Perceived environmental and personal factors associated with walking and cycling for transportation in Taiwanese adults

Walk Score and Neighborhood Walkability: A Case Study of Daegu, South Korea

Walking is a popular physical activity that helps prevent obesity and cardiovascular diseases. The Walk Score, which measures neighborhood walkability, considers access to nine amenities using a geographic information system but does not deal with pedestrian perception. This study aims to (1) examine the correlation between access to each amenity, an individual component of the Walk Score, and perceived neighborhood walkability and (2) investigate the correlation with the perceived neighborhood walkability by adding variables of pedestrian perception to the existing Walk Score components. This study conducted a survey with 371 respondents in Daegu, South Korea, between 12 October and 8 November 2022. A multiple regression model was used to examine the correlations. The results showed no association between perceived neighborhood walkability and the individual component of the Walk Score. As variables of environmental perception, the fewer hills or stairs, the more alternative walking routes, the better separation between road and pedestrians, and the richer the green space, the more people perceived their neighborhood as walkable. This study found that the perception of the built environment had a more substantial influence on perceived neighborhood walkability than the accessibility to amenities. It proved that the Walk Score should include pedestrian perception and quantitative measurement.

Analysis of Urban Built Environment Impacts on Outdoor Physical Activities-A Case Study in China

Outdoor physical activities can promote public health and they are largely influenced by the built environment in different urban settings. Understanding the association between outdoor physical activities and the built environment is important for promoting a high quality of life. Existing studies typically focus on one type of outdoor activity using interview-based small samples and are often lack of systematic understanding of the activities' intensity and frequency. In this study, we intend to gain deeper insight into how the built environment influences physical activities using the data extracted from individual's wearables and other open data sources for integrated analysis. Multi-linear regression with logarithm transformation is applied to perform the analysis using the data from Changsha, China. We found that built environment impacts on outdoor physical activities in Changsha are not always consistent with similar studies' results in other cities. The most effective measures to promote outdoor physical activities are the provision of good arterial and secondary road networks, community parks, among others in Changsha. The results shed light on future urban planning practices in terms of promoting public health.

Developing a Health-Spatial Indicator System for a Healthy City in Small and Midsized Cities

A recent examination of the significant role of public health has prompted calls to re-investigate how the urban environment affects public health. A vital part of the solution includes Healthy City initiatives that have been the subject of extensive policies, implications, and practices globally. However, the existing literature mainly focuses on big cities and metropolitan areas, while investigations into small and midsized cities (SMCs) are lacking, and thus reflect the underlying issues of health inequity. This study develops an indicator system for evaluating Healthy City initiatives in SMCs, linking urban design and public health, supported by the analyzed opinions from experts collected using both questionnaires and interviews. The indicator system includes six primary dimensions and 37 variables: urban form and transportation (UFT); health-friendly service (HFS); environmental quality and governance (EQG); community and facility (CF); green and open space (GOS); and ecological construction and biodiversity (ECB). A fuzzy synthetic evaluation technique was used to assess the relative importance of factors, emphasizing the importance of UFT, HFS, and EQG, with importance indexes of 0.175, 0.174, and 0.174, respectively. This indicator system is helpful for SMCs seeking to construct a Healthy City in the future, and is based on urban design and governance inputs and for enhancing the Healthy City knowledge base of cities of varied scales.

Perceived Neighborhood Environment Associated with Sarcopenia in Urban-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

Sarcopenia is associated with adverse health outcomes among older individuals. However, little is known about its association with neighborhood environmental factors. We explored the relationship between sarcopenia and perceived neighborhood environmental factors among community-dwelling older adults aged 70-84 years. We analyzed 1778 participants (mean age of 75.9 ± 3.8 years; 54.0% women) who lived in urban areas and underwent dual-energy X-ray absorptiometry from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 definition. Perceived neighborhood environmental factors were assessed using the Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). In the multivariate analysis, compared to the fifth quintile of the IPAQ-E score, the odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia in the first, second, third, and fourth quintiles were 2.13 (1.40-3.24), 1.72 (1.12-2.64), 1.75 (1.15-2.66), and 1.62 (1.06-2.47), respectively. These neighborhood environmental characteristics were linked with an increased likelihood of sarcopenia: no public transportation access (OR = 2.04; 95% CI = 1.19-3.48), poor recreational facilities access (OR = 1.39; 95% CI = 1.01-1.90), absence of destination (OR = 1.53; 95% CI = 1.06-2.20), many hill hazards (OR = 1.36; 95% CI = 1.03-1.78), and lack of traffic safety (OR = 1.35; 95% CI = 1.02-1.78). Thus, better neighborhood environmental strategies may help prevent sarcopenia among urban-dwelling older adults.

