Perceived Neighborhood Environmental Attributes Associated with Walking and Cycling for Transport among Adult Residents of 17 Cities in 12 Countries: The IPEN Study

A Longitudinal Theory-Based Investigation of How Environmental Aesthetics Predicts Home-Based Exercise

INTRODUCTION

Environmental aesthetics is a recognized macro environmental correlate of physical activity participation. Extrapolating this effect, we hypothesize this variable to also function as a determinant of exercise participation in the microenvironment , such as the home. Specifically, we predict that the environmental aesthetics of the location of cardio and resistance training equipment will predict determinants of exercise participation within the integrated behavior change model.

METHODS

Adult owners of exercise equipment ( N = 231) completed measures on the environmental aesthetics of their cardio and resistance training equipment, exercise time, and constructs from the integrated behavior change model across three consecutive monthly surveys. Study hypotheses were tested using multilevel structural equation modeling with participants (level 2) nested within time (level 1).

RESULTS

The model revealed predictive effects of intention, habit, and planning on exercise participation over time. The findings indicated a total effect of autonomous motivation on intention and habit. In addition, environmental aesthetics of cardio and strength training equipment predicted autonomous motivation, along with habit and intention when accounting for indirect effects. Finally, planning moderated the intention-behavior relationship, indicating that participants who scored higher on planning were more likely to translate their intentions to behavior.

CONCLUSIONS

These findings provide informative notes for designing effective home-based exercise programs, which have increased in popularity over the past recent years. Specifically, experimental studies that provide exercise equipment should ensure that the location of the equipment is appealing to the participant to increase the likelihood equipment use and exercise engagement.

Exploring the Relationship between Built Environment Attributes and Physical Activity in Lower-Income Aging Adults: Preliminary Insights from a Multi-Level Trial

The built environment has been linked to physical activity (PA) behaviors, yet there is limited knowledge of this association among lower-income midlife and older adults who are insufficiently active. The present cross-sectional study utilized baseline data collected between October 2017 and November 2019 from a clustered randomized controlled trial to determine how built environment attributes were associated with PA behaviors among midlife and older adults (n = 255) residing in or near affordable housing sites (n = 10). At each site, perceptions of the built environment were collected and scored at the participant level via the abbreviated Neighborhood Environment Walkability Survey (NEWS-A), while objective built environment attributes were measured and scored by trained research staff using the Physical Activity Resource Assessment (PARA). Multiple PA behaviors-walking, total PA, and moderate-to-vigorous PA (MVPA) (min/wk)-were measured using the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Adjusted linear regression models examined associations between NEWS-A measures and PA behaviors, and site-level correlations between PARA measures and PA behaviors were examined using Spearman's rank correlations. At the participant level, adjusted models revealed that a one point increase in the NEWS-A aesthetics score was associated with a 57.37 min/wk increase in walking (β = 57.37 [95% CI: 20.84, 93.91], p = 0.002), with a similar association observed for street connectivity and MVPA (β = 24.31 min/wk [95% CI: 3.22, 45.41], p = 0.02). At the site level, MVPA was positively correlated with the quality of the features of local, PA-supportive environmental resources (ρ = 0.82, p = 0.004). Findings indicate that participant- and site-level measures of the built environment may play a role in promoting PA behavior among this demographic and similar populations. Results also suggest that improvements in aesthetic attributes and street connectivity, along with enhancing the quality of local, PA-supportive environmental resources, may be effective strategies for promoting physical activity among lower-income midlife and older adults.

Associations of perceived built environment characteristics using NEWS questionnaires with all-cause mortality and major cardiovascular diseases: The prospective urban rural epidemiology (PURE)-China study

BACKGROUND

Despite increased literature focusing on the role of the built environment (BE) in health, few cohort studies have quantitatively analyzed neighborhood walkability environment in relation to the risk of death and cardiovascular disease (CVD). This longitudinal study aimed at evaluating the association between perceived BE attributeswith mortality and major CVD based on the Prospective Urban Rural Epidemiology study in China (PURE-China).

METHODS

The PURE-China study recruited 47,931 participants aged 35-70 years from 12 provinces of China between 2005 and 2009. The perceived BE information, including land use, street, aesthetics, and safety, was collected using the neighborhood environment walkability scale (NEWS) questionnaire, with higher scores indicating a more favorable rating. Two primary outcomes are all-cause mortality and major CVD event. The Cox frailty model with random intercepts was used to assess the association between the perceived total BE/subscales score and outcomes.

RESULTS

Of 32,163 participants included in this study, 19,253 (59.9 %) were women, and the mean (SD) age was 51.0 (9.5) years. After a median follow-up period of 11.7 years (IQR 9.4 - 12.2), we observed that one standard deviation higher of combined BE scores was related to a lower risk of all-cause mortality (HR = 0.85; 95 %CI, 0.80-0.90), and major CVD events (HR = 0.95; 95 %CI, 0.90-0.99). The subscales of perceived BE were related to a lower risk, although a few were not significant. Land use mix-diversity and safety from crime were the two most significant subscales. Stronger risks were observed among urban and female participants.

CONCLUSION

Favorable perceived BE characteristics were linked with a lower risk of all-cause mortality and major CVD events in Chinese population, especially in urban areas and females. Our findings can be used by policymakers to take action to mitigate the adverse effect of poor community conditions on health, such as improving local amenities and transport connectivity, providing building paths for walking, running and cycling.

Cities and mental health: The role of the built environment, and environmental and lifestyle factors in Barcelona

Built environment characteristics and related environmental exposures and behaviors have been, separately, implicated in the development of poor mental health. However, it is unclear how these factors act together in relation to mental health. We studied these factors simultaneously to evaluate the impact of the built environment, and the mediating role of environmental exposures and physical activity, on mental health, while also studying moderation by sex, age, and length of residence. We used a cross-sectional population-based sample of 3145 individuals aged 15-97 years from Barcelona, Spain. Time spent walking and mental health status were assessed with validated questionnaires, administered through a face-to-face interview. We characterized the built environment (e.g., building, population and intersection density and green space), road traffic noise, and ambient air pollution at the residential level using land cover maps, remote sensing, noise maps and land use regression models. Adjusted regression models accounting for spatial clustering were analyzed to study associations between built environment attributes and mental health, and mediation and moderation effects. Density attributes were directly or indirectly, through air pollution and less consistently through walking, associated with poor mental health. Green space indicators were associated with lower prevalence of poor mental health, partly through lower air pollution exposure and more walking. In some cases, these associations differed by sex, age or length of residence. Non-linear associations of density indicators with environmental exposures, and of particulate matter with poor mental health indicated threshold effects. We conclude that living in dense areas with high air pollution concentrations was associated with poor mental health. On the other hand, green areas with lower air pollution concentrations were protective against poor mental health. Greater urban density might benefit health, but might only do so when air pollution concentrations are low.

Long-Term Exposure to Walkable Residential Neighborhoods and Risk of Obesity-Related Cancer in the New York University Women's Health Study (NYUWHS)

BACKGROUND

Living in neighborhoods with higher levels of walkability has been associated with a reduced risk of obesity and higher levels of physical activity. Obesity has been linked to increased risk of 13 cancers in women. However, long-term prospective studies of neighborhood walkability and risk for obesity-related cancer are scarce.

