Physical Environmental Correlates of Domain-Specific Sedentary Behaviours across Five European Regions (the SPOTLIGHT Project)

The interplay between social environment and opportunities for physical activity within the built environment: a scoping review

BACKGROUND

The association between social and built environments plays a crucial role in influencing physical activity levels. However, a thorough understanding of their combined impact remains unclear. This scoping review seeks to clarify the interplay between social environments and opportunities for physical activity within different built environments, with a particular focus on the implications of socioeconomic status and urban planning on physical activity participation.

METHODS

We conducted a systematic literature search across several databases to identify studies exploring the associations between social factors, built environment characteristics, and physical activity levels. The inclusion criteria were studies published in English between 2000 and 2022, encompassing urban, suburban, and rural contexts. Thematic analysis was employed to categorise studies based on the specific aspects of the built environment they investigated (walking infrastructure, cycling infrastructure, parks and open spaces, and sports facilities) and the social determinants they examined.

RESULTS

A total of 72 studies were included in the review, illustrating a multifaceted relationship between access to physical activity opportunities and social determinants such as socioeconomic status, community engagement, and urban design. The findings highlight the significant role of socioeconomic factors and the quality of PA infrastructure in promoting or hindering PA across communities. Effective urban planning was identified as crucial in providing expanded physical activity opportunities, notably through more pedestrian-friendly environments, comprehensive cycling infrastructure, and accessible green spaces and sports facilities.

CONCLUSIONS

This review emphasises the significant impact of socioeconomic status and urban planning on access to physical activity opportunities. This underscores the necessity for urban planning policies to adopt an inclusive approach, considering the varied needs of different population groups to ensure equitable access to physical activity resources. Such strategies are crucial for public health initiatives aimed at enhancing physical activity levels across diverse community sectors, offering a potential avenue to alleviate health disparities associated with inactivity.

Protocol for a Study Investigating Context-Specific Sedentary Behaviors and Cardiometabolic Health in College-Based Young Adults (CONTEXT-SB)

Background

Sedentary behavior (SB) is detrimental to cardiometabolic disease (CMD) risk, which can begin in young adulthood. To devise effective SB-CMD interventions in young adults, it is important to understand which context-specific sedentary behaviors (CS-SB) are most detrimental for CMD risk, the lifestyle behaviors that co-exist with CS-SBs, and the socioecological predictors of CS-SB.

Methods

This longitudinal observational study will recruit 500 college-aged (18-24 years) individuals. Two laboratory visits will occur, spaced 12 months apart, where a composite CMD risk score (e.g., arterial stiffness, metabolic and inflammatory biomarkers, heart rate variability, and body composition) will be calculated, and questionnaires to measure lifestyle behaviors and different levels of the socioecological model will be administered. After each visit, total SB (activPAL) and CS-SB (television, transportation, academic/ occupational, leisure computer, "other"; ecological momentary assessment) will be measured across seven days.

Discussion

It is hypothesized that certain CS-SB will show stronger associations with CMD risk, compared to T-SB, even after accounting for coexisting lifestyle behaviors. It is expected that a range of intra-individual, inter-individual, and physical environment socioecological factors will predict CS-SB. The findings from this study will support the development of an evidence-based, multi-level intervention to target SB reduction and mitigate CMD risk in CBYA.

Associations of the audited residential neighborhood built-environment attributes with objectively-measured sedentary time among adults: a systematic review

This study systematically reviewed the relevant studies and summarized the associations of objective measures of residential neighborhood built-environment attributes with sedentary time among adults. Published studies were obtained from PubMed and Scopus, restricting to those published in English language peer-reviewed journals to Oct. 2021. There were nine studies and 48 instances of estimated associations. Most instances showed no statistical-significant associations; by contrast, few instances showed that adults living in a neighborhood characterized by a high density of local destinations and connected intersections were associated with less sedentary time. The findings suggest that a high density of destinations and street intersections around residence may provide opportunities to transfer and access to services, thus reducing the sedentary time. Future research strengthening the research design and measurements are needed to investigate the potential explanations of the associations between residential neighborhood built environments and sedentary time in adults.