Differences in the Association of Neighborhood Environment With Physical Frailty Between Urban and Rural Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

OBJECTIVE

We examined the difference in the relationship between perceived neighborhood environments and physical frailty between urban and rural older adults.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

Urban and rural community in South Korea; a total of 2593 community-dwelling older adults aged 70-84 years (mean age: 76.0 years, 51.0% women) in the Korean Frailty and Aging Cohort Study (KFACS).

METHODS

The neighborhood environment was assessed using the 17-item Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). The IPAQ-E had 7 environmental factors (residential density, access to destinations, neighborhood infrastructure, neighborhood safety, social environment, aesthetic qualities, and street connectivity). Physical frailty was defined using the Fried frailty criteria with modified cutoffs.

RESULTS

The number of participants residing in urban and rural areas was 1902 and 691, respectively. The prevalence of frailty was 5.3% and 12.0% in urban and rural areas, respectively. In urban areas, frailty was associated with the total IPAQ-E score (β = -0.007, P = .009) after adjusting for confounding factors. There was no association in the rural areas (β = -0.003, P = .535). In urban older adults, logistic regression showed that absence of destination [odds ratio (OR) 2.58, 95% confidence interval (CI) 1.36-4.90] and no crime safety at night (OR 2.00, 95% CI 1.12-3.57) were associated with a higher risk of frailty. In rural older adults, poor access to recreational facilities (OR 2.17, 95% CI 1.07-4.40) and no aesthetics (OR 2.49, 95% CI 1.22-5.10) were associated with frailty.

CONCLUSIONS AND IMPLICATIONS

Our study indicated that the presence of destination and crime safety at night was significantly associated with physical frailty among older adults living in urban areas, whereas aesthetics and recreational facilities were significantly associated with physical frailty in rural older adults.

Which Neighborhood Destinations Matter in the Asian Context? The Role of Destinations in Older Adults' Physical Activity and Sedentary Behaviors

Background

Neighborhood destinations play important roles in daily activity levels of older adults. However, little is known about how specific destinations are associated with these activities and/or sedentary behaviors, especially in Asia. This study investigated how neighborhood destinations were associated with physical activity recommendations and excessive sedentary time among older adults.

Methods

A telephone-based survey was conducted to collect cross-sectional data on the sociodemographic variables, residential neighborhoods, physical activities, and sedentary behaviors of 1,040 adults aged 65 years and above. Using data derived from Geographic Information Systems (GIS), an adjusted logistic regression was performed to examine the relationships between five neighborhood destination types (i.e., recreational facilities, utilitarian destinations, transit stops, temples, and schools) and both overall physical activity level and sedentary behavior.

Results

Significant interactions related to physical activity and sedentary behavior were observed based on both gender and neighborhood destinations. After adjusting for potential confounders, older men living in neighborhoods containing higher numbers of temples were more likely to achieve physical activity recommendations (OR = 1.85; 95% CI: 1.16-2.96). On the other hand, older women living in neighborhoods containing higher numbers of utilitarian destinations were more likely to engage in excessive sedentary time (OR = 1.70; 95% CI: 1.12-2.56).

Conclusions

In Asia, the presence of favorable local neighborhood temples may support physical activity levels for older men, while utilitarian destinations (which have previously been found to support activeness) may be related to excessive sedentary behaviors in older women.

A systematic review of empirical and simulation studies evaluating the health impact of transportation interventions

