Social and physical environmental correlates of independent mobility in children: a systematic review taking sex/gender differences into account

National trends and ecological factors of physical activity engagement among U.S youth before and during the COVID-19 pandemic: A cohort study from 2019 to 2021

BACKGROUND

This study aims to investigate the trends and ecological determinants of physical activity among U.S. children and adolescents during the 2019-2021 period, encompassing the COVID-19 pandemic's onset and subsequent years.

METHODS

Utilizing data from the National Survey of Children's Health over three years, this cohort study analyzed physical activity levels and ecological determinants among 82,068 participants aged 6-17. The sample included 36,133 children (44%) and 45,935 adolescents (56%), with variables assessed by caregiver reports.

RESULTS

The analysis revealed a significant decline in physical activity among children from 2019 to 2020, followed by a recovery in 2021, whereas adolescents showed a continued decrease without recovery. Over the study period, children were consistently more active than adolescents. Better health status, normal weight, less screen time, stronger peer relationships, higher parental involvement, better family resilience and greater school participation were consistently correlated with increased physical activity in both age groups. Sleep duration was a predictor of activity only in children, while mental health status was solely a predictor in adolescents. Neighborhood environment consistently predicted children's activity levels but was a significant factor for adolescents only in 2020.

CONCLUSIONS

These findings highlight the differing impacts of the pandemic on physical activity between children and adolescents, emphasizing the need for targeted public health interventions, particularly for adolescents whose activity levels have not recovered from the pandemic period. Age-specific physical activity interventions should consider sleep duration and neighborhood environmental factors when targeting children and mental health factors when focused on adolescents.

Pathways linking greenspace to behavioural problems in Polish children

Background

Previous cross-sectional studies have found a beneficial relationship between greenspace and children's behaviour. Nevertheless, evidence on the mechanisms underlying this association remains scant. We examined whether the availability of greenspace was related to fewer behavioural problems in Polish children and investigated potential mechanisms.

Methods

Data were obtained from the case-control NeuroSmog study, in which children with and without attention deficit hyperactivity disorder (ADHD) were tested from October 2020 to September 2022. The analytic sample comprised 679 children aged 10-13 years. Parents reported internalizing, externalizing, and total behavioural problems using the Child Behaviour Check List (CBCL), as well as information about the presence of a domestic garden and potential mediators: greenspace perception, neighbourhood social cohesion, and physical activity. Tree and grass covers were extracted in 500 m and 1 km buffers around lifelong residences. Structural equation modelling (SEM) was used to examine the psychosocial pathways linking the greenspace metrics to behavioural problems.

Results

Greenspace was only indirectly related to fewer behavioural problems. Specifically, tree cover was related to greater levels of physical activity which, in turn, was related to fewer internalizing and total behavioural problems. Tree cover and presence of garden were related to greenspace perception which, in turn, was associated with higher neighbourhood social cohesion which, in turn, was linked to fewer behavioural problems. The patterns of associations in children without ADHD were very similar to those in the full sample except that the associations from garden to greenspace perception and from physical activity to total behavioural problems were no longer significant. The only association persisted among girls was from neighbourhood social cohesion to behavioural problems and among boys were from tree cover to physical activity and tree cover and garden to greenspace perception.

Conclusion

Trees and garden, but not grass, are linked to fewer behavioural problems through greenspace perception, neighbourhood social cohesion, and physical activity in Polish children.

After-School Activities of Japanese Elementary School Children: Comparison of Children Who Attend Lessons and Cram Schools With Those Who Do Not

BACKGROUND

This study examined the after-school activities of Japanese elementary school children in which little information is available for understanding the process by which participation in organized activities leads to the decrease in children's independent mobility.

METHODS

One thousand eight hundred and twenty-four mothers of elementary school children participated in an online survey. The mothers responded to the questions on the number of lessons (or cram schools) their children attended weekdays, as well as their children's behavior after classes, and parents providing transportation when their children go out to play.

RESULTS

The proportion of children attending lessons and/or cram schools increased as their grades progressed. A significant interaction existed between the degree of parental transportation and grade in terms of whether or not the children attended lessons and/or cram schools. Parental involvement included pick up or drop-off for a large percentage of younger children without lessons, whereas the degree of parental involvement was greater for older children attending lessons. In other words, parents of children without attending lessons or cram schools tended to allow children to engage in independent activities when they reached the higher grades, whereas parents of children who frequently attended lessons and cram schools tended to remain involved in transporting their children, even when they reached the higher grades.

CONCLUSIONS

The results suggested that the participation of children in organized activities leads to a routine of parental pickup and/or drop-off, which renders difficult the facilitation of opportunities for children to independently participate in play activities.

