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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Active 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.

Perceived Safety Influencing Active Travel to School-A Built Environment Perspective

Despite the many research studies on active school travel (AST), the number of children walking/cycling to school is decreasing as there is a lack of implementable research evidence. This review through database searches from 2000 to 2020 aims to identify research gaps and explore new perspectives. The articles are selected and screened methodically for systematic presentation of the review. An existing active school travel framework is used to structure and discuss this review paper on mediating factors influencing children's active travel to school, that is the perceived traffic safety, neighborhood safety, and distance to school. Perception of traffic safety could be ameliorated through lateral separation from the traffic, and this could be a new area of research. The neighborhood safety perception may require more research to validate the previous findings. Schools should be located within high-density residential development so that many children can walk to school.

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.

Influence of the Built Environment on Physical Activity Choices among Emirati Male and Female Adolescents: An Examination of Parents’ and Students’ Perceptions

The UN Human Development Report 2020 ranked the United Arab Emirates (UAE) as having achieved ‘very high human development’ and as being at the 31st position among all countries. Despite this, the ever increasing obesity rates among Emirati youth, higher than international standards, is alarming. This research aims at identifying how different perceptions of the built environment by parents and adolescents are likely to affect physical activity (PA) choices among male and female Emirati youth. This can help inform better health and education policies to achieve three of the interconnected UN Sustainable Development Goals (SDGs), namely good quality health and well-being, quality education, and gender equality, that the UAE strives to achieve. Responses from 335 students (aged 14–20) from six schools and 250 parent responses in the Al Ain region of Abu Dhabi Emirate were used to understand the mean variation in perception of five built environment constructs. Further, multinomial logit regression was used to assess the health condition using the perception, behavior, and built environment measures. Results indicate that Emirati males perceive the built environment factors as barriers more than female adolescents. Parents perceive street crossing (p < 0.016) and sidewalk characteristics (p < 0.020) to be more of a hindrance. Traffic exposure, self-reported physical activity, and walkability near homes and schools significantly affect Emirati adolescents’ health conditions. Recommendations are made for various stakeholders including parents, school authorities, Abu Dhabi Municipality and Transportation, and the Urban Planning department on ways to enhance the built environment and encourage PA and well-being of Emirati adolescents.

Implementation of School Remote Drop-off Walking Programs: Results from Qualitative Interviews

BACKGROUND

Remote drop-off programs allow children living "unwalkable" distances from school to walk partway by being dropped off by personal vehicle or bus closer to the school, supporting physical activity and health. However, little evidence exists to guide implementation of such programs.

METHODS

Semi-structured interviews were conducted with key informants from 7 remote drop-off programs to capture descriptive information and qualitative content (e.g., barriers, facilitators, outcomes). Qualitative content was analyzed using inductive thematic analysis and identified themes were organized within implementation science frameworks.

RESULTS

Programs were from low and high socioeconomic areas (free/reduced price lunch range=4%-92%) and initiated by various champions (school staff=29%, parents=29%, external=42%). 29% of programs incorporated the yellow school bus, 43% involved >100 students, and 71% involved route distances ≥0.5 miles. Twenty themes were identified across 5 implementation science domains (Intervention Characteristics, Inner Setting, Outer Setting, Implementation Process, and Outcomes). Positive outcomes included physical activity, socialization, and improved focus for students; decreased traffic; and positive perceptions of the program by students, parents, and school staff/administrators. Barriers included traffic, weather, and student engagement. Facilitators included having a champion and support from school leaders and the community, conducting process improvements, and incentivizing participation.

CONCLUSIONS

Remote drop-offs are feasible for supporting active school commuting but underutilized. Promising strategies for supporting uptake and implementation of such programs include communicating benefits, developing champions, engaging school and community leaders, and improving the neighborhood built environment.

Is the physical activity environment surrounding primary schools associated with students' weight status, physical activity or active transport, in regional areas of Victoria, Australia? A cross-sectional study

OBJECTIVES

To explore whether the physical activity (PA) environment (walkability, greenspace and recreational facilities) surrounding regional primary schools is associated with children's PA levels, active transport and weight status. Limited research on this topic has been conducted outside of major cities.

DESIGN

Cross-sectional ecological study using baseline data from two large-scale obesity prevention interventions.

SETTING

Eighty (n=80) primary schools across two regional areas in Victoria, Australia.

PARTICIPANTS

Students aged 8-13 years (n=2144) attending participating primary schools.

OUTCOME MEASURES

Measured weight status (body mass index z-score, proportion overweight/obese) and self-reported PA behaviours (meeting PA recommendations and active travel behaviour).

RESULTS

When adjusted for student and school demographics, students had significantly increased odds of using active transport to or from school when the school neighbourhood was more walkable (OR 1.21 (95% CI 1.09 to 1.35), had a greater number of greenspaces (OR 1.35 (95% CI 1.20 to 1.53)) and a greater number of recreational facilities (OR 1.18 (95% CI 1.07 to 1.31)). A higher cumulative PA environment score was also associated with a higher proportion of children using active transport (OR 1.33 (95% CI 1.28 to 1.51)). There were no significant associations between the PA environment measures and either weight status or meeting the PA recommendations in adjusted models.

CONCLUSIONS

This study is the first of its kind exploring school neighbourhood environments and child weight status and PA in regional areas of Australia. It highlights the potential of the environment surrounding primary schools in contributing to students' active travel to and from school. Further research with the use of objective PA measurement is warranted in regional areas that have been under-researched.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry (ANZCTR.org.au) identifier 12616000980437; Results.

Associations between Community Built Environments with Early Care and Education Classroom Physical Activity Practices and Barriers

The influence of community-built environments on physical activity (PA) support in Early Childhood Education settings (ECEs) is unknown. The purpose of this cross-sectional study was to determine associations between community PA environments and ECE classroom PA practices. We included licensed Oklahoma ECE directors serving 3-to-5-year-old children. Parks and playground locations were exported from Google Earth. National Walkability Index was derived from 2010 US Census data. ArcMap 10.6 was used to geocode ECE locations, which were within an Activity Desert if no parks/playgrounds were located within a 1-mile radius or if Walkability Index was 10.5 or below. Classroom PA practices were determined by using the Nutrition and PA Self-Assessment tool (NAP SACC). Barriers to implementing practices were reported. Most Head Starts (n = 41; 80.3%), center-based childcare settings (CBC; n = 135; 87.0%), and family childcare homes (FCCHs; n = 153; 96.4%) were in an Activity Desert. Parks/playgrounds within a 10-mile buffer were correlated with classroom PA practices in FCCHs only (p < 0.001). Activity Desert status was not related to classroom PA practices for any ECE context (p > 0.029). While FCCHs may be the most vulnerable to lack of park and playground access, overall findings suggest ECEs provide a healthful micro-environment protective of the typical influence of community-built environments.

