Walking school buses as a form of active transportation for children-a review of the evidence

Evaluation of a walking school bus program: a cluster randomized controlled trial

BACKGROUND

The purpose of this study was to investigate the effects of a walking school bus intervention on children's active commuting to school.

METHODS

We conducted a randomized controlled trial (RCT) in Houston, Texas (Year 1) and Seattle, Washington (Years 2-4) from 2012 to 2016. The study had a two-arm, cluster randomized design comparing the intervention (walking school bus and education materials) to the control (education materials) over one school year October/November - May/June). Twenty-two schools that served lower income families participated. Outcomes included percentage of days students' active commuting to school (primary, measured via survey) and moderate-to-vigorous physical activity (MVPA, measured via accelerometry). Follow-up took place in May or June. We used linear mixed-effects models to estimate the association between the intervention and outcomes of interest.

RESULTS

Total sample was 418 students [Mage=9.2 (SD = 0.9) years; 46% female], 197 (47%) in the intervention group. The intervention group showed a significant increase compared with the control group over time in percentage of days active commuting (β = 9.04; 95% CI: 1.10, 16.98; p = 0.015) and MVPA minutes/day (β = 4.31; 95% CI: 0.70, 7.91; p = 0.02).

CONCLUSIONS

These findings support implementation of walking school bus programs that are inclusive of school-age children from lower income families to support active commuting to school and improve physical activity.

TRAIL REGISTRATION

This RCT is registered at clinicaltrials.gov (NCT01626807).

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.

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.

The Comprehensive School Physical Activity Program: An Invited Review

Physical inactivity is a global challenge that necessitates early intervention during childhood. Schools are positioned to make a significant impact on children's current and future physical activity behavior, but numerous barriers hinder the implementation and sustainability of school-based physical activity opportunities. The purpose of this invited article is to provide an overview of the comprehensive school physical activity program (CSPAP) as a concept, framework, and promising approach to institutionalizing physical activity within the school environment. Despite the availability of numerous published reviews on the topic, a broad, up-to-date panorama of the CSPAP literature that encompasses and consolidates historical, conceptual, empirical, and practical perspectives is currently lacking. Contained within this article is an explanation of the public health context that undergirds the CSPAP concept, a historical perspective of the concept's origins and evolution, examples of CSPAP research, recommendations for advancing the knowledge base, and evidence-informed frameworks and principles for professional practice.

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.

Systematic Review of Active Travel to School Surveillance in the United States and Canada

Active travel to school is one way youths can incorporate physical activity into their daily schedule. It is unclear the extent to which active travel to school is systematically monitored at local, state, or national levels. To determine the scope of active travel to school surveillance in the US and Canada and catalog the types of measures captured, we conducted a systematic review of peer-reviewed literature documenting active travel to school surveillance published from 2004 to February 2018. A study was included if it addressed children's school travel mode across two or more time periods in the US or Canada. Criteria were applied to determine whether a data source was considered an active travel to school surveillance system. We identified 15 unique data sources; 4 of these met our surveillance system criteria. One system is conducted in the US, is nationally representative, and occurs every 5-8 years. Three are conducted in Canada, are limited geographically to regions and provinces, and are administered with greater frequency (e.g., 2-year cycles). School travel mode was the primary measure assessed, most commonly through parent report. None of the systems collected data on school policies or program supports related to active travel to school. We concluded that incorporating questions related to active travel to school behaviors into existing surveillance systems, as well as maintaining them over time, would enable more consistent monitoring. Concurrently capturing behavioral information along with related environmental, policy, and program supports may inform efforts to promote active travel to school.

Parental Perceptions and Perceived Environmental Influences on Active Transport to School in U.S. Inner-City Neighborhoods: Through the Lens of Health Equity

Physical inactivity remains high amongst Asian American (AA) children. The Safe Routes to School (SRTS) Program is a viable approach for increasing levels of physical activity by encouraging active transport to school (ATS). The objective of this study was to investigate the factors that affect ATS among Asian American children in inner-city schools. An adapted version of the national SRTS survey that measures socio-demographics, environmental factors, and parental perceptions toward school routes and transportation modes were administered in eight public schools in Hamtramck, Michigan. Multinominal logistic regression results indicated that the age of children, distance to school, perceived school encouragement, and parents' perceptions on safety were the predominant factors associated with Asian American children participating in ATS. The study is among the first to investigate underserved environmental and access factors that influence Asian American children's ATS patterns. Particularly, these findings showed that the safety perceptions of parents play a key role in affecting their decisions about ATS and should be considered in future interventions and programming designs to promote ATS.

