Physical activity cost of the school run: impact on schoolchildren of being driven to school (EarlyBird 22)

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.

Enhancing cardiometabolic health through physical activity and breakfast manipulations in children and adolescents: good for humans, good for the planet

The human health benefits of cardiometabolic disease prevention can be accompanied by planetary co-benefits. Focusing efforts towards young people, including children and adolescents, is conducive to disease prevention. In the context of cardiometabolic disease prevention, this review paper critically summarises the available literature on the acute cardiometabolic responses to physical activity and breakfast manipulations among young people. Given the seriousness of global climate change, which will disproportionally affect our younger generations, this review paper offers new insights into the inherent interactions between child-adolescent behaviour and cardiometabolic health from an environmental sustainability perspective to aid climate change mitigation efforts, including exploring future research avenues. A growing evidence base suggests acute moderate- to high-intensity exercise bouts can attenuate postprandial plasma glucose, insulin and triacylglycerol concentrations for up to 24-48 h in young people. Whether accumulating physical activity throughout the day with short, frequent bouts promotes cardiometabolic risk marker attenuations is unclear. Breakfast consumption may enhance free-living physical activity and reduce glycaemic responses to subsequent meals for a possible additive impact. If repeated habitually, attenuations in these cardiometabolic risk factors would be conducive to disease prevention, reducing the greenhouse gas emissions associated with disease diagnosis and treatment. To progress current understanding with high public health and planetary relevance, research among samples of 'at risk' young people that span cellular-level responses to ecologically valid settings and address human and planetary health co-benefits is needed. Indeed, certain physical activity opportunities, such as active travel to school, offer important direct co-benefits to humans and planetary health.

The Contribution of Walking to School in Students' Physical Activity and Its Effect on Being Overweight

Results

The findings of this research showed that being overweight is a concerning issue even in a small-sized and lightly populated city such as Bandar-Turkmen, Iran. Most students (90%) did not perform the required minimum daily activity when commuting to school. Further, overweight could be found even among those students who walked more than one hour to commute to school. The contribution of walking to school to the MVPA of overweight students was found to be low on school days and throughout the year. Counterintuitively, the situation is even worse for nonoverweight students.

Conclusion

The population of overweight students was more active compared to nonoverweight students in general, although they still suffered from excess weight since walking distances were short and not all days were school days. Thus, encouraging students to walk to school is necessary, while it is not sufficient alone as a single measure. Moreover, we recommend that all students should perform extra PA at home, school, or other places, on both school days and all other days of the year.

Individual, parental and built environmental features as influencing factors of active travel to school in northeast China: findings from a cross-sectional study

OBJECTIVES

Active travel to school (ATS)-associated factors had been studied in some developed countries but rarely in China. We studied the associated factors of ATS at individual, parental and built environment domains in northeast China.

DESIGN AND PARTICIPANTS

A cross-sectional survey was conducted among 4-6 grade students in 2017. Sociodemographic features and information of parents were collected using questionnaires, and SuperMap (a geographical information system software) was used to catch built environment features. Logistic regression models were used to examine the relationship between multilevel factors and ATS.

RESULTS

Our study sample comprised 3670 primary school students aged from 8 to 15 (boys=51.0%, ATS=48.8%). Perceived to be fat (OR 1.25, 95% CI 1.00 to 1.55, p<0.05), feeling easy to walk for a short distance (OR 1.63, 95% CI 1.21 to 2.20, p<0.05), mother unemployed (OR 1.52, 95% CI 1.13 to 2.06, p<0.05), higher land use mix (OR 1.23, 95% CI 1.11 to 1.37, p<0.001) and higher density of public transport stations (OR 1.22, 95% CI 1.09 to 1.37, p<0.05) were positively associated with increased possibility of ATS, while higher household annual income (OR 0.60, 95% CI 0.44 to 0.83, p<0.05) and possession of private vehicles (OR 0.56, 95% CI 0.45 to 0.69, p<0.001) were negatively associated with possibility of ATS.

CONCLUSIONS

The significant factors associated with ATS were at every examined level, which implies multilevel interventions are needed to encourage ATS. Further interventions could focus on the children's willingness to lead students to opt for healthy behaviours, and children from wealthier families should be encouraged to choose ATS. Also, the government should improve built environment walkability so as to encourage ATS.

Associations of mode and distance of commuting to school with cardiorespiratory fitness in Slovenian schoolchildren: a nationwide cross-sectional study

Background

It is unclear whether active commuting has the potential to improve children’s health. This study examined the association of commuting mode and distance with children’s cardiorespiratory fitness (CRF).

Methods

We conducted a cross-sectional study, including 713 Slovenian schoolchildren aged 12 to 15 years. Commuting modes were self-reported, and four commuting groups were constructed, while CRF was determined with a 20-m shuttle run test. The distance from home to school was calculated using the Geographic Information System. Effects of commuting mode and distance, controlling for age, gender and amount of total physical activity, were evaluated using general two linear models (one for each direction of commuting to/from school).

Results

The main effect of commuting group on CRF and its interaction with distance were significant in the direction from school to home (P = 0.013 and P = 0.028, respectively), but not in the opposite direction. Predicted differences in CRF between commuting groups were moderate and generally higher in males than in females. When comparing commuting group median distance from home to school, males driven by car had around 4 ml/min/kg lower predicted CRF than those who walked (P = 0.01) or used wheels commuting (e.g., bicycle, skateboard).

Conclusions

The distance of commuting had a small effect on CRF, except in the Car group where children who live close to school had significantly lower CRF than those living further away. Children driven by car who live within wheels or walk distance from school should be targeted by interventions promoting active transport.

Active travel to non-school destinations but not to school is associated with higher physical activity levels in an ethnically diverse sample of inner-city schoolchildren

Background

This study investigated the association of travel mode to school and non-school destinations with objectively assessed health markers and physical activity in an ethnically diverse sample of inner-city UK schoolchildren.

Methods

We used data from the Camden Active Spaces project (n = 450 children aged 9.1 yrs) to examine associations of school travel mode and frequency of active travel to non-school destinations with daily and out-of-school physical activity, sedentary time and health markers; whilst controlling for appropriate covariates including objectively measured route length.

Results

High frequency of active travel to non-school destinations was associated with more time in moderate-to-vigorous physical activity during out-of-school periods (3.8, 0.8–6.9 min/d) and greater out-of-school (738, 197.4–1278.6 steps/d) and daily step counts (588.1, 51.6–1124.6 steps/d). No associations were observed between school travel mode, health outcomes and activity levels.

Conclusion

High frequency of active travel to non-school destinations is associated with higher levels of physical activity. These findings highlight the contribution of travel to non-school destinations to overall physical activity levels in schoolchildren.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3920-1) contains supplementary material, which is available to authorized users.