OBJECTIVES

We evaluated the association between long-term average neighborhood walkability and obesity-related cancer risk in women.

METHODS

The New York University Women's Health Study (NYUWHS) is a prospective cohort with 14,274 women recruited between 1985 and 1991 in New York City and followed over nearly three decades. We geocoded residential addresses for each participant throughout follow-up and calculated an average annual measure of neighborhood walkability across years of follow-up using data on population density and accessibility to destinations associated with geocoded residential addresses. We used ICD-9 codes to characterize first primary obesity-related cancers and employed Cox proportional hazards models to assess the association between average neighborhood walkability and risk of overall and site-specific obesity-related cancers.

RESULTS

Residing in neighborhoods with a higher walkability level was associated with a reduced risk of overall and site-specific obesity-related cancers. The hazards ratios associated with a 1-standard deviation increase in average annual neighborhood walkability were 0.88 (95% CI: 0.85, 0.93) for overall obesity-related cancer, 0.89 (95% CI: 0.84, 0.95) for postmenopausal breast cancer, 0.82 (95% CI: 0.68, 0.99) for ovarian cancer, 0.87 (95% CI: 0.76, 0.99) for endometrial cancer, and 0.68 (95% CI: 0.49, 0.94) for multiple myeloma, adjusting for potential confounders at both the individual and neighborhood level. The association between neighborhood walkability and risk of overall obesity-related cancer was stronger among women living in neighborhoods with higher levels of poverty compared with women living in areas with lower poverty levels (p Interaction = 0.006 ).

DISCUSSION

Our study highlights a potential protective role of neighborhood walkability in preventing obesity-related cancers in women. https://doi.org/10.1289/EHP11538.

Relationships of walking activity with depressed mood and suicidal ideation among the middle-aged Korean population: a nationwide cross-sectional study

Introduction

The suicide rate of middle-aged adults has increased rapidly, which is a significant public health concern. A depressed mood and suicidal ideation are significant risk factors for suicide, and non-pharmacological interventions such as exercise therapy have been suggested as potential treatments. Walking is a feasible and accessible form of exercise therapy for middle-aged adults.

Methods

We conducted a study based on the Seventh Korea National Health and Nutrition Examination Survey (2016-2018) data of 6,886 general middle-aged adults in South Korea to investigate the relationships of walking exercise with depressed mood and suicidal ideation. Multiple logistic regression analysis was used to adjust for confounding variables. Sampling weights were applied to obtain estimates for the general Korean population.

Results

Participants who walked ≥5 days per week had a significantly lower odds ratio (OR) for depressed mood [OR = 0.625, 95% confidence interval (CI): 0.424-0.921, p = 0.018] and suicidal ideation (OR = 0.252, 95% CI: 0.125-0.507, p < 0.001) compared to those who never walked, regardless of the duration of exercise. The same results were obtained for males after stratifying the data by sex and suicidal ideation was associated with walking in females.

Conclusion

Regular walking exercise was associated with diminished mental health problems in middle-aged adults. Light walks may serve as a useful starting point for patients with serious mental health issues, such as suicidal ideation.

Barriers and enablers to local active travel during COVID-19: A case study of Streetspace interventions in two London boroughs

Background: During the coronavirus disease 2019 (COVID-19) pandemic, UK local authorities increased emergency active travel interventions. This study aimed to understand what aspects of temporary Streetspace for London schemes represent barriers or enablers to walking and cycling for short local journeys. Methods: Focusing on two Inner London boroughs, we conducted 21 semi-structured stakeholder interviews and sampled 885 public comments about Streetspace schemes. We triangulated the data in a thematic analysis to identify barriers and enablers, which were categorised using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results: Opportunity and motivation factors were reflected in the barriers (accessibility and integration of the schemes; controversy, dissatisfaction, and doubt) and enablers (new routes and spaces; sustainability and health beliefs) and mixed themes (changes to traffic and appeal of the area; feelings of safety). Capability was not reflected in the main themes. Conclusions: Although aspects of Streetspace schemes were seen to enable active travel, our findings suggest that additional processes to address the acceptability, fairness, and unintended consequences of emergency interventions will be important to their long-term success for health and sustainability.

Urbanization and physical activity in the global Prospective Urban and Rural Epidemiology study

Urbanization may influence physical activity (PA) levels, although little evidence is available for low- and middle- income countries where urbanization is occurring fastest. We evaluated associations between urbanization and total PA, as well as work-, leisure-, home-, and transport-specific PA, for 138,206 adults living in 698 communities across 22 countries within the Prospective Urban and Rural Epidemiology (PURE) study. The 1-week long-form International PA Questionnaire was administered at baseline (2003-2015). We used satellite-derived population density and impervious surface area estimates to quantify baseline urbanization levels for study communities, as well as change measures for 5- and 10-years prior to PA surveys. We used generalized linear mixed effects models to examine associations between urbanization measures and PA levels, controlling for individual, household and community factors. Higher community baseline levels of population density (- 12.4% per IQR, 95% CI - 16.0, - 8.7) and impervious surface area (- 29.2% per IQR, 95% CI - 37.5, - 19.7), as well as the rate of change in 5-year population density (- 17.2% per IQR, 95% CI - 25.7, - 7.7), were associated with lower total PA levels. Important differences in the associations between urbanization and PA were observed between PA domains, country-income levels, urban/rural status, and sex. These findings provide new information on the complex associations between urbanization and PA.

Role of Environment on Physical Activity Patterns of Older Adults Living With HIV in New York City

ABSTRACT

The purpose of this study was to survey the physical activity (PA) patterns of older adults with HIV and investigate the relationship between environmental factors and PA in this population. This study was a secondary data analysis from 100 adults, ages 50 years and older, living with HIV in New York City. Descriptive statistics assessed PA patterns. Linear regression assessed the association between environmental factors and time spent in PA. All participants had been living with HIV for 21 years on average, were on antiretroviral therapy, ranged in age from 50 to 71 years, and were 50% female. Participants performed at 75% of their functional capacity ( p < .0001), and females walked less than males ( p < .05). Traffic hazards were the sole environmental predictor of PA participation. Targeted interventions are needed to increase PA in this growing population. Interventions at the policy level should reduce traffic hazards to support PA.

Associations between walkability and pedestrian related injuries is modified by sociodemographic characteristics

BACKGROUND

Walkability scores have been developed to measure how well the characteristics of the physical environment support walking. However, because pedestrian safety is not taken into account, areas that have higher Walk Scores could be associated with more walking and also more pedestrian-related injury. We aimed to explore the association between Walk Score and pedestrian-related injury in Sydney.

METHOD

Pedestrian-related injuries from 2010 to 2018 in Sydney were identified in the New South Wales Combined Admitted Patient Epidemiology Data. Walk Score was used to measure area-level walkability in Sydney statistical division. Regression models were used to examine the association between Walk Score, pedestrian-related injury, length of hospital stay (LOS) and injury severity.

