Associations of the perceived and objective neighborhood environment with physical activity and sedentary time in New Zealand adolescents

Where Are Czech Adolescents Active? The Patterns of Movement and Transport Behavior in Different Active Living Domains

To understand the environmental determinants of physical activity (PA), precise spatial localization is crucial. This cross-sectional study focuses on the spatiotemporal distribution of PA among Czech adolescents (n = 171) using Global Positioning System loggers and accelerometers. The results showed that adolescents spent most of their time in sedentary behavior, with 57.2% and 58.5% of monitored time at home and school, respectively. The park and playground had the lowest proportion of sedentary behavior but also the lowest amount of moderate to vigorous PA (MVPA). However, when considering the time spent in each domain, the highest proportion of MVPA was seen in publicly accessible playgrounds (13.3% of the time). Chi-square analysis showed that the relative distribution of different PA intensities did not differ across spatial domains. Based on these results, the authors propose 2 key strategies for increasing MVPA in adolescents: Increase the time spent in activity-supportive environments, such as parks and playgrounds, and design techniques to increase MVPA at home and school settings.

Built environment and physical activity in adolescents: Use of the kernel density estimation and the walkability index

The availability of places for physical activity (PA) and the walkability of the neighborhood can impact the level of PA of adolescents. However, studies of this nature are still limited in Latin America. This study had two objectives: 1- using kernel density estimative, it investigated whether individuals living near PA places that are more intensely distributed than dispersed are more likely to be sufficiently active; 2-checked whether adolescents who live in neighborhoods with better walkability have a greater chance of being sufficiently active. Were evaluated 292 adolescents and PA was measured by accelerometry. Were measured five environmental variables for composing the walkability index. 98 PA points (places) were identified and destinations within these areas were geocoded and kernel density estimates (KDE) of places intensity were created using kernels (radius) of 400m (meters), 800, 1200 and 1600m. Using Logistic Regression, the association between the intensity of PA places (classified into quartiles Q1(smallest)-Q4(largest)) and the probability of being "Sufficient PA"; and the association between walkability (quartiles Q1(least)-Q4(highest)) and the probability of being "PA Sufficient " were estimated (p≤0.05). There were associations only for the intensities of places with the largest radius. Among adolescents who lived in places with higher intensity compared with lower intensity places: 1200m (Q3, OR 2.18 95% CI 1.12-4.22; Q4, OR 2.77 95% CI 1.41-5.43) and 1600m (Q3, OR 3.68 95%CI 1.86-7.30; Q4, OR 3.69 95%CI 1.86-7.30) were more likely to be "Sufficient PA". There were also associations for walkability, where those living in places with better walkability (Q4, OR 2.58 95% CI 1.33-5.02) had greater chances of being "Sufficient PA" compared to Q1. In conclusion, living in places with bigger densities and better walkability increases adolescent's chances of being "Sufficient PA".

Does the built environment influence location- and trip-based sedentary behaviors? Evidence from a GPS-based activity space approach of neighborhood effects on older adults

OBJECTIVE

Evidence on the influence of built environments on sedentary behaviors remains unclear and is often contradictory. The main limitations encompass the use of self-reported proxies of sedentary time (ST), the scarce consideration of the plurality of sedentary behaviors, and environmental exposures limited to the residential neighborhood. We investigated the relationships between GPS-based activity space measures of environmental exposures and accelerometer-based ST measured in total, at the place of residence, at all locations, and during trips.

METHODS

This study is part of the CURHA project, based on 471 older adults residing in Luxembourg, who wore a GPS receiver and a tri-axial accelerometer during 7 days. Daily ST was computed in total, at the residence, at all locations and during trips. Environmental exposures included exposure to green spaces, walking, biking, and motorized transportation infrastructures. Associations between environments and ST were examined using linear and negative binomial mixed models, adjusted for demographics, self-rated health, residential self-selection, weather conditions and wear time.

RESULTS

Participants accumulated, on average, 8 h and 14 min of ST per day excluding sleep time. ST spent at locations accounted for 83 % of the total ST. ST spent at the residence accounted for 87 % of the location-based ST and 71 % of the total ST. Trip-based ST represents 13 % of total ST, and 4 % remained unclassified. Higher street connectivity was negatively associated with total ST, while the density of parking areas correlated positively with total and location-based ST. Stronger associations were observed for sedentary bouts (uninterrupted ST over 20 and 30 min).

CONCLUSION

Improving street connectivity and controlling the construction of new parking, while avoiding the spatial segregation of populations with limited access to public transport, may contribute to limit ST. Such urban planning interventions may be especially efficient in limiting the harmful uninterrupted bouts of ST among older adults.

The impact of neighborhood mental health on the mental health of older adults

BACKGROUND

In this article, we use cross-sectional data obtained from the 2018 China Health and Aging Tracking Survey (CHARLS) to examine the impact of neighborhood mental health at the community level on the mental health of older adults aged 60 years and older.

METHODS

NMH is the average mental health of older adults in the same community, excluding the older adults themselves. The explained variable mental health in this paper was measured using the simple CES-D depression scale. The mediating variables were social connectedness, social participation and social inclusion, and the instrumental variables were physical exercise and amusement. regression analysis was conducted using OLS regression models, two-stage least squares (IV-2SLS) instrumental variables to address the two-way causality of NMH and MH, and KHB decomposition was used to investigate the effect mechanism.

RESULTS

Baseline regressions showed that the neighborhood mental health effect positively influenced the mental health of older adults (Coef. = 0.356, 95% CI 0.315,0.397). The neighborhood mental health effect estimated by IV-2SLS (Coef. = 0.251, 95% CI 0.096,0.405) was higher than the OLS regression, indicating endogeneity. The mediated effects of KHB showed total (Coef. = 0.356, 95% CI 0.314,0.398), direct (Coef. = 0.281, 95% CI 0.232,0.330), and indirect effects (Coef. = 0.075, 95% CI 0.049,0.101). While the total effect was 1.266 times higher than the direct effect, 21.03% of the total effect came from mediating variables.

CONCLUSIONS

First, the neighborhood mental health effect has a positive impact on the mental health of older adults, but there are heterogeneous differences based on gender, age, and place of residence. Second, the results of the IV-2SLS estimation showed that the effect of the neighborhood mental health effect was underestimated if endogenous problems were not controlled for. Third, the effect of neighborhood mental health on older adults' mental health was tested to be stable. Moreover, social connectedness, social participation, and social interaction are important mediating mechanisms for the effect of neighborhood mental health on older adults' mental health. This study provides new perspectives and ideas for an in-depth understanding of the mental health of older adults in the context of social transformation in China.

Objective and perceived measures of tobacco marketing are uniquely associated with cigar use

BACKGROUND

Few studies have examined associations between perceived and objective exposure to tobacco marketing and cigar use, which is the second most commonly used tobacco product by youth.