Adapting the SPOTLIGHT Virtual Audit Tool to assess food and activity environments relevant for adolescents: a validity and reliability study

Background

Physical inactivity and unhealthy diet are key behavioral determinants underlying obesity. The neighborhood environment represents an important arena for modifying these behaviors, and hence reliable and valid tools to measure it are needed. Most existing virtual audit tools have been designed to assess either food or activity environments deemed relevant for adults. Thus, there is a need for a tool that combines the assessment of food and activity environments, and which focuses on aspects of the environment relevant for youth.

Objective

The aims of the present study were: (a) to adapt the SPOTLIGHT Virtual Audit Tool (S-VAT) developed to assess characteristics of the built environment deemed relevant for adults for use in an adolescent population, (b) to assess the tool’s inter- and intra-rater reliability, and (c) to assess its criterion validity by comparing the virtual audit to a field audit.

Methods

The tool adaptation was based on literature review and on results of a qualitative survey investigating how adolescents perceived the influence of the environment on dietary and physical activity behaviors. Sixty streets (148 street segments) in six neighborhoods were randomly selected as the study sample. Two raters assessed the inter- and intra-rater reliability and criterion validity, comparing the virtual audit tool to a field audit. The results were presented as percentage agreement and Cohen’s kappa (κ).

Results

Intra-rater agreement was found to be moderate to almost perfect (κ = 0.44–0.96) in all categories, except in the category aesthetics (κ = 0.40). Inter-rater agreement between auditors ranged from fair to substantial for all categories (κ = 0.24–0.80). Criterion validity was found to be moderate to almost perfect (κ = 0.56–0.82) for most categories, except aesthetics and grocery stores (κ = 0.26–0.35).

Conclusion

The adapted version of the S-VAT can be used to provide reliable and valid data on built environment characteristics deemed relevant for physical activity and dietary behavior among adolescents.

Sensor-based physical activity, sedentary time, and reported cell phone screen time: A hierarchy of correlates in youth

BACKGROUND

Evidence on correlates relies on subjective metrics and fails to include correlates across all levels of the ecologic model. We determined which correlates best predict sensor-based physical activity (PA), sedentary time (ST), and self-reported cell phone screen time (CST) in a large sample of youth, while considering a multiplicity of correlates.

METHODS

Using sensor-based accelerometry, we assessed the PA and ST of 2179 youths. A χ² automatic interaction detection algorithm was used to hierarchize the correlates associated with too much ST (> 50th percentile), insufficient moderate-to-vigorous PA (MVPA) (<60 min/day), and prolonged CST (≥2 h/day).

RESULTS

Among youth 10-14 years old, the correlates for being inactive consisted of being a girl, not having sport facilities in the neighborhood, and not perceiving the neighborhood as a safe place, whereas in the youth 15-18 years old, the correlate for being inactive was not performing sports (9.7% chance of being active). The correlates for predicting high ST in the younger group was not performing sports (55.8% chance for high ST), and in the older group, the correlates were not owning a pet, perceiving the neighborhood as safe, and having inactive parents (63.7% chance for high ST). In the younger group, the greatest chances of having high CST were among those who were in the last elementary school years, who were girls, and who did not have friends in the neighborhood (73.1% chance for high CST), whereas in the older group, the greatest chance for having high CST was among those who were girls and had a TV in the bedroom (74.3% chance for high CST).

CONCLUSION

To counteract ST and boost MVPA among youths, a specific focus on girls, the promotion of sport participation and facilities, neighborhood safety, and involvement of family must be prioritized.

Measuring the association of objective and perceived neighborhood environment with physical activity in older adults: challenges and implications from a systematic review

BACKGROUND

A supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence.

METHODS

A systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided.

RESULTS

Of the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified.

CONCLUSIONS

The strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.