RESULT

Among people aged ≤64 years, there was no significant association between walkability score and pedestrian-related injury. Among people aged ≥ 65 years, walkability score was significantly positively associated with pedestrian-related injury, which peaked at Somewhat Walkable. For most disadvantaged areas, the risk of pedestrian-related injury was highest for areas that were classified as Somewhat Walkable. For moderately disadvantaged areas, the risk of pedestrian-related injury was highest at Very Walkable to Walker's Paradise areas. For the least disadvantaged areas, there was no significant association between walkability score and pedestrian-related injury. For LOS among people aged ≥ 65 years or in the most disadvantaged areas, it peaked at Somewhat Walkable areas. For injury severity, the risk of serious pedestrian-related injury was highest at Very Walkable to Walker's Paradise areas among people aged 16-64 years.

CONCLUSION

For the majority of the population, built environment characteristics that are considered to make walking attractive also make it safer, offsetting any exposure-related increase injury risk. However, this is not the case for people aged ≥ 19 years, and those living in socioeconomically disadvantaged areas. Incorporating measures of pedestrian safety in walkability scores may create an impetus to ensure that the built environment is designed to support the safety of pedestrians from these groups.

Perception of the Neighborhood Environment, Physical Activity by Domain and Sitting Time in Brazilian Adults

This study aimed to examine the association between the neighborhood environment and domain-specific physical activity and sitting time in Brazilian adults. This cross-sectional study included 1803 adults (53.7% women) from Brazil's five regions (North, Northeast, Midwest, Southeast and South). The perception of the environment was evaluated via a questionnaire. We considered seven indicators of the neighborhood environment: land use mix-diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic and safety from crime. Using the IPAQ, we evaluated physical activity (transport and leisure) and sitting time. Overall, land use mix-diversity (β = 3.22; 95% CI = 0.26, 6.19), land use mix-access (β = 2.27; 95% CI = 0.76, 3.79), and walking/cycling facilities (β = 2.42; 95% CI = 0.35, 4.49) were positively associated with leisure-time physical activity (min/week). On the other hand, only land use mix-diversity (β = 3.65; 95% CI = 0.63, 5.49) was positively associated with transport physical activity (min/week). No neighborhood environment indicator was associated with sitting time (min/day). Perception of the neighborhood environment was associated with physical activity (transport and leisure), while no significant associations occurred with sitting time among the five regions of Brazil. The neighborhood environment can be a viable component in the promotion of physical activity, but geographic diversity must be considered.

Walking Behavior of Older Adults in Temuco, Chile: The Contribution of the Built Environment and Socio-Demographic Factors

The amount of walking for daily transport has decreased significantly over the last decades in Temuco, Chile. Moreover, the percentage of older adults (aged over 65) who did not meet the recommendations of at least 150 min of physical activity per week has increased during this time. In this regard, the present study examines the contribution of socio-demographic and built environment factors on the walking behavior of older adults in Temuco, Chile, with a view to improving their level of physical activity. A cross-sectional study was conducted among 463 older adults aged 60 years and over. Travel Diary Data taken from "Encuesta Origin Destino" (EOD) 2013, Geographic information systems (GIS), audits (PEDS with certain revisions) and finally, multiple regression analysis, were used to examine the objectives. Associations were found between the walking behavior of older adults and several socio-demographic factors, as well as several built environment factors including destination (the number of parks and the land use mix), functionality (street connectivity, length of street sections and off-street parking lots) and aesthetics (views of nature, building height, and articulation in building design). These findings should be considered by urban/transport policymakers to improve the walking behavior of older adults in this city.

Perceived Neighborhood Safety and Active Transportation in Adults from Eight Latin American Countries

Neighborhood built environment is associated with domain-specific physical activity. However, few studies with representative samples have examined the association between perceived neighborhood safety indicators and domain-specific active transportation in Latin America. This study aimed to examine the associations of perceived neighborhood safety with domain-specific active transportation in adults from eight Latin American countries. Data were obtained from the Latin American Study of Nutrition and Health (n = 8547, aged 18-65). Active transportation (walking and cycling) was assessed using the long form of the International Physical Activity Questionnaire. Specifically, traffic density and speed as well as street lightening, visibility of residents regarding pedestrians and bicyclists, traffic lights and crosswalks, safety of public spaces during the day and at night, crime rate during the day and at night were used to evaluate perceived neighborhood safety. Slow traffic speeds, unsafe public spaces during the day, and crime during the day were associated with ≥10 min/week vs. <10 min/week of walking. Furthermore, drivers exceeding the speed limit and crime rate during the day were associated with reporting ≥10 min/week vs. <10 min/week of cycling. These results indicate a stronger association of the perceived neighborhood safety with walking compared to cycling.

Barriers and facilitators for physical activity domains in Brazil: a systematic review

Abstract This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

Barriers and facilitators for physical activity domains in Brazil: a systematic review

This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

Do residents with a 20-min neighbourhood walk more? Findings from ProjectPLAN

BACKGROUND

The 20-min neighbourhood (20 MN) concept aims to provide people the ability to meet their daily needs within a 20-min non-motorised trip from home. Evidence as to whether the 20 MN encourages more walking for transport or recreation is currently absent.

METHODS

This cross-sectional study used self-reported data from the Places and Locations for Activity and Nutrition study (ProjectPLAN) targeting adults (n = 843) residing in Melbourne or Adelaide, Australia. Multiple services and amenities were used to represent access to five service domains (healthy food, community resources, recreational resources, public open space, public transport). Address points meeting the access criteria for each of the five domains were defined as having a 20 MN. Non-20 MNs were defined as having five or fewer individual services and amenities. This study examined if those residing in a 20 MN compared with a non-20MN undertook more walking for transport or for recreation. The analysis considered separately each of the cities to support the estimation of effects specific to each local context.

RESULTS

Respondents residing in a 20 MN relative to a non-20MN had higher odds of walking for transport in Melbourne (OR = 4.24, 95% CI = 2.38, 7.56), whilst in Adelaide there was no evidence of a difference (OR = 1.31, 95% CI = 0.80, 2.13). In Melbourne, the mean time spent walking for transport was greater for 20 MNs (82.5 min/week, 95% CI = 65.3, 99.7) compared to non-20MNs (41.2 min/week, 95% CI = 32.7, 49.7). Whilst minutes spent walking for recreation was higher than minutes spent walking for transport, no differences were found between neighbourhood types and walking for recreation in either city.

CONCLUSION

20 MNs appeared to promote walking for transport in the higher density setting of Melbourne, but no association was observed in the lower density city of Adelaide. Further investigation is required to determine other factors beyond service provision that can promote walking for transport in Adelaide (e.g. pedestrian safety). Recreational walking did not differ across neighbourhood types highlighting that service provision and thus the 20 MN is not related to walking for exercise/recreation purposes.

Urban environment and health behaviours in children from six European countries

BACKGROUND

Urban environmental design is increasingly considered influential for health and wellbeing, but evidence is mostly based on adults and single exposure studies. We evaluated the association between a wide range of urban environment characteristics and health behaviours in childhood.

METHODS

We estimated exposure to 32 urban environment characteristics (related to the built environment, traffic, and natural spaces) for home and school addresses of 1,581 children aged 6-11 years from six European cohorts. We collected information on health behaviours including total amount of overall moderate-to-vigorous physical activity, physical activity outside school hours, active transport, sedentary behaviours and sleep duration, and developed patterns of behaviours with principal component analysis. We used an exposure-wide association study to screen all exposure-outcome associations, and the deletion-substitution-addition algorithm to build a final multi-exposure model.