Australia in 2030: what is our path to health for all?

CHAPTER 1: HOW AUSTRALIA IMPROVED HEALTH EQUITY THROUGH ACTION ON THE SOCIAL DETERMINANTS OF HEALTH: Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non-existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID-19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality. CHAPTER 2: ABORIGINAL AND TORRES STRAIT ISLANDER CONNECTION TO CULTURE: BUILDING STRONGER INDIVIDUAL AND COLLECTIVE WELLBEING: Aboriginal and Torres Strait Islander peoples have long maintained that culture (ie, practising, maintaining and reclaiming it) is vital to good health and wellbeing. However, this knowledge and understanding has been dismissed or described as anecdotal or intangible by Western research methods and science. As a result, Aboriginal and Torres Strait Islander culture is a poorly acknowledged determinant of health and wellbeing, despite its significant role in shaping individuals, communities and societies. By extension, the cultural determinants of health have been poorly defined until recently. However, an increasing amount of scientific evidence supports what Aboriginal and Torres Strait Islander people have always said - that strong culture plays a significant and positive role in improved health and wellbeing. Owing to known gaps in knowledge, we aim to define the cultural determinants of health and describe their relationship with the social determinants of health, to provide a full understanding of Aboriginal and Torres Strait Islander wellbeing. We provide examples of evidence on cultural determinants of health and links to improved Aboriginal and Torres Strait Islander health and wellbeing. We also discuss future research directions that will enable a deeper understanding of the cultural determinants of health for Aboriginal and Torres Strait Islander people. CHAPTER 3: PHYSICAL DETERMINANTS OF HEALTH: HEALTHY, LIVEABLE AND SUSTAINABLE COMMUNITIES: Good city planning is essential for protecting and improving human and planetary health. Until recently, however, collaboration between city planners and the public health sector has languished. We review the evidence on the health benefits of good city planning and propose an agenda for public health advocacy relating to health-promoting city planning for all by 2030. Over the next 10 years, there is an urgent need for public health leaders to collaborate with city planners - to advocate for evidence-informed policy, and to evaluate the health effects of city planning efforts. Importantly, we need integrated planning across and between all levels of government and sectors, to create healthy, liveable and sustainable cities for all. CHAPTER 4: HEALTH PROMOTION IN THE ANTHROPOCENE: THE ECOLOGICAL DETERMINANTS OF HEALTH: Human health is inextricably linked to the health of the natural environment. In this chapter, we focus on ecological determinants of health, including the urgent and critical threats to the natural environment, and opportunities for health promotion arising from the human health co-benefits of actions to protect the health of the planet. We characterise ecological determinants in the Anthropocene and provide a sobering snapshot of planetary health science, particularly the momentous climate change health impacts in Australia. We highlight Australia's position as a major fossil fuel producer and exporter, and a country lacking cohesive and timely emissions reduction policy. We offer a roadmap for action, with four priority directions, and point to a scaffold of guiding approaches - planetary health, Indigenous people's knowledge systems, ecological economics, health co-benefits and climate-resilient development. Our situation requires a paradigm shift, and this demands a recalibration of health promotion education, research and practice in Australia over the coming decade. CHAPTER 5: DISRUPTING THE COMMERCIAL DETERMINANTS OF HEALTH: Our vision for 2030 is an Australian economy that promotes optimal human and planetary health for current and future generations. To achieve this, current patterns of corporate practice and consumption of harmful commodities and services need to change. In this chapter, we suggest ways forward for Australia, focusing on pragmatic actions that can be taken now to redress the power imbalances between corporations and Australian governments and citizens. We begin by exploring how the terms of health policy making must change to protect it from conflicted commercial interests. We also examine how marketing unhealthy products and services can be more effectively regulated, and how healthier business practices can be incentivised. Finally, we make recommendations on how various public health stakeholders can hold corporations to account, to ensure that people come before profits in a healthy and prosperous future Australia. CHAPTER 6: DIGITAL DETERMINANTS OF HEALTH: THE DIGITAL TRANSFORMATION: We live in an age of rapid and exponential technological change. Extraordinary digital advancements and the fusion of technologies, such as artificial intelligence, robotics, the Internet of Things and quantum computing constitute what is often referred to as the digital revolution or the Fourth Industrial Revolution (Industry 4.0). Reflections on the future of public health and health promotion require thorough consideration of the role of digital technologies and the systems they influence. Just how the digital revolution will unfold is unknown, but it is clear that advancements and integrations of technologies will fundamentally influence our health and wellbeing in the future. The public health response must be proactive, involving many stakeholders, and thoughtfully considered to ensure equitable and ethical applications and use. CHAPTER 7: GOVERNANCE FOR HEALTH AND EQUITY: A VISION FOR OUR FUTURE: Coronavirus disease 2019 has caused many people and communities to take stock on Australia's direction in relation to health, community, jobs, environmental sustainability, income and wealth. A desire for change is in the air. This chapter imagines how changes in the way we govern our lives and what we value as a society could solve many of the issues Australia is facing - most pressingly, the climate crisis and growing economic and health inequities. We present an imagined future for 2030 where governance structures are designed to ensure transparent and fair behaviour from those in power and to increase the involvement of citizens in these decisions, including a constitutional voice for Indigenous peoples. We imagine that these changes were made by measuring social progress in new ways, ensuring taxation for public good, enshrining human rights (including to health) in legislation, and protecting and encouraging an independent media. Measures to overcome the climate crisis were adopted and democratic processes introduced in the provision of housing, education and community development.

Street connectivity, physical activity, and childhood obesity: A systematic review and meta-analysis

Street connectivity, as a neighbourhood built environmental factor, may affect individual physical activity (PA) and subsequently weight status. However, these associations remain inconclusive. This study aimed to systematically review the association between street connectivity and childhood obesity. A literature search was conducted in the Cochrane Library, PubMed, and Web of Science for articles published before January 1, 2019. All original studies that investigated the association between street connectivity and weight-related behaviours or outcomes among children and adolescents were included. Forty-seven articles were identified, including eight longitudinal and 41 cross-sectional studies conducted in eight countries. The sample size ranged from 88 to 46 813. Street intersection density (SID), measured by Geographic Information Systems in 36 studies and reported in 13 studies, was the main indicator used to represent street connectivity. Forty-four studies examined the association between SID and weight-related behaviours, including overall PA (n = 15), moderate-to-vigorous PA (n = 13), active transport (n = 12), dog walking (n = 1), walking (n = 1), sedentary behaviours (n = 2), and TV viewing (n = 1). Fifteen studies focused on the association between SID and weight-related outcomes. Overall, evidence from this systematic review and meta-analyses suggested a positive association between street connectivity and PA. However, it was difficult to draw a conclusion on the association between street connectivity and BMI. More longitudinal evidence is needed to confirm the causal association between street connectivity and weight status.