Associations among Individual, Social, and Environmental Barriers and Children's Walking or Cycling to School

Purpose.

To examine associations among individual, social, and environmental barriers and children's walking or cycling to school.

Design.

Exploratory cross-sectional study.

Setting.

All eight capital cities in Australia.

Subjects.

Parents (N = 720) of school-aged children (4–13 years; 27% response rate; 49% parents of boys).

Measures.

Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for parental reporting of barriers to their children's walking or cycling to school, based on a computer-assisted telephone interview.

Results.

Forty-one percent of children walked or cycled to school at least once per week. Multivariable analyses found inverse associations with individual (“child prefers to be driven” [OR = 0.4, 95% CI = 0.3–0.6], “no time in the mornings” [OR = 0.5, 95% CI = 0.3–0.8]); social (“worry child will take risks” [OR = 0.6, 95% CI = 0.3–0.9], “no other children to walk with” [OR = 0.7, 95% CI = 0.4–0.99], “no adults to walk with” [OR = 0.6, 95% CI = 0.4–0.9]); and environmental barriers (“too far to walk” [OR = 0.1, 95% CI = 0.0–0.1], “no direct route” [OR = 0.4, 95% CI = 0.2–0.7]) and positive associations with “concern child may be injured in a road accident” (OR = 1.9, 95% CI = 1.1–3.1) and active commuting.

Conclusion.

Working with parents, schools, and local authorities to improve pedestrian skills and environments may help to overcome barriers.

Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia-A multi-centre study

Background

We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes.

Methods

This analysis on rural South Asian children aged 5–14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores).

Results

The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2.4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education (OR = 2.1; 95 % CI: 1.1, 4.1). In multivariate analyses, sedentary activity ≤ 2 h/day was associated with lower BMI-z-scores (β = −0.3; 95 % CI: −0.5, −0.08) and lower waist-z-scores (β = −1.1; 95 % CI: −2.2, −0.07).

Conclusion

Only one quarter of children in these rural areas achieved RPAL in active travel, leisure and sedentary activity. Improved understanding of RPAL in rural South Asian children is important due to rapid socio-economic transition.

Correlates of sedentary behaviour in 8- to 10-year-old children at elevated risk for obesity

The purpose of this study was to describe correlates of sedentary behaviour (SED) in children at elevated risk of obesity because of parental obesity. Participants were 534 children aged 8-10 years with ≥ 1 obese parent. SED and physical activity (PA) were measured by accelerometer, screen time by self-report, and height, weight, waist circumference, and cardiovascular fitness objectively measured. Data describing the child, parents, friends, and home and neighbourhood environments were from child self-report. Higher total SED time was significantly positively associated with child's age, mother's age, Tanner stage, weight status or waist circumference, less self-reported PA, choosing screen time over PA/sport, mother saying PA/sport good for them, and fewer weekly physical education (PE) classes. Exceeding 2 h/day screen time was significantly associated with child's age, male sex, weight status or waist circumference, choosing screen time over PA/sport, and dinnertime TV viewing. Children regularly watching TV with dinner had 2.3 times greater odds (95% confidence interval (CI) 1.52, 3.58) of exceeding screen time guidelines compared with children rarely watching TV with dinner; children reporting ≤ 2 PE classes/week had 2.4 times greater odds (95% CI 1.41, 4.10) of being in the highest SED tertile compared with children reporting >2 PE classes/week. Hence, the most sedentary children are older, more biologically mature, less active, more overweight/obese, have fewer PE classes, and are more likely to choose screen time over PA and watch TV with dinner compared with less sedentary children. PE opportunities and mealtime TV viewing are potentially modifiable targets for reducing total SED and screen time in children.

Effect of a School Choice Policy Change on Active Commuting to Elementary School

Purpose.

The purposes of this study were to assess the effect of restricting school choice on changes in travel distance to school and transportation mode for elementary school students.

Design.

Study design was pre-post (spring 2010–fall 2010) quasi-experimental.

Setting.

Study setting was all public elementary schools in Minneapolis, Minnesota.

Subjects.

Subjects comprised approximately 20,500 students across 39 schools.

Intervention.

Study assessed a school choice policy change that restricted school choice to a school closer to the family's home.

Measures.

School district transportation data were used to determine distance to school. Direct observations of student travel modes (two morning and two afternoon commutes at each time point) were used to assess transportation mode.

Analysis.

Chi-square and independent-sample t-tests were calculated to describe the schools. Repeated measures general linear models were used to assess changes in travel distance to school and observed commuting behavior.

Results.

Distance to school significantly decreased (1.83 ± .48 miles to 1.74 ± .46 miles; p = .002). We failed to observe any significant changes in morning (+.7%) or afternoon (–.7%) active commuting (both p = .08) or the number of automobiles in the morning (–7 autos per school; p = .06) or afternoon (+3 autos per school; p = .14).

Conclusion.

The more restrictive school choice policy decreased distance to school but had no significant effect on active commuting. Policy interventions designed to increase active commuting to school may require additional time to gain traction and programmatic support to induce changes in behavior.

A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling) and physical activity (92 studies) or sedentary behaviors (19 studies). Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14), including organic food, locally-sourced food and plate waste) and other health behaviors ((n = 20) smoking, dietary intake, alcohol). These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

Compensation of physical activity and sedentary time in primary school children

Purpose

There is considerable debate about the possibility of physical activity compensation. This study examined whether increased levels in physical activity and/or sedentary behavior on 1 d were predictive of lower levels in these behaviors on the following day (compensatory mechanisms) among children.

Methods

Two hundred and forty-eight children (121 boys and 127 girls) age 8–11 yr from nine primary schools in Melbourne, Australia, wore a GT3X+ ActiGraph for seven consecutive days. Time spent in light physical activity (LPA) and moderate- to vigorous-intensity physical activity (MVPA) was derived using age-specific cut points. Sedentary time was defined as 100 counts per minute. Meteorological data (temperature, precipitation, relative humidity, and daylight hours) were obtained daily and matched to accelerometer wear days. Multilevel analyses (day, child, and school) were conducted using generalized linear latent and mixed models.

Results

On any given day, every additional 10 min spent in MVPA was associated with approximately 25 min less LPA and 5 min less MVPA the following day. Similarly, additional time spent in LPA on any given day was associated with less time in LPA and MVPA the next day. Time spent sedentary was associated with less sedentary time the following day. Adjusting for meteorological variables did not change observed compensation effects. No significant moderating effect of sex was observed.

Conclusion

The results are consistent with the compensation hypothesis, whereby children appear to compensate their physical activity or sedentary time between days. Additional adjustment for meteorological variables did not change the observed associations. Further research is needed to examine what factors may explain apparent compensatory changes in children’s physical activity and sedentary time.