METHODS

We used Geographic Ecological Momentary Assessment data over 14 days from youth aged 16-20 years (n=83 participants, n=948 observations; 34% past month users of any tobacco product) in eight city areas in California. Tobacco outlets in study cities were visited by trained observers to record outlet Global Positioning System (GPS) point locations and outdoor tobacco marketing. We assessed daily perceived exposure to tobacco marketing within participants' activity spaces; daily objective exposure to tobacco outlets with outdoor marketing within 50 m of activity space polylines (number of outlets and time spent near outlets) and daily cigar use excluding and including blunts.

RESULTS

Controlling for demographics and baseline tobacco use, results from mixed logistic regression models showed that greater perceived exposure to tobacco marketing was positively associated with higher odds of cigar use each day, excluding blunts (adjusted odds ratios (aOR): 2.00; 95% CI 1.03 to 3.87) and including blunts (aOR: 1.87; 95% CI 1.26 to 2.77). Also, exposure to a greater number of tobacco outlets with outdoor marketing was associated with higher odds of cigar use each day, excluding blunts (aOR: 1.34; 95% CI 1.01 to 1.78), but not including blunts.

CONCLUSIONS

Tobacco control efforts should consider both perceived and objective exposure to tobacco marketing and unique associations with blunt use to prevent cigar use.

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.

Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents

Adolescence is a life stage critical to the establishment of healthy behaviours, including physical activity (PA). Factors associated with the built environment have been shown to impact PA across the life course. We examined the sociodemographic differences in, and associations between, perceived neighbourhood walkability, PA, and body mass index (BMI) in South African adolescents. We recruited a convenience sample (n = 143; 13-18 years; 65% female) of students from three high schools (middle/high and low-income areas). Participants completed a PA questionnaire and the Neighbourhood Environment Walkability Scale (NEWS)-Africa and anthropometry measurements. Multivariable linear regression was used to examine various relationships. We found that, compared with adolescents living in middle/high income neighbourhoods, those living in low-income neighbourhoods had lower perceived walkability and PA with higher BMI percentiles. The associations between neighbourhood walkability and PA were inconsistent. In the adjusted models, land use diversity and personal safety were associated with club sports participation, street connectivity was positively associated with school sports PA, and more favourable perceived walkability was negatively associated with active transport. Overall, our findings suggest that the perceived walkability of lower income neighbourhoods is worse in comparison with higher income neighbourhoods, though the association with PA and BMI is unclear.

Association of built environment constructs and physical activity among children and adolescents in Africa: a systematic review and meta-analysis

OBJECTIVE

The objective of this review was to synthesize the association between built environment constructs and physical activity among children and adolescents in Africa.

INTRODUCTION

Previous reviews have found that several built environment constructs, such as residential density, crime safety, and availability of physical activity facilities and infrastructure, are associated with physical activity in children and adolescents; however, these reviews have tended to focus on non-African countries. Therefore, this systematic review synthesized the association between the built environment and physical activity among children and adolescents in Africa.

INCLUSION CRITERIA

This systematic review included comparative observational studies that assessed the relationship between built environmental constructs and physical activity among children and adolescents (between the ages of 5 and 19 years) in Africa.

METHODS

Comprehensive electronic searches of MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, SPORTDiscus, EThOS, and ProQuest Dissertations and Theses from inception to October 22, 2021, were conducted to identify relevant published and unpublished studies. Two reviewers independently screened papers, assessed the quality of the included studies using the JBI standard critical appraisal tool, and extracted data using a pre-piloted form. Where possible, data were synthesized using random effects meta-analyses, with effect sizes reported as mean differences (MDs) with 95% confidence intervals (CIs). The Grading of Recommendations Assessment, Development and Evaluations (GRADE) was used to assess the certainty of the findings.

RESULTS

Of the 10,706 identified records, six cross-sectional studies were included, which comprised 4628 children and adolescents. Three of the studies had a high-quality score of 7 or 8 out of 8. Seven built environment constructs were reported within the included studies, namely, residential density, street connectivity, crime safety, availability of physical activity facilities and infrastructure, walkability, esthetics, and traffic safety. Three of the constructs were assessed with objective measures. Results from individual studies found significant associations between physical activity and objective measure of traffic safety (MD 2.63 minutes per day; 95% CI 0.16 to 5.1; one study) and an objective measure of crime safety (MD 2.72 minutes per day; 95% CI 0.07 to 5.37; one study). No significant associations were found between active transportation and any of the built environment constructs. The GRADE evidence for all of the assessed constructs was either low (the built environment constructs may lead to little or no difference in physical activity or active transportation) or very low (it was uncertain whether the built environment constructs affect physical activity).

CONCLUSION

In African settings, the evidence base for the association between built environment constructs and physical activity is limited, with no consistent evidence of an association. Therefore, further high-quality studies should be conducted before firm conclusions can be drawn.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019133324.

How different are objective operationalizations of walkability for older adults compared to the general population? A systematic review

Background

Walking is an essential activity for everyone and for older adults in particular, given that it is the most accessible form of physical activity and one of the healthiest transportation modes. Understanding how walkability (the potential of the environment to enable and/or encourage walking) has been objectively measured and analyzed for older adults is critical to create more inclusive, healthy, and sustainable environments and to promote healthy aging. Despite the numerous reviews on physical activity among older adults and its relationship with the built environment, the literature still lacks comparison reviews focusing specifically on objective operationalizations of walkability for older adults vs. the general population.

Methods

We conducted a systematic review of 146 empirical studies that measured walkability objectively in relation to walking-related outcomes. We compared studies focused on older adults (n = 24) and the general population (n = 122). Content analysis included the characteristics of the study design, walkability measures, spatial extent, and associations found between walkability and walking-related outcomes.

Results

In both groups of publications, the majority of studies were conducted in the US, Canada, and Europe, and largely in high-income countries. They were mostly published in health-related journals and used cross-sectional designs, operationalized walkability by using indexes, employed self-reported measures for walking-related outcomes, and found positive associations between walkability and walking outcomes. However, we observed some differences among studies focusing on older adults. Compared to studies focusing on the general population, a larger proportion of studies on older adults was conducted in the Middle East and Asia, and they used longitudinal designs, mixed methods to measure walking-related outcomes, variables related with land-use characteristics, safety from traffic and crime, and greenery, and a larger proportion found positive, as well as no associations between walkability and walking-related outcomes.

Conclusion

Although there is a promising increase in interest in older adults-focused walkability studies in the last decade, there is still a need for more studies focusing on different settings, using wider spatial extents, longitudinal designs, objective or mixed methods to collect outcome data, and specific variables and/or specially created indexes for older adults and for settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03233-x.