Patterns of Avoidance Behavior in Response to Fear of Victimization in the Mexican Context: A Latent Class Analysis

Fear of victimization (FOV) is a powerful determinant of behavior and prompts behavioral responses such as avoidance, associated with a decline in health-promoting activities and quality of life. Avoidance behaviors, which include constraining activities to perceived safe areas and avoiding areas regarded as unsafe, are of particular interest due to their high prevalence as a coping response to FOV and their link to adverse physical and mental health. Most research on FOV-related avoidance treats it as a single construct and have yet to elucidate the potential heterogeneity within this set of behaviors. We argue that such approach could mask potential heterogeneity among people who respond to FOV through avoidance and how they adapt to manage perceived risk. Our analysis extends the foundational knowledge regarding FOV-related avoidance using a person-centered approach. We attempted to capture distinct profiles across avoidance behaviors and how they are shaped by physical and social vulnerabilities. Data from the 2021 Mexico's National Survey of Victimization and Perception of Security Survey (n = 83,696) was analyzed using Latent Class Analysis focusing on 15 avoidance behaviors (e.g., stopped using public transportation). We conducted multinomial logistic regression to test whether age, gender, education, and neighborhood deprivation significantly predicted class membership. Findings revealed three classes: avoidant (most behavioral adjustments across the board), cautious (only adapted some behaviors), and protective (least behavioral adjustments, but more concerned about minors in their households). The results supported the hypothesized associations between age, gender, education, and neighborhood deprivation with group membership, but the significance differed by group. This research underscores the role of environmental context in shaping individual perceptions of safety and avoidance behavior. Finally, contrary to the approach of treating avoidance behavior as a single category, these findings present a more complex picture as distinct and meaningful patterns emerged across the three groups.

The Role of Attachment, Insecurity, and Stress in Partner Maltreatment: A Meta-Analysis

Negative, destructive, and abusive behaviors in romantic relationships can vary from explicit kinds of abuse and aggression to more subtle and seemingly innocuous slights against or ways of treating a partner. However, regardless of the severity or explicit nature, these behaviors all, to one extent or another, reflect acts of invalidation, disrespect, aggression, or neglect toward a partner, and could be considered maltreatment of a partner. The current paper proposes the term partner maltreatment as a broad overarching concept, which was used to facilitate a meta-analytic synthesis of the literature to examine the associations between attachment insecurity (i.e., attachment anxiety, attachment avoidance) and perpetration of partner maltreatment. Additionally, this paper situated partner maltreatment within an attachment-based diathesis-stress perspective to explore the moderating role of stress. Five databases were systematically searched for published and unpublished studies that examined the direct association between perpetrator's adult attachment orientation and perpetration of partner maltreatment behaviors. We synthesized effect sizes from 139 studies (N = 38,472) and found the effect between attachment insecurity and acts of partner maltreatment varied between r = .11 to .21. Our findings provide meta-analytic evidence to suggest that attachment insecurity is a significant individual vulnerability factor (diathesis) associated with partner maltreatment; and that when individuals with an insecure attachment orientation experience stress, the tendency to perpetrate partner maltreatment is typically heightened. The findings of this meta-analysis provide empirical evidence for the importance of considering and addressing contextual factors, especially stress, for those individuals and couples seeking therapy for partner maltreatment.

Child and youth physical activity throughout the COVID-19 pandemic: The changing role of the neighbourhood built and social environments

We explored associations between neighbourhood environments and children and youths' moderate-to-vigorous physical activity (MVPA) during three different waves of the COVID-19 pandemic: spring 2020, fall 2020 and spring 2021, using three nationally representative cross-sectional surveys. In wave 2, higher dwelling density was associated with lower odds of a child achieving higher-level MVPA, however, the odds were higher in neighbourhoods with higher density that also had better access to parks. With regard to the social environment, ethnic concentration (wave 3) and greater deprivation (waves 1 and 3) were associated with lower odds of a child achieving higher-level MVPA. Results indicate that built and social environments were differently associated with MVPA levels depending on pandemic restrictions.

Exploring correlates of physical activity behaviour in UK children and their inter-relationships using a multidisciplinary approach: A concept mapping study

It is still unknown which correlates of physical activity behaviour (PAB) may be effective and how they may influence PAB in UK children. The objective of the current study was to generate a conceptual analysis of the correlates of PAB in UK children (5-12 years) using the input of researchers in the field of physical activity (PA experts; PAE) and other fields (non-PA experts; non-PAE). A concept mapping approach was used to identify potential (new) correlates of PAB in children, assess their importance based on rating of potential modifiability and effect, and generate a concept map depicting the associations between them. In the first (brainstorming) stage (n = 32 experts) yielded 93 correlates, including 14 new correlates not identified in previous reviews. In the second (rating and sorting) stage (n = 26 experts), 32 correlates were rated as important and a four-cluster concept map was generated including themes related to Society/community, Home/social setting, Personal/social setting and Psychological/emotional correlates. Two additional concept maps were generated for PAE and non-PAE. From expert opinion, we identified new correlates of PAB that warrant further research and we highlight the need to consider the interaction between intrapersonal and external correlates when designing interventions to promote PA in UK children.

Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany

Background

According to socio-ecological theories, physical activity behaviors are linked to the physical and social neighborhood environment. Reliable and contextually adapted instruments are needed to assess environmental characteristics related to physical activity. This work aims to develop an audit toolbox adapted to the German context, to urban and rural settings, for different population groups, and different types of physical activity; and to evaluate its inter-rater reliability.