On the buses: a mixed-method evaluation of the impact of free bus travel for young people on the public health

Background

In September 2005 London introduced a policy granting young people aged < 17 years access to free bus and tram travel. A year later this policy was extended to people aged < 18 years in education, work or training. This intervention was part of a broader environmental strategy in London to reduce private car use, but its primary aim was to decrease ‘transport exclusion’, and ensure that access to goods, services, education and training opportunities were not denied to some young people because of transport poverty. However, there were also likely to be positive and negative health implications, which were difficult to assess in the absence of a robust evidence base on the impact of transport policies on health and well-being.

Objectives

To evaluate the impact of free bus travel for young people in London on the public health. Specifically, to provide empirical evidence for the impact of this ‘natural experiment’ on health outcomes and behaviours (e.g. injuries, active travel) for young people; explore the effects on the determinants of health; identify the effects on older citizens of increased access to bus travel for young people and to identify whether or not the intervention represented value for money.

Design

Quasi-experimental design, using secondary analysis of routine data, primary qualitative data and literature reviews.

Setting

London, UK.

Participants

Young people aged 12–17 years and older citizens aged ≥ 60 years.

Intervention

The introduction of free bus travel for those aged < 17 years living in London in 2005, extended to those aged < 18 years in 2006.

Main outcome measures

Quantitative: number of journeys to school or work; frequency and distance of active travel (i.e. walking and/or cycling), bus travel, car travel; incidence of road traffic injuries and assaults and socioeconomic gradients in travel patterns. Qualitative: how free bus travel affected young people and older citizens’ travel and well-being.

Methods

Quantitative component: change-on-change analysis comparing pre–post change in the target age group (12–17 years) against that seen in ‘non-exposed’ groups [for travel mode, road traffic injury (RTI) and assaults]. Qualitative component: interviews analysed using both deductive and inductive methods. Economic evaluation: cost–benefit analysis (CBA).

Data sources

London Area Transport Survey (LATS) and London Travel Demand Survey (LTDS) (travel mode); STATS19 Road Accident data set (RTI); Hospital Episode Statistics (HES) (assaults); interviews with young people and older citizens; and cost data from providers and literature reviews.

Results

The introduction of free bus travel for young people was associated with higher use of bus travel by adults and young people [31% increase, 95% confidence interval (CI) 19% to 42%; and 26% increase, 95% CI 13% to 41%, respectively], especially for short journeys, and lower car distances relative to adults (relative change 0.73, 95% CI 0.55 to 0.94); no significant overall reduction in ‘active travel’ [reduction in number of walking trips but no evidence of change in distance walked (relative change 0.99, 95% CI 0.92 to 1.07)]; significant reduction in cycling relative to adults (but from a very low base); a reduction in road traffic injuries for car occupants (relative change 0.89, 95% CI 0.84 to 0.95) and cyclists (relative change 0.60, 95% CI 0.55 to 0.66), but not pedestrians; an overall modest increase in journeys to work or school (relative change 1.09, 95% CI 1.06 to 1.14); equivocal evidence of impact on socioeconomic gradients in travel behaviour and no evidence of adverse impact on travel of older people aged > 60 years. An increase in assaults largely preceded the scheme. Qualitative data suggested that the scheme increased opportunities for independent travel, social inclusion, and a sense of belonging and that it ‘normalised’ bus travel. The monetised benefits of the scheme substantially outweighed the costs, providing what the Department for Transport (DfT) considers ‘high’ value for money.

Conclusion

The free bus travel scheme for young people appears to have encouraged their greater use of bus transport for short trips without significant impact on their overall active travel. There was qualitative evidence for benefits on social determinants of health, such as normalisation of bus travel, greater social inclusion and opportunities for independent travel. In the context of a good bus service, universal free bus travel for young people appears to be a cost-effective contributor to social inclusion and, potentially, to increasing sustainable transport in the long term. Further research is needed on the effects of both active and other travel modes on the determinants of health; the factors that influence maintenance of travel mode change; travel as ‘social practice’; the impact of driving license changes on injury rates for young adults and the value of a statistical life for young people.

Funding

The National Institute for Health Research Public Health Research programme.

The physical activity profile of active children in England

BACKGROUND

In line with WHO guidelines, the UK government currently recommends that school-aged children participate in at least 60 minutes, and up to several hours, of at least moderate physical activity on a daily basis. A recent health survey indicates that the amount of reported physical activity varies by age, gender and socioeconomic status. The objective of this study is to identify what types of activity contribute most towards overall physical activity in children who achieve the UK physical activity recommendations; and how this varies according to age, gender and socioeconomic status.

METHODS

Self-reported physical activity was captured through the Health Survey for England 2008, a nationally representative, cross-sectional survey. We analysed data from 1,110 children aged 5-15 years who reported meeting the UK physical activity recommendations. The proportions of total physical activity achieved in various domains of activity were calculated and associations with age, gender and socioeconomic status were examined.

RESULTS

Active play was the largest contributor to overall physical activity (boys = 48%, girls = 53%), followed by walking (boys = 17%, girls = 23%). Active school travel contributed only a small proportion (6% for boys and girls). With increasing age, the contribution from active play decreased (rho = -0.417; p < 0.001) and the contribution of walking (rho = 0.257; p < 0.001) and formal sport (rho = 0.219; p < 0.001) increased. At all ages, sport contributed more among boys than girls. Sport contributed proportionately less with increasing deprivation (rho = -0.191; p < 0.001).

CONCLUSIONS

The contributors to overall physical activity among active children varies with age, socioeconomic status and gender. This knowledge can be used to target interventions appropriately to increase physical activity in children at a population level.

A favorable built environment is associated with better physical fitness in European adolescents

OBJECTIVE

To assess the association between the built environment and physical fitness and physical activity in adolescents.

METHODS

The study included 3528 adolescents, aged 12.5-17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The health-related physical fitness components were assessed using the physical fitness tests. Participants wore a uniaxial accelerometer (ActiGraph®) for 7 days to measure physical activity. A specific questionnaire addressing the built environment was used. Potential confounding factors including age, gender, body mass index, body composition, pubertal status, smoking, educational level of parents, and socioeconomic status were analyzed using backward stepwise linear regression analysis.

RESULTS

Heavy traffic in the neighborhood was the strongest factor negatively associated with both physical fitness and physical activity (both P<0.05). Conversely, a secure bicycling or walking route from home to school was positively associated with various components of physical fitness and physical activity (P<0.01). Outdoor fields and gymnasiums near home were also associated with better physical fitness (P<0.01), but not with physical activity.

CONCLUSIONS

A favorable built environment may contribute to health-related physical fitness and physical activity of adolescents and should be considered in future interventions and health promotion strategies.