Are neighborhood characteristics associated with sedentary behavior in adolescents? A systematic review

Sedentary behavior (SB) has emerged as a potential risk factor for chronic diseases. SB includes activities requiring low energy expenditure (≤1.5 metabolic equivalents) performed in a sitting or reclining posture. Our study aimed to gather evidence on the association between SB outcomes in adolescents (10-19 years) and neighborhood characteristics. This systematic review (PROSPERO registration number: CRD42018076877) examined studies indexed in PubMed Central®, LILACS, ScienceDirect, and SPORTDiscus databases. Sixteen articles were included. Insecurity during daytime hours, crime incidence, physical and social disorders, a higher neighborhood socioeconomic level, and time spent with peers were associated with higher levels of SB. Traffic, availability of a favorable environment for physical activity, and higher residential density were associated with lower levels of SB. Despite great variability in the SB cutoff points and methodology used for evaluating SB and neighborhood characteristics among studies, the evidence suggests that adolescent SB might be influenced by neighborhood characteristics.

Neighborhood Walkability Is Not Associated with Adults' Sedentary Behavior in the Residential Setting: Evidence from Breda, The Netherlands

Sedentary behavior has negative health effects. It is assumed that the walkability of the living environment is related to the amount of time spent on sedentary behavior in the residential setting. However, evidence on such a relation is still scarce, and results are contradictory. Therefore, we examined to what extent residential neighborhood walkability is associated with a variety of sedentary behaviors that frequently occur in the residential setting among adults. We carried out a cross-sectional survey using the domain-specific sedentary behavior questionnaire among adults in Breda, the Netherlands. Respondents’ walkability of the living environment was assessed objectively by means of road network buffers. We employed gamma generalized linear regressions to assess correlations between multiple sedentary behaviors and neighborhood walkability. We found no significant associations between residential neighborhood walkability and sedentary behavior levels. The lack of correlations was consistent across buffer sizes. Our models showed that adults with a higher education, a job, and a driver’s license spent significantly less time on sedentary behaviors. Our findings suggest that person-level characteristics should be targeted when developing intervention strategies to counteract sedentary time, rather than intervening in the walkability of the residential living environment.

Neighbourhood environment and transport-related and leisure-time sedentary behaviour amongst women in a city in Southern Brazil: a multilevel analysis

OBJECTIVES

To assess the association between neighbourhood environmental variables and excessive transport-related and leisure-time sedentary behaviour (ETSB and ELSB, respectively) amongst adult women in Southern Brazil.

METHODS

A cross-sectional survey was conducted using a representative sample of 1079 women 20 to 69 years of age who lived in 44 neighbourhoods. Each neighbourhood was determined by drawing a 400-m buffer around the median point of the participants' homes. Neighbourhoods were assessed by audit and by using government data. Sedentary behaviour (SB) and the remaining individual variables were assessed via questionnaire that was administered as an interview. Multilevel logistic regression analysis was conducted.

RESULTS

In the adjusted analysis, women who lived in neighbourhoods with a higher percentage of terrain slope and fewer public recreation areas per resident had significantly (p ≤ 0.05) increased odds of exhibiting ETSB and ELSB, with 50% and 40% increases, respectively.

CONCLUSIONS

The results show that some aspects of the neighbourhood environment such as terrain slope and total public recreation areas per resident are related to specific SBs, indicating that improvements in neighbourhoods can reduce SB in women.

The association between population density and blood lipid levels in Dutch blood donors

BACKGROUND

In low and middle-income countries (LMIC), the total and LDL cholesterol and triglyceride levels of residents of urban areas are reported to be higher than those of rural areas. This may be due to differences in lifestyle behaviors between residents of urban areas and rural areas in LMIC. In this study, our aims were to (1) examine whether or not LDL cholesterol, total/HDL ratios and triglyceride levels of individuals in densely populated areas are higher than those of individuals living in less-densely populated areas in a high-income country (HIC) and (2) investigate the potential mediating roles of physical activity and sedentary behavior.

METHODS

We used cross-sectional data from 2547 Dutch blood donors that participated in Donor InSight-III. Linear regression was used to analyze the association between population density and LDL cholesterol, total/HDL cholesterol ratio and HDL cholesterol. The mediating roles of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were investigated in a subsample (n = 740) for which objectively measured MVPA/sedentary behavior data was available. Multiple mediation with linear regression analyses were performed and the product-of-coefficients method was used to calculate direct and indirect effects.