Methods

We conducted a systematic literature search to collect existing audit tools and to identify the latest evidence of environmental factors influencing physical activity in general, as well as in German populations. The results guided the construction of a category system for the toolbox. Items were assigned to the categories based on their relevance to physical activity and to the German context as well as their comprehensibility. We piloted the toolbox in different urban and rural areas (100 street segments, 15 parks, and 21 playgrounds) and calculated inter-rater reliability by Cohen's Kappa.

Results

The audit toolbox comprises a basic streetscape audit with seven categories (land use and destinations, traffic safety, pedestrian infrastructure, cycling infrastructure, attractiveness, social environment, and subjective assessment), as well as supplementary tools for children and adolescents, seniors and people with impaired mobility, parks and public open spaces, playgrounds, and rural areas. 76 % of all included items had moderate, substantial, or almost perfect inter-rater reliability (κ > 0.4).

Conclusions

The audit toolbox is an innovative and reliable instrument for the assessment of the physical activity friendliness of urban and rural environments in Germany.

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

Introduction

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

Methods

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

Results

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

Discussion

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

Children's independent mobility during dark hours: a scoping review

Introduction

Independent mobility is every child's right and has implications for their health, wellbeing, and development. This scoping review addresses children's needs and experiences of light conditions in their everyday outdoor life. The review examines peer-reviewed scientific literature that analyses associations between different light conditions and children's independent mobility (CIM) during dark hours.

Methods

By formulating a Boolean search string, including terms related to children independent mobility, light and outdoor environment, five scientific databases were searched. The search resulted in 67 eligible papers that were analyzed through an inductive, thematic analysis.

Results

Four overarching themes representing the researched topics of the effects of light conditions with importance for CIM during dark hours were identified: (1) physical activity (PA) and active travel, (2) outdoor activities and place use, (3) safety perception, and (4) outdoor risks. The findings highlight that darkness constitutes a major obstacle for CIM, and that fear of darkness is common among children. It restricts the degree of CIM and influences children's safety perception as well as how they navigate through public places outdoors. The findings show that the type and design of outdoor settings during dark hours and children's familiarity with places during daytime could play a role in the degree of CIM after dark. The presence of outdoor lighting is related to children's increased PA and active travel, and outdoor lighting seems to also influence children's place use and interaction with the environment. The presence and extent of outdoor lighting and lighting quality may play a role in children's safety perception, which in turn can influence CIM.

Discussion

The findings suggest that promoting CIM during dark hours might not only contribute to the accumulation of children's PA, confidence, and skills, but also support mental health. The understanding of children's perspectives on the quality of outdoor lighting needs to be deepened to support CIM. Highlighting the child perspective would aid the development of current recommendations for outdoor lighting and the implementation of the Agenda 2030 of ensuring healthy lives and promoting wellbeing for all at all ages, and making cities inclusive, safe, resilient and sustainable throughout the day and seasons.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Obesogenic environment around schools is associated with atherogenic risk in Brazilian children

INTRODUCTION

Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status.

METHODS

In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations.

RESULTS

"Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR = 0.63; p < 0.001).

CONCLUSION

We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.

Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index

OBJECTIVE

We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI).

METHODS

A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters.

RESULTS

The neighborhood obesogenic environment had a significant total association (Standardized Coefficient = 0.172, p = .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient = 0.066, p = .049).

CONCLUSIONS

Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.

Higher independent mobility to school among adolescents: A secondary analysis using cross-sectional data between 2010 and 2017 in Spanish youth

AIM

To describe and to analyse the associations between independent mobility to school (IM) with gender and age in Spanish youth aged 6-18 years old from 2010 to 2017. Moreover, to study the changes in the rates of IM from 2010 to 2017 by gender and age.

METHODS

Cross-sectional data were obtained from 11 Spanish studies. The study sample comprised 3460 children and 1523 adolescents. Logistic regressions models (IM with gender and age) and multilevel logistic regressions (IM with time period) were used.

RESULTS

Boys had higher odds ratio (OR) of IM than girls in children (OR = 1.86; CI: 1.50-2.28, p < 0.01). Adolescents showed higher IM than children: 12-14 years old (OR: 6.30; CI: 1.65-23.97) and 14-16 years old (OR: 7.33; CI: 1.18-45.39) had higher IM than 6-8 years old for boys (all, p < 0.05). Moreover, 12-14 years old (OR: 4.23; CI: 1.01-17.81) had higher IM than 6-8 years old for girls (p < 0.001). IM was not associated with the time period.

CONCLUSION

The IM is higher in boys and in adolescents, highlighting the relevance to promote IM strategies targeting girls and children. In these strategies is essential the support of researchers, public health practitioners and families to achieve positive results.

Relationship between Perceived Physical Competence and Outdoor Play among Children Aged 9-12 Years-Focused Sex-Specific Differences

BACKGROUND

Outdoor play (OP), which is considered important for children's development, is declining every year. Perceived physical competence (PPC) is a vital factor that promotes physical activity such as OP, sports clubs, etc., but the relationship between PPC and OP was unknown. The purpose of this research was to investigate the relationship between PPC and OP in children and consider whether there were any sex-specific changes.