Physical and social environmental factors related to co-occurrence of unhealthy lifestyle behaviors

Previous work identifying determinants of co-occurrence of behavioral risk factors have focused on their association with individuals' characteristics with scant attention paid to their relationship to contextual factors. Data came from 21,007 individuals ≥15 years of age who participated in the cross-sectional 2011-2012 Spanish National Health Survey. Two indicators were defined by tobacco consumption, alcohol intake, diet, physical activity, and body mass index. The first indicator, based on dichotomized measures, ranges from 0 to 5. The second one (unhealthy lifestyle index), ranges from 0 to 15, with 0 denoting the healthiest score. Among the determinants, we examined social support, five perceived characteristics of the neighborhood, and the socioeconomic deprivation index of the census tract of residence. Data were analyzed using multilevel linear and logistic regression models adjusted for the main sociodemographic characteristics. Using the dichotomized indicator, the probability of having 3-5 risk factors versus <3 factors was associated with low social support (Odds Ratio [OR] 1.50; 95% Confidence Interval [CI]: 1.25-1.80). Issues surrounding neighborhood cleanliness (OR = 1.18; 95%CI: 1.04-1.33), air pollution (OR = 1.38; 95%CI: 1.16-1.64), and street crime (OR = 1.21; 95%CI: 1.03-1.42) were associated with determinants of co-occurrence. Risk factors co-occurrence increased as deprivation level increased: the OR for the highest deprivation quintile versus the lowest was 1.30 (95%CI: 1.14-1.48). Similar results were observed when using the unhealthy lifestyle index. Poorer physical and social environments are related to greater co-occurrence of risk factors for chronic diseases. Health promotion interventions targeting the prevention of risk factors should consider the contextual characteristics of the neighborhood environment.

The mental health of children and young people living in big cities in a revolving postpandemic world

PURPOSE OF REVIEW

The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structures living conditions. In this sense, it is timely to discuss what are the social and structural determinants of mental health of children and young people in such settings.

RECENT FINDINGS

Three domains of determinants of mental health were selected for discussion: economics and living conditions, crime and violence, and urban layouts. For each, we debated realities faced by urban children and young people, providing an overview of recent evidence on implications for mental disorders and well being. We also discuss the potential impacts of the covid-19 pandemic on each domain, as well as recommendations for future action.

SUMMARY

Structural factors are of major relevance for the mental health of children and young people living in cities. The agenda of mental health promotion and prevention must include whole-of-society interventions aimed at improving living conditions, including economic and social capital, violence prevention and urbanistic planning.

Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study

INTRODUCTION

Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries.

METHODS

Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers.

RESULTS

No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (β=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (β=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (β=0.16, 95% CI=0.05, 0.27), aesthetics (β=0.16, 95% CI=0.02, 0.30), and safety from traffic (β=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela.

CONCLUSIONS

These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults.

Systematic review of quantitative studies assessing the relationship between environment and mental health in rural areas

OBJECTIVE

Physical and natural environments might strongly influence mental health and well-being. Many studies have examined this relationship in urban environments, with fewer focused on rural settings. The aim of this systematic review was to synthesise quantitative evidence for the relationship between environmental factors (drought, climate and extreme weather events, land use/environmental degradation, green space/vegetation, engagement in natural resource management activities) and mental health or well-being in rural areas.

DESIGN

Following a systematic search of three databases (PsycINFO, MEDLINE and Web of Science), 4368 articles were identified, of which 28 met eligibility criteria for inclusion in the review.

RESULTS

Poorer mental health and well-being was typically found to have an association with extreme climate or weather events and environmental degradation. The observed relationships were largely assessed at area-wide or community levels.

CONCLUSIONS

Studies examining the relationship between the environmental condition of land and mental health at an individual level, particularly within farms, are lacking. Addressing this gap in research requires interdisciplinary expertise and diverse methodology. Few studies examined the effects of natural resource management practices/principles or biodiversity on mental health. While there is evidence that extreme climate or weather events have a negative impact on mental health in rural areas, there remain considerable gaps in our knowledge of how rural environments influence mental health and well-being.

Associations between Children's Physical Activity and Neighborhood Environments Using GIS: A Secondary Analysis from a Systematic Scoping Review

Regular participation in physical activity is essential for children's physical, mental, and cognitive health. Neighborhood environments may be especially important for children who are more likely to spend time in the environment proximal to home. This article provides an update of evidence for associations between children's physical activity behaviors and objectively assessed environmental characteristics derived using geographical information system (GIS)-based approaches. A systematic scoping review yielded 36 relevant articles of varying study quality. Most studies were conducted in the USA. Findings highlight the need for neighborhoods that are well connected, have higher population densities, and have a variety of destinations in the proximal neighborhood to support children's physical activity behaviors. A shorter distance to school and safe traffic environments were significant factors in supporting children's active travel behaviors. Areas for improvement in the field include the consideration of neighborhood self-selection bias, including more diverse population groups, ground-truthing GIS databases, utilising data-driven approaches to derive environmental indices, and improving the temporal alignment of GIS datasets with behavioral outcomes.

Association between leisure-time physical activity and the built environment in China: Empirical evidence from an accelerometer and GPS-based fitness app

To reexamine the relationship between leisure-time physical activity (LTPA) and the built environment (BE), this paper takes advantage of the massive amount of data collected by an accelerometer and GPS-based fitness mobile app. Massive LTPA data from more than 3 million users were recorded by Codoon in 500m by 500m grid cells and aggregated to 742 natural cities in mainland China. Six BE indicators were quantified using GIS at the city scale. Robust regression analysis was used to estimate the correlation between LTPA and BE. Five of six BE indicators—connectivity, road density, land use mix, points of interest density, and density of parks and squares—were significantly, positively, independently, and linearly related to LTPA in the regression analysis. The study obtains findings that are consistent with the previous literature but also provides novel insights into the important role of POI density in encouraging LTPA, as well as how the relationship between LTPA and BE varies by time of day. The study also sheds light on the embrace of new technology and new data in public health and urban studies.

Parental-perceived home and neighborhood environmental correlates of accelerometer-measured physical activity among school-going children in Uganda

The benefits of physical activity (PA) on children's health and well-being are well established. However, many children do not meet the PA recommendations, increasing their risk of being overweight, obese, and non-communicable diseases. Environmental characteristics of homes and neighborhoods may constrain a child's ability to engage in PA, but evidence is needed to inform country-specific interventions in understudied low-income countries. This study assessed the associations between parental-perceived home and neighbourhood, built environment characteristics, and moderate-to-vigorous physical activity (MVPA) among children in Kampala city, Uganda. In this cross-sectional study, data were obtained from 256 children (55.5% girls) aged between 10 and 12 years and their parents. Children's MVPA was measured using waist-worn ActiGraph accelerometers. The environments were assessed using a valid self-reported parent survey. Linear regression models with standard errors (clusters) were used to analyze the relationship between environmental variables and children's MVPA. Sex-specific relationships were assessed using sex-stratified models. Play equipment at home (β = -2.37, p <0.001; unexpected direction), residential density (β = 2.70, p<0.05), and crime safety (β = -5.29, p <0.05; unexpected direction) were associated with children's MVPA. The sex-specific analyses revealed more inconsistent patterns of results with a higher perception of land use mix associated with less MVPA in girls (irrespective of school type attended), and higher perceptions of sidewalk infrastructure (β = -12.01, p <0.05) and walking and cycling infrastructure (β = -14.72, p <0.05) associated with less MVPA in girls attending public schools only. A better perception of crime safety was associated with less MVPA among boys and girls attending private schools (β = -3.80, p <0.05). Few environmental characteristics were related to children's MVPA in Uganda, and findings were largely inconsistent, especially among girls. Future studies are needed to understand the ecological determinants of health-related PA behaviors among children in Uganda.

Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study

Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015-2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11-17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

Identifying risk profiles for excess sedentary behaviour in youth using individual, family and neighbourhood characteristics

There are few known determinants of sedentary behaviour (SB) in children. We generated and compared profiles associated with risk of excess SB among children (n = 294) both at 8-10 and 10-12 years of age (Visits 1 and 2, respectively), using data from the QUebec Adipose and Lifestyle InvesTigation in Youth. Excess SB was measured by accelerometry and defined as >50% of total wear time at <100 counts/minutes. Recursive partitioning analyses were performed with candidate individual-, family-, and neighbourhood-level factors assessed at Visit 1, and distinct groups at varying risk of excess SB were identified for both timepoints. From the ages of 8-10 to 10-12 years, the prevalence of excess SB more than doubled (24.5% to 57.1%). At Visit 1, excess SB was greatest (73%) among children simultaneously not meeting physical activity guidelines, reporting >2 h/day of weekday non-academic screen time, living in low-dwelling density neighbourhoods, having poor park access, and living in neighbourhoods with greater disadvantage. At Visit 2, the high-risk group (70%) was described by children simultaneously not meeting physical activity guidelines, reporting >2 h/day of non-academic screen time on weekends, and living in neighbourhoods with low disadvantage. Risk factors related to individual lifestyle behaviours are generally consistent, and neighbourhood factors generally inconsistent, as children age from late childhood to pre-adolescence. Multiple factors from developmental, behavioural and contextual domains increase risk for excess sedentary behaviour; these warrant consideration to devise effective prevention or management strategies.

Measuring the Built Environment in Studies of Child Health-A Meta-Narrative Review of Associations

Although the built environment (BE) is important for children’s health, there is little consensus about which features are most important due to differences in measurement and outcomes across disciplines. This meta-narrative review was undertaken by a multi-disciplinary team of researchers to summarise ways in which the BE is measured, and how this links to children’s health. A structured search of four databases across the relevant disciplines retrieved 108 relevant references. The most commonly addressed health-related outcomes were active travel, physical activity and play, and obesity. Many studies used objective (GIS and street audits) or standardised subjective (perceived) measurements of the BE. However, there was a wide variety, and sometimes inconsistency, in their definition and use. There were clear associations between the BE and children’s health. Objective physical activity and self-reported active travel, or obesity, were positively associated with higher street connectivity or walkability measures, while self-reported physical activity and play had the strongest association with reduced street connectivity, indicated by quieter, one-way streets. Despite the high heterogeneity found in BE measures and health outcomes, the meta-narrative approach enabled us to identify ten BE categories that are likely to support children’s health and be protective against some non-communicable disease risk factors. Future research should implement consistent BE measures to ensure key features are explored. A systems approach will be particularly relevant for addressing place-based health inequalities, given potential unintended health consequences of making changes to the BE.

Active use and perceptions of parks as urban assets for physical activity: A mixed-methods study

Parks are potential key urban assets for improved population health; however, their use is not equal among all social groups. Individual and contextual factors could influence residents' perceptions of parks and how they interact with and, eventually, benefit from them. The use of complementary methodologies provides a deeper understanding of the relationship between park use, physical activity (PA), and residents' perceptions. Thus, we designed a mixed-methods study to analyze differences in park use and PA, and the perceptions of parks as urban assets for PA. We selected six parks from three neighborhoods in Madrid (Spain) with different neighborhood socioeconomic status (NSES) for systematic social observation. We registered park users by age, PA level (low, medium, and high), gender, and NSES using the System for Observing Play and Recreation in Communities (SOPARC) audit tool adapted for iOS software (iSOPARC). We also conducted 37 semi-structured interviews and 29 focus groups to analyze residents' perceptions of parks as urban assets for PA in the same neighborhoods. We adopted a convergent-parallel design to analyze both quantitative and qualitative data, and to describe the convergence and divergence areas between them. Parks within the high-NSES were more visited, showing a higher proportion of people performing high PA (11.9%) as compared to residents of the middle (9.3%) and low-NSES (3.2%). Female visitors showed lower PA levels compared to men, especially for parks within high-NSES. The following issues were reported as influence urban park use and perceptions: park maintenance and area perception, works constraints, insecurity and crime, differential perceptions by age, and the availability of organized activities in the parks. Residents from high-NSES reported fewer barriers to park use compared to residents from the other areas, who reported limitations such as less leisure time due to job constrains or perceived insecurity in parks. Senior participants reported that having parks with organized activities and a design oriented towards different age-groups are valuable. Our study shows consistency between the fewer and less intense use of parks registered in the middle and low-NSES neighborhoods, and the more barriers for PA reported in this areas during the qualitative analysis. Mixed-methods provided an insight of the potential causes leading to the differences in park use and PA within cities, which is essential in terms of environmental justice and health equity. Thus, a mixed-methods comprehensive approach to public health problems can help designing public policies addressing relevant factors related to urban health inequities.

Improving spatial data in health geographics: a practical approach for testing data to measure children's physical activity and food environments using Google Street View

Background

Geographic information systems (GIS) are often used to examine the association between both physical activity and nutrition environments, and children’s health. It is often assumed that geospatial datasets are accurate and complete. Furthermore, GIS datasets regularly lack metadata on the temporal specificity. Data is usually provided ‘as is’, and therefore may be unsuitable for retrospective or longitudinal studies of health outcomes. In this paper we outline a practical approach to both fill gaps in geospatial datasets, and to test their temporal validity. This approach is applied to both district council and open-source datasets in the Taranaki region of Aotearoa New Zealand.

Methods

We used the ‘streetview’ python script to download historic Google Street View (GSV) images taken between 2012 and 2016 across specific locations in the Taranaki region. Images were reviewed and relevant features were incorporated into GIS datasets.

Results

A total of 5166 coordinates with environmental features missing from council datasets were identified. The temporal validity of 402 (49%) environmental features was able to be confirmed from council dataset considered to be ‘complete’. A total of 664 (55%) food outlets were identified and temporally validated.

Conclusions

Our research indicates that geospatial datasets are not always complete or temporally valid. We have outlined an approach to test the sensitivity and specificity of GIS datasets using GSV images. A substantial number of features were identified, highlighting the limitations of many GIS datasets.