Free-living physical activity and energy expenditure of rural children and adolescents in the Nandi region of Kenya

PURPOSE

To examine the relationship between physical activity and energy demands in children and adolescents with highly active lifestyles.

METHODS

Physical activity patterns of 30 rural Kenyan children and adolescents (14 ± 1 years, mean ± SD) with median body mass index (BMI) z-score = -1.06 [-3.29-0.67] median [range] were assessed by accelerometry over 1 week. Daily energy expenditure (DEE), activity-induced energy expenditure (AEE) and physical activity level (PAL) were simultaneously determined using doubly-labelled water (DLW). Active commuting to school was assessed by global positioning system.

RESULTS

Mean DEE, AEE and PAL were 12.2 ± 3.4, 5.7 ± 3.0 MJ/day and 2.3 ± 0.6, respectively. A model combining body mass, average accelerometer counts per minute and time in light activities predicted 45% of the variance in DEE (p < 0.05) with a standard error of DEE estimate of 2.7 MJ/day. Furthermore, AEE accounted for ∼47% of DEE. Distance to school was not related to variation in DEE, AEE or PAL and there was no association between active commuting and adiposity.

CONCLUSION

High physical activity levels were associated with much higher levels of energy expenditure than observed in Western societies. These results oppose the concept of physical activity being stable and constrained in humans.

What are the health benefits of active travel? A systematic review of trials and cohort studies

Background

Increasing active travel (primarily walking and cycling) has been widely advocated for reducing obesity levels and achieving other population health benefits. However, the strength of evidence underpinning this strategy is unclear. This study aimed to assess the evidence that active travel has significant health benefits.

Methods

The study design was a systematic review of (i) non-randomised and randomised controlled trials, and (ii) prospective observational studies examining either (a) the effects of interventions to promote active travel or (b) the association between active travel and health outcomes. Reports of studies were identified by searching 11 electronic databases, websites, reference lists and papers identified by experts in the field. Prospective observational and intervention studies measuring any health outcome of active travel in the general population were included. Studies of patient groups were excluded.

Results

Twenty-four studies from 12 countries were included, of which six were studies conducted with children. Five studies evaluated active travel interventions. Nineteen were prospective cohort studies which did not evaluate the impact of a specific intervention. No studies were identified with obesity as an outcome in adults; one of five prospective cohort studies in children found an association between obesity and active travel. Small positive effects on other health outcomes were found in five intervention studies, but these were all at risk of selection bias. Modest benefits for other health outcomes were identified in five prospective studies. There is suggestive evidence that active travel may have a positive effect on diabetes prevention, which may be an important area for future research.

Conclusions

Active travel may have positive effects on health outcomes, but there is little robust evidence to date of the effectiveness of active transport interventions for reducing obesity. Future evaluations of such interventions should include an assessment of their impacts on obesity and other health outcomes.

School-day and overall physical activity among youth

BACKGROUND

Increasing school-day physical activity through policy and programs is commonly suggested to prevent obesity and improve overall child health. However, strategies that focus on school-day physical activity may not increase total physical activity if youth compensate by reducing physical activity outside of school.

PURPOSE

Objectively measured, nationally representative physical activity data were used to test the hypothesis that higher school-day physical activity is associated with higher overall daily physical activity in youth.

METHODS

Accelerometer data from 2003-2004/2005-2006 National Health and Nutrition Examination Surveys were analyzed in 2012 to estimate physical activity levels during the school day (8AM-3PM) among youth aged 6-19 years (n=2548). Fixed-effects regressions were used to estimate the impact of changes in school-day minutes of moderate-to-vigorous physical activity (MVPA) on changes in total daily MVPA.

RESULTS

Each additional minute of school-day MVPA was associated with an additional 1.14 minutes (95% CI=1.04, 1.24; p<0.001) of total daily MVPA, or 0.14 additional minutes (95% CI=0.04, 0.24; p=0.008) outside the school day, controlling for total daily accelerometer wear time and age, gender, race/ethnicity, and other non-time varying covariates. There were no differences in the effect of school-day MVPA on total MVPA by age group, gender, race/ethnicity, poverty status, or degree of change in MVPA.

CONCLUSIONS

Higher school-day MVPA was associated with higher daily MVPA among U.S. youth with no evidence for same-day "compensation." Increasing school-based physical activity is a promising approach that can improve total daily physical activity levels of youth.

Factors influencing whether children walk to school

Few studies have simultaneously evaluated multiple levels of influence on whether children walk to school. A large cohort of 4338 subjects from 10 communities was used to identify the determinants of walking through (1) a one-level logistic regression model for individual-level variables and (2) a two-level mixed regression model for individual and school-level variables. Walking rates were positively associated with home-to-school proximity, greater age, and living in neighborhoods characterized by lower traffic density. Greater land use mix around the home was, however, associated with lower rates of walking. Rates of walking to school were also higher amongst recipients of the Free and Reduced Price Meals Program and attendees of schools with higher percentage of English language learners. Designing schools in the same neighborhood as residential districts should be an essential urban planning strategy to reduce walking distance to school. Policy interventions are needed to encourage children from higher socioeconomic status families to participate in active travel to school and to develop walking infrastructures and other measures that protect disadvantaged children.

Associations of children's independent mobility and active travel with physical activity, sedentary behaviour and weight status: a systematic review

Health benefits from children's independent mobility and active travel beyond school travel are largely unexplored.

OBJECTIVES

This review synthesized the evidence for associations of independent mobility and active travel to various destinations with physical activity, sedentary behaviour and weight status.

DESIGN

Systematic review.

METHODS

A systematic search in six databases (PubMed, Scopus, CINAHL, SportDiscus, PsychInfo, TRIS) for papers published between January 1990 and March 2012 was undertaken, focussing on children aged 3-18 years. Study inclusion and methodological quality were independently assessed by two reviewers.

RESULTS

52 studies were included. Most studies focussed solely on active travel to and/or from school, and showed significant positive associations with physical activity. The same relationship was detected for active travel to leisure-related places and independent mobility with physical activity. An inverse relationship between active travel to school and weight status was evident but findings were inconsistent. Few studies examined correlations between active travel to school and self-reported screen-time or objectively measured sedentary behaviour, and findings were unclear.

CONCLUSIONS

Studies on independent mobility suggested that children who have the freedom to play outdoors and travel actively without adult supervision accumulate more physical activity than those who do not. Further investigation of children's active travel to leisure-related destinations, measurement of diverse sedentary behaviour beyond simply screen-based activities, and consistent thresholds for objectively measured sedentary behaviour in children will clarify the inconsistent evidence base on associations of active travel with sedentary behaviour and weight status.