METHODS

A cross-sectional study was conducted in Japan with 288 children (134 girls, age: 10.6 ± 1.01 years). OP was assessed using an original self-report questionnaire. Each weekday, the children reported the time of OP and were classified as "high" if they played outside for at least an hour three times. PPC was evaluated with a self-report questionnaire developed by Okazawa et al. (1996). It has 12 questions and was assessed on a 5-point Likert scale. After adjusting for age, sex, BMI, screen time, sports club participation, and the number of friends, logistic regression analyses were carried out.

RESULTS

Children with better PPC were significantly more likely to be classified as "high" [crude odds ratio (OR): 1.04; 95% confidence interval (CI): 1.00-1.08; adjusted OR: 1.04; 95% CI: 1.00-1.08]. Only girls with better PPC were significantly more likely to be classified as "high" in a sex-based stratified analysis [crude OR: 1.08; 95% CI: 1.01-1.15, adjusted OR 1.09; 95% CI: 1.02-1.17].

CONCLUSIONS

Particularly among girls, OP could be promoted as a voluntary physical activity with improved PPC.

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

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

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

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

Relationship between Children's Independent Activities and the Built Environment of Outdoor Activity Space in Residential Neighborhoods: A Case Study of Nanjing

Children are a vulnerable population that is frequently overlooked in urban planning. The spatial demands of children are garnering broader consideration in the development of public spaces in cities as efforts to promote child-friendly cities. Children's independent activities (CIAs) during childhood are undeniably beneficial to their physical and mental health. Residential areas are the main places for children's daily activities. Building a suitable outdoor activity space in the community for children's recreation is an essential foundation for improving CIAs and promoting the development of child-friendly neighborhoods. A sample of 15 typical children's outdoor activity spaces in residential neighborhoods of Nanjing, China, was selected for the study to observe and record CIAs. The built environment indicators of residential outdoor spaces were extracted, and correlation analysis was employed to investigate the residential outdoor space elements relevant to CIAs. The results indicated that at the site level, higher percentages of tree coverage and soft paving enhanced CIAs, while high functional mix inhibited them. Additionally, gated communities, top-notch sanitation, secure facilities, neighborhoods with higher residential densities, and a diversity of activity facilities all stimulated children to engage in independent activities. Furthermore, questionnaires for the guardian indicated that they placed a high priority on site safety, and that waterfront areas and activity sites where incidents had occurred decreased parents' willingness to allow participation in CIAs, whereas safety education or the use of positioning devices may promote CIAs. Based on the above results, we proposed appropriate adaptations for places in residential neighborhoods. The study expects to create a higher quality environment in residential neighborhoods for children to play in public spaces and provide beneficial help to improve the child-friendly neighborhood.

Effects of Attending Extracurricular Lessons and Cram School on Independent Mobility in Japanese Children

Independent mobility and its related factors were examined among Japanese elementary school children. Based on the responses of 1,824 mothers with elementary school-aged children, the effects of demographic variables such as children’s grade, gender, and birth order as well as regional characteristics, neighborhood environment, distance to and means of getting to school, children’s use of bicycles, keys and cell phones, and the number of weekdays spent attending lessons or cram schools were explored. Factor analysis revealed that independent mobility comprised activities in public places, including outings to supermarkets, and traveling by bus and train as well as activities in the school district such as visiting friends’ homes and parks. Hierarchical multiple regression analyses that comprised five steps were conducted in which the number of days of attending lessons and cram school was entered in the final step. There was a strong gender effect and grade effect for outings to public places and activities in the school district. Concerns about traffic accidents and security were associated with lower independent mobility. With regard to activities in the school district, proximity to school, use of bicycles, and possession of house keys had a positive effect. It is noteworthy that the effect of the number of days spent attending lessons or cram school was observed even after the other variables were entered, thus resulting in a negative effect. It is recommended that further comparative studies involving other Asian countries be conducted to evaluate the effects of extracurricular activities.

Examining the state, quality and strength of the evidence in the research on built environments and physical activity among children and youth: An overview of reviews from high income countries

BACKGROUND

Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews.

OBJECTIVE

Examine the current state and quality of research looking at associations between built environments and total PA and domains of PA (i.e., leisure/recreation, transportation, school) among children and youth (1-18 years).

METHODS

We systematically searched the grey literature and six bibliographic databases from January 2000 to May 2020. Review quality was assessed using the AMSTAR2. Results by age group were synthesized using narrative syntheses and harvest plots, and certainty of the evidence was assessed using a modified GRADE approach.

RESULTS

This overview included 65 reviews. Most reviews were of very low-to-low quality. High certainty was found for positive associations between transportation PA and walking/cycling/active transportation (AT) infrastructure. There was high certainty for positive associations between streets/play streets and total PA, alongside lower certainty for transportation and leisure PA. Very low-to-moderate certainty supports schoolyards designed to promote PA were positively associated with total PA, but mixed for school PA (except children). Less consistent positive associations were found for forests/trees, greenspace/open space, recreation facilities, street lighting, traffic safety, population/residential density, proximity/access to destinations, neighbourhood characteristics, and home environments. There is very low-to-moderate certainty for negative associations between greater distance to school and traffic volume and domains of PA. Generally, null or mixed associations were observed for aesthetics, parks, AT comfort infrastructure, land-use mix, street connectivity, urban/rural status, and public transit.