Are school-based measures of walkability and greenness associated with modes of commuting to school? Findings from a student survey in Ontario, Canada

OBJECTIVES

In Canada, students are increasingly reliant on motorized vehicles to commute to school, and few meet the recommended overall physical activity guidelines. Infrastructure and built environments around schools may promote active commuting to and from school, thereby increasing physical activity. To date, few Canadian studies have examined this research question.

METHODS

This study is a cross-sectional analysis of 11,006 students, aged 11-20, who participated in the 2016/2017 Ontario Student Drug Use and Health Survey. The remote sensing-derived Normalized Difference Vegetation Index (NDVI), at a buffer of 500 m from the schools' locations, was used to characterize greenness, while the 2016 Canadian Active Living Environments (Can-ALE) measure was used for walkability. Students were asked about their mode of regular commuting to school, and to provide information on several socio-demographic variables. Multivariable logistic regression models were used to quantify associations between active commuting and greenness and the Can-ALE. The resulting odds ratios, and their 95% confidence intervals, were adjusted for a series of risk factors that were collected from the survey.

RESULTS

Overall, 21% of students reported active commuting (biking or walking) to school, and this prevalence decreased with increasing age. Students whose schools had higher Can-ALE scores were more likely to be active commuters. Specifically, the adjusted odds ratio (OR) of being an active commuter for schools in the highest quartile of the Can-ALE was 2.11 (95% CI = 1.64, 2.72) when compared with those in the lowest. For children, aged 11-14 years, who attended schools in high dwelling density areas, a higher odds of active commuting was observed among those in the upper quartile of greenness relative to the lowest (OR = 1.41; 95% CI = 0.92, 2.15). In contrast, for lower dwelling density areas, greenness was inversely associated with active commuting across all ages.

CONCLUSION

Our findings suggest that students attending schools with higher Can-ALE scores are more likely to actively commute to school, and that positive impacts of greenness on active commuting are evident only in younger children in more densely populated areas. Future studies should collect more detailed data on residential measures of the built environment, safety, distance between home and school, and mixed modes of commuting behaviours.

It's about being the good parent: exploring attitudes and beliefs towards active school transportation

In recent decades, there has been a decline in active school transportation (AST). Parents play an important role as the key decision-makers of children’s AST, and there is a need of more knowledge about the decision-making process and parents’ beliefs towards AST. The overall aim of this study was to explore parents’ attitudes and beliefs towards AST in the northern part of Sweden. Twenty parents participated in semi-structured interviews, which was based on the theory of planned behaviour. Qualitative content analysis was used to analyse the interviews. The analysis yielded one main theme, “Parenting and active school transportation – making route choices in a changed landscape” and four subthemes, “Knowing that it is beneficial while struggling with daily life”, “Considering barriers and solutions to enable AST”, “Parenting is challenging and about balancing”, and “Reflecting and contemplating about what we and others do”. Winter conditions affect parents’ decisions, and this needs to be considered when facilitating AST in these regions. Overall better health, increased physical activity, time spent outdoors, and free play were revealed as positive outcomes of AST. Decisions were also influenced by social norms and how the idea of parenting has changed through generations. The findings of this study are likely to be important when promoting AST.

Children’s neighbourhood physical environment and early development: an individual child level linked data study

Background

Identification of features of the neighbourhood physical environment that have a causal association with positive child development is important for promoting long-term developmental health. Previous research on these associations have been conducted at the neighbourhood level, and do not account for individual variation in exposure to these features.

Methods

This cross-sectional study utilised de-identified linked administrative data. Neighbourhood features were measured with Geographic Information Systems and identified within a 1600 m service area around the child’s home address. The study population included a random selection of 5024 Western Australian children who participated in the 2012 Australian Early Development Census (AEDC; median age 5 years, 5 months). Multi-level logistic regressions modelled the odds of children scoring in the bottom 10% on the physical, social or emotional AEDC domains as an outcome of neighbourhood features.

Results

After adjustment for individual and neighbourhood sociodemographic factors, lower odds of physical vulnerability were associated with increased neighbourhood residential density, presence of railway station, and higher counts of playgroups and kindergartens. Larger areas of neighbourhood home-yard space were associated with increased odds of physical and social vulnerability. Presence of high-quality green spaces was associated with lower odds of social vulnerability. Increased road traffic exposure was associated with higher odds of social and emotional vulnerability.

Conclusions

The neighbourhood physical environment has a weak but significant association with early childhood development. Future research should consider the interplay between the neighbourhood environment and proximal influences, including parenting attributes and socioeconomic status, and how they influence early child development.

Evaluation of Children's Screen Viewing Time and Parental Role in Household Context

Limited screen time has been recommended by the American Academy of Pediatrics for all children and no screen time for children under 2 years of age. With the advancement in technology, the prevalence and detrimental effects of excess screen time on children has become a global problem that can lead to health issues such as obesity and other cardiovascular diseases among both adults and children. This article examines the drivers of screen-related sedentary behavior within the home context and reports on parents’ attitude in supporting children’s associated behavior. The study implemented a mixed method approach of online questionnaire and face-to-face interviews. A total of 140 questionnaires, 10 semistructured interviews, and responses from parents were used to evaluate children’s behavior toward screen use and parents’ perception. The analysis of the article has shown that parents are concerned about their children’s screen time during weekends and holidays with a significant correlation between the number of hours their children spend on on-screen activities and their level of concern (P < .01). Also, for the same P value (P < .01), it has been found that there is a statistically significant positive relationship between children’s screen time and their food and beverages consumption. Children’s use of screen technology is becoming a challenge for parents as they present barriers to healthy physical activities. From the parents’ viewpoint, there is a need to change the screen use habit and this requires an appropriate intervention that promotes gratifying measures to induce more active behaviors to displace screen viewing.

Cross-sectional changes in weight status and weight related behaviors among Australian children and Australian Indigenous children between 2010 and 2015

BACKGROUND

Since 2006 there has been substantial long-term investment in school-based child obesity prevention programs in New South Wales (Australia). Whether these programs have led to population level improvements in children's weight status and weight-related behaviors are yet to be determined. The purpose of this study was to describe changes in children's weight status and weight-related behaviors, including Indigenous children, who are at greater risk of poorer health outcomes than non-Indigenous children.

METHODS

Representative cross-sectional population surveys conducted in 2010 and 2015 among children age 5-16 years (n = 15,613). Objective measurements included height, weight, waist circumference, cardiorespiratory fitness, and fundamental movement skills. Indigenous status and indicators of weight-related behavior (i.e., diet, physical activity, school travel, screen-time) were measured by questionnaire with parents responding for children age <10 years and self-report by children age ≥10 years.