Physical activity, energy intake, and obesity prevalence among urban and rural schoolchildren aged 11–12 years in Japan

The prevalence of childhood overweight and obesity has been shown to differ among regions, including rural–urban regional differences within nations. This study obtained simultaneous accelerometry-derived physical activity, 24 h activity, and food records to clarify the potential contributing factors to rural–urban differences in childhood overweight and obesity in Japan. Sixth-grade children (n = 227, 11–12 years old) from two urban elementary schools in Kyoto and four rural elementary schools in Tohoku participated in the study. The children were instructed to wear a pedometer that included a uniaxial accelerometer and, assisted by their parents, keep minute-by-minute 24 h activity and food records. For 12 children, the total energy expenditure was measured by the doubly labeled water method that was used to correct the Lifecorder-predicted activity energy expenditure and physical activity level. The overweight and obesity prevalence was significantly higher in rural than in urban children. The number of steps per day, activity energy expenditure, physical activity level, and duration of walking to school were significantly lower in rural than in urban children. In contrast, the reported energy intake did not differ significantly between the regions. The physical activity and duration of the walk to school were significantly correlated with body mass index. Rural children had a higher prevalence of overweight and obesity, and this may be at least partly caused by lower physical activity, especially less time spent walking to school, than urban children.

The impact of state safe routes to school-related laws on active travel to school policies and practices in U.S. elementary schools

This study examined the relationship between state laws requiring minimum bussing distances, hazardous route exemptions, sidewalks, crossing guards, speed zones, and traffic control measures around schools and active travel to school (ATS) policies/practices in nationally representative samples of U.S. public elementary schools between 2007-2009. The state laws and school data were compiled through primary legal research and annual mail-back surveys of principals, respectively. Multivariate logistic and zero-inflated poisson regression indicated that all state law categories (except for sidewalks) relate to ATS. These laws should be considered in addition to formal safe routes to school programs as possible influences on ATS.

Travel to school and physical activity levels in 9-10 year-old UK children of different ethnic origin; Child Heart and Health Study in England (CHASE)

Background

Travel to school may offer a convenient way to increase physical activity levels in childhood. We examined the association between method of travel to school and physical activity levels in urban multi-ethnic children.

Methods and Findings

2035 children (aged 9–10 years in 2006–7) provided data on their usual method of travel to school and wore an Actigraph-GT1M activity monitor during waking hours. Associations between method of travel and mean level of physical activity (counts per minute [CPM], steps, time spent in light, moderate or vigorous activity per day) were examined in models adjusted for confounding variables. 1393 children (69%) walked or cycled to school; 161 (8%) used public transport and 481 (24%) travelled by car. White European children were more likely to walk/cycle, black African Caribbeans to travel by public transport and South Asian children to travel by car. Children travelling by car spent less time in moderate to vigorous physical activity (−7 mins, 95%CI-9,-5), and had lower CPM (−32 CPM, 95%CI-44,-19) and steps per day (−813 steps, 95%CI,-1043,-582) than walkers/cyclists. Pupils travelling by public transport had similar activity levels to walkers/cyclists. Lower physical activity levels amongst car travellers' were especially marked at travelling times (school days between 8–9 am, 3–5 pm), but were also evident on weekdays at other times and at weekends; they did not differ by gender or ethnic group.

Conclusion

Active travel to school is associated with higher levels of objectively measured physical activity, particularly during periods of travel but also at other times. If children travelling by car were to achieve physical activity levels (steps) similar to children using active travel, they would increase their physical activity levels by 9%. However, the population increase would be a modest 2%, because of the low proportion of car travellers in this urban population.

The Strathclyde Evaluation of Children's Active Travel (SE-CAT): study rationale and methods

Background

The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG) is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children.

Methods/Design

Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years) over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male) aged 8-9 years from 5 primary schools. Two schools (n = 79 children) received TG in September/October 2009. Three schools (n = 87 children) acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up.

Discussion

The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including 5 and 12 month follow-up, have been collected and processed. Data analysis is ongoing. Results will indicate whether TG successfully increases active commuting in a sample of Scottish school children and will inform future efforts in school active travel promotion.

Increasing Children’s Physical Activity

Background. Efforts to increase the prevalence of children’s active school transport require evidence to inform the development of comprehensive interventions. This study used a multilevel ecological framework to investigate individual, social, and environmental factors associated with walking to and from school among elementary school-aged children, stratified by gender. Method. Boys aged 10 to 13 years ( n = 617) and girls aged 9 to 13 years ( n = 681) attending 25 Australian primary schools located in high or low walkable neighborhoods completed a 1-week travel diary and a parent/child questionnaire on travel habits and attitudes. Results. Boys were more likely (odds ratio [OR] = 3.37; p < .05) to walk if their school neighborhood had high connectivity and low traffic and less likely to walk if they had to cross a busy road (OR = 0.49; p < .05). For girls, confidence in their ability to walk to or from school without an adult (OR = 2.03), school encouragement (OR = 2.43), scheduling commitments (OR = 0.41), and parent-perceived convenience of driving (OR = 0.24) were significantly associated ( p < .05) with walking. Irrespective of gender and proximity to school, child-perceived convenience of walking (boys OR = 2.17 and girls OR = 1.84) and preference to walk to school (child perceived, boys OR = 5.57, girls OR = 1.84 and parent perceived, boys OR = 2.82, girls OR = 1.90) were consistently associated ( p < .05) with walking to and from school. Conclusion. Although there are gender differences in factors influencing children walking to and from school, proximity to school, the safety of the route, and family time constraints are consistent correlates. These need to be addressed if more children are to be encouraged to walk to and from school.

Active commuting to school and association with physical activity and adiposity among US youth

BACKGROUND

Walking or bicycling to school (ie, active commuting) has shown promise for improving physical activity and preventing obesity in youth. Our objectives were to examine, among US youth, whether active commuting was inversely associated with adiposity and positively associated with moderate-to-vigorous physical activity (MVPA). We also examined whether MVPA mediated the relationships between active commuting and adiposity.

METHODS

Using data of participants aged 12 to 19 years from the US National Health and Nutrition Examination Survey 2003 to 2004 (n=789 unweighted), we constructed multiple linear regression models that controlled for dietary energy intake and sociodemographics. The main exposure variable was active commuting. The outcomes were BMI z-score, waist circumference, skinfolds and objectively measured MVPA. The product-of-coefficients method was used to test for mediation.

RESULTS

Active commuting was inversely associated with BMI z-score (β=-0.07, P=.046) and skinfolds (β=-0.06, P=.029), and positively associated with overall daily (β=0.12, P=.024) and before- and after-school (β=0.20, P<.001) MVPA. Greater before- and after-school MVPA explained part of the relationship between active commuting and waist circumference (Sobel z=-1.98, P=.048).