RESULTS

In multi-exposure models, green spaces (Normalized Difference Vegetation Index, NDVI) were positively associated with active transport, and inversely associated with sedentary time (22.71 min/day less (95 %CI -39.90, -5.51) per interquartile range increase in NDVI). Residence in densely built areas was associated with more physical activity and less sedentary time, and densely populated areas with less physical activity outside school hours and more sedentary time. Presence of a major road was associated with lower sleep duration (-4.80 min/day (95 %CI -9.11, -0.48); compared with no major road). Results for the behavioural patterns were similar.

CONCLUSIONS

This multicohort study suggests that areas with more vegetation, more building density, less population density and without major roads are associated with improved health behaviours in childhood.

Walking Behavior in Temuco, Chile: The Contribution of Built Environment and Socio-Demographic Factors

The increase in active travel contributes to maintaining the minimum rate of physical activity and therefore has a positive impact on inhabitants’ public health. The level of walking for daily transport has decreased significantly during the last decades in Temuco, Chile. This study examined the contribution of socio-demographic factors, active family environment, and built environment factors to walking behavior and walking level based on three types of destination in Temuco. The results of Encuesta Origin Destino (EOD 2013), geographic information system (GIS), and, finally, hierarchical multiple regression analysis were used to examine the objectives. Correlations were found between total walking behavior, walking level based on three destination types, and several socio-demographic factors such as age, gender, and access to TV and Internet. Furthermore, correlations were found between walking behavior and active family environment, as well as several built environment factors. For instance, the higher mixed land use as well as number of parks and plazas contribute towards more overall walking as well as two types of walking. Identifying that most persons who walk come from low-income families and the negative impact of network connectivity on overall walking are the major differences between this context and developed countries.

The relationship between perceived built environment and cycling or e-biking for transport among older adults–a cross-sectional study

The built environment plays a key role in promoting active mobility for healthy aging. Encouraging active mobility among older adults, however, can be especially challenging in more rural areas where distances tend to be longer and infrastructure is favoring car traffic. The association of older adults’ perception of attributes of the built environment with cycling and e-biking for transport was investigated. The potential moderating effects of age, sex, and mobility impairments were explored. A cross-sectional survey was conducted in towns and communities of <100,000 inhabitants, including 2,144 participants (mean age: 74; 53% men). Three different cycling outcomes (any cycling/e-biking, frequency (≥3 days/week) and amount (minutes/week)) were analyzed among all cyclists and e-bike users separately, resulting in six dependent variables. The impact of ten environmental attributes on these outcomes was analyzed in separate models. Overall, street connectivity, and the proximity and number of destinations were most important. Only street connectivity and traffic safety were related to minutes cycling or e-biking per week. Cycling amount was higher overall for e-biking but fewer environmental attributes showed an association compared to any cycling, regardless of bicycle type. Traffic safety was not associated with four out of the six cycling outcomes and was inversely associated with minutes cycling or e-biking. Density was not related to any of the variables investigated. Several interaction effects of sex, age, and mobility impairments were found. Further research is needed on environmental attributes influencing e-bike use, the most important types of destinations, and a more differentiated assessment of perceived traffic safety in older adults.

Perceived Neighborhood Walkability is Associated with Recent Falls in Urban Dwelling Older Adults

BACKGROUND AND PURPOSE

In rural communities, perceptions of neighborhood walkability, the rating of how easy it is to walk in an area, influence engagement in physical activity outside the home. This has not been studied in older adults residing in urban settings. Additionally, it is not known how perceived walkability is associated with falls. Therefore, the purpose of this study was to first describe the perceptions of neighborhood walkability in urban-dwelling older adults based on recent fall history and then examine associations between recent falls and neighborhood walkability constructs after controlling for fall risk factors.

METHODS

Urban-dwelling older adults (N = 132) 65 years and older without cognitive dysfunction or uncontrolled comorbidity completed a survey assessing health status, physical activity, and walkability using the Neighborhood Environment Walkability Scale-Abbreviated. Group assignment was based on recent fall history. Between-group comparisons of demographic and walkability constructs were completed using analysis of variance. Logistic regression was used to examine associations between walkability constructs and recent falls after controlling for covariates.

RESULTS AND DISCUSSION

Poorer perception of land use was significantly associated with recent falls. Questions assessing the ease of walking to a store or transit stop may be valuable in understanding fall risk in older adults living in urban settings.

CONCLUSIONS

Perceptions of neighborhood walkability are lower in urban-dwelling older adults with a history of falling.

Smart Watch Versus Classic Receivers: Static Validity of Three GPS Devices in Different Types of Built Environments

In order to study the relationship between human physical activity and the design of the built environment, it is important to measure the location of human movement accurately. In this study, we compared an inexpensive GPS receiver (Holux RCV-3000) and a frequently used Garmin Forerunner 35 smart watch, with a device that has been validated and recommended for physical activity research (Qstarz BT-Q1000XT). These instruments were placed on six geodetic points, which represented a range of different environments (e.g., residential, open space, park). The coordinates recorded by each device were compared with the known coordinates of the geodetic points. There were no differences in accuracy among the three devices when averaged across the six sites. However, the Garmin was more accurate in the city center and the Holux was more accurate in the park and housing estate areas compared to the other devices. We consider the location accuracy of the Holux and the Garmin to be comparable to that of the Qstarz. Therefore, we consider these devices to be suitable instruments for locating physical activity. Researchers must also consider other differences among these devices (such as battery life) when determining if they are suitable for their research studies.

Individual Characteristics Associated with Active Travel in Low and High Income Groups in the UK

Active travel (AT) has gained increasing attention as a way of addressing low levels of physical activity. However, little is known regarding the relationship between income and AT. The aim of this study was to investigate characteristics associated with undertaking AT in an adult population and by low- and high-income groups. Data collected from the Physical Activity and the Rejuvenation of Connswater (PARC) study in 2017 were used. Participants were categorised into socio-economic groups according to their weekly household income, and were categorised as participating in ‘no’ AT or ‘some’ AT and ‘sufficient’ AT. Multivariable logistic regression explored characteristics associated with AT in the full cohort, and the low- and high-income groups separately. Variables associated with AT in the low-income group were body mass index (BMI), physical activity self-efficacy, marital status, long term illness, difficulty walking and housing tenure. For the high-income group, BMI, marital status, housing tenure and education were associated with AT. For both income groups, there were consistent positive associations with the action/maintenance phase of the stage of change model across all AT categories. The findings suggest that population sub-groups may benefit from targeted initiatives to support engagement in AT and prevent further widening of inequalities.

Social and Economic Differences in Neighborhood Walkability Across 500 U.S. Cities

INTRODUCTION

Neighborhood walkability has been established as a potentially important determinant of various health outcomes that are distributed inequitably by race/ethnicity and sociodemographic status. The objective of this study is to assess the differences in walkability across major urban centers in the U.S.

METHODS

City- and census tract-level differences in walkability were assessed in 2020 using the 2019 Walk Score across 500 large cities in the U.S.