RESULTS

Mean LDL cholesterol and median total cholesterol/HDL cholesterol ratio and triglyceride levels were 2.89, 3.43 and 1.29 mmol/L, respectively. Population density was not associated with LDL cholesterol [β 0.00 (- 0.01; 0.01)], log transformed total/HDL cholesterol ratio [β 1.00 (1.00; 1.00)] and triglyceride levels [β 1.00 (0.99; 1.00)]. No statistically significant direct or indirect effects were found.

CONCLUSION

Contrary to previous findings in LMIC, no evidence was found that population density is associated with blood lipid levels in blood donors in the Netherlands or that MVPA and sedentary behavior mediate this association. This may be the result of socioeconomic differences and, in part, may be due to the good health of the study population and the relatively high population density in the Netherlands. Also, compared to LMIC, differences in physical activity levels in more versus less populated areas may be less pronounced in HIC.

Systematic review of the use of Google Street View in health research: Major themes, strengths, weaknesses and possibilities for future research

We systematically reviewed the current use of Google Street View (GSV) in health research and characterized major themes, strengths and weaknesses in order to highlight possibilities for future research. Of 54 qualifying studies, we found that most used GSV to assess the neighborhood built environment, followed by health policy compliance, study site selection, and disaster preparedness. Most studies were conducted in urban areas of North America, Europe, or New Zealand, with few studies from South America or Asia and none from Africa or rural areas. Health behaviors and outcomes of interest in these studies included injury, alcohol and tobacco use, physical activity and mental health. Major strengths of using GSV imagery included low cost, ease of use, and time saved. Identified weaknesses were image resolution and spatial and temporal availability, largely in developing regions of the world. Despite important limitations, GSV is a promising tool for automated environmental assessment for health research. Currently untapped areas of health research using GSV include identification of sources of air, soil or water pollution, park design and usage, amenity design and longitudinal research on neighborhood conditions.

Correlates of sedentary behaviour and light physical activity in people living with rheumatoid arthritis: protocol for a longitudinal study

BACKGROUND

Sedentary behaviour (SB) is associated with adverse health outcomes in the general population. Replacing sedentary time with light intensity physical activity (LPA) has been linked with improvements in all-cause and cardiovascular disease mortality in adults. People with Rheumatoid Arthritis (RA) typically spend long periods of time sedentary, but the health consequences of 'too much sitting', and possible benefits of LPA, have not been fully explored in this population. Moreover, little is known regarding the determinants of these behaviours among people living with RA, and such knowledge is required for the development of effective behavioural interventions.

AIMS

To examine longitudinal relationships between: 1) objectively-assessed SB/LPA with health outcomes in RA, 2) hypothesised determinants of SB/LPA with objectively-assessed SB/LPA in RA.

METHODS

This longitudinal study will secure assessments at baseline (Time 1) and 6-month follow-up (Time 2) from RA patients. At both time points, physical assessments will be undertaken, and questionnaires administered to measure physical (e.g., percentage body fat, disease activity, physical function, pain) and psychological (e.g., depression, anxiety, vitality) health outcomes. Additional questionnaires will be administered to establish hypothesised determinants (i.e., psychosocial, individual differences, and physical environmental). Participants will wear the ActiGraph GT3X accelerometer and activPAL3μTM for 7 days to objectively measure SB and LPA.

DISCUSSION

Findings will elucidate the health correlates of SB in RA, as well as the relevance of interventions targeting reductions in SB by promoting LPA. Results will also assist in identifying intervention targets (i.e., determinants), with the potential to encourage SB change in RA.