CONCLUSIONS

Active commuting was associated with greater MVPA and lower measures of adiposity among US youth. Before- and after-school MVPA mediated the relationships between active commuting and waist circumference.

The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review

BACKGROUND

Active travel to school (ATS) has been identified as an important source of physical activity for youth. However, the relationship between ATS and health-related fitness (HRF) among youth remains unclear.

METHODS

A systematic search of seven electronic databases (EMBASE, OVID MEDLINE, PsycINFO, PubMed, Scopus, SPORTDiscus and TRIS on line) was conducted in December 2009 and studies published since 1980 were considered for inclusion.

RESULTS

Twenty seven articles were identified that explored the relationship between ATS and the following aspects of HRF: weight status/body composition, cardiorespiratory fitness, muscular fitness and flexibility. Forty-eight percent of the studies that examined the relationship between ATS and weight status/body composition reported significant associations, this increased to 55% once poor quality studies were removed. Furthermore, the findings from five studies, including one longitudinal study, indicate that ATS is positively associated with cardiorespiratory fitness in youth. However, the evidence for the relationships between ATS and muscular fitness or flexibility is equivocal and limited by low study numbers.

CONCLUSIONS

There is some evidence to suggest that ATS is associated with a healthier body composition and level of cardiorespiratory fitness among youth. Strategies to increase ATS are warranted and should be included in whole-of-school approaches to the promotion of physical activity.

Descriptive epidemiology of screen and non-screen sedentary time in adolescents: a cross sectional study

Background

Much attention has been paid to adolescents' screen time, however very few studies have examined non-screen sedentary time (NSST). This study aimed to (1) describe the magnitude and composition of screen sedentary time (SST) and NSST in Australian adolescents, (2) describe the socio-demographic correlates of SST and NSST, and (3) determine whether screen time is an adequate surrogate for total sedentary behaviour in this population.

Methods

2200 9-16 year old Australians provided detailed use of time data for four days. Non-screen sedentary time (NSST) included time spent participating in activities expected to elicit <3 METs whilst seated or lying down (other than sleeping), excluding screen-based activities (television, playing videogames or using computers). Total sedentary time was the sum of screen time and NSST.

Results

Adolescents spent a mean (SD) of 345 (105) minutes/day in NSST, which constituted 60% of total sedentary time. School activities contributed 42% of NSST, socialising 19%, self-care (mainly eating) 16%, and passive transport 15%. Screen time and NSST showed opposite patterns in relation to key socio-demographic characteristics, including sex, age, weight status, household income, parental education and day type. Because screen time was negatively correlated with NSST (r = -0.58), and exhibited a moderate correlation (r = 0.53) with total sedentary time, screen time was only a moderately effective surrogate for total sedentary time.

Conclusions

To capture a complete picture of young people's sedentary time, studies should endeavour to measure both screen time and NSST.

Les parents et les déplacements entre la maison et l’école primaire : quelle place pour l’enfant dans la ville?

La forme urbaine et l’organisation du système scolaire ont une influence sur la mobilité des enfants et, en particulier, sur leurs déplacements scolaires. Les habitudes, les perceptions et les choix des parents pèsent tout autant. Le présent article porte sur les relations entre les considérations et les comportements parentaux, d’une part, et les modes de déplacement des enfants lors des déplacements entre la maison et l’école, d’autre part. Il prend appui sur une enquête par questionnaire menée par le Groupe de recherche ville et mobilité auprès de 1495 parents d’élèves du primaire (écoles publiques et privées, francophones et anglophones) de Montréal et de Trois-Rivières entre 2006 et 2008. On observe un lien entre les pratiques de déplacement des écoliers et les perceptions parentales au sujet de la sécurité dans le quartier et de l’importance du transport actif. On observe également un lien entre le mode de transport des parents et celui des enfants lors des trajets scolaires.

The cost-effectiveness of Australia's Active After-School Communities program

The objective of this study was to assess from a societal perspective the cost-effectiveness of the Active After-school Communities (AASC) program, a key plank of the former Australian Government's obesity prevention program. The intervention was modeled for a 1-year time horizon for Australian primary school children as part of the Assessing Cost-Effectiveness in Obesity (ACE-Obesity) project. Disability-adjusted life year (DALY) benefits (based on calculated effects on BMI post-intervention) and cost-offsets (consequent savings from reductions in obesity-related diseases) were tracked until the cohort reached the age of 100 years or death. The reference year was 2001, and a 3% discount rate was applied. Simulation-modeling techniques were used to present a 95% uncertainty interval around the cost-effectiveness ratio. An assessment of second-stage filter criteria ("equity," "strength of evidence," "acceptability to stakeholders," "feasibility of implementation," "sustainability," and "side-effects") was undertaken by a stakeholder Working Group to incorporate additional factors that impact on resource allocation decisions. The estimated number of children new to physical activity after-school and therefore receiving the intervention benefit was 69,300. For 1 year, the intervention cost is Australian dollars (AUD) 40.3 million (95% uncertainty interval AUD 28.6 million; AUD 56.2 million), and resulted in an incremental saving of 450 (250; 770) DALYs. The resultant cost-offsets were AUD 3.7 million, producing a net cost per DALY saved of AUD 82,000 (95% uncertainty interval AUD 40,000; AUD 165,000). Although the program has intuitive appeal, it was not cost-effective under base-case modeling assumptions. To improve its cost-effectiveness credentials as an obesity prevention measure, a reduction in costs needs to be coupled with increases in the number of participating children and the amount of physical activity undertaken.

Encouraging walking for transport and physical activity in children and adolescents: how important is the built environment?

In the post-World War II era, there have been dramatic changes to the environment that appear to be having a detrimental impact on the lifestyles and incidental physical activities of young people. These changes are not trivial and have the potential to influence not only physical health, but also mental health and child development. However, the evidence of the impact of the built environment on physical activity to date is inconsistent. This review examines the evidence on the association between the built environment and walking for transport as well as physical activity generally, with a focus on methodological issues that may explain inconsistencies in the literature to date. It appears that many studies fail to measure behaviour-specific environmental correlates, and insufficient attention is being given to differences according to the age of study participants. Higher levels of out-of-school-hours physical activity and walking appear to be significantly associated with higher levels of urban density and neighbourhoods with mixed-use planning, especially for older children and adolescents. Proximate recreational facilities also appear to predict young people's level of physical activity. However, there are inconsistencies in the literature involving studies with younger children. Independent mobility increases with age. For younger children, the impact of the built environment is influenced by the decision-making of parents as the gatekeepers of their behaviour. Cross-cultural differences may also be present and are worthy of greater exploration. As children develop and are given more independent mobility, it appears that the way neighbourhoods are designed - particularly in terms of proximity and connectivity to local destinations, including schools and shopping centres, and the presence of footpaths - becomes a determinant of whether children are able, and are permitted by their parents, to walk and use destinations locally. If older children and adolescents are to enjoy health and developmental benefits of independent mobility, a key priority must be in reducing exposure to traffic and in increasing surveillance on streets (i.e. 'eyes-on-the-street') through neighbourhood and building design, by encouraging others to walk locally, and by discouraging motor vehicle use in favour of walking and cycling. Parents need to be assured that the rights and safety of pedestrians (and cyclists) - particularly child pedestrians and cyclists - are paramount if we are to turn around our 'child-free streets', now so prevalent in contemporary Australian and US cities. There remains a need for more age- and sex-specific research using behaviour- and context-specific measures, with a view to building a more consistent evidence base to inform future environmental interventions.