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.

Systematic Review of Active Travel to School Surveillance in the United States and Canada

Active travel to school is one way youths can incorporate physical activity into their daily schedule. It is unclear the extent to which active travel to school is systematically monitored at local, state, or national levels. To determine the scope of active travel to school surveillance in the US and Canada and catalog the types of measures captured, we conducted a systematic review of peer-reviewed literature documenting active travel to school surveillance published from 2004 to February 2018. A study was included if it addressed children's school travel mode across two or more time periods in the US or Canada. Criteria were applied to determine whether a data source was considered an active travel to school surveillance system. We identified 15 unique data sources; 4 of these met our surveillance system criteria. One system is conducted in the US, is nationally representative, and occurs every 5-8 years. Three are conducted in Canada, are limited geographically to regions and provinces, and are administered with greater frequency (e.g., 2-year cycles). School travel mode was the primary measure assessed, most commonly through parent report. None of the systems collected data on school policies or program supports related to active travel to school. We concluded that incorporating questions related to active travel to school behaviors into existing surveillance systems, as well as maintaining them over time, would enable more consistent monitoring. Concurrently capturing behavioral information along with related environmental, policy, and program supports may inform efforts to promote active travel to school.

Traffic-related air pollution reduction at UK schools during the Covid-19 lockdown

Elevated urban Nitrogen Dioxide (NO₂) is a consequence of road traffic and other fossil-fuel combustion sources, and the road transport sector provides a significant contribution to UK NO₂ emissions. The inhalation of traffic-related air pollution, including NO₂, can cause a range of problems to human health. Due to their developing organs, children are particularly susceptible to the negative effects of air pollution inhalation. Accordingly, schools and associated travel behaviours present an important area of study for the reduction of child exposure to these harmful pollutants. COVID-19 reached the UK in late January 2020. On the 23rd of March that year, the UK government announced a nationwide stay-at-home order, or lockdown, banning all non-essential travel and contact with people outside of their own homes. The lockdown was accompanied by the closure of schools, public facilities, amenities, businesses and places of worship. The current study aims to assess the significance of nationwide NO₂ reductions at schools in England as a consequence of the lockdown in order to highlight the benefits of associated behavioural changes within the context of schools in England and potential child exposure. NO₂ data were collected from all AURN (Automatic Urban and Rural Network) monitoring sites within 500 m of nurseries, primary schools, secondary schools and colleges in England. A significant reduction of mean NO₂ concentrations was observed in the first month of the UK lockdown at background (-35.13%) and traffic (-40.82%) sites. Whilst lockdown restrictions are undoubtedly unsustainable, the study results demonstrate the possible reductions of NO₂ at schools in England and potential reductions of child exposure that are achievable when public behaviours shift towards active travel, work from home policies and generally lower use of polluting vehicles.

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 ).

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

BACKGROUND

Active school travel by bike may provide appropriate means to promote physical activity through commuting to and from school, expanding the mobility during leisure time, and integrating a lifelong positive behavior routine. However, bicycling seems to be a less common form of active school transport and declining cycling to school trends in some European countries have been observed. Therefore, effective interventions aiming at promoting biking to school are warranted. To gain a better understanding of effective programs, the systematic review will summarize strategies and effects of school-based interventions targeted on positively influencing active school travel by bicycle.

METHODS

The databases ERIC, PsycINFO, PSYNDEX, PubMed, Scopus, SPORTDiscus, SURF, and Web of Science will be searched utilizing a detailed search strategy according to "PICo". Consequently, there will be no restriction regarding the outcomes measured in studies. For inclusion in the review, the identified primary studies (i.e. randomized and non-randomized controlled trials) should be published between 2000 and 2019 due to their current relevance, and written in English. The screening, data extraction, and appraisal of study quality as well as behavior change techniques will be undertaken by two independent researchers. To assess the methodological quality of every included study, the quality assessment tool "Effective Public Health Practice Project" for quantitative studies will be used. Behavior change techniques will be identified by utilizing the "BCT Taxonomy v1". If data permits, meta-analyses for intervention effects will be conducted where appropriate.

DISCUSSION

The planned systematic review can provide information about how bicycling is considered in school-based interventions as an effective strategy to promote active commuting to school among students. In this regard, the conclusions drawn from the review will establish a basis for researchers to plan and implement a comprehensive cycling intervention in the school setting.

SYSTEMATIC REVIEW REGISTRATION

PROSPEROCRD42019125192.