RESULTS

The prevalences of overweight/obesity, obesity and abdominal obesity were higher in 2015, than 2010, and higher among Indigenous than non-Indigenous children at both timepoints. There were some small positive changes towards healthier weight-related behaviors between surveys among all children, but many unhealthy weight-related behaviors remain highly prevalent. The magnitude of changes and the 2015 prevalences of weight-related behaviors were generally similar for Indigenous and non-Indigenous children.

CONCLUSIONS

Schools play an important role in health promotion, but our findings suggest the current approaches need re-thinking. Upstream factors that shape weight-related behaviors such as the regulation of the food industry and food environment, urban, neighborhood and public transport planning must be including in solutions to ensure populations can eat healthily and be physical active.

Between Privilege and Oppression: An Intersectional Analysis of Active Transportation Experiences Among Washington D.C. Area Youth

The use of active transportation (AT), such as walking, cycling, or even public transit, as a means of transport offers an opportunity to increase youth physical activity and improve health. Despite the well-known benefits of AT, there are environmental and social variables that converge on the AT experiences of low-income youth and youth of color (YOC) that have yet to be fully uncovered. This study uses an intersectional framework, largely focusing on the race-gender-class trinity, to examine youth AT within a context of transportation inequity. Theoretically guided by the Ecological Model of Active Transportation, focus groups were completed with two groups of girls (15 participants) and two groups of boys (nine participants) ranging between the ages of 12–15 years who lived within the Washington D.C. area. This research found race, gender, and class to be inhibitors of AT for both boys and girls, but with more pronounced negative influences on girls.

Do Not Forget About Public Transportation: Analysis of the Association of Active Transportation to School Among Washington, DC Area Children With Parental Perceived Built Environment Measures

BACKGROUND

Although the active transportation (AT) indicator received an F grade on the 2016 US Report Card on Physical Activity for Children and Youth, this AT assessment excluded public transportation. An objective of the Built Environment and Active Play Study was to assess youth AT, including public transportation, among Washington, DC area children in relation to parental perceptions of neighborhood built environment (BE) variables.

METHODS

Questionnaires were mailed to 2000 parents of children aged 7-12 years. AT to school (ATS) was assessed with the question: "In an average school week, how many days does your child use each of the following ways to get to and from school? (a) Walk; (b) Bike; (c) Car; (d) Bus or Metro." Parental perceived BE data were obtained through questionnaire items, and logistic regression was conducted to determine if BE variables were associated with youth ATS.

RESULTS

The sample included 144 children (50% female; average age 9.7 years; 56.3% white; 23.7% African American; 10.4% Asian American). Over 30% used ATS-public transportation 5 days per week, and nearly 13% used ATS-walking daily. Parental perceived BE variables significantly predicted youth ATS-walking and ATS-public transportation.

CONCLUSIONS

ATS-public transportation is common among Washington, DC area youth, and parental perceptions of BE can significantly predict ATS.

Examining the Influence of a New Light Rail Line on the Health of a Demographically Diverse and Understudied Population within the Washington, D.C. Metropolitan Area: A Protocol for a Natural Experiment Study

Approximately two-thirds of adults and youth in Prince George's County, Maryland, a suburb of Washington, D.C. are overweight or obese and less than half are achieving daily physical activity recommendations. Active transportation (AT), such as walking, biking or using public transportation (PT), is a strategic pathway to improving physical activity levels and thus reducing excess weight. Utilizing an expansion of the Washington, D.C. area transportation system with a new light rail line, the Purple Line Outcomes on Transportation (PLOT) Study will exam pre- and post-Purple Line PT use, AT behaviors and attitudes and physical activity among Prince George's County adults and youth. The PLOT Study will take advantage of this natural experiment in an area enduring significant racial/ethnic and gender-based overweight or obesity and physical inactivity disparities. While similar natural experiments on AT have been conducted in other U.S. cities, those studies lacked diverse and representative samples. To effectively evaluate these physical activity outcomes among this population, efforts will be used to recruit African American and Latino populations, the first and second most common racial/ethnic groups in Prince George's County. Finally, the PLOT Study will also examine how contextual effects (e.g., neighborhood built environment) impact PT, AT and physical activity.

The longitudinal relationship between generalized self-efficacy and physical activity in school-aged children

Our understanding of the longitudinal relationship between generalized self-efficacy (GSE) and physical activity in children and youth is limited. The purpose of this study was to investigate the effect of GSE towards physical activity on sedentary behaviours and physical activity in school-aged children over time. A total of 2278 nine-year-old children (1120 girls and 1158 boys) were recruited at baseline and followed for seven waves of data collection from 2005 to 2008. All children completed questionnaires at each wave assessing their GSE (adequacy, predilection, and enjoyment), sedentary behaviours, free play, and organized activity. Mixed-effects models were used to estimate changes in physical activity and GSE within individuals over time, controlling for gender and motor ability. The results showed that participation in free play significantly increased over time, whereas organized activity significantly decreased over the same period. Children with high perceived adequacy and predilection had higher free play and organized activity participation relative to other children over time. However, the effect of perceived adequacy diminished over time, while the gaps between groups with different levels of predilection widened over time. While sedentary behaviours were lower over time in children with high predilection, these behaviours were consistently higher in children with high enjoyment. The differences in sedentary behaviours between groups increased over time for both predilection and enjoyment. This study highlights the importance of different components of GSE on physical activity participation. In addition, interventions targeting the enhancement of predilection may facilitate physical activity and reduce sedentary behaviours.

The Safety of the Neighborhood Environment and Physical Activity in Czech and Polish Adolescents

(1) Background: An increase in or at least the sustainment of walking activities across a wide section of the population is a crucial health-related task for Central and East European countries. The aim of this study was to assess the associations between adolescents’ walking activities and various levels of perceived safety of the built environment in differing socio-demographic backgrounds of Poland and the Czech Republic. Furthermore, we aimed to determine major moderators affecting the walking habits of adolescents in areas with different levels of walkability. (2) Methods: The surveys were conducted during the 2008–2009 and 2013–2014 school years in 24 Polish and 35 Czech secondary schools, with a sample of 2001 adolescents. All participants completed the International Physical Activity Questionnaire–Long Form and the NEWS–Abbreviated. Selected students took part in objective weekly monitoring of physical activity (PA). (3) Results: Boys and girls who perceived their neighborhood environment as the safest were significantly more likely to meet the recommendations for leisure-time walking. Adolescents from the safest environment achieved 11,024 steps/day on average, while those from the least safe environment achieved 9686 steps/day. (4) Conclusions: A safe neighborhood environment significantly predicts walking activities among girls. Environmental safety improvement can support the active transport and better use of leisure time PA.