RESULTS

At both geographic levels, high-income and majority White geographic units had the lowest walkability overall. Walkability was lower with increasing tertile of median income among majority White, Latinx, and Asian American and Native Hawaiian and Pacific Islander neighborhoods. However, this association was reversed within majority Black neighborhoods, where tracts in lower-income tertiles had the lowest walkability. Associations varied substantially by region, with the strongest differences observed for cities located in the South.

CONCLUSIONS

Differences in neighborhood walkability across 500 U.S. cities provide evidence that both geographic unit and region meaningfully influence associations between sociodemographic factors and walkability. Structural interventions to the built environment may improve equity in urban environments, particularly in lower-income majority Black neighborhoods.

Sociodemographic inequities and active transportation in adults from Latin America: an eight-country observational study

Background

Active transportation is a crucial sort of physical activity for developing sustainable environments and provides essential health benefits. This is particularly important in Latin American countries because they present the highest burden of non-communicable diseases relative to other worldwide regions. This study aimed to examine the patterns of active transportation and its association with sociodemographic inequities in Latin American countries.

Methods

This cross-sectional study was conducted in eight countries. Participants (n = 8547, 18–65 years) self-reported their active transportation (walking, cycling, and total) using the International Physical Activity Questionnaire. Sex, age, ethnicity, socioeconomic level, education level, public and private transport use, and transport mode were used as sociodemographic inequities.

Results

Participants spent a total of 19.9, 3.1, and 23.3 min/day with walking, cycling, and total active transportation, respectively. Mixed and other ethnicity (Asian, Indigenous, Gypsy, and other), high socioeconomic level as well as middle and high education level presented higher walking than Caucasian, low socioeconomic and education level. Private transport mode and use of ≥ 6 days/week of private transport showed lower walking than public transport mode and ≤ 2 days/week of private transport. Use of ≥ 3 days/week of public transport use presented higher walking than ≤ 2 days/week of public transport. Men had higher cycling for active transportation than women. Use of ≥ 3 days/week of public transport use presented higher cycling than ≤ 2 days/week of public transport. ≥6 days/week showed lower cycling than ≤ 2 days/week of private transport use. Men (b: 5.57: 95 %CI: 3.89;7.26), black (3.77: 0.23;7.31), mixed (3.20: 1.39;5.00) and other ethnicity (7.30: 2.55;12.04), had higher total active transportation than women and Caucasian. Private transport mode (-7.03: -11.65;-2.41) and ≥ 6 days/week of private transport use (-4.80: -6.91;-0.31) showed lower total active transportation than public transport mode and ≤ 2 days/week of private transport use. Use of 3–5 (5.10: 1.35;8.85) and ≥ 6 days/week (8.90: 3.07;14.73) of public transport use presented higher total active transportation than ≤ 2 days/week of public transport use. Differences among countries were observed.

Conclusions

Sociodemographic inequities are associated differently with active transportation across Latin American countries. Interventions and policies that target the promotion of active policies transportation essential to consider sociodemographic inequities.

Trial registration

ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-021-01524-0.

Factors influencing walking trips. Evidence from Gdynia, Poland

Political support for active mobility is growing for many reasons, including land use planning, health, and improved mobility. As the vital part of many cities is their central area, decision-makers need to know what factors are essential for increasing walkability. This paper aims to identify the main factors affecting the walkability of the city centre of Gdynia (Poland). To achieve this, the research design was adjusted to the specificity of the local use case. Based on primary data collected via personal interviews, factor analysis was applied to rule out potential collinearity and reduce dimensions. Logistic regression models were then constructed. The results were compared with the research carried out in other cities. The results show that only two of the analysed factors are significant, namely accessibility and safety. Both are extensive categories and include many subcomponents that are influential among different groups of citizens. Our research also confirms that walkability is a city-specific issue that is influenced by many local factors.

The Hierarchy of Walking Needs and the COVID-19 Pandemic

More than 150 cities around the world have expanded emergency cycling and walking infrastructure to increase their resilience in the face of the COVID 19 pandemic. This tendency toward walking has led it to becoming the predominant daily mode of transport that also contributes to significant changes in the relationships between the hierarchy of walking needs and walking behaviour. These changes need to be addressed in order to increase the resilience of walking environments in the face of such a pandemic. This study was designed as a theoretical and empirical literature review seeking to improve the walking behaviour in relation to the hierarchy of walking needs within the current context of COVID-19. Accordingly, the interrelationship between the main aspects relating to walking-in the context of the pandemic- and the different levels in the hierarchy of walking needs were discussed. Results are presented in five sections of "density, crowding and stress during walking", "sense of comfort/discomfort and stress in regard to crowded spaces during walking experiences", "crowded spaces as insecure public spaces and the contribution of the type of urban configuration", "role of motivational/restorative factors during walking trips to reduce the overload of stress and improve mental health", and "urban design interventions on arrangement of visual sequences during walking".

A Latent Class Analysis of Perceived Neighborhood Conditions Associated with Mental Disorders Among Children in the United States

The current study examined the association between perceived neighborhood conditions and common childhood mental disorders in a nationally representative sample of children in the U.S. The data were derived from the 2017 National Survey of Children's Health, including American children aged 6-17 years (N = 15,438). Latent class analysis was used to identify subtypes of perceived neighborhood conditions regarding neighborhood physical environment, social capital, and violence. Three classes were identified: Ideal Neighborhood (55.99%); Insufficient Assets (27.38%), and Broken and Unsafe Neighborhood (16.63%). The effects of latent classes on psychiatric outcomes (i.e. attention deficit hyperactivity disorder, depression, anxiety, conduct problem, and any of these four disorders) were examined. Class membership was differentially associated with the mental disorders after adjustment for demographic variables, food insufficiency, and guardian's mental health. The Broken and Unsafe Neighborhood class was associated with greater odds of all childhood psychiatric disorders than the Ideal Neighborhood and Insufficient Assets class. Insufficient Assets class was associated with greater odds of all childhood psychiatric disorders than the Ideal Neighborhood class. The findings suggest that neighborhood-level interventions to decrease children's mental health burdens are critically needed.

Prevalence and Social and Built Environmental Determinants of Maternal Prepregnancy Obesity in 68 Major Metropolitan Cities of the United States, 2013-2016

Objective

Maternal prepregnancy obesity is related to increased maternal morbidity and mortality and poor birth outcomes. However, prevalence and risk factors for prepregnancy obesity in US cities are not known. This study examines the prevalence and social and environmental determinants of maternal prepregnancy obesity (BMI ≥30), overweight/obesity (BMI ≥25), and severe obesity (BMI ≥40) in the 68 largest metropolitan cities of the United States.

Methods

We fitted logistic and Poisson regression models to the 2013–2016 national vital statistics birth cohort data (N = 3,083,600) to derive unadjusted and adjusted city differentials in maternal obesity and to determine social and environmental determinants.