Parent Perceptions on a Walking School Bus Program Among Low-Income Families: A Qualitative Study

BACKGROUND

The walking school bus (WSB) is a promising intervention to increase walking to school and physical activity in school-age children. The aim of this qualitative study was to assess parent perceptions of a WSB program that was part of a randomized controlled trial to inform future programs.

METHODS

The authors interviewed 45 parents whose children had participated in a WSB program in the Seattle area, in which third- and fifth-grade students walked to/from school with adult chaperones along a set route. The authors performed a qualitative analysis of the interview transcripts and coded interview segments into 4 broad categories as follows: facilitators, barriers, general positive sentiments, and proposals.

RESULTS

Most parents spoke of the benefits of the WSB program; in particular, parents frequently applauded exercise/physical health benefits. Of the barriers, the most frequently cited was time, with work schedule and commute changes leading some families to walk less frequently.

CONCLUSIONS

Most parents voiced support for the WSB program as a means to improve child health, to learn pedestrian safety, and to interact with positive adult role models. Parents made several suggestions to improve the program, including better recruitment methods, logistical improvements, and a platform for communicating with other parents.

Sur le chemin de l’école : perceptions de parents et d’enfants du primaire face au risque routier lors de la mise en place d’un Trottibus au Québec

Cadre de la recherche : Dans les pays occidentaux, la marche pour se rendre à l’école est en forte diminution depuis la fin des années 1990. Cette diminution des déplacements à pied modifie le rapport des enfants aux espaces publics. Pour enrayer la diminution de la marche vers l’école, les Pédibus sont un programme d’incitation à la marche vers l’école sous la forme de l’organisation d’un ramassage scolaire pédestre sous la supervision d’un adulte.

Objectifs : Ces programmes ont fait l’objet d’évaluations, mais peu de recherches ont ciblé les différenciations des perceptions des parents et des enfants. L’objectif de cet article est d’analyser les différences de perceptions entre les parents et les enfants sur le risque routier lors de la mise en place d’un Pédibus afin d’interroger l’apprentissage de l’autonomie et le rapport aux espaces publics.

Méthodologie : Pour répondre à ces questionnements, nous nous appuyons sur une recherche concernant la mise en place de projets Trottibus, programme de Pédibus au Québec financé par la Société Canadienne du Cancer (SCC-Québec). Une enquête a été autoadministrée par Internet auprès de 189 parents et d’un de leurs enfants âgés de 5 à 11 ans avant ou au tout début de leur participation à un Trottibus.

Résultats : Les résultats montrent un plus grand sentiment de sécurité de la part des enfants lorsqu’ils marchent sur un espace sécurisé pour les piétons et une plus forte confiance dans les autres usagers quant au respect des piétons. Pour les parents, le Trottibus a des bienfaits éducatifs quant à l’apprentissage de la mobilité piétonne. Les enfants et les parents mettent en avant les dimensions de sociabilité de ce programme.

Conclusions : Les résultats permettent de mieux comprendre la familiarisation du trajet scolaire par les enfants et leurs perceptions de la sécurité routière sous divers scénarios (marcher sur le trottoir, traverser, jouer dans la rue, etc.) ainsi que de documenter les différences entre les attentes des parents et des enfants.

Contribution : L’accompagnement par les adultes interroge le rapport à la ville et l’acquisition de l’autonomie. Si les parents craignent de laisser leur enfant marcher seul pour un trajet connu entre le domicile et l’école à l’âge où s’expérimente la mobilité autonome, les enfants risquent d’acquérir plus tardivement les compétences pour se déplacer en sécurité et expérimenter les espaces publics des villes.

A regional vision of physical activity, sedentary behaviour and physical education in adolescents from Latin America and the Caribbean: results from 26 countries

BACKGROUND

Latin America and the Caribbean (LAC) countries, have been historically under-represented due to the lack of surveillance of physical behaviours in young populations. Therefore, the aim of this study was to describe and compare overall physical activity (PA), active transportation to and from school (i.e. walking or cycling), physical education (PE) participation, and sedentary behaviour (SB) in adolescents from 26 countries in LAC.

METHODS

Data were collected in the Global School-based Student Health Survey (2007-13). Prevalences for each physical behaviour were compared by sex across the region.