Understanding active school travel through the Behavioural Ecological Model

Active school travel (AST) is an important source of physical activity for children and a conceptual understanding of AST is necessary to inform promotion efforts. The aim of this article is to provide a conceptual analysis of AST. All currently identified AST formulations include intra-individual variables which are often recommended as intervention targets. However, existing literature lacks clarity on precisely how these intra-individual variables might shape specific AST interventions. Moreover, evaluative studies of AST interventions typically fail to specify an underpinning theory or model. To address this limitation, the Behavioural Ecological Model (BEM), not previously addressed in AST, is presented to guide this area of research. Based on specific examples, we draw attention to the role of potential antecedents and potential reinforcers of AST, as well as potential reinforcers of motorised travel. Antecedents and reinforcers may help to explain choices of school travel mode, and to inform and increase intervention options to promote AST. Consistent with the BEM, the provision of more immediate consequences, such as fun and material prizes, is an evidence-based strategy for increasing AST which is likely to be low-cost and easier to deliver than alternative interventions. This approach to the study of AST is expected to contribute to similar analyses in this and other areas of behaviour change research, and to a more useful discussion and treatment of theoretical and conceptual behavioural models.

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.

Neighborhood Built Environment and Socioeconomic Status in Relation to Active Commuting to School in Children

Background:

The role of neighborhood type in active commuting to school (ACS) has not been extensively studied in children. The purpose of this study was to analyze the association between neighborhood built environment (walkability) and neighborhood socioeconomic status (SES) with ACS among children.

Methods:

A cross-sectional study of 310 Spanish children (aged 10–12 y; 51% male) was conducted in 2015. Walkability was defined as an index of 3 built environment characteristics (ie, residential density, land-use mix, and street connectivity) based on geographical information system data. Children’s home and school neighborhoods were evaluated. ACS was evaluated by questionnaire. Mixed model regression analyses evaluated ACS in relation to neighborhood walkability and SES.

Results:

There were no significant SES–walkability interactions for ACS. Children living in more walkable neighborhoods reported 2.5 more trips per week compared with those living in less walkable neighborhoods (P < .001). Children attending schools located in lower SES neighborhoods reported more ACS trips per week than those attending schools in higher SES neighborhoods (P < .05).

Conclusions:

Home-neighborhood walkability and school-neighborhood SES were associated with ACS. This study highlights the importance of assessing children’s home environment and school environment when ACS behavior is analyzed.

School transportation mode, by distance between home and school, United States, ConsumerStyles 2012

INTRODUCTION

Motor-vehicle crashes are a leading cause of death among children in the United States, and almost one-fourth of all trips by school-aged children are trips to and from school. This study sought to determine how children (5-18years) travel to and from school and, among those living ≤1mile of school, to explore the role of school bus service eligibility on school travel mode.

METHODS

We used national 2012 survey data to determine prevalence of usual school travel mode, stratified by distance from school. For those living ≤1mile of school, multivariable regression was conducted to assess the association between bus service eligibility and walking or bicycling.

RESULTS

Almost half (46.6%) of all children rode in passenger vehicles (PV) to school and 41.8% did so for the trip home. Results were similar among those living ≤1mile (48.1%, PV to school; 41.3%, PV to home). Among those living ≤1mile, 21.9% and 28.4% of children walked or bicycled to and from school, respectively. Ineligibility for school bus service was strongly associated with walking or bicycling to school [adjusted prevalence ratio (aPR: 5.36; p<0.001)] and from school (aPR: 5.36; p<0.001).

CONCLUSIONS

Regardless of distance from school, passenger vehicles were a common mode of travel. For children who live close to school, the role that school bus service eligibility plays in walking or bicycling deserves further consideration.

PRACTICAL APPLICATIONS

Given the large proportion of children who use passenger vehicles for school travel, effective interventions can be adopted to increase proper child restraint and seat belt use and reduce crash risks among teen drivers. Better understanding of conditions under which bus service is offered to children who live close to school could inform efforts to improve pedestrian and bicyclist safety for school travel.

Social and built-environment factors related to children's independent mobility: The importance of neighbourhood cohesion and connectedness

This study examines aspects of neighbourhood social environments (namely, neighbourhood safety, cohesion and connection) and child-specific built environment attributes in relation to children's independent mobility. The results suggest that children aged 8-13 years with parents who perceive their neighbourhood as more cohesive and more connected, and are located closer to school, engaged in higher levels of independently mobile trips. The qualitative component of this research revealed that for NZ European, Māori, Samoan and other Pacific parents, 'people danger' was the most common concern for letting their children go out alone, whereas for Asian and Indian parents, 'traffic danger' was the most common reason for their concern.

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.

Association between intersection characteristics and perceived crash risk among school-aged children

This research examined how environmental attributes near intersections influence the perceived crash risk among school-aged children, which provides information on the potential risks of pedestrian crashes that can guide the development of proactive countermeasures. In a sample of 799 children aged 10-12 years old in Korea, the environmental attributes of intersections perceived as having a high risk of producing crashes near elementary schools were investigated using standard negative binomial and zero-inflated negative binomial models.The results showed that a higher number of student crossings, a wider road width, the presence of crosswalks, student-friendly facilities at the intersection, and four-way intersections were significant and positively associated with perceived crash risk among school-aged children. The findings related to building characteristics indicated that a higher number of entrances at an intersection increased the perceived crash risk while higher visibility at the intersection reduced the perception of risk. Associations with traffic-calming measures were weak,suggesting that the measures used in the study areas were not effective in reducing the perceived crash risk. The results of a police-reported crash model showed that school-aged children have a relatively accurate perception of crash risk and that the perceived crash risk of school-aged children may provide valuable information on the intersection characteristics in need of attention near school sites.

Understanding caregivers' intentions for their child to walk to school: Further application of the theory of planned behavior

Increases in childhood obesity have coincided with declines in active transportation to school. This research builds on largely atheoretical extant literature examining factors that influence walk-to-school behavior through application of the theory of planned behavior (TPB). Understanding caregivers' decision for their child to walk to/from school is key to developing interventions to promote this cost-effective and accessible health behavior. The results from an online survey of 512 caregivers provide support for the TPB, highlighting the important role of subjective norms. This suggests marketers should nurture caregivers' perception that important others approve of walking to school.

From attitude to action: What shapes attitude toward walking to/from school and how does it influence actual behaviors?