Results

Considerable disparities existed across cities, with the prevalence of prepregnancy obesity ranging from 10.4% in San Francisco to 36.6% in Detroit. Approximately 63.0% of mothers in Detroit were overweight or obese before pregnancy, compared with 29.2% of mothers in San Francisco. Severe obesity ranged from 1.4% in San Francisco to 8.5% in Cleveland. Women in Anchorage, Buffalo, Cleveland, Fresno, Indianapolis, Louisville, Milwaukee, Oklahoma City, Sacramento, St Paul, Toledo, Tulsa, and Wichita had >2 times higher adjusted odds of prepregnancy obesity compared to those in San Francisco. Race/ethnicity, maternal age, parity, marital status, nativity/immigrant status, and maternal education were important individual-level risk factors and accounted for 63%, 39%, and 72% of the city disparities in prepregnancy obesity, overweight/obesity, and severe obesity, respectively. Area deprivation, violent crime rates, physical inactivity rates, public transport use, and access to parkland and green spaces remained significant predictors of prepregnancy obesity even after controlling for individual-level covariates.

Conclusions

Substantial disparities in maternal prepregnancy obesity among the major US cities remain despite risk-factor adjustment, with women in several Southern and Midwestern cities experiencing high risks of obesity. Sound urban policies are needed to promote healthier lifestyles and favorable social and built environments for obesity reduction and improved maternal health.

How Is Urban Greenness Spatially Associated with Dockless Bike Sharing Usage on Weekdays, Weekends, and Holidays?

Dockless bike sharing plays an important role in residents’ daily travel, traffic congestion, and air pollution. Recently, urban greenness has been proven to be associated with bike sharing usage around metro stations using a global model. However, their spatial associations and bike sharing usage on public holidays have seldom been explored in previous studies. In this study, urban greenness was obtained objectively using eye-level greenness with street-view images by deep learning segmentation and overhead view greenness from the normalized difference vegetation index (NDVI). Geographically weighted regression (GWR) was applied to fill the research gap by exploring the spatially varying association between dockless bike sharing usage on weekdays, weekends, and holidays, and urban greenness indicators as well as other built environment factors. The results showed that eye-level greenness was positively associated with bike sharing usage on weekdays, weekends, and holidays. Overhead-view greenness was found to be negatively related to bike usage on weekends and holidays, and insignificant on weekdays. Therefore, to promote bike sharing usage and build a cycling-friendly environment, the study suggests that the relevant urban planner should pay more attention to eye-level greenness exposure along secondary roads rather than the NDVI. Most importantly, planning implications varying across the study area during different days were proposed based on GWR results. For example, the improvement of eye-level greenness might effectively promote bike usage in northeastern and southern Futian districts and western Nanshan on weekdays. It also helps promote bike usage in Futian and Luohu districts on weekends, and in southern Futian and southeastern Nanshan districts on holidays.

Walking for Transport among Older Adults: A Cross-Sectional Study on the Role of the Built Environment in Less Densely Populated Areas in Northern Germany

In the last decades, there has been rising interest in public health research in the importance of the built environment for a healthy and active life in old age, but little attention has been paid to less densely populated areas. This study aimed to explore the impact of the built environment on walking for transport in the context of an older population living in communities of <100,000 inhabitants. Within the project AFOOT–Securing urban mobility of an aging population, a cross-sectional postal survey was carried out from May to September 2019 in older adults (≥65 years) in the Metropolitan Region Northwest, Germany. Self-reported data from 2189 study participants were analyzed. Logistic and linear regression models were used to examine the associations between the built environment and walking for transport. Any walking and frequent walking were positively associated with nearly all built environment attributes, even after adjustment for demographic and health covariates. The amount of walking in minutes per week was associated only with residential density. Moderating effects of gender, age, and use of walking aids were identified. Improving the built environment appears to be a promising opportunity to motivate and enable older adults to walk for transport.

Age-related differences in the associations of physical environmental factors and psychosocial factors with accelerometer-assessed physical activity

The aim of the current study was to examine age-related differences in the associations of physical environmental and psychosocial factors with accelerometer-assessed MVPA across three age groups (adolescents, adults, and older adults). Therefore, data from three studies with a comparable study protocol were combined. Results showed that both physical environmental factors and psychosocial factors were most strongly associated with MVPA in older adults. Consequently, health behavior interventions for older adults should focus on physical environmental factors as well as psychosocial factors. While adolescents and adults may benefit less from such interventions.

Traffic Safety Perception, Attitude, and Feeder Mode Choice of Metro Commute: Evidence from Shenzhen

Like many other transit modes, the metro provides stop-to-stop services rather than door-to-door services, so its use undeniably involves first- and last-mile issues. Understanding the determinants of the first- and last-mile mode choice is essential. Existing literature, however, mostly overlooks the mode choice effects of traffic safety perception and attitudes toward the mode. To this end, based on a face-to-face questionnaire survey in Shenzhen, China, this study uses the two-sample t-test to confirm the systematic differences in traffic safety perception and attitudes between different subgroups and develops a series of multinomial logistic (MNL) models to identify the determinants of first- and last-mile mode choice for metro commuters. The results of this study show that: (1) Walking is the most frequently used travel mode, followed by dockless bike-sharing (DBS) and buses; (2) Variances in traffic safety perception and attitude exist across gender and location; (3) Vehicle-related crash risks discourage metro commuters from walking to/from the metro station but encourage them to use DBS and buses as feeder modes; (4) DBS–metro integration is encouraged by the attitude that DBS is quicker than buses and walking, and positive attitudes toward the bus and DBS availability are decisive for the bus–metro and DBS–metro integration, respectively; and (5) Substantial differences exist in the mode choice effects of traffic safety perception and attitudes for access and egress trips. This study provides a valuable reference for metro commuters’ first- and last-mile travel mode choice, contributing to developing a sustainable urban transport system.

Walking toward Metro Stations: the Contribution of Distance, Attitudes, and Perceived Built Environment

Walking as an active means of travel is important as a sustainable mode of transport. Moreover, the level of walking in the surrounding areas of metro stations would contribute to maintaining the minimum rate of physical activity and, therefore, inhabitants’ general health. This study examined the impacts of walking attitude, walking distance, and perceived built environment on walking behavior for reaching the metro stations in Shiraz, Iran. Three metro stations were selected and a quantitative approach was used to examine the objectives. It was found that the average walking distance is less than the average in developed countries, such as the United States. People walked more when there was a shorter distance between their starting points and the metro stations. The contribution of walking attitudes and several built environment attributes to walking behavior was demonstrated. Finding the contribution of aesthetic attributes, such as accessibility to parks and housing types of the starting points of the walking trips, to walking for transport are taken into account as the novelties of this study. Policy makers of this city may apply the findings of this study—especially around the metro stations—to improve the average walking distance as well as walking behavior.

The Association between the Regular Use of ICT Based Mobility Services and the Bicycle Mode Choice in Tehran and Cairo

Regarding the sharp growth rate of ICT (information and communication technology)—based mobility services like ridesourcing, it is essential to investigate the impact of these new mobility services on the transport mode choices, particularly on active mobility modes like cycling. This impact is more important in the MENA context (the Middle East and North Africa), where cycling does not constitute the main mobility mode in the modal split of most MENA cities. This paper studies the relationship between the regular use of ICT-based mobility services like ridesourcing and the tendency to cycle to near destinations. This paper contains the analysis of 4431 interviews in two large cities of the MENA region (Cairo and Tehran). This research uses logistic regression to analyze and compare the odds of cycling among regular and non-regular users of ridesourcing by considering the socio-economic, land use, and perception variables. The findings indicate that the odds of cycling among the regular users of ridesourcing are 2.30 and 1.94 times greater than these odds among non-regular ridesourcing users in Tehran and Cairo, respectively. Therefore, the regular users of ridesourcing are more likely to cycle to their near destinations than non-regular ridesourcing users in these cities.