RESULTS

In total, 64 034 adolescents provided complete data (age range: 11 to 18 years; 47.7% male). Only about 15% of adolescents in LAC countries were physically active (at least 60 min/day of moderate-to-vigorous PA) with most countries showing sex disparities. Overall, 41.9% reported being active for transportation to and from school at least 3 days per week. In 12 countries, at least 50% of the adolescents reported sitting ≥3 h per day outside school, and a third of adolescents reported participation in PE classes on 3 days or more per week.

CONCLUSIONS

The study sets a challenge for the LAC region, as physical inactivity and SB are highly prevalent across all countries. Gender inequity was shown in most countries, with boys reporting more active behaviours. Regional and national actions for implementing policies to revert this situation are urgent.

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.

Physical and Social Contexts of Physical Activity Behaviors of Fifth and Seventh Grade Youth

BACKGROUND

The purpose of this study was to characterize the temporal, social, and physical contexts for physical activities commonly reported in a diverse cohort of 753 boys and girls from fifth to seventh grade.

METHODS

Data were obtained from a multilevel longitudinal study, the Transitions and Activity Changes in Kids. The Physical Activity Choices instrument assessed previous 5-day participation in specific physical activities and their temporal, social, and physical contexts. Mixed model repeated measure analyses of variance and multinomial analyses examined sex differences and change over time.

RESULTS

Fifth grade boys and girls reported participation in similar activities at similar frequencies, which declined significantly by seventh grade. One temporal pattern, playing with younger children, changed over time from "both inside/outside" to "outside" school. Boys and females reported more activities performed in class/team groups over time. Most activities took place primarily at home for all participants in both grades.

CONCLUSIONS

Boys and girls reported declines in the variety and frequency of activities from fifth to seventh grade. There were sex-specific patterns in physical activities and groups; however, all participants reported home as the primary location and a shift to class/team groups over time. Schools are well-positioned to provide additional physical activity opportunities.

What Influences Parents' Fear about Children's Independent Mobility? Evidence from a State-Wide Survey of Australian Parents

PURPOSE

To identify factors associated with generalized and stranger-specific parental fear (PF) about children's independent mobility (CIM), a critical aspect of physical activity.

DESIGN

Cross-sectional survey; random sampling frame, minimum quotas of fathers, rural residents.

SETTING

State of Victoria, Australia.

SUBJECTS

Parents of children aged 9 to 15 years (n = 1779), 71% response rate.

MEASURES

Validated measures of PF and fear of strangers (FoS); parent, child, social, and environmental factors.

ANALYSIS

Unadjusted and adjusted linear regression stratified by child age (9-10; 11-13; 14-15).

RESULTS

Adjusted models explained a substantial proportion of variance across all age groups (PF: 33.6%-36.7%; FoS: 39.1%-44.0%). Perceived disapproval from others was consistently associated with both outcomes (PF: β =.11 to 23, p ≤ .05; FoS: β =.17-.21, p ≤ .001) as was parents' perception of children's competence to travel safely (PF: β = -.24 to -.11, p ≤ .05; FoS: β = -.16 to -.13, p ≤ .01). Factors associated with FoS included having a female child (β = -.21 to -.13, p ≤ .001), language other than English (β = .09 to.11, p ≤ .01), and low levels of parent education (β = -.14 to -08, p ≤ .05).

CONCLUSION

The current study suggests that social norms, child competence, and perceptions about the benefits of CIM underpin PF. This evidence informs the development of interventions to reduce PF and promote CIM and children's physical activity.

An empirical examination of the ecological and cognitive active commuting framework

Purpose

Evidence indicates that active school travel (AST) including walking can effectively lower levels of obesity among school-age children. Yet Queensland has been identified as one of the most inactive states in Australia where only 5 per cent of Years 1 and 5 children engaged in AST on a daily basis. The purpose of this paper is to explain walking to school behaviour among Queensland children by investigating the explanatory potential of the ecological and cognitive active commuting (ECAC) model.

Design/methodology/approach

An online survey of 537 carers in Queensland, Australia was conducted to collect data about demographics and the variables in the ECAC model. Structural equation modelling was used to analyse the ECAC model and the pathways between variables.

Findings

The results indicate that the ECAC model explained 53.4 per cent of the variance in walking to school. Social norms are the dominating factor in the model. Distance to school affects how the ECAC model works by moderating the associations among walking to school behaviours, perceived risks, and social norms.

Practical implications

Changing carers’ social norms and lowering the perceived risks they associate with walking to school should increase the incidence of walking to school in Queensland.

Originality/value

Although the ECAC model was proposed as a comprehensive framework to explain walking to school behaviour, to date, it has not been tested empirically. Informed by a modified ECAC framework this study aims to empirically explore the factors that may be preventing or facilitating Queensland children from walking to school.