Compensation or displacement of physical activity in middle-school girls: the Trial of Activity for Adolescent Girls

The “activitystat” hypothesis suggests that increases in moderate-to-vigorous physical activity (MVPA) are accompanied by a compensatory reduction in light physical activity (LPA) and/or an increase in inactivity in order to maintain a consistent total physical activity level (TPA).

The mode of school transportation in pre-pubertal children does not influence the accrual of bone mineral or the gain in bone size--two year prospective data from the paediatric osteoporosis preventive (POP) study

BACKGROUND

Walking and cycling to school are one source of regular physical activity. The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content (BMC) and bone width than when going by car or bus.

METHODS

133 boys and 99 girls aged 7-9 years were recruited to the Malmö Prospective Paediatric Osteoporosis Prevention (POP) study. BMC (g) was measured by dual X-ray absorptiometry (DXA) in total body, lumbar spine (L2-L4) and femoral neck (FN) at baseline and after 24 months. Bone width was measured in L2-L4 and FN. Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car. All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and questionnaires. Comparisons were made by independent student's t-tests between means and Fisher's exact tests. Analysis of covariance (ANCOVA) was used to adjust for group differences in age at baseline, duration of organized physical activity, annual changes in length and BMC or bone width if there were differences in these traits at baseline.

RESULTS

After the adjustments, there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus. Furthermore, there were no differences in the levels of everyday physical activity objectively measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day.

CONCLUSION

A physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation, possibly due to the fact that the everyday physical activity in these pre-pubertal children, independent of the mode of school transportation, was high.

The increase in physical performance and gain in lean and fat mass occur in prepubertal children independent of mode of school transportation. One year data from the prospective controlled Pediatric Osteoporosis Prevention (POP) Study

Background

Methods

Results

Conclusion

The contribution of active travel to children's physical activity levels: cross-sectional results from the ALSPAC study

OBJECTIVE

To assess the association between active travel to school and physical activity (PA) in a large population-based sample of 11-year old children.

METHOD

Cross-sectional analyses using data from the Avon Longitudinal Study of Parents and Children (Bristol, UK), collected in 2002-2004. The analyses include all children providing valid data on objectively measured PA (Actigraph accelerometer), and having parent-proxy reported data on travel mode (walk, cycle, public transport, car) and distance to school (N=4688).

RESULTS

43.5% of children regularly walked or cycled to school (i.e. on every or most days). Compared with car travelers, walking to school was associated with 5.98 (95%CI: 3.82-8.14) more minutes of moderate-to-vigorous PA (MVPA) on weekdays in those living 0.5-1 miles from school, and with 9.77 (95%CI: 7.47-12.06) more minutes in those living at 1-5 miles. This equates to 24.6 to 40.2% of the average daily minutes of MVPA. Only modest differences were observed in those living <0.5 mile from school.

CONCLUSION

Children who regularly walk to school are more active during the week than those travelling by car, especially if the distance is >0.5 mile. Increasing participation in active travel might be a useful part of an overall strategy to increase population PA.

Active school transport, physical activity levels and body weight of children and youth: a systematic review

OBJECTIVES

Active school transport (AST) may be an important source of children's physical activity (PA). Innovative solutions that increase PA time for children, without putting added pressure on the school curriculum, merit consideration. Before implementing such solutions, it is important to demonstrate that active school transport is associated with health-related outcomes.

METHODS

Following a standardized protocol, we conducted a systematic review of published research to address this question and explore whether children who actively commute to school also have a healthier body weight. Online searches of 5 electronic databases were conducted. Potential studies were screened on the basis of objective measures of physical activity.

RESULTS

Thirteen studies were included in this review. Nine studies demonstrated that children who actively commute to school accumulate significantly more PA and two studies reported that they expended significantly more kilocalories per day. Where studies examined body weight (n=10), only one reported active commuters having a lower body weight.

CONCLUSIONS

These studies demonstrate that active school commuters tend to be more physically active overall than passive commuters. However, evidence for the impact of AST in promoting healthy body weights for children and youth is not compelling.

Active and passive commuting to school: influences on affect in primary school children

Active commuting among school children is being encouraged for physical and environmental reasons, but little is known about its influence on affect. The aim of this study was to test the hypothesis that children who walk further to school experience increased arousal and affective valence compared with children who walk a short distance. This was assessed with the children's feeling scale (CFS) and children's felt arousal scale (CFAS). Distance walked to school and affective change between home and school were assessed over a 2-week period in 99 children between 5 and 10 years of age. Home to school differences in CFS and CFAS scores were compared in children who walked a short (100-300 m); medium (301-500 m), and long distance (over 500 m). Although differences were not always statistically significant, there was evidence that the children who walked further reported a greater increase in their CFAS scores between home and school (average eta2 = .08, range: .01-.15) and, to a lesser extent, in their CFS scores (eta2 = .04, range: .002-.06). Further research is needed to explore whether there is an optimum walking distance and the contribution of other factors, especially social contacts during commuting, the environment, and the weather.

Walking and Bicycling to School: A Review

Walking and bicycling (active commuting) to school has been proposed as a strategy for increasing youth physical activity and decreasing the prevalence of overweight. Citations for this review were retrieved through PubMed, Transport, ERIC, and ISI database searches using relevant keywords (1975 to March 2007), government and organization Web sites, and bibliographic citations. This review presents (1) prevalence estimates for active commuting to school; (2) the correlates of active commuting to school, presented using a new conceptual framework; (3) the associations between active commuting to school and health (ie, physical activity, weight status, environmental); and (4) a summary of the findings and recommendations for further research. Considerable heterogeneity exists among the reviewed studies for sample size and demographics, the methods used to measure active commuting, and the definition used to identify a positive case (active commuter). In general, active commuting to school is much less prevalent in the United States compared with European countries. A wide range of correlates of active commuting to school have been studied (individual to policy level). Active commuters tend to be more active than nonactive commuters, although no difference in weight status was observed in most studies. More research is needed to corroborate these findings and build on the knowledge base so that effective walk-to-school interventions can be implemented independently or as part of other health promotion efforts, including physician counseling for physical activity.