DISCUSSION

There remains a need for high quality systematic reviews and studies to evaluate the effects of environmental changes across the pediatric age spectrum and using a PA domain approach. Given the global physical inactivity crisis the built environment remains and important means to promote PA among children/youth.

Social-Ecological Correlates of Children’s Independent Mobility: A Systematic Review

Children’s independent mobility (IM) is associated with a range of benefits and understanding the factors that influence IM can support creation of effective interventions. The review (Prospero CRD42016042174) systematically summarized the available literature for social-ecological correlates of children’s IM in school-aged children and youth (aged 5–17 years). In this case, 53 studies were included and evaluated six individual, 15 interpersonal, 12 social environment, and 19 built environment- level variables. Most studies originated from Australia (n = 15) and Canada (n = 8) with most published in 2011 or later (n = 48). Variables that were consistently (positively and/or negatively) associated with children’s IM were age, ethnicity/race, child’s perceived competence, ownership of a house/access to house keys, having siblings, parents’ attitude toward IM and perception of child’s confidence, children’s interest in environment and activities, parents’ concern around traffic, housing/residential density, length of residency in one’s home, distance to destinations, and proximity to green space. Given the inter-related social-ecological correlates identified, intervention to promote children’s IM will likely need a multi-level and multi-sectoral approach. However, focus areas of building children’s skills and confidence, helping parents gain confidence in their children’s abilities, assuaging parental traffic concerns, and building environments with shorter distances to destinations of interest for children should be prioritized.

Enabling Better Physical Activity and Screen Time Behaviours for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents

The unrelenting obesity pandemic in Middle Eastern (ME) adolescents living in Australia warrants culturally responsive and locally engineered interventions. Given the influence of parents on the lifestyle behaviours of adolescents, this qualitative study aimed to capture the opinions of ME parents on the barriers and enablers to sufficient physical activity and limiting screen time behaviours in adolescents. Semi-structured interviews were conducted with 26 ME parents (female) aged 35–59 years old, most of whom resided in lower socioeconomic areas (n = 19). A reflexive thematic analysis using the Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behaviour model was performed for coding. Parents voiced confidence in their knowledge of the importance of physical activity and limiting screen time but were less optimistic in their ability to enable change in behaviours, especially for older adolescents without outside support. Despite adolescents having the necessary skills to engage in a wide array of sports, the parents admitted deep fears regarding the safety of the social environment and restricted their children’s independent mobility. Gender differences were noted, with parents reporting older girls expressing disinterest in sports and having limited physical opportunities to participate in sports at school. It may be that a community-based participatory framework is needed to improve physical activity opportunities and to address specific physical, social, and cultural barriers.

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

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

Walkability indices and children's walking behavior in rural vs. urban areas

PURPOSE

This study described associations between selected walk indices (WI) and walking and physical activity behaviors in rural and urban children.

FINDINGS

WI were higher in urban environments, yet children from rural areas walked for transportation more than children from urban areas. There was a negative correlation between National WI scores and walking for transportation in urban areas, and between the Frank WI scores and walking for exercise in rural areas.

CONCLUSIONS

Indices of walkability are not associated with objectively measured physical activity or self-reported walking behavior in children living in rural and urban settings.

Parent's sociodemographic factors, physical activity and active commuting are predictors of independent mobility to school

Background

Independent mobility (IM) provides young people with many opportunities to increase their autonomy and physical activity (PA). This study aimed to analyse whether the parent’s PA, active commuting to work and sociodemographic factors serve as predictors of IM to school in children and adolescents.

Methods

A total of 684 parents (52.8% mothers) and their offspring (56.4% girls) were included in this study, which was performed in Granada (Spain) and Valparaíso (Chile). The parents self-reported their sociodemographic characteristics, PA and mode of commuting to work. The mode of commuting to and from school and the offspring accompaniment mode were reported. T-test and chi-square test were used to study quantitative and qualitative differences by parental gender, respectively. Binary logistic regression models (odds ratio = OR) and stepwise analysis were performed to study the association between the parents’ sociodemographic variables and IM to school.

Results

Adolescents showed higher IM to school than children (58.9% vs 40.2%; p < 0.001). No car availability and shorter distance to work were positively associated with higher IM to school in children (OR = 2.22 and 2.29, respectively). Mothers' lower salary/month (OR = 2.75), no car availability (OR = 3.17), and mother passive commuting to work (OR = 2.61) were positively associated with higher IM to school in adolescents. The main predictor of IM to school in children and adolescents was no car availability (OR = 6.53).

Conclusion

Parental sociodemographic factors, such as salary, distance to work and car availability, were associated more strongly with IM than parental PA and active commuting to work.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12942-021-00280-2.