Associations Between Perceived Neighborhood Walkability and Device-Based Physical Activity and Sedentary Behavior Patterns in Older Adults

Neighborhood walkability has been associated with self-reported sedentary behavior (SB) and self-reported and objective physical activity. However, self-reported measures of SB are inaccurate and can lead to biased estimates, and few studies have examined how associations differ by gender and age. The authors examined the relationships between perceived neighborhood walkability measured with the Physical Activity Neighborhood Environment Scale (scored 1.0-4.0) and device-based SB and physical activity in a cohort of community-dwelling older adults (N = 1,077). The authors fit linear regression models adjusting for device wear time, demographics, self-rated health, and accounting for probability of participation. The Higher Physical Activity Neighborhood Environment Scale was associated with higher steps (+676 steps/point on the Physical Activity Neighborhood Environment Scale, p = .001) and sit-to-stand transitions (+2.4 transitions/point, p = .018). Though not statistically significant, stratified analyses suggest an attenuation of effect for those aged 85 years and older and for women. Consistent with previous literature, neighborhood walkability was associated with more steps, though not with physical activity time. The neighborhood environment may also influence SB.

The Effect of Season and Neighbourhood-Built Environment on Home Area Sedentary Behaviour in 9-14 Year Old Children

There is little understanding of how the built environment shapes activity behaviours in children over different seasons. This study sought to establish how seasonal weather patterns, in a given year in a mid-western Canadian city, affect sedentary time (SED) in youth and how the relationship between season and SED are moderated by the built environment in their home neighbourhood. Families with children aged 9-14 years were recruited from the prairie city of Saskatoon, Canada. Location-specific, device-based SED was captured in children during three timeframes over a one-year period using GPS-paired accelerometers. Multilevel models are presented. Children accumulated significantly greater levels of SED in spring but significantly less SED in the fall months in comparison to the winter months. Children living in neighbourhoods with the highest density of destinations accumulated significantly less SED while in their home area in comparison to their counterparts, and this effect was more pronounced in the spring and summer months. On weekends, the rise in sedentariness within the home area was completely diminished in children living in neighbourhoods with the greatest number of destinations and highest activity friendliness. These results suggested that increasing neighbourhood amenities can lead to a reduced sedentariness of youth, though more so in the warmers months of the year.

Access to public transport and childhood obesity: A systematic review

The lack of access to public transport is generally considered to be a risk factor for childhood obesity by discouraging active transport and thus physical activity. To explore the association between access to public transport and childhood obesity, we have conducted a systematic literature search in the Cochrane Library, PubMed, and Web of Science for studies published before January 1, 2019. A total of 25 cross-sectional and two longitudinal studies conducted in 10 countries were identified. Inconsistent findings were identified arising from a great variety of sample characteristics, definitions of exposure (ie, access to public transport), and outcome variables (eg, obesity), and analysis methods. While over half of the studies showed null associations between access to public transport and childhood obesity, we have observed more positive than negative associations among the rest of the studies. These observations suggest that an increased level of access to public transport may have a health-promoting effect and hence prevent the development of childhood obesity. However, this conclusion needs to be further corroborated in future research on the basis of large-sample health surveys, in situ observations, and comparative analyses among different study areas.

Walkability indices and childhood obesity: A review of epidemiologic evidence

The lack of an active neighbourhood living environment can impact community health to a great extent. One such impact manifests in walkability, a measure of urban design in connecting places and facilitating physical activity. Although a low level of walkability is generally considered to be a risk factor for childhood obesity, this association has not been established in obesity research. To further examine this association, we conducted a literature search on PubMed, Web of Science and Scopus for articles published until 31 December 2018. The included literature examined the association between measures of walkability (e.g., walkability score and walkability index) and weight-related behaviours and/or outcomes among children aged under 18 years. A total of 13 studies conducted in seven countries were identified, including 12 cross-sectional studies and one longitudinal study. The sample size ranged from 98 to 37 460, with a mean of 4971 ± 10 618, and the age of samples ranged from 2 to 18. Eight studies reported that a higher level of walkability was associated with active lifestyles and healthy weight status, which was not supported by five studies. In addition to reviewing the state-of-the-art of applications of walkability indices in childhood obesity studies, this study also provides guidance on when and how to use walkability indices in future obesity-related research.

Land use mix in the neighbourhood and childhood obesity

Land use mix (LUM) in the neighbourhood is an important aspect for promoting healthier lifestyles and consequently reducing the risk for childhood obesity. However, findings of the association between LUM and childhood obesity remain controversial. A literature search was conducted on Cochrane Library, PubMed and Web of Science for articles published before 1 January 2019. In total, 25 cross-sectional and two longitudinal studies were identified. Among them, Geographic Information Systems were used to measure LUM in 15 studies, and perceived LUM was measured in 12 studies. Generally, most studies revealed an association between a higher LUM and higher PA levels and lower obesity rates, although some studies also reported null or negative associations. The various exposure and outcome assessment have limited the synthesis to obtain pooled estimates. The evidence remains scare on the association between LUM and children's weight status, and more longitudinal studies are needed to examine the independent pathways and causality between LUM and weight-related behaviours/outcomes.

Neighbourhood residential density and childhood obesity

Residential density is considered an important attribute of the built environment that may be relevant to childhood obesity. However, findings remain inconclusive, and there are no reviews yet on the association between residential density and childhood obesity. This study aimed to systematically review the associations between residential density and weight-related behaviours and outcomes. A comprehensive literature search was conducted using the Cochrane Library, PubMed and Web of Science for articles published before 1 January 2019. A total of 35 studies conducted in 14 countries were identified, including 33 cross-sectional studies, one longitudinal study and one containing both study designs. Residential density was measured by Geographic Information Systems in 28 studies within a varied radius from 0.25 to 2 km around the individual residence. Our study found a general positive association between residential density and physical activity (PA); no significant associations were observed. This study provided evidence for a supportive role of residential density in promoting PA among children. However, it remained difficult to draw a conclusion between residential density and childhood obesity. Future longitudinal studies are warranted to confirm this association.

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.

International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures

INTRODUCTION

Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese).

METHODS AND ANALYSIS

The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status.

ETHICS AND DISSEMINATION

Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

Objective measurement of children's physical activity geographies: A systematic search and scoping review

This study aimed to systematically identify, map out, and describe geographical information systems (GIS)-based approaches that have been employed to measure children's neighborhood geographies for physical activity behaviors. Forty studies were included, most were conducted in the USA. Heterogeneity in GIS methods and measures was found. The majority of studies estimated children's environments using Euclidean or network buffers ranging from 100 m to 5 km. No singular approach to measuring children's physical activity geographies was identified as optimal. Geographic diversity in studies as well as increased use of measures of actual neighborhood exposure are needed. Improved consistency and transparency in reporting research methods is urgently required.

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Varied GIS measures of children's physical activity geographies were identified.

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Evidence was heterogeneous and predominantly from the USA.

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Most research used Euclidean or network buffers ranging from 100 m to 5 km.