Walking to/from school could promote children's physical activity and help combat childhood obesity. Parental attitudes have been identified as one of the important predictors. But it is unclear what factors shape parental attitudes, and how those in turn influence children's school travel. This study addresses this gap of knowledge by examining the mediating effect of parental attitudes for the relationships between personal, social, and built environmental factors and children's walking-to/from-school behaviors. Survey data (N=2597) were collected from 20 public elementary schools in Austin, Texas, measuring students' typical school travel mode; personal, social, and built environmental factors related to walking-to/from-school; and relevant parental attitudes. The analysis was conducted in M-plus 6.11 to test the proposed conceptual framework using a structural equation model (SEM). Parental attitudes showed significant mediating effects on walking-to/from-school behaviors. Older child, positive peer influence, walkable home-to-school distance, and favorable walking environments were associated with more enjoyment and lower attitudinal barriers, and in turn increased likelihood of walking to/from school. Being Hispanic, increased car ownership, and stronger traffic safety concerns reduced enjoyment and increased attitudinal barriers, and thus decreased likelihood of walking to/from school. This study highlighted the importance of using multilevel interventions to reduce attitudinal barriers and increase enjoyment of walking to/from school. Collaborations among different stakeholders are needed to address environmental issues (e.g., safety concerns) and social factors (e.g., peer influence), while being sensitive to personal factors (e.g., age, ethnicity, and car ownership).

Breaking Out of Surveillance Silos: Integrative Geospatial Data Collection for Child Injury Risk and Active School Transport

The preponderance of active school transport (AST) and child injury research has occurred independently, yet they are inherently related. This is particularly true in urban areas where the environmental context of AST may pose risks to safety. However, it can be difficult to make these connections due to the often segregated nature in which these veins of research operate. Spatial video presents a geospatial approach for simultaneous data collection related to both issues. This article reports on a multi-sector pilot project among researchers, a children's hospital, and a police department, using spatial video to map child AST behaviors; a geographic information system (GIS) is used to analyze these data in the environmental context of child pedestrian injury and community violence.

Can the Neighborhood Built Environment Make a Difference in Children's Development? Building the Research Agenda to Create Evidence for Place-Based Children's Policy

Healthy child development is determined by a combination of physical, social, family, individual, and environmental factors. Thus far, the majority of child development research has focused on the influence of individual, family, and school environments and has largely ignored the neighborhood context despite the increasing policy interest. Yet given that neighborhoods are the locations where children spend large periods of time outside of home and school, it is plausible the physical design of neighborhoods (built environment), including access to local amenities, can affect child development. The relatively few studies exploring this relationship support associations between child development and neighborhood destinations, green spaces, interaction with nature, traffic exposure, and housing density. These studies emphasize the need to more deeply understand how child development outcomes might be influenced by the neighborhood built environment. Pursuing this research space is well aligned with the current global movements on livable and child-friendly cities. It has direct public policy impact by informing planning policies across a range of sectors (urban design and planning, transport, public health, and pediatrics) to implement place-based interventions and initiatives that target children's health and development at the community level. We argue for the importance of exploring the effect of the neighborhood built environment on child development as a crucial first step toward informing urban design principles to help reduce developmental vulnerability in children and to set optimal child development trajectories early.

Playability: Built and Social Environment Features That Promote Physical Activity Within Children

The role of neighbourhood built and social environments in shaping children's physical activity has received increasing interest over the past 10 years. We reviewed recent evidence published between 2011 and 2014. Most of the recent evidence continues to be cross-sectional. Few macro-level neighbourhood attributes were consistently associated with physical activity in the expected direction. The strongest evidence for associations between neighbourhood attributes and physical activity with was for the transportation environment, particularly in relation to proximity to school and transport-related physical activity. There was intermediate evidence that neighbourhood walking/cycling infrastructure and pedestrian safety structures are associated with transport-related PA. Recent evidence on associations between the neighbourhood built and social environment and children's PA is modest. Stronger study designs and greater attention to conceptual-matching and specificity of measures are critical to advance the evidence base.

Does the effect of walkable built environments vary by neighborhood socioeconomic status?

OBJECTIVE

To examine socioeconomic status as a moderator of the relationship between the built environment and active transportation such as walking or cycling using measures of built environment exposure derived from individuals transport trips.

METHODS

The 2008 Montreal Origin-destination (OD) survey provided origin-destination coordinates for a sample of 156,700 participants. We selected participants from this survey that had traveled within the census metropolitan area of Montreal the day preceding the interview, and that were between 18-65 years of age. Measures of connectivity, land-use mix, and density of business and services were collected using 400-m buffers of the trip routes. Logistic regression was used to model the relationship between built environment variables and active transportation.

RESULTS

Trip routes in the 2nd, 3rd, and 4th quartile of density of business and services or connectivity translated into greater odds of taking AT (compared to a trip in the lowest quartile). Trip routes in the 2nd, 3rd, and 4th quartile of land-use mix translated into lower odds of taking AT. Trips in the highest quartiles of connectivity and density of business and services were found to have a weaker association with active transportation if the individual undergoing the trip was from a low SES neighborhood.

CONCLUSION

Our results suggest that previous studies finding no effect modification may have been due to the limitation of measurements of exposures to the residential neighborhood.

Cross-continental comparison of the association between the physical environment and active transportation in children: a systematic review

BACKGROUND

The purpose of this systematic review was to determine the relationship between a wide range of physical environmental characteristics and different contexts of active transportation in 6- to 12-year-old children across different continents.

METHODS

A systematic search was conducted in six databases (Pubmed, Web of Science, Cinahl, SportDiscus, TRIS and Cochrane) resulting in 65 papers, eligible for inclusion. The investigated physical environmental variables were grouped into six categories: walkability, accessibility, walk/cycle facilities, aesthetics, safety, recreation facilities.

RESULTS

The majority of the studies were conducted in North America (n = 35), Europe (n = 17) and Australia (n = 11). Active transportation to school (walking or cycling) was positively associated with walkability. Walking to school was positively associated with walkability, density and accessibility. Evidence for a possible association was found for traffic safety and all forms of active transportation to school. No convincing evidence was found for associations between the physical environment and active transportation during leisure. General safety and traffic safety were associated with active transportation to school in North America and Australia but not associated with active transportation to school in Europe.

CONCLUSIONS

The physical environment was mainly associated with active transportation to school. Continent specific associations were found, indicating that safety measures were most important in relation to active commuting to school in North America and Australia. There is a need for longitudinal studies and studies conducted in Asia, Africa and South-America and studies focusing specifically on active transportation during leisure.

Socio-demographic factors and neighbourhood social cohesion influence adults' willingness to grant children greater independent mobility: A cross-sectional study

Background

In developed countries, children’s independent mobility levels are low. Built environmental factors and parental safety concerns are well-known to predict the level of independent mobility adults grant to children. In contrast, the influence of adults’ socio-demographic characteristics and neighbourhood social cohesion on children’s independent mobility is largely unexplored. This study investigated the influence of adults’ socio-demographic factors and neighbourhood social cohesion on distances they would permit children for independent travel and outdoor play.