Bicycle Trains, Cycling, and Physical Activity: A Pilot Cluster RCT

INTRODUCTION

Increasing children's cycling to school and physical activity are national health goals. The objective was to conduct an RCT of a bicycle train program to assess impact on students' school travel mode and moderate-to-vigorous physical activity (MVPA).

STUDY DESIGN

Pilot cluster RCT with randomization at the school level and N=54 participants.

SETTING/PARTICIPANTS

Fourth-fifth graders from four public schools serving low-income families in Seattle, WA in 2014 with analyses in 2015-2016. All participants were provided and fitted with bicycles, safety equipment (helmets, locks, and lights), and a 2- to 3-hour bicycle safety course.

INTERVENTION

The intervention was a bicycle train offered daily (i.e., students volunteered to cycle with study staff to and from school).

MAIN OUTCOME MEASURES

Time 1 assessments occurred prior to randomization. Time 2 assessments occurred after 3-5 weeks of the intervention (i.e., during Weeks 4-6 of the intervention period). The primary outcome was the percentage of daily commutes to school by cycling measured by validated survey. MVPA, measured by accelerometry and GPS units and processed by machine learning algorithms, was a secondary outcome.

RESULTS

For two separate adjusted repeated measures linear mixed effects models in which students (N=54) were nested within schools (N=4), intervention participants had: (1) an absolute increase in mean percentage of daily commutes by cycling of 44.9%, (95% CI=26.8, 63.0) and (2) an increase in mean MVPA of 21.6 minutes/day, (95% CI=8.7, 34.6) from Time 1 to Time 2 compared with controls.

CONCLUSIONS

A pilot bicycle train intervention increased cycling to school and daily MVPA in the short term among diverse, inner-city elementary school students. The bicycle train intervention appears promising and warrants further experimental trials among large, diverse samples with longer follow-up.

TRIAL REGISTRATION

This study is registered at www.clinicaltrials.gov NCT02006186.

Does parental support influence children's active school travel?

Today's 'backseat generation' of children is more often driven to school. Active school travel (AST) can contribute up to 30% of recommended daily physical activity. Although governed by a complex set of factors, parents are considered 'gatekeepers' of children's travel mode decisions. Therefore, we investigate the relationship between parental support and children's AST. Data were from Active Streets, Active People-Junior (British Columbia, Canada). Children self-reported travel mode to/from school for 1 week (10 trips). We assessed parental perceived neighborhood traffic and crime safety (Neighborhood Environmental Walkability Scale-Youth) and frequency of parental support for AST (0-5 ×/week). We investigated the association between daily AST behaviour and parental support using logistic regression (controlling for age, sex, distance to school and perceived neighborhood safety). In our sample (n = 179, 11.0 ± 1.0 years, 59% girls), 57% reported daily AST and 63% of parents provided daily support. Bivariate analyses showed AST behaviour was significantly associated with parental support frequency and parents' perceived safety. In adjusted analysis, daily parental support remained significantly associated with daily AST (OR 9.0, 95% CI 4.2, 19.7). The relationship between parental support and AST was independent of noted correlates of AST. Thus, interventions that focus solely on changes to the built environment may not be enough to encourage AST. Therefore, interventions that aim to increase AST should involve parents and children in the planning process.

Increasing Children's Physical Activity During the School Day

Insufficient levels of daily physical activity (PA) among children in the USA and worldwide have profound implications for pediatric obesity and children's health and well-being more generally. Public health recommendations highlight the central role that schools play in providing equitable opportunities for PA for all children. This review identifies evidence-based approaches for increasing children's PA throughout the school day and discusses multilevel factors that support implementation of such approaches. Opportunities to increase school-day PA span not only in-school time (e.g., quality recess and physical education, classroom activity breaks) but also time before school (e.g., active commuting initiatives) and after school (e.g., intramural and interscholastic sports programs). For such approaches to impact children's PA, dimensions of implementation such as adoption, fidelity, penetration, implementation costs, and sustainability are critical. Multilevel factors that influence implementation include policies, school environment and organizational factors, teacher and classroom factors, child and family characteristics, and attributes of the PA approach itself. Research and field observations reinforce the importance of understanding challenges specific to working with schools, including multiple stakeholders, competing priorities, limited facilities and staff capacity, and heterogeneity of students. Thus, while schools hold promise as promoters and equalizers of PA engagement for all children, more research is needed on the levers that influence implementation of effective school-based PA policies and programs.