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Larger buffer sizes (i.e., ≥800 m) performed better than smaller buffer sizes.

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No optimal approach to measuring children's activity geographies was determined.

Community Environments That Promote Intergenerational Interactions vs. Walking Among Older Adults

Background: Intergenerational interactions and walking are two of the most beneficial forms of activities for older adults. As older adults spend most of their time at or near home, the characteristics of the proximate residential environments are particularly important for supporting those activities. This study aims to (1) explore places used for various social interactions older adults engage in, (2) examine specific neighborhood environmental features associated with intergenerational interactions, and (3) compare similarities and differences in environmental correlates of intergenerational interactions vs. walking.

Methods: This cross-sectional study analyzed self-reported survey data from 455 community-dwelling adults aged 65+ from Austin, Texas, as well as Geographic Information System (GIS) measures capturing the neighborhood environment around each participant's home. Descriptive statistics were used for Aim 1. Multivariable binary logistic models were used for Aims 2 and 3, to identify environmental variables predicting the odds of participating in intergenerational interactions (with children 1+ times/week, and with children, teenagers, or adults 1+ times/week) in one's neighborhood, as well as walking 1+ times/week for transportation or recreation purposes.

Results: Participants had a mean age of 73 years, and were primarily female (72.1%) and non-Hispanic white (72.8%). Older adults interacted frequently with adults (79.2%, 1+ times/week) and other older adults (66.9%) in their neighborhood, while less frequently with children (28.0%) and teenagers (21.9%). Recreational walking (73.3%, 1+ times/week) was more popular for older adults than transportation walking (43.8%). Multivariable analyses showed that neighborhood perceptions, transportation infrastructure, land uses, land covers, population densities, development activities, and composite scores were significant predictors of intergenerational activities. Both similarities and differences were found in terms of the neighborhood environmental factors associated with intergenerational interactions vs. walking although differences were more evident in the domains of land covers, development activities, and composite scores.

Conclusions: Given the significant health benefits, promoting intergenerational interactions and walking among older adults should be a national/global responsibility. Further work is needed to improve our understanding of the specific social and physical environmental facilitators as well as barriers to creating intergenerational communities that can support healthy living of all generations.

Influence of Neighborhood Environment on Physical Activity Participation among Children with Autism Spectrum Disorder

Despite the positive influence of environmental factors on physical activity (PA) levels of children, further investigation is necessary when considering the unique characteristics of children with autism spectrum disorder (ASD). The purpose of this study was to examine the relationship between neighborhood environment factors and PA among children with ASD by examining the extent to which (a) the built environment, (b) neighborhood safety, and (c) neighborhood support contributes to PA. A secondary data analysis using the 2016 and 2017 combined dataset of the National Survey of Children's Health was used. The total sample included 14,944 children between the ages of 6-17 years; of this, a sample of 494 children had a parent-reported diagnosis of ASD. Multivariate logistic regressions were conducted to explore the unique influences of the above three neighborhood environment factors on PA engagement. Among children with and without ASD, an association was found between feeling safe and engaging in PA, that is, the odds of engaging in PA are greater among children who were safe in their neighborhoods than children who were not in safe neighborhoods. Surprisingly, other neighborhood factors do not have a significant relationship with PA participation among children with ASD at this time. Future studies should consider how to incorporate the support of others and feeling of safety into the neighborhood along with how to improve accessibility of the built environment in order to increase PA for children with ASD. LAY SUMMARY: The results of this study showed that neighborhood factors influence physical activity (PA) among children with ASD differently compared to their peers without ASD. Children with ASD who live in safe neighborhoods are more likely to engage in PA, while other neighborhood factors, such as playgrounds and support, are not associated with an increased likelihood of engaging in PA at this time. Efforts should be made to improve neighborhood accessibility and design in order to increase PA among children with ASD.

Motivational processes in physical education and objectively measured physical activity among adolescents

PURPOSE

Grounded in self-determination theory (SDT), the present study tested how students' perceptions of autonomy support from physical education teachers predicts objectively measured moderate-to-vigorous physical activity (MVPA) of adolescents. According to SDT, it was expected that psychological needs and autonomous and controlled forms of motivation would mediate these relationships.

METHODS

Students (n = 397) aged from 11 to 15 years in 17 different schools filled in questionnaires regarding SDT variables. In addition, objective MVPA was measured using an accelerometer (ActiGraph GT3X; ActiGraph, Pensacola, FL, USA) for 7 days. Structural equation modelling was used to examine the hypothesized relationships among the study variables.

RESULTS

The theory-based model showed a good fit with the data: χ2 = 642.464, df = 257; comparative fit index = 0.932; non-normed fit index = 0.921; root mean square error of approximation = 0.062; root mean square error of approximation 90% confidence interval: 0.054-0.067. As hypothesized, there was a significant and positive direct relationship between autonomy support and need satisfaction (β = 0.81, p = 0.001). In turn, need satisfaction positively predicted intrinsic motivation (β = 0.86, p = 0.001). Intrinsic motivation was positively related to MVPA (β = 0.29, p = 0.009). A significant indirect effect (β = 0.20, p = 0.004) supported the mediating role of psychological need satisfaction and intrinsic motivation in the relationship between perceived autonomy support and objectively measured MVPA.

CONCLUSION

The findings of the current study support the applicability of the SDT-based model in explaining the antecedents of objectively measured MVPA of adolescents. To enhance adolescents' daily MVPA, special focus should be put on increasing their intrinsic motivation toward physical education.

Physical Activity and Sedentary Behaviour Patterns among Kenyan and Japanese Children: A Comprehensive Cross-Country Comparison

Health benefits of physical activity are well known, yet available physical activity data is limited from children living in African and Asian countries. The purpose of the cross-sectional study was to evaluate and compare physical activity and sedentary behavior patterns, particularly hourly variations, among children in Kenya and Japan. Participants included 298 primary school students (122 Kenyan, 176 Japanese) aged 9-12 years. Physical activity and sedentary behavior were measured with accelerometers. Domain-specific physical activity, screen time, and proportion of children using active transport to school were measured by questionnaire. A two-way ANOVA (countries × time) was used to examine the differences in the activity patterns between Kenyan and Japanese children. The results from the present study demonstrated that Kenyan children spent more time in moderate-to-vigorous physical activity compared to Japanese children (p < 0.05) with the greatest differences found for weekday evenings (for boys and girls) and weekend afternoons (for girls). This suggests that these were 'critical periods' to differentiate the physical activity levels between Kenyan and Japanese children. However, a higher proportion of the children from Japan used active transport to school and spent less time in television viewing and computer gaming. The results suggest that both countries have successes and challenges that can aid in developing effective and country-specific intervention strategies for promoting physical activity.

Specific Features of the Ukrainian Urban Adolescents' Physical Activity: A Cross-Sectional Study

Background

An increase in the proportion of physically active peoples is one of the public health priorities. Particular attention should be addressed to the adolescent group with regard to their sensitivity. The purpose of our study is to determine the overall level of physical activity (PA) of urban adolescents and to evaluate its components.