Paving the Way for Outdoor Play: Examining Socio-Environmental Barriers to Community-Based Outdoor Play

Outdoor play and independent, neighborhood activity, both linked with healthy childhood development, have declined dramatically among Western children in recent decades. This study examines how social, cultural and environmental factors may be hindering children’s outdoor and community-based play. A comprehensive survey was completed by 826 children (aged 10–13 years) and their parents from 12 schools (four each urban, suburban and rural) from a large county in Ontario, Canada. Five multilevel regression models, controlling for any school clustering effect, examined associations between outdoor play time per week and variable sets representing five prevalent factors cited in the literature as influencing children’s outdoor play (OP). Models predicted that younger children and boys were more likely to spend time playing outdoors; involvement in organized physical activities, other children nearby to play with, higher perception of benefits of outdoor play, and higher parental perceptions of neighborhood social cohesion also predicted more time in outdoor play. Time outdoors was less likely among children not allowed to play beyond home without supervision, felt they were ‘too busy’ with screen-based activities, and who reported higher fears related to playing outdoors. Study findings have important implications for targeting environmental, cultural and policy changes to foster child-friendly communities which effectively support healthy outdoor play.

"Well, You Feel More Responsible When You're Unsupervised": Exploring Family Perspectives on Children's Independent Mobility

While children's independent mobility (CIM) is associated with various benefits, there is evidence of a generational decline in CIM in westernized countries; therefore, it is helpful to understand how CIM is currently negotiated between children and their parents. The purpose of this study was to examine children's and parents' perspectives and negotiations of CIM within the family unit. Face-to-face interviews and walk-along interviews were conducted with parents (n = 44) and children (n = 22), respectively. Interviews were audio-recorded and transcribed verbatim, and a thematic analysis was conducted. Four key preconditions were identified that facilitated negotiation of CIM within family units, including (1) the influence of parents' childhood experiences regarding their view of CIM (e.g., positive interpretations of childhood on parenting practices), (2) the role of children's individual characteristics on their independent mobility (e.g., child's confidence in their abilities), (3) family communication as a key coping strategy (parent-parent and parent-child communication), and (4) the influence of positive perceptions of the social environment on CIM. The findings suggest that CIM thrives when these conditions are present; as a result, it may be particularly helpful to develop policies and programs that support children's skill training, explore strategies to support communication between parents and children, and build neighbourhood connections.

"You Can't Go to the Park, You Can't Go Here, You Can't Go There": Exploring Parental Experiences of COVID-19 and Its Impact on Their Children's Movement Behaviours

The COVID-19 outbreak and related public health guidelines have changed the daily lives of Canadians and restricted opportunities for healthy movement behaviours for children. The purpose of this study was to explore how parents experienced the pandemic-related restrictions and how they impacted their children’s movement behaviours. Methods: Twenty-nine semi-structured one-on-one interviews were conducted (June–July 2020) with parents of children (5–11 years old) in Ontario and British Columbia. Interviews lasted between 24–104 min, were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Findings emphasized various individual (e.g., motivation), interpersonal (e.g., parent work schedule), built (e.g., closure of parks) and natural environment (e.g., weather) factors related to children’s movement behaviours. The findings highlighted the loss of structured activities and destinations for children’s physical activity, and restricted opportunities for outdoor play exacerbated by shrinking childhood independent mobility. Conclusion: Families are adapting to many pandemic-related challenges including adhering to public health restrictions, parents juggling multiple roles, conducting work and school from home, as well as exacerbating factors like weather. It will be important to continue to encourage outdoor time, support policies and practice that facilitate independent mobility, and develop centralized resources that help families in the maintenance of healthy movement behaviours.

Individual and neighborhood characteristics associated with neighborhood walking among US older adults

BACKGROUND

Neighborhood walking connotes physical activity and opportunities for social and cognitive engagement and improved mental health, factors previously associated with outcomes including mortality, cardiovascular disease, and dementia. Few studies have examined correlates of neighborhood-specific walking in older adults.

PURPOSE

We investigated the individual and neighborhood/regional correlates of neighborhood-based walking among US older adults.

METHODS

We obtained cross-sectional data on ≥ 65 year olds from the population-based 2017 National Household Travel Survey (n = 73,523). Respondents completed diaries detailing trips during an assigned travel day. Adjusted logistic regression (using survey weights) tested associations between individual, neighborhood, and regional characteristics and ≥ 1 versus no neighborhood walk trips/day (from travel diary).

RESULTS

Twelve percent had ≥ 1 neighborhood walk trip/day and 54% of the neighborhood walkers achieved ≥ 30 min of walking/day. African Americans/Blacks (versus non-Hispanic Whites) and working individuals (versus retired) had lower odds of neighborhood walking. Individuals without cars, bus/train users, and those with higher neighborhood housing density had greater odds of neighborhood walking. Utilitarian walking was less likely among African Americans/Blacks and Hispanics but more likely among Asians (versus non-Hispanic Whites). Social/recreational neighborhood walking was more likely for those without cars, bus/train users, and those with greater neighborhood housing density.

CONCLUSION

Few US older adults walked in their neighborhoods, suggesting a potentially fruitful target for health promotion efforts and community interventions to improve health and quality of life in older adults. Future work is needed to determine other neighborhood factors associated with greater neighborhood walking.

Social determinants of playing outdoors in the neighbourhood: family characteristics, trust in neighbours and daily outdoor play in early childhood

OBJECTIVES

The goal of this study was to investigate socio-demographic and contextual factors in relation to the frequency of outdoor play in the neighbourhood in early childhood, drawing from a large sample of children in British Columbia, Canada.