Urban transportation is an important determinant of health and environmental outcomes, and therefore essential to achieving the United Nation's Sustainable Development Goals. To better understand the health impacts of transportation initiatives, we conducted a systematic review of longitudinal health evaluations involving: a) bus rapid transit (BRT); b) bicycle lanes; c) Open Streets programs; and d) aerial trams/cable cars. We also synthesized systems-based simulation studies of the health-related consequences of walking, bicycling, aerial tram, bus and BRT use. Two reviewers screened 3302 unique titles and abstracts identified through a systematic search of MEDLINE (Ovid), Scopus, TRID and LILACS databases. We included 39 studies: 29 longitudinal evaluations and 10 simulation studies. Five studies focused on low- and middle-income contexts. Of the 29 evaluation studies, 19 focused on single component bicycle lane interventions; the rest evaluated multi-component interventions involving: bicycle lanes (n = 5), aerial trams (n = 1), and combined bicycle lane/BRT systems (n = 4). Bicycle lanes and BRT systems appeared effective at increasing bicycle and BRT mode share, active transport duration, and number of trips using these modes. Of the 10 simulation studies, there were 9 agent-based models and one system dynamics model. Five studies focused on bus/BRT expansions and incentives, three on interventions for active travel, and the rest investigated combinations of public transport and active travel policies. Synergistic effects were observed when multiple policies were implemented, with several studies showing that sizable interventions are required to significantly shift travel mode choices. Our review indicates that bicycle lanes and BRT systems represent promising initiatives for promoting population health. There is also evidence to suggest that synergistic effects might be achieved through the combined implementation of multiple transportation policies. However, more rigorous evaluation and simulation studies focusing on low- and middle-income countries, aerial trams and Open Streets programs, and a more diverse set of health and health equity outcomes is required.

Trends in Transportation Modes and Time among Chinese Population from 2002 to 2012

Giving the rising trends in obesity and chronic diseases in China, strategies to increase physical activity are important. Transport-related activity is a substantial source of physical activity and can be easily incorporated into the daily lives. It is a key social factor of health, which can help improve people’s mental and physical health and decrease environmental pollution. However, little is known about recent trends in transportation modes and time in China. Between 2002 and 2010–2012, information about transportation behaviors of Chinese population aged 15 years or older were collected within two Chinese Nutrition and Health Surveys. A stratified multistage cluster sampling method was conducted to select participants. Sociodemographic information, transportation modes, and time were collected during face-to-face interviews. The study included 82,377 (mean age 41.2 years) and 143,075 (mean age 48.7 years) participants in the 2002 and 2010–2012 surveys respectively. The weighted prevalence of active transportation (including walking and cycling) decreased from 83.8% in 2002 to 54.3% in 2010–2012 (p < 0.001). During the same period, the number of participants using public transportation (including taking the bus, subway, or shuttle bus) has doubled (7.5% and 15.7%, respectively, for 2002 and 2010–2012, (p < 0.001)), and the proportion of inactive transportation (including driving or taking a car, motorcycle, taxi, or electric bicycle) more than tripled. Concurrently, the transportation time almost doubled with an increase of 25.9 min over the 10 years (p < 0.001). The prevalence of active transportation increased with age. Participants with higher family income and education reported a lower prevalence of active transportation. Females were more likely to use active transportation (OR (95% CI): 4.41 (4.14–4.70) and 2.50 (2.44–2.57), respectively, for 2002 and 2010–2012, where males were the reference). Before the prevalence of active transportation and physical activity gets lower, there is a need for the public health sector and the transport and land use sector to work together to develop related policies and initiatives with the aim of promoting active transportation and public transportation to increase the levels of physical activity and to decrease the risks of chronic diseases.

Personal, behavioral, and perceived environmental factors associated with late-life depression in older men and women

INTRODUCTION

Previous investigations on factors associated with depression were highly focused on personal characteristics and health behaviors; however, few studies used an ecological perspective on the issue, much less on sex differences. This study examined the factors associated with depression, including any sex differences.

METHODS

A total of 1025 Taiwanese adults older than 65 years were recruited. Their personal demographics, lifestyle behaviors, and perceived environmental factors were obtained through a telephone-based survey. The multiple factors associated with depression in older adults were examined using logistic regression analyses.

RESULTS

Fully logistic regression analyses revealed that poor self-rated health (odds ratio =2.54) was correlated with a greater likelihood of depression. Aside from poor self-rated health, being older, sufficient leisure time spent in walking, and perceptions of a safe environment were associated with lower risks of depression in older men, whereas having hypertension and excessive TV viewing were associated with higher risks of depression in older women.

CONCLUSION

Apart from self-rated health, sex differences in the associations of factors such as leisure-time walking, TV watching, and safe traffic environment with depression were observed among older adults. Strategies applied for geriatric depression prevention should take into consideration different sex group.

Why Some Walk and Others Don't: Neighborhood Safety and the Sociodemographic Variation Effect on Walking for Leisure and Transportation

OBJECTIVE

The study was aimed at assessing the association of all components of safety (crime, traffic, social, and physical) and general safety with walking for leisure and transportation among Iranian adults. In this regard, sociodemographic factors as potential effect modifiers on walking behavior and the association of neighborhood safety with the level of walking were explored.