Methods

In 2013, a random sample of 1293 Australian adults (mean age: 56.1 years, 52 % male, 81 % parents) participated in the Queensland Social Survey (QSS) via computer-assisted telephone interview. Socio-demographic factors measured included age, sex, parental status, education and area-level socio-economic disadvantage. Perceived neighbourhood social cohesion was assessed using a standardised scale. Adults reported the distances children aged 8–12 years should be allowed to walk/cycle to places, and play outdoors without adults. Responses were categorised into ‘within sight’, < 0.5 kilometres (km) , 0.5-1 km and >1 km. Ordinal logistic regression was used to assess associations of socio-demographic factors and neighbourhood social cohesion with distances adults would permit for children’s independent travel and outdoor play.

Results

Parents and adults with lower education were less likely to permit greater distances for children’s independent travel (OR = 0.57 and OR = 0.59, respectively). Women, parents and adults with lower education were less likely to grant children greater distances for independent outdoor play (OR = 0.61, OR = 0.50 and OR = 0.60, respectively). In contrast, adults with higher perceptions of neighbourhood social cohesion were more likely to permit children greater distances for independent travel (OR = 1.05)and outdoor play (OR = 1.05). Adult age and area-level socio-economic disadvantage were not associated with distances adults would permit for independent travel and outdoor play.

Conclusions

Women, parents (particularly those of younger children), adults with lower education and those who perceived neighbourhood social cohesion as being lower were less willing to let children independently travel further away from home. Interventions to increase children’s independent mobility may be more effective if targeted to these groups. In addition, increasing neighbourhood social cohesion may help increase adults’ willingness to grant children greater independent mobility.

Perceptions of the Neighborhood Environment and Children's Afterschool Moderate-to-Vigorous Physical Activity

Previous research suggests the neighborhood environment may be an important influence on children's physical activity (PA) behaviors; however, findings are inconsistent. The purpose of this study was to further understand the relationship between perceptions of the neighborhood environment and children's afterschool moderate-to-vigorous PA. Utilizing a structural equation modeling technique, we tested a conceptual model linking parent and child perceptions of the neighborhood environment, parent support for PA, and child outdoor PA with children's afterschool moderate-to vigorous PA. We found that child perception of the neighborhood environment and outdoor PA were positively associated with afterschool moderate-to-vigorous PA. In addition, parent support for PA positively influenced children's outdoor PA. The neighborhood environment and outdoor activity appear to play an influential role on children's afterschool PA behaviors.

Active commuting and its associations with blood pressure and adiposity markers in children

OBJECTIVE

The positive impacts of active travel on health markers still require further research, especially in youth populations with higher risk of obesity. The present study aimed to analyze the associations between blood pressure and adiposity risk (BPAR) and active travel to school in children.

METHODS

The sample comprised 665 Portuguese children (345 boys) aged 7-9 years. Data on height, weight, and skinfold thickness were collected by a trained fieldworker as well as data on BPAR between March 2009 and January 2010 (data were analyzed in 2012-2013). Information on mode and duration of travel to school (i.e. exposure) was gathered by questionnaire. Outcome variables were statistically normalized and expressed as Z scores. A BPAR score was computed as the mean of the Z scores. Multiple linear regression, with adjustments for confounders, was used.

RESULTS

Active commuting was inversely associated with BPAR after adjustment for several potential confounders. After adjusting for BMI, the strength of the relationship between BPAR and active commuting was significantly improved (p≤0.01).

CONCLUSIONS

Findings showed an independent association between the clustered BPAR and active commuting in children aged 7-9 years.

Leadership skills are associated with health behaviours among Canadian children

Life skills development is a core area for action in the Ottawa Charter for Health Promotion. The role of life skills in influencing health behaviours among children has received little attention in research. The purpose of this cross-sectional study was to investigate the relationship between self-leadership, as a model of life skills, and diet quality, physical activity, sleep duration and body weight. A provincially representative sample of 2328 grade 5 students (aged 10-11 years) was surveyed in Alberta, Canada. Self-leadership skills were assessed based on student responses indicating frequency of performing various leadership traits. Diet quality was based on responses to the Harvard Youth/Adolescent Food Frequency Questionnaire and physical activity on responses to the Physical Activity Questionnaire for Children. Sleep duration was assessed based on parent survey responses, and body mass index determined based on measured height and weight. Random effects regression models with children nested within schools were used to determine the associations. Higher self-leadership was associated with better diet quality (P < 0.01) and more physical activity (P < 0.01). Although not statistically significant, higher self-leadership was suggestive of healthier body weight status (OR = 0.91, 95% CI = 0.66, 1.27). No association of self-leadership with sleep duration was found. The incorporation of leadership skill development may enhance the effectiveness of school-based health promotion programs. This study reinforces the importance of leadership skill promotion in the promotion of healthy eating and active living, which may help curb the obesity epidemic in the short term, and prevention of chronic diseases and mounting healthcare costs in the long term.

Development of a 15-Item Scale to Measure Parental Perceptions of Their Neighborhood

Socioecological theory suggests that there are a range of influences that affect the physical activity levels of children, including parents’ perceptions of the neighborhood. A questionnaire instrument to quantify parental neighborhood perceptions was developed for the Location of Children’s Activity in Their Environment study as a potential predictor of children’s physical activity. A literature review revealed a lack of appropriate instruments, many containing highly localized items. Following initial instrument development including pretesting, where items showed face and content validity, a two-phase pilot study was undertaken. Pilot testing investigated test–retest reliability (overall intraclass correlation coefficient = .75) and internal consistency (α = .62 and α = .73 for the two phases, respectively), finding that the instrument was acceptable overall although some changes in wording were made to specific items with low reliability and/or internal consistency. Using data from the first year of the Location of Children’s Activity in Their Environment study, the instrument showed acceptable internal consistency (overall α = .73) and predictive validity (associated with time living in residence and walking to school) to be used in future studies. The scale was not found to be associated with child physical activity, which may be due to activity displacement. Proposed subscales for the neighborhood infrastructure and social aspects were marginal for internal consistency and a safety subscale was not acceptable in this regard. Given the impact of parental perceptions of the neighborhood, and its potential modifiable nature, a measure of it should be included in studies looking at the intensity and location of children’s physical activity.

Examining the impact of the walking school bus with an agent-based model

We used an agent-based model to examine the impact of the walking school bus (WSB) on children's active travel to school. We identified a synergistic effect of the WSB with other intervention components such as an educational campaign designed to improve attitudes toward active travel to school. Results suggest that to maximize active travel to school, children should arrive on time at "bus stops" to allow faster WSB walking speeds. We also illustrate how an agent-based model can be used to identify the location of routes maximizing the effects of the WSB on active travel. Agent-based models can be used to examine plausible effects of the WSB on active travel to school under various conditions and to identify ways of implementing the WSB that maximize its effectiveness.