Methods

The study included the results of a survey of 415 children aged 11–15 years from public schools in Ukraine. We have adapted the standardized questionnaire QAPACE, which allows characterizing the level of adolescent's PA by indicators: type, duration, and intensity.

Results

A sedentary lifestyle is typical for most Ukrainian urban adolescents. Only 30.8% of Ukrainian urban adolescents (45.4% of boys and 21.4% of girls; p < 0.001) meet the recommended level of moderate-to-vigorous PA (at least 60 minutes per day). The chances to follow the recommended moderate-to-vigorous PA are almost 5 times higher in the group of adolescents exercising at their own wish and not by parents' direction (OR = 4.96; 95% CI: 2.77–8.90; p < 0.001). Girls have a 3.0 higher chance of not adhering to recommendations for duration of PA (OR = 3.01; 95% CI: 1.95–4.63). They are 2.5 times more likely to lead a sedentary lifestyle (OR = 2.48; 95% CI: 1.54–3.98) than boys.

Conclusion

The obtained results are indicative of a lack of implementation of measures to increase physical activity, which requires public attention to this problem. A search for ways to improve public policy towards optimizing adolescents' PA is still an urgent goal for scholars and practitioners. PA-promoting measures should be developed taking into account the impact of family traditions, accessibility of sports facilities, leisure, advertising, and other factors. The obtained results are the initial stage for developing the program of physical inactivity prevention.

Built Environment and Childhood Weight Status: A Multi-Level Study Using Population-Based Data in the City of Hannover, Germany

In recent years, built environmental characteristics have been linked to childhood overweight, but the results remain inconsistent across studies. The present study examines associations between several built environmental features and body weight status (BMI) z-score among a large sample of preschool children in the city of Hannover, Germany. Walkability (Index), green space availability, and playground availability related to preschool children's home environments were measured using data from OpenStreetMap (OSM). These built environment characteristics were linked to the data from the 2010-2014 school entry examinations in the Hannover city (n = 22,678), and analysed using multilevel linear regression models to examine associations between the built environment features and the BMI z-score of these children (4-8 years old). No significant associations of built environmental factors on children's BMI were detected, but the effect between green space availability and BMI was modified by the parental educational level. In children with lower compared to higher educated parents, a higher spatial availability of greenspace was significantly associated with reduced body weight. Future research should continue to monitor the disparities in diverse built environment features and how these are related to children's health.

Residential vs school neighborhoods: Associations with physical activity among adolescents

Adolescents have the potential to be active in multiple places across weekdays and weekends. While the built environment features around home are known to be important for adolescents' physical activity, specific built environment features that facilitate physical activity outside the home neighbourhood are not well explored. Given that adolescents spend most days of the week at school, the built environment surrounding school may be particularly important for supporting their physical activity. This study examined cross-sectional associations of objective built environments around home and school at multiple spatial scales with accelerometer assessed moderate-to-vigorous physical activity (MVPA) across the week. Moderating effects of adolescents' age were further explored. Data from up to 417 adolescents aged 12-20 years from 18 schools in Melbourne, Australia were used. Features of the built environment around school were positively associated with MVPA on weekdays; and a wide range of built environment features around home were found to be important for MVPA during weekends. Age was found to moderate the relationship between some built environment features around both home and school and MVPA across the week. Understanding the contribution of the built environment features around both home and school with MVPA could inform policy recommendations and public health interventions for each setting.

Association of the built environment with physical activity in children and adolescents in Africa: a systematic review protocol

OBJECTIVE

The objective of this systematic review is to summarize the association between the built environment and physical activity in children and adolescents in Africa.

INTRODUCTION

Physical activity offers immense benefits to children and adolescents. Some built environment constructs, such as street connectivity and the availability of parks, have been identified to facilitate physical activity in children and adolescents; however, this evidence has come from developed countries. This review will present evidence from Africa on the built environment constructs that facilitate physical activity in children and adolescents.

INCLUSION CRITERIA

This review will consider quantitative studies that have built environment constructs as one of their exposure variables and physical activity as one of their outcomes and were conducted in children and adolescents aged five to 19 years residing in Africa.

METHODS

A systematic search of MEDLINE, Embase, Web of Science and other sources will be conducted to locate both published and unpublished studies. There will be no date or language restrictions. Titles, abstracts, and full text of articles retrieved from the search will be screened and read by two reviewers independently for eligibility. Included articles will be critically appraised independently by two reviewers. Data extraction will be performed in two phases, first for information regarding the study characteristics and then to extract specific study findings. Meta-analysis will be used to synthesize the findings from the studies; however, where this is not possible, a narrative synthesis will be performed.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019133324.

Built environment and physical activity among adolescents: the moderating effects of neighborhood safety and social support

BACKGROUND

Increasing emphasis has been placed on improving physical activity levels through multilevel interventions. This study aims to examine moderating effects of neighborhood safety (crime and traffic) and social support (from parent and sibling/peer) for physical activity in the relationship between the built environment and moderate-to-vigorous physical activity (MVPA) outside school hours among adolescents in Melbourne.

METHODS

Data were from the NEighbourhood Activity in Youth study conducted among adolescents in Melbourne, Australia (n = 358, 15.3 (SD = 1.5) years). MVPA outside school hours was assessed by accelerometer. Built environment features within 1 km and 2 km residential buffers including recreation facilities, park area, and walkability and its components were assessed using Geographic Information Systems. Neighborhood safety, social support for physical activity and sociodemographic information were self-reported by adolescents. Multilevel linear regression models were used to estimate associations.

RESULTS

Support for physical activity from sibling/peer positively moderated the relationship between recreation facilities (1 km), residential density (2 km) and MVPA. Recreation facility (count within 2 km), walkability (1 km and 2 km) and residential density (1 km) had significant positive associations with MVPA outside school hours.

CONCLUSION

The built environment appeared to have stronger facilitating effects on MVPA among adolescents who had favourable support for physical activity from their sibling or peer. Multilevel interventions that target the built environment and social factors are needed to promote MVPA outside school hours among adolescents.

Development and validation of the neighborhood environment walkability scale for youth across six continents

BACKGROUND

The IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents' physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability.

METHODS

Adolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status.

RESULTS

Final country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity.

CONCLUSIONS

A robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.

Associations between Neighborhood Walkability and Incident and Ongoing Asthma in Children

RATIONALE

Childhood asthma has shown variable associations with children's physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes.

OBJECTIVES

We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma.