The Moderating Effect of Distance on Features of the Built Environment and Active School Transport

Despite growing research supporting the impact of the built environment on active school transport (AST), distance persists as the most powerful predictor of walking and biking to school. There is a need to better understand how environmental features interact with distance to affect AST, and whether the influence of environmental factors persist across different distance thresholds. Multilevel models using cluster-robust standard errors were used to examine for interactions between objectively measured macroscale environmental features and several reported distances from home to school (up to ¼, ¼ up to ½, ½ up to 1, 1+ miles) on the likelihood of parent reported AST for children grades 3-8 (n = 2751) at 35 schools who completed a Safe Routes to School Parent Survey about Walking and Biking to School (SRTS Parent Survey). An interaction between both intersection density and food-related land use with distance was observed. The likelihood of AST decreased as intersection density and distance increased (i.e., 31.0% reduced odds among those living within ¼ mile compared to 18.2% using ½-1-mile criterion). The likelihood of using AST were reduced as food-related land use and distance increased (i.e., 43.67% reduced odds among those living under ¼ mile compared to 19.83% reduced odds among those living ½-1 mile). Programs and infrastructure improvements focused on overcoming environmental barriers to promote AST may be most effective when targeting neighborhoods within ¼ mile of schools.

Built Environment Correlates of the Propensity of Walking and Cycling

Walking and cycling are not only frequently-used modes of transport but also popular physical activities. They are beneficial to traffic congestion mitigation, air pollution reduction, and public health promotion. Hence, examining and comparing the built environment correlates of the propensity of walking and cycling is of great interest to urban practitioners and decision-makers and has attracted extensive research attention. However, existing studies mainly look into the two modes separately or consider them as an integral (i.e., active travel), and few compare built environment correlates of their propensity in a single study, especially in the developing world context. Thus, this study, taking Xiamen, China, as a case, examines the built environment correlates of the propensity of walking and cycling simultaneously and compares the results wherever feasible. It found (1) built environment correlates of the propensity of walking and cycling differ with each other largely in direction and magnitude; (2) land use mix, intersection density, and bus stop density are positively associated with walking propensity, while the distance to the CBD (Central Business District) is a negative correlate; (3) as for cycling propensity, only distance to CBD is a positive correlate, and job density, intersection density, and bus stop density are all negative correlates. The findings of this study have rich policy implications for walking and cycling promotion interventions.

Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study

Background

Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries.

Methods

This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data.

Results

Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA.

Conclusions

Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA.

Trial registration

ClinicalTrials. Gov NCT02226627. Retrospectively registered on August 27, 2014.

Association between Perceived Neighborhood Built Environment and Walking and Cycling for Transport among Inhabitants from Latin America: The ELANS Study

Purpose: This study aimed to examine the associations of the perceived neighborhood built environment with walking and cycling for transport in inhabitants from Latin American countries. Methods: This cross-sectional study involved 9218 participants (15–65 years) from the Latin American Study of Nutrition and Health, which included a nationally representative sample of eight countries. All participants completed the International Physical Activity Questionnaire-Long Form for measure walking and cycling for transport and the Neighborhood Environment Walkability Scale-Abbreviated. Furthermore, perceived proximity from home to public open spaces and shopping centers was assessed. Results: Perceived land use mix-access (OR: 1.32; 95%CI: 1.16,1.50) and the existence of many alternative routes in the neighbourhood (1.09 1.01,1.17) were associated with higher odds of reporting any walking for transport (≥10 min/week). Perceived slow speed of traffic (1.88 1.82,1.93) and few drivers exceeding the speed limits (1.92; 1.86,1.98) were also related to higher odds of reporting any walking for transport. The odds of reporting any cycling for transport (≥10 min/week) were higher in participants perceiving more walking/cycling facilities (1.87 1.76,1.99), and better aesthetics (1.22 1.09,1.38). Conclusions: Dissimilar perceived neighborhood built environment characteristics were associated with walking and cycling for transport among inhabitants from Latin America.

Objective and subjective measures of the neighbourhood environment: Associations with frailty levels

OBJECTIVES

The aim of this study was to investigate whether perceptions of the neighbourhood environment (NE) and objective measures of the NE were associated with frailty in older adults.

METHODS

A cross-sectional study in Adelaide, Australia, recruited a sample of 115 community-dwelling adults aged ≥60 years. Respondents' perceptions of their NEs were assessed using the Neighbourhood Environment Walkability Scale (NEWS). An objective assessment of these NEWS survey questions was conducted using seven variables: residential density, land use mix diversity, street connectivity, accessibility, seasonal persistent green cover, road crash density and crime rate. Frailty was evaluated using the FRAIL (fatigue, resistance, ambulation, illnesses and loss of weight) scale. Multivariable linear regression analyses were employed to assess the associations between NEWS and frailty, and to assess the associations between objective neighbourhood variables and frailty.

RESULTS

Frail and pre-frail older adults were more likely to live in areas with lower residential density, lower density of road crashes, and higher accessibility than robust participants. Additionally, a poorer perception of the overall environment, worse land-use mix and accessibility and worse crime safety were associated with frailty and pre-frailty after adjustment of covariates and objective GIS variables.

DISCUSSION

Neighbourhood characteristics, both objective and perceived, are associated with frailty levels in older adults, and that strategies to tackle frailty must consider the impact of the neighbourhood environment.

Correlates of walking among disadvantaged groups: A systematic review

Socioeconomically disadvantaged groups are less likely to be physically active. Walking is important to public health, therefore understanding correlates of walking will inform the development of targeted interventions. The aim of this systematic review was to examine the correlates of walking among socioeconomically disadvantaged adults. PubMed/MEDLINE and Scopus were searched up to February 2020 and titles/abstracts and full-texts were screened against eligibility criteria. Methodological quality was assessed. Correlates were synthesized when two or more comparisons were available. 35 studies were selected for synthesis. 21 examined overall walking, 16 examined leisure-time walking and 9 examined walking for transport (8 examined two or more types of walking). Employment status, home ownership, self-rated health, density or number of social ties, perceived neighborhood aesthetics, perceived walkability and perceived individual safety were positively associated with overall walking. Social support for physical activity from friends and family and perceived individual safety were positively associated with leisure-time walking. Objective walkability, perceived walkability and perceived individual safety were positively associated with walking for transport. Most studies were cross-sectional, did not report response rates and used a validated measure of physical activity. Strategies to improve self-rated health, social ties, neighborhood aesthetics, walkability and perceptions of individual safety should be the focus of interventions that aim to improve walking among socioeconomically disadvantaged groups. Recommendations for future studies include the need to focus on leisure-time walking and walking for transport; the correlates of walking in males; prospective longitudinal designs; psychological, cognitive and emotional variables; and social, behavioral attributes and skills.

