was self-reported and categorized as three categories: walking, cycling, and passive commuting to school. Body mass index, percentage body fat (PBF, measured by skinfold thickness), waist circumference (WC) was measured, and depressive symptoms was assessed by Children's Depression Inventory.

RESULTS

A total of 12,151 girls and 9,445 boys from grade 4 to grade 12 participated in this study. Totally 39.9% of Chinese children walked and 15.9% cycled to school, 44.2% traveled by passive commuting mode. ACS was predictive of lower body mass index, PBF, and WC. Children who commuted via active modes had body mass index, PBF, and WC scores of .167 (95% confidence interval [CI] .274-.060), .566 (95% CI .270-.862), and .724 (95% CI .423-1.025) points lower, respectively, than those who used passive transport. ACS was associated with .855 lower odds of being obese (p < .001) and .907 lower (p < .001) odds of having depressive symptoms compared with children using passive transport.

CONCLUSIONS

ACS is correlated with better physical and mental well-being. Sustainable transport planning aimed at increasing active travel to school among Chinese children and adolescents is in great need.