METHODS

In this population-based cohort study, we used prospectively collected administrative healthcare data for the Province of Ontario housed at the Institute for Clinical Evaluative Sciences. We followed an administrative data cohort of 326,383 Toronto children born between 1997 and 2003, inclusive, until ages 8-15 years. Home neighborhood walkability quintile was measured using a validated walkability index with four dimensions: population density, dwelling density, access to retail and services, and street connectivity. Incident asthma was defined by time of entry into the validated Ontario Asthma Surveillance Information System database, which requires two outpatient visits for asthma within two consecutive years or any hospitalization for asthma and follows children with asthma longitudinally starting at any age. Associations between walkability and incident asthma were examined using Cox proportional hazards models. Associations between ongoing asthma and walkability in each year of life were examined using generalized linear mixed models.

RESULTS

Twenty-one percent of children (n = 69,628) developed incident asthma and were followed longitudinally in the Ontario Asthma Surveillance Information System database. Low birth home neighborhood walkability was associated with an increased incidence of asthma (hazard ratio, 1.11; 95% confidence interval, 1.08-1.14). Among children with asthma, low walkability in a given year of a child`s life was associated with greater odds of ongoing asthma in the same year (odds ratio, 1.12; 95% confidence interval, 1.09-1.14).

CONCLUSIONS

Children living in neighborhoods with low walkability were at increased risk of incident and ongoing asthma. Neighborhood walkability improvement, such as by adding pedestrian paths to improve street connectivity, offers potential strategies to contribute to primary asthma prevention.

The Importance of Pedestrian Network Connectivity for Adolescent Health: A Cross-sectional Examination of Associations between Neighbourhood Built Environments and Metabolic Health in the Pacific Islands Families Birth Cohort Study

The research aim was to investigate associations between objectively-assessed built environment attributes and metabolic risk in adolescents of Pacific Islands ethnicity, and to consider the possible mediating effect of physical activity and sedentary time. Youth (n = 204) undertook a suite of physical assessments including body composition, blood sampling, and blood pressure measurements, and seven day accelerometry. Objective measures of the neighbourhood built environment were generated around individual addresses. Logistic regression and linear modelling were used to assess associations between environment measures and metabolic health, accounting for physical activity behaviours. Higher pedestrian connectivity was associated with an increase in the chance of having any International Diabetes Federation metabolic risk factors for males only. Pedestrian connectivity was related to fat free mass in males in unadjusted analyses only. This study provides evidence for the importance of pedestrian network connectivity for health in adolescent males. Future research is required to expand the limited evidence in neighbourhood environments and adolescent metabolic health.

Hilly neighborhoods are associated with increased risk of weight gain among older adults in rural Japan: a 3-years follow-up study

Background

Neighborhood environments have been regularly associated with the weight status. Although the evidence is mostly limited to adults residing in western urban settings, the weight status of older adults living in rural areas is also assumed to be significantly affected by their neighborhood environments. This study aimed to identify environmental attributes specific to rural areas that could affect the risk of longitudinal weight gain among older adults (≥ 65 years) in Japan.

Methods

We examined five environmental attributes, i.e., land slope, public transportation accessibility, residential density, intersection density, and the availability of parks and recreational centers, measured by the geographic information system. Our analysis was based on 714 subjects participated in Shimane Community-based Healthcare Research and Education study in 2012 and 2015. Multinomial logistic regression model was conducted to examine the association between each neighborhood environmental attribute and weight change status (gain, loss and unchanged).

Results

We observed a significant increase in the risk of weight gain as the steepness of the neighborhood land slope increased. There was no significant association between other environmental attributes and risk of weight gain as well as weight loss among older adults.

Conclusion

Living in hilly neighborhoods was associated with increased risk of weight gain among rural Japanese older adults. Future research should consider region-specific environmental attributes when investigating their effect on older adults’ weight status.

Neighborhood built environment associations with adolescents' location-specific sedentary and screen time

Less is known about how neighborhood environments relate to sedentary time as compared to physical activity. This study examined relations of perceived and objective neighborhood environments with TV time, total screen time, total sedentary time, sedentary time at home, sedentary time in the home neighborhood, and time spent at home, in 524 12-16 year olds. Better perceived aesthetics and a perceived neighborhood environment index were related to less TV and screen time, and greater cul-de-sac density was related to less total and home sedentary time. Greater street connectivity, mixed land use, and an objective neighborhood environmental index were related to more total sedentary time. Findings suggest that some neighborhood environment attributes may not have the same potential influences on limiting sedentary time as they do for supporting physical activity.

A Cross-Sectional Description of Parental Perceptions and Practices Related to Risky Play and Independent Mobility in Children: The New Zealand State of Play Survey

The potential for risky play and independent mobility to increase children’s physical activity, and enhance cognitive development and emotional wellbeing has been recognised for some time. The aim of this study was to describe the attitudes of New Zealand parents towards such risky play practices and independent mobility, the barriers preventing them from allowing their children to participate, and how often their children engaged in risky play activities. An online survey comprised mostly of validated scales and standardised questions was completed by a nationally representative sample of 2003 parents. We found that parents had neutral feelings about the risk of injury to their child through play, rather they were concerned about road safety and “stranger danger”. There was strong agreement that there are multiple benefits to be gained from exposure to risk and challenge, and that health and safety rules are too strict. However, 73% of respondents stated that their 5–12 year old child seldom or never engaged in four or more risky activities, and only 14.3% engaged in four or more often or always. While parents agree that their child is likely to benefit from risky play, they do not have the confidence to allow their children to engage in such activities. Future research should address barriers and fears when implementing strategies to facilitate risky play.

Enabling participation for disabled young people: study protocol

BACKGROUND

Participation in community life is vital for health and wellbeing, promoting a sense of belonging, networks of social support and opportunities for physical activity. Disabled young people have lower levels of mobility and participation in recreational activities (physical, social and cultural), education and employment, than their peers without disabilities. This has implications for their health and wellbeing and life course opportunities. Previous research on the participation levels of disabled young people has primarily relied on parent/caregiver reports and been oriented to home and school environments. This study investigates how physical and social environmental factors cohere to support or restrict the everyday mobility and participation of disabled young people.

METHODS/DESIGN

The study is located in Auckland, Aotearoa/New Zealand (NZ). Participants comprise 35 young people aged 12-25 years with mobility, vision or hearing impairments. A mixed-methods research design combines objective (global positioning systems, accelerometers, geographical information systems) and self-report measures (travel diaries, and questionnaires) to assess young people's mobility and levels of participation in leisure/educational and employment activities with in-depth interviews exploring their everyday experiences of inclusion/exclusion, and factors enabling or constraining community participation. Parents/caregivers and disability sector key informant viewpoints on the community participation of disabled young people have also been gathered through in-depth interviews. Follow-up workshops with young people and parents/caregivers will identify pathways to increase participation and challenge current disabling practices.

DISCUSSION

This study looks beyond barriers in the physical environment to the interplay of personal, social and physical factors that enable or constrain the community participation of disabled young people. In keeping with the study's overarching goal of increasing opportunities for effective community participation and full citizenship of disabled young people, research methods were applied flexibily - negotiated and adapted to maximise each young person's participation in light of their abilities and preferences.