METHODS

Parents/caregivers of 2280 4- to 5-year-old children completed the Childhood Experiences Questionnaire (CHEQ) in 2018. Binary logistic regression analyses were conducted to predict the likelihood of children participating in everyday outdoor play in their neighbourhood based on the child's gender, family ethnicity (i.e., European origin vs. other), household income (i.e., less vs. equal/more than CDN$75,000), population centre (i.e., urban vs. rural) and parent's trust in neighbours (i.e., trusting vs. not trusting neighbours to look out for children).

RESULTS

Thirty-five percent of children in this study met recommendations of playing outdoors every day. Children whose parents perceived strong trust in neighbours were twice as likely to play outdoors in their neighbourhood every day, when compared with those whose parents perceived low trust in neighbours. Additionally, children from families with higher incomes (equal/more than $75,000) were significantly more likely to play outdoors daily than those with lower incomes, but only if they resided in rural areas. Last, children with European family backgrounds were 64% more likely to play outdoors every day compared with those with non-European backgrounds.

CONCLUSION

Findings from this study contribute to an emerging body of work examining socio-economic, demographic and contextual factors associated with children meeting the recommendations for everyday outdoor play in their neighbourhood.

Systematic review of the community environment for physical activity in young people - an update to the Report Card Brazil

abstract – The aim of this study was to update a systematic review on the relationship between the environment and physical activity among Brazilian children and adolescents. The search for articles for this review was performed in the MEDLINE, LILACS / BIREME, and SCIELO databases. For this update, only articles published in 2018 and 2019 were used. Descriptors were defined in English and Portuguese. The Boolean used for the advanced search was used, with 3 main blocks: environment, physical activity, and population. Additional filters were used in accordance with the structure of a database. In all, 5 articles were included in this systematic review, 4 with a population-based sample and 1 with a school-based sample. Among the selected studies, 4 were carried out in the southern region of Brazil (2 in Santa Catarina; 1 in Rio Grande do Sul; 1 in Paraná) and the other article was carried out with a national sample. The research period ranged between 2012 and 2017, with a sample size ranging from 38 volunteers to 102,072 participants. The environmental indicators found were road safety, the existence and use of spaces for the practice of physical activity, the characteristics of the school, and the possibility of practice in the school environment. It was concluded that environmental indicators can enhance the practice of physical activity among young Brazilians, requiring public policies that develop environmental projects to promote physical activity.

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

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

Children's active outdoor play: 'good' mothering and the organisation of children's free time

This qualitative study draws on the Foucault-inspired notion of biopedagogies to examine and problematise the salient factors of contemporary motherhood impacting children's active outdoor play (AOP). The study positions mothering as a practice, through which children's health and bodies are constructed and disciplined. A discourse analysis of 21 interviews with Canadian mothers identified three discursive constructions of the 'good mother': mothers as time managers, risk managers and screen-time managers. Each was characterised by discursive conflicts that compromised the provision of AOP by mothers. This study provides data necessary for successfully including AOP as a leisure practice within family-centred health promotion.

Urban Moveability and physical activity in children: longitudinal results from the IDEFICS and I.Family cohort

Background

Physical activity (PA) is one of the major protective behaviours to prevent non-communicable diseases. Positive effects of the built environment on PA are well investigated, although evidence of this association is mostly based on cross-sectional studies. The present study aims to investigate the longitudinal effects of built environment characteristics in terms of a moveability index on PA of children in their transition phase to adolescence using data of the IDEFICS/I.Family cohort.

Methods

We used data on 3394 accelerometer measurements of 2488 children and adolescents aged 3 to 15 years old from survey centres of three countries, Germany, Italy, and Sweden, who participated in up to three surveys over 6 years. In network-dependent home neighbourhoods, a moveability index was calculated based on residential density, land use mix, street connectivity, availability of public transport and public open spaces such as green spaces and public playgrounds in order to quantify opportunities for PA of children and adolescents. Linear trajectories of light PA (LPA) and moderate-to-vigorous PA (MVPA) were estimated using linear mixed models accounting for repeated measurements nested within individuals. Least squares means were estimated to quantify differences in trajectories over age.

Results

LPA and MVPA declined annually with age by approximately 20 min/day and 2 min/day respectively. In girls, the moveability index showed a consistent significantly positive effect on MVPA (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \hat{\beta} $$\end{document}β^ = 2.14, 95% CI: (0.11; 4.16)) for all ages, while in boys the index significantly lessened the decline in LPA with age for each year. (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \hat{\beta} $$\end{document}β^ = 2.68, 95% CI: (0.46; 4.90)).

Availability of public open spaces was more relevant for MVPA in girls and LPA in boys during childhood, whereas in adolescence, residential density and intersection density became more important.

Conclusion

Built environment characteristics are important determinants of PA and were found to have a supportive effect that ameliorates the decline in PA during the transition phase from childhood to adolescence. In childhood environmental support for leisure time PA through public open spaces was found to be the most protective factor whereas in adolescence the positive influence of street connectivity and residential density was most supportive of physical activity.