Children's active commuting to school: current knowledge and future directions

INTRODUCTION

Driven largely by international declines in rates of walking and bicycling to school and the noted health benefits of physical activity for children, research on children's active commuting to school has expanded rapidly during the past 5 years. We summarize research on predictors and health consequences of active commuting to school and outline and evaluate programs specific to children's walking and bicycling to school.

METHODS

Literature on children's active commuting to school published before June 2007 was compiled by searching PubMed, PsycINFO, and the National Transportation Library databases; conducting Internet searches on program-based activities; and reviewing relevant transportation journals published during the last 4 years.

RESULTS

Children who walk or bicycle to school have higher daily levels of physical activity and better cardiovascular fitness than do children who do not actively commute to school. A wide range of predictors of children's active commuting behaviors was identified, including demographic factors, individual and family factors, school factors (including the immediate area surrounding schools), and social and physical environmental factors. Safe Routes to School and the Walking School Bus are 2 public health efforts that promote walking and bicycling to school. Although evaluations of these programs are limited, evidence exists that these activities are viewed positively by key stakeholders and have positive effects on children's active commuting to school.

CONCLUSION

Future efforts to promote walking and bicycling to school will be facilitated by building on current research, combining the strengths of scientific rigor with the predesign and postdesign provided by intervention activities, and disseminating results broadly and rapidly.

Critical factors for active transportation to school among low-income and minority students. Evidence from the 2001 National Household Travel Survey

BACKGROUND

Walking to school may be an important source of daily physical activity in children's lives, and government agencies are supporting programs to encourage walking to school (e.g., Safe Routes to School and the CDC's KidsWalk programs). However, little research has looked at differences in behavior across racial/ethnic and income groups.

METHODS

This cross-sectional study used data from the 2001 National Household Travel Survey to document rates of walking and biking to school among low-income and minority youth in the U.S. (N=14,553). Binary models of the decision to use active transport to school were developed to simultaneously adjust for trip, individual, household, and neighborhood correlates. All analyses were conducted in 2007.

RESULTS

The data showed that low-income and minority groups, particularly blacks and Hispanics, use active travel modes to get to school at much higher rates than whites or higher-income students. However, racial variation in travel patterns is removed by controlling for household income, vehicle access, distance between home and school, and residential density.

CONCLUSIONS

Active transportation to school may be an important strategy to increase and maintain physical activity levels for low-income and minority youth. Current policy interventions such as Safe Routes to School have the opportunity to provide benefits for low-income and minority students who are the most likely to walk to school.

Pedometer-determined physical activity and active transport in girls

BACKGROUND

It is well established that the risk of insufficient physical activity is greater in girls than in boys, especially during the adolescent years. The promotion of active transport (AT) to and from school has been posited as a practical and convenient solution for increasing girls' total daily activity. However, there is limited information describing the associations between AT choices and girls' physical activity across a range of age, ethnic, and socioeconomic groups. The objectives of this study were to (1) investigate physical activity patterns in a large multiethnic sample of female children and adolescents, and to (2) estimate the physical activity associated with AT to and from school.

METHODS

A total of 1,513 girls aged 5-16 years wore sealed multiday memory (MDM) pedometers for three weekdays and two weekend days. The ethnic composition of this sample was 637 European (42.1%), 272 Pacific Island (18.0%), 207 East Asian (13.7%), 179 Maori (11.8%), 142 South Asian (9.4%), and 76 from other ethnic groups (5%). Pedometer compliance and school-related AT were assessed by questionnaire.

RESULTS

Mean weekday step counts (12,597 +/- 3,630) were higher and less variable than mean weekend steps (9,528 +/- 4,407). A consistent decline in daily step counts was observed with age: after adjustment for ethnicity and SES, girls in school years 9-10 achieved 2,469 (weekday) and 4,011 (weekend) fewer steps than girls in years 1-2. Daily step counts also varied by ethnicity, with Maori girls the most active and South Asian girls the least active. Overall, 44.9% of participants used AT for school-related travel. Girls who used AT to and from school averaged 1,052 more weekday steps than those who did not use AT. However, the increases in steps associated with AT were significant only in older girls (school years 5-10) and in those of Maori or European descent.

CONCLUSION

Our data suggest that adolescent-aged girls and girls of Asian descent are priority groups for future physical activity interventions. While the apparent benefits of school-related AT vary among demographic groups, promoting AT in girls appears to be a worthwhile strategy.

Validity and reliability of a school travel survey

BACKGROUND

Despite the growing interest in active (ie, nonmotorized) travel to and from school, few studies have explored the measurement properties to assess active travel. We evaluated the criterion validity and test-retest reliability of a questionnaire with a sample of young schoolchildren to assess travel to and from school, including mode, travel companion, and destination after school.

METHODS

To assess test-retest reliability, 54 children age 8 to 11 years completed a travel survey on 2 consecutive school days. To assess criterion validity, 28 children age 8 to 10 years and their parents completed a travel survey on 5 consecutive weekdays.

RESULTS

Test-retest reliability of all questions indicated substantial agreement. The questions on mode of transport, where you will go after school, and how you will get there also displayed substantial agreement between parental and child reports.

CONCLUSIONS

For this population, a questionnaire completed by school-age children to assess travel to and from school, including mode, travel companion, and destination after school, was reliably collected and indicated validity for most items when compared with parental reports.

Trends in Australian children traveling to school 1971-2003: burning petrol or carbohydrates?

OBJECTIVE

To determine how Australian children traveled to and from school between 1971 and 2003.

METHODS

The 1971 (n=4284), 1981 (n=4936), 1991 (n=662) and 1999-2003 (n=816) Household Travel Surveys from the New South Wales Government Department of Planning were used to determine the mode of transport kids (5-14 years) took to and from school in the area of Sydney (Australia).

RESULTS

The results showed that the percentage of children aged 5-9 that walked to school was 57.7, 44.5, 35.3 and 25.5 in 1971, 1981, 1991 and 1999-2003, respectively. The percentage of children aged 5-9 that were driven to school by car in the four surveys was 22.8, 37.3, 53.9 and 66.6, respectively. The results for children aged 10-14 were similar, walking decreased from 44.2% to 21.1% and car use increased from 12.2% to 47.8% over the study period. Similar results were found for travel from school and there were no major differences between boys and girls.

CONCLUSION

Between 1971 and 2003, Australian children's mode of travel to and from school has markedly shifted from active (walking) to inactive (car) modes.