METHOD

A total of 1300 questionnaires were distributed among respondents residing in 8 neighborhoods in Bandar Abbas city, among which 1132 qualified for use in further analysis. Using a binary logistic regression method, differences in walking behavior and perceived safety to walk were evaluated across sociodemographic characteristics.

RESULTS

The results showed that the walking rate is higher among older adults, married people, and adults with lower education and a higher length of residency. An increase in neighborhood safety from crime, traffic, social disorders, and overall safety associates with increased leisure walking among all populations. Further, overall neighborhood safety and safety from crime and traffic positively correlate with the level of transportation walking among all respondents. For both types of walking, this association varies in sociodemographic groups.

CONCLUSION

The study suggests that an increase in the safety of a neighborhood contributes to a higher level of leisure and transportation walking; however, it varies in different subgroups. This study provides the knowledge needed to consider all aspects of neighborhood safety to measure walking behavior level.

Walk Score® and Its Associations with Older Adults' Health Behaviors and Outcomes

This study aimed to investigate the associations between Walk Score^® and lifestyle behaviors and health outcomes in older Taiwanese adults. A nationwide survey was conducted through telephone-based interviews with older adults (65 years and older) in Taiwan. Data on Walk Score^®, lifestyle behaviors (physical activity, sedentary behavior, healthy eating behavior, alcohol use, and smoking status), health outcomes (overweight/obesity, hypertension, type 2 diabetes, and cardiovascular disease), and personal characteristics were obtained from 1052 respondents. A binary logistic regression adjusting for potential confounders was employed. None of the Walk Score^® categories were related to the recommended levels of total physical activity. The categories "very walkable" and "walker's paradise" were positively related to total sedentary time and TV viewing among older adults. No significant associations were found between Walk Score^® and other lifestyle health behaviors or health outcomes. While Walk Score^® was not associated with recommended levels of physical activity, it was positively related to prolonged sedentary time in the context of a non-Western country. The different associations between the walk score and health lifestyle behaviors and health outcomes in different contexts should be noted.

Prevalence of Total Physical Activity, Muscle-Strengthening Activities, and Excessive TV Viewing among Older Adults; and Their Association with Sociodemographic Factors

The study aimed to describe the prevalence of meeting moderate-to-vigorous-intensity physical activity (MVPA), muscle-strengthening (MS) activities, and television (TV) viewing guidelines, and their association with sociodemographic factors. Data from older adults aged 65 or above were sampled by age and sex to the population aged 65+ years for each area in Taiwan and collected through telephone interviews. The prevalence of meeting MVPA and MS activities, MVPA and MS activities guidelines, and excessive TV viewing were calculated. We also investigated their associations with sociodemographic variables using logistic regression analyses. A total of 1068 older adults (response rate: 32.5%) participated in the present study. 79.4% met the MVPA guidelines (150 min weekly), 25.3% met the MS guidelines (twice a week), 22.4% met both MVPA and MS guidelines, and 53.1% engaged in excessive TV viewing (more than or equal to two hours per day). Overall, in old age, low educational level was associated with lower odds of meeting MVPA and MS activities, and both the MVPA and MS activity guidelines; while living alone and having no full-time job had higher odds of excessive TV viewing. A large number of older adults do not meet the MS recommendations, but are engaged in excessive TV viewing. Our findings may be important for public health interventions to promote MS and avoid excessive TV viewing, especially for at-risk subgroups.

Dog ownership, dog walking, and leisure-time walking among Taiwanese metropolitan and nonmetropolitan older adults

Background

This study examined the prevalence of dog ownership and dog walking and its association with leisure-time walking among metropolitan and nonmetropolitan older adults.

Methods

A telephone-based cross-sectional survey targeting Taiwanese older adults was conducted in November 2016. Data related to dog ownership, time spent dog walking (categorized as non-dog owner, non-dog walkers, and dog walkers), and sociodemographic variables were obtained from 1074 older adults. Adjusted binary logistic regression was then performed.

Results

In this sample, 12% of Taiwanese older adults owned a dog and 31% of them walked their dogs for an average of 232.13 min over 5.9 days/week (standard deviation = 2.03). Older adults living in nonmetropolitan areas were more likely to own a dog (14.7% vs. 9.1%) but less likely to walk their dog (25.9% vs. 39.6%) than were those living in metropolitan areas. Compared with non-dog owners, only older adults living in nonmetropolitan areas who were dog walkers achieved 150 min of leisure-time walking (odds ratio: 3.03, 95% confidence interval: 1.05–8.77), after adjustment for potential confounders.