Associations between the neighbourhood characteristics and body mass index, waist circumference, and waist-to-hip ratio: Findings from Alberta's Tomorrow Project

This study estimated the associations between neighbourhood characteristics and self-reported body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) risk categories among Canadian men and women. Using data from the Alberta's Tomorrow Project (n = 14,550), we estimated 3- and 4-way intersections, business destinations, population count, and normalized difference vegetation index (NDVI) within a 400 m radius of participant's home. Intersections, business destinations, and population count (z-scores) were summed to create a walkability score. Four-way intersections and walkability were negatively associated with overweight and obesity. Walkability was negatively associated with obesity. NDVI was negatively associated with high-risk WHR and population count and walkability positively associated with high-risk WHR. Among men, population count and walkability were negatively associated with obesity, and business destinations and walkability were negatively associated with overweight and obesity. Among women, NDVI was negatively associated with overweight (including obesity), obesity, and high-risk WC. Interventions promoting healthy weight could incorporate strategies that take into consideration local built environment characteristics.

Neighborhood characteristics and transport walking: Exploring multiple pathways of influence using a structural equation modeling approach

In studies of neighborhood effects on transport walking, residential preferences along with other personal characteristics (walking attitude, factors that affect decision to walk for transport) are important factors to consider. However, few studies have examined relationships between neighborhood characteristics and transport walking accounting for a complex suite of personal factors. This study employed a structural equation modeling approach to examine associations between neighborhood characteristics and transport walking behaviors by accounting for residential preferences, self-assessed factors that affect decision to walk for transportation, and socio-demographics; and to examine whether neighborhood effects were modified by walking attitude and residential preferences. Based on a cross-sectional phone and mail survey of 2,848 residents of New York City, Baltimore, Chicago, Los Angeles, St. Paul, and Winston Salem in 2011-12, we found neighborhood characteristics had significant independent associations with transport walking, even after adjusting for residential preferences and other personal factors. Neighborhood effects on transport walking did not differ significantly by walking attitude or residential preferences. Our findings highlight the importance of neighborhood effects in promoting transport walking, and suggest that while residential preferences are important factors, they do not obviate the neighborhood effects on transport walking.

Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts

OBJECTIVES

To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models.

SETTING

Five different regions and cities of Germany using data from five cohort studies.

PARTICIPANTS

For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male.

OUTCOMES

(1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height.

RESULTS

Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance.

CONCLUSION

We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.

Built Environment, Physical Activity, and Obesity: Findings from the International Physical Activity and Environment Network (IPEN) Adult Study

Creating more physical activity-supportive built environments is recommended by the World Health Organization for controlling noncommunicable diseases. The IPEN (International Physical Activity and Environment Network) Adult Study was undertaken to provide international evidence on associations of built environments with physical activity and weight status in 12 countries on 5 continents (n > 14,000). This article presents reanalyzed data from eight primary papers to identify patterns of findings across studies. Neighborhood environment attributes, whether measured objectively or by self-report, were strongly related to all physical activity outcomes (accelerometer-assessed total physical activity, reported walking for transport and leisure) and meaningfully related to overweight/obesity. Multivariable indexes of built environment variables were more strongly related to most outcomes than were single-environment variables. Designing activity-supportive built environments should be a higher international health priority. Results provide evidence in support of global initiatives to increase physical activity and control noncommunicable diseases while achieving sustainable development goals.

International Mind, Activities and Urban Places (iMAP) study: methods of a cohort study on environmental and lifestyle influences on brain and cognitive health

INTRODUCTION

Numerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent to which and how a wide range of characteristics of urban environments influence brain and cognitive health via lifestyle behaviours in mid-aged and older adults in three cities across three continents.

METHODS AND ANALYSIS

Participants aged 50-79 years and living in preselected areas stratified by walkability, air pollution and socioeconomic status are being recruited in Melbourne (Australia), Barcelona (Spain) and Hong Kong (China) (n=1800 total; 600 per site). Two assessments taken 24 months apart will capture changes in brain and cognitive health. Cognitive function is gauged with a battery of eight standardised tests. Brain health is assessed using MRI scans in a subset of participants. Information on participants' visited locations is collected via an interactive web-based mapping application and smartphone geolocation data. Environmental characteristics of visited locations, including the built and natural environments and their by-products (e.g., air pollution), are assessed using geographical information systems, online environmental audits and self-reports. Data on travel and lifestyle behaviours (e.g., physical and social activities) and participants' characteristics (e.g., sociodemographics) are collected using objective and/or self-report measures.

ETHICS AND DISSEMINATION

The study has been approved by the Human Research Ethics Committee of the Australian Catholic University, the Institutional Review Board of the University of Hong Kong and the Parc de Salut Mar Clinical Research Ethics Committee of the Government of Catalonia. Results will be communicated through standard scientific channels. Methods will be made freely available via a study-dedicated website.

TRIAL REGISTRATION NUMBER

ACTRN12619000817145.

Longitudinal effects of urban green space on walking and cycling: A fixed effects analysis

This study examined whether changes in green space within the living environment were associated with changes in walking and cycling frequencies in a cohort of 3,220 Dutch adults between 2004, 2011 and 2014. Data on self-reported weekly time spent walking and cycling for active commute and leisure were linked to geographic information system (GIS) measures of total green areas within 1000 m buffer zones around each participant's home address, and distance to the nearest green space. First, cross-sectional linear regression models showed no statistically significant associations between green space measures and walking and cycling. Second, fixed effects (FE) models were used to analyze whether changes in green space were associated with changes in walking and cycling, using longitudinal data from respondents who did not relocate over time. As distance to the nearest green area increased by 100 m, individuals spent 22.76 fewer (95% CI: -39.92, -5.60) minutes walking for leisure per week and 3.21 more (95% CI: 0.46, 5.96) minutes walking for active commute. Changes in distance to green space were not significantly related to changes in cycling measures. No clear associations between changes in green areas within 1000 m buffers and changes in walking and cycling were observed. Overall, there was weak evidence of an effect of changes in green space area on changes in walking, and no evidence for cycling.

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.

A population-based study of the associations between neighbourhood walkability and different types of physical activity in Canadian men and women

Few Canadian studies have examined whether or not associations between neighbourhood walkability and physical activity differ by sex. We estimated associations between perceived neighbourhood walkability and physical activity among Canadian men and women. This study included cross-sectional survey data from participants in 'Alberta's Tomorrow Project' (Canada; n = 14,078), a longitudinal cohort study. The survey included socio-demographic items as well as the International Physical Activity Questionnaire (IPAQ) and the abbreviated Neighbourhood Environment Walkability Scale (NEWS-A), which captured perceived neighbourhood built characteristics. We computed subscale and overall walkability scores from NEWS-A responses. Covariate-adjusted generalized linear models estimated the associations of participation (≥10 min/week) and minutes of different types of physical activity, including transportation walking (TW), leisure walking (LW), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with walkability scores. Walkability was positively associated with participation in TW, LW, MPA and VPA and minutes of TW, LW, and VPA. Among men, a negative association was found between street connectivity and VPA participation. Additionally, crime safety was negatively associated with VPA minutes among men. Among women, pedestrian infrastructure was positively associated with LW participation and overall walkability was positively associated with VPA minutes. Notably, overall walkability was positively associated with LW participation among men and women. Different perceived neighbourhood walkability characteristics might be associated with participation and time spent in different types of physical activity among men and women living in Alberta. Interventions designed to modify perceptions of neighbourhood walkability might influence initiation or maintenance of different types of physical activity.