A cross-sectional study of demographic, environmental and parental barriers to active school travel among children in the United States

Background

Promoting daily routine physical activities, such as active travel to school, may have important health implications. Practitioners and policy makers must understand the variety of factors that influence whether or not a child uses active school travel. Several reviews have identified both inhibitors and promoters of active school travel, but few studies have combined these putative characteristics in one analysis. The purpose of this study is to examine associations between elementary school children’s active school travel and variables hypothesized as correlates (demographics, physical environment, perceived barriers and norms).

Methods

The current project uses the dataset from the National Evaluation of Walk to School (WTS) Project, which includes data from 4^th and 5^th grade children and their parents from 18 schools across the US. Measures included monthly child report of mode of school travel during the previous week (n = 10,809) and perceived barriers and social norms around active school travel by parents (n = 1,007) and children (n = 1,219). Generalized linear mixed models (GLMM) with log-link functions were used to assess bivariate and multivariate associations between hypothesized correlates and frequency of active school travel, assuming random school effect and controlling for the distance to school.

Results

The final model showed that the most relevant significant predictors of active school travel were parent’s perceived barriers, specifically child resistance (Estimate = −0.438, p < 0.0001) and safety and weather (Estimate = −0.0245, p < 0.001), as well as the school’s percentage of Hispanic students (Estimate = 0.0059, p < 0.001), after adjusting for distance and including time within school cluster as a random effect.

Conclusions

Parental concerns may be impacting children’s use of active school travel, and therefore, future interventions to promote active school travel should more actively engage parents and address these concerns. Programs like the Walk to School program, which are organized by the schools and can engage community resources such as public safety officials, could help overcome many of these perceived barriers to active transport.

Promoting youth physical activity in rural southern communities: practitioner perceptions of environmental opportunities and barriers

PURPOSE

Research on youth physical activity has focused on urban areas. Rural adolescents are more likely to be physically inactive than urban youth, contributing to higher risk of obesity and chronic diseases. Study objectives were to: (1) identify perceived opportunities and barriers to youth physical activity within a rural area and (2) identify rural community characteristics that facilitate or inhibit efforts to promote youth physical activity.

METHODS

Thirty in-depth interviews were conducted with expert informants in 2 rural southern US counties. Interviewees were recruited from diverse positions across multiple sectors based on their expert knowledge of community policies and programs for youth physical activity.

FINDINGS

Informants saw ball fields, natural amenities, and school sports as primary resources for youth physical activity, but they were divided on whether opportunities were abundant or scarce. Physical distance, social isolation, lack of community offerings, and transportation were identified as key barriers. Local social networks facilitated political action and volunteer recruitment to support programs. However, communities often lacked human capital to sustain initiatives. Racial divisions influenced perceptions of opportunities. Despite divisions, there were also examples of pooling resources to create and sustain physical activity opportunities.

CONCLUSIONS

Developing partnerships and leveraging local resources may be essential to overcoming barriers for physical activity promotion in rural areas. Involvement of church leaders, school officials, health care workers, and cooperative extension is likely needed to establish and sustain youth rural physical activity programs. Allocating resources to existing community personnel and volunteers for continuing education may be valuable.

Built environment characteristics and parent active transportation are associated with active travel to school in youth age 12-15

PURPOSE

To investigate the relation of factors from multiple levels of ecological models (ie, individual, interpersonal and environmental) to active travel to/from school in an observational study of young adolescents.

METHODS

Participants were 294 12-15-year olds living within two miles of their school. Demographic, psychosocial and perceived built environment characteristics around the home were measured by survey, and objective built environment factors around home and school were assessed in Geographic Information Systems (GIS). Mixed effects multinomial regression models tested correlates of engaging in 1-4 (vs 0) and 5-10 (vs 0) active trips/week to/from school, adjusted for distance and other covariates.

RESULTS

64% of participants reported ≥1 active trip/week to/from school. Significant correlates of occasional and/or habitual active travel to/from school included barriers (ORs=0.27 and 0.15), parent modelling of active travel (OR=3.27 for habitual), perceived street connectivity (OR=1.78 for occasional), perceived pedestrian safety around home (OR=2.04 for habitual), objective street connectivity around home (OR=0.97 for occasional), objective residential density around home (ORs=1.10 and 1.11) and objective residential density around school (OR=1.14 for habitual). Parent modelling interacted with pedestrian safety in explaining active travel to/from school.

CONCLUSIONS

Results supported multilevel correlates of adolescents' active travel to school, consistent with ecological models. Correlates of occasional and habitual active travel to/from school were similar. Built environment attributes around schools, particularly residential density, should be considered when siting new schools and redeveloping neighbourhoods around existing schools.

Parental safety concerns and active school commute: correlates across multiple domains in the home-to-school journey

Background

Empirical evidence of the relationship between safety concerns and walking to school (WTS) is growing. However, current research offers limited understanding of the multiple domains of parental safety concerns and the specific mechanisms through which parents articulate safety concerns about WTS. A more detailed understanding is needed to inform environmental and policy interventions. This study examined the relationships between both traffic safety and personal safety concerns and WTS in the U.S.

Methods

This cross-sectional analysis examined data from the Texas Childhood Obesity Prevention Policy Evaluation (T-COPPE) project, an evaluation of state-wide obesity prevention policy interventions. All study data were from the survey (n = 830) of parents with 4th grade students attending 81 elementary schools across Texas, and living within two miles from their children's schools. Traffic safety and personal safety concerns were captured for the home neighborhood, en-route to school, and school environments. Binary logistic regression analysis was used to assess the odds of WTS controlling for significant covariates.

Results

Overall, 18% of parents reported that their child walked to school on most days of the week. For traffic safety, students were more likely to walk to school if their parent reported favorable perceptions about the following items in the home neighborhood environment: higher sidewalk availability, well maintained sidewalks and safe road crossings. For the route to school, the odds of WTS were higher for those who reported "no problem" with each one of the following: traffic speed, amount of traffic, sidewalks/pathways, intersection/crossing safety, and crossing guards, when compared to those that reported "always a problem". For personal safety in the en-route to school environment, the odds of WTS were lower when parents reported concerns about: stray or dangerous animals and availability of others with whom to walk.

Conclusions

Findings offered insights into the specific issues that drive safety concerns for elementary school children’s WTS behaviors. The observed associations between more favorable perceptions of safety and WTS provide further justification for practical intervention strategies to reduce WTS barriers that can potentially bring long-term physical activity and health benefits to school-aged children.