Do Physical Activity Friendly Neighborhoods Affect Community Members Equally? A Cross-Sectional Study

An activity-friendly environment may increase physical activity (PA) levels and decrease sedentary behavior (SB). This study investigated associations between socio-demographic characteristics, health-related quality of life (HRQoL), perceived environment and objectively measured PA outcomes. Socio-demographic characteristics were assessed using a questionnaire and HRQoL was measured using the EQ-5D. The Neighborhood Environment Walkability Scale (NEWS-A) was used to assess the perceived environment. SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) were measured using the Actigraph GT3X+. Data from 622 Dutch adults were used in multivariate linear regression analyses to investigate associations between NEWS-A and PA outcomes. Analyses were controlled for socio-demographic characteristics and HRQoL. The presence of attractive buildings was associated with less SB (β = −0.086, p < 0.01) and more MVPA (β = 0.118, p < 0.01). Presence of destinations within walking distance was also positively associated with MVPA (β = 0.106, p < 0.01). Less crime was associated with less MVPA (β = 0.092, p < 0.05). Interactions between personal and environmental characteristics showed that the absence of PA-hindering characteristics (e.g., heavy traffic) was associated with less SB and more MVPA, but only for residents with problems regarding pain and usual activities. The presence of PA-facilitating characteristics (e.g., aesthetics and destinations) was associated with less SB, more LPA and more MVPA but only for the more advantaged people in society. Results suggest that to reduce health inequalities, it would be more helpful to remove barriers rather than introduce PA facilitating characteristics.

Cross-Sectional Associations of Environmental Perception with Leisure-Time Physical Activity and Screen Time among Older Adults

This study investigated associations of perceived environmental factors with leisure-time physical activity (LTPA) and screen time (ST) among older adults. A cross-sectional study was conducted by administering computer-assisted telephone interviews to 1028 older Taiwanese adults in November 2016. Data on personal factors, perceived environmental factors, LTPA, and ST were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine associations of environmental perception with LTPA and ST by using logistic regression analyses. The results showed that after adjusting for potential confounders, older adults who perceived their neighborhood with good access to shops (AS) and to public transportation (AT) were more likely to have sufficient LTPA (AS: OR = 1.64, 95% CI: 1.16–2.32; AT: OR = 1.43; 95% CI, 1.00–2.03) and less likely to have excessive ST (AS: OR = 0.70; 95% CI: 0.50–0.97; AT: OR = 0.64; 95% CI: 0.46–0.90). Different perceived environmental factors were also associated with LTPA and ST, respectively. This study highlights environment perception as a crucial factor for LTPA and ST. These findings suggest that policy makers and physical activity intervention designers should develop both common and individual environmental strategies to improve and increase awareness of the neighborhood environment to promote LTPA and reduce ST among older adults.

Objectively measured physical environmental neighbourhood factors are not associated with accelerometer-determined total sedentary time in adults

Background

The physical neighbourhood environment may influence adults’ sedentary behaviour. Yet, most studies examining the association between the physical neighbourhood environment and sedentary behaviour rely on self-reported data of either the physical neighbourhood environment and/or sedentary behaviour. The aim of this study was to investigate the associations between objectively measured physical environmental neighbourhood factors and accelerometer-determined total sedentary time in adults.

Methods

In total, 219 Dutch and 128 Belgian adults (mean age ± SD: 55.8 ± 15.4 years) were recruited between March and August 2014 as part of the European SPOTLIGHT project. Physical environmental neighbourhood factors, grouped into eight domains, i.e. walking, cycling, public transport, aesthetics, land use mix, grocery stores, food outlets and recreational facilities, were assessed using the SPOTLIGHT Virtual Audit Tool. Sedentary time was collected using ActiGraph GT3X+ accelerometers. General linear mixed models were conducted to examine associations between physical environmental neighbourhood factors and total sedentary time.

Results

Participants were sedentary, on average, for 542.9 min/day (SD: 84.3), or 9.1 h/day. None of the examined physical environmental neighbourhood factors were significantly related to total sedentary time.

Conclusions

Our findings do not support associations of objectively measured physical environmental neighbourhood factors with adults’ objectively sedentary time in Dutch and Belgian adults. More research on sedentary behaviours in settings such as the home and work setting is needed to examine the influence of more specific physical environmental factors on these context-specific sedentary behaviours.