Examining the Features of Parks That Children Visit During Three Stages of Childhood

Parks provide an opportunity for children to be physically active, but are rarely fully utilised. A better understanding of which park features attract children of varying ages is needed. This study examined which features are present at parks that children visit most often at different stages throughout childhood. Parents reported the park their child visited most often at three timepoints: T1 = 3-5 years, T2 = 6-8 years, and T3 = 9-11 years. These parks were then audited (using a purposely created audit tool) to capture information relating to access, activity areas and quality. Online mapping tools were also used to determine walking distance to parks and park size. Parks visited at T2 were further from home, larger, and had more road crossings, full courts, other facilities and comfort amenities such as toilets and lights than T1 parks. Parks visited at T3 were larger and had more sports ovals compared to T1 parks, and were significantly less likely to have barbeque facilities than T2 parks. Our findings suggest that as children transition from pre-school (T1), to primary school age (T2 and T3), they visit parks that have more facilities to support sport and active recreation.

Children's Transport Built Environments: A Mixed Methods Study of Associations between Perceived and Objective Measures and Relationships with Parent Licence for Independent Mobility in Auckland, New Zealand

Children's independent mobility is declining internationally. Parents are the gatekeepers of children's independent mobility. This mixed methods study investigates whether parent perceptions of the neighbourhood environment align with objective measures of the neighbourhood built environment, and how perceived and objective measures relate to parental licence for children's independent mobility. Parents participating in the Neighbourhood for Active Kids study (n = 940) answered an open-ended question about what would make their neighbourhoods better for their child's independent mobility, and reported household and child demographics. Objective measures of the neighbourhood built environment were generated using geographic information systems. Content analysis was used to classify and group parent-reported changes required to improve their neigbourhood. Parent-reported needs were then compared with objective neighbourhood built environment measures. Linear mixed modelling examined associations between parental licence for independent mobility and (1) parent neighbourhood perceptions; and (2) objectively assessed neighbourhood built environment features. Parents identified the need for safer traffic environments. No significant differences in parent reported needs were found by objectively assessed characteristics. Differences in odds of reporting needs were observed for a range of socio-demographic characteristics. Parental licence for independent mobility was only associated with a need for safer places to cycle (positive) and objectively assessed cycling infrastructure (negative) in adjusted models. Overall, the study findings indicate the importance of safer traffic environments for children's independent mobility.

Assessment of direct and indirect associations between children active school travel and environmental, household and child factors using structural equation modelling

BACKGROUND

Active school travel (AST) is influenced by multiple factors including built and social environments, households and individual variables. A holistic theory such as Mitra's Behavioural Model of School Transportation (BMST) is vital to comprehensively understand these complex interrelationships. This study aimed to assess direct and indirect associations between children's AST and environmental, household and child factors based on the BMST using structural equation modelling (SEM).

METHODS

Data were drawn from Neighbourhoods for Active Kids (NfAK), a cross-sectional study of 1102 children aged 8-13 years (school years 5-8) and their parents from nine intermediate and 10 primary schools in Auckland, New Zealand between February 2015 and December 2016. Data were collected using an online participatory mapping survey (softGIS) with children, a computer-assisted telephone interviewing survey (CATI) with parents, and ArcGIS for built environment attributes. Based on the BMST a conceptual model of children's school travel behaviour was specified for SEM analyses ('hypothesised SEM'), and model modification was made to improve the model ('modified SEM'). SEM analyses using Mplus were performed to test the hypothesised/modified SEM and to assess direct and indirect relationships among variables.

RESULTS

The overall fit of the modified SEM was acceptable (N = 542; Root mean square error of approximation = 0.04, Comparative fit index = 0.94, Tucker-Lewis index = 0.92). AST was positively associated with child independent mobility, child-perceived neighbourhood safety, and parent-perceived importance of social interaction and neighbourhood social environment. Distance to school, and parental perceptions of convenience and concerns about traffic safety were negatively associated with AST. Parental fears of stranger danger were indirectly related to AST through those of traffic safety. Distance to school and child independent mobility mediated relationships between AST and child school year and sex.

CONCLUSIONS

Increasing children's AST requires action on multiple fronts including communities that support independent mobility by providing child friendly social and built environments, safety from traffic, and policies that promote local schools and safe vehicle-free zones around school.

Children's Independent Mobility: Current Knowledge, Future Directions, and Public Health Implications

Environmental changes significantly impact health behavior. Active travel behavior is mostly affected by increasing motorization, urban sprawl, and traffic safety. Especially for children, active and independent travel can contribute to physical activity, social and motor development, and other health-related outcomes. A reduced number of children engaging in independent mobility over the last 20 years demanded researchers to further examine the construct of children’s independent mobility. By examining relevant literature, this narrative review aims to provide the current state of knowledge on children’s independent mobility, and identify future directions in research, as well as practical implications. From a public health perspective, considering children’s independent mobility in intervention programs is recommended, since it is associated with numerous health and environmental benefits. To develop interventions, multilevel socio-ecological influences on children’s independent mobility are widely examined; however, evidence is limited due to heterogeneous measurements and a lack of high-quality prospective studies. To oppose the decline in children’s independent mobility, further analysis using comparable measures is needed to understand the determinants of children’s independent mobility and to enable international comparison.