Conclusion

Older Taiwanese adults living in nonmetropolitan areas who owned and walked their dogs were more likely to achieve health-enhancing levels of leisure-time walking. Tailored physical activity interventions for promoting dog walking should be developed for older adults who are dog owners living in nonmetropolitan areas and who do not engage in dog walking.

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.

Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults

Background

Although research has shown that numerous perceived environmental factors are supportive of physical activity, little is known about their associations with sedentary transport in motorcycle-oriented countries. This study examined the association between perceptions of Taiwan’s environmental factors and urban adults’ motorcycle use.

Methods

Cross-sectional data from 1003 Taiwanese adults aged 20–64 years from three urban cities were collected through telephonic surveys in 2015. Data on motorcycle use, sociodemographic variables, and perceived environmental attributes were obtained. Logistic regression analyses were performed.

Results

In Model 1, adults who perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night were less likely to use motorcycles. In Model 2, in which potential covariates were additionally adjusted for, the same four environmental attributes (perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night; odds ratio [OR] = 0.46, 0.65, 0.63, 0.64, respectively) were significantly associated with motorcycle use.

Conclusion

The investigated perceived environmental factors, which have previously been associated with facilitating active transportation, discourage sedentary modes of transport, such as motorized vehicles.

Individual, Social, and Environmental Correlates of Active Transportation Patterns in French Women

The objectives were (1) to define physical activity (PA) and sedentary behaviors (SB) patterns in daily life contexts (work, leisure, and transportation) in French working women from NutriNet-Santé web-cohort and (2) to identify pattern(s) of active transportation and their individual, social, and environmental correlates. 23,432 participants completed two questionnaires to evaluate PA and SB in daily life contexts and individual representations of residential neighborhood and transportation modes. Hierarchical cluster analysis was performed which identified 6 distinct movement behavior patterns: (i) active occupation, high sedentary leisure, (ii) sedentary occupation, low leisure, (iii) sedentary transportation, (iv) sedentary occupation and leisure, (v) active transportation, and (vi) active leisure. Multinomial logistic regressions were performed to identify correlates of the “active transportation” cluster. The perceived environmental characteristics positively associated with “active transportation” included “high availability of destinations around home,” “presence of bicycle paths,” and “low traffic.” A “positive image of walking/cycling,” the “individual feeling of being physically active,” and a “high use of active transport modes by relatives/friends” were positively related to “active transportation,” identified as a unique pattern regarding individual and environmental correlates. Identification of PA and SB context-specific patterns will help to understand movement behaviors' complexity and to design interventions to promote active transportation in specific subgroups.

Gender differences in walking (for leisure, transport and in total) across adult life: a systematic review

BACKGROUND

The aim of this systematic review was to examine gender differences in walking for leisure, transport and in total in adults living in high-income countries, and to assess whether gender differences in walking practices change across the life-course.

METHODS

A systematic literature search was conducted of publications dated 1995 to 2015. Papers providing quantitative data on participation in walking of both men and women aged at least 18 years in a high-income country were screened for the quality of the data on gender differences in walking. Data were extracted and results were synthesised using forest plots and narrative summary.

RESULTS

Thirty-six studies were included in the review: 18 reported on walking for leisure, 16 on walking for transport (in total, or for particular purposes), and 14 on total walking. Most (33) studies provided data comparing the proportion of men and women who walked (at all or for a minimum duration) over a defined period, usually one week. There was consistent evidence that more women than men walk for leisure, although effect sizes were small. However, this effect varies by age: more younger women than younger men walk for leisure, but the gender difference diminishes with age and appears to reverse in the oldest age groups. Taking all ages together, there was no consistent gender difference in walking for transport or in total walking, although the small number of studies reporting on walking to undertake errands suggested that more women than men walk for this purpose.

CONCLUSIONS

While there is little evidence that levels of total walking consistently vary by gender, our findings suggest that there are consistent gender differences in participation in walking for some purposes, including for leisure, and that there are gender differences in the impact of age on walking. We conclude that more research is needed to improve our understanding of how walking fits into the lives of women and men across the life-course, especially in relation to gender differences in the impact of aging on walking.

PROSPERO REGISTRATION

PROSPERO registration number: CRD42015025961 .

Association between perceived neighbourhood characteristics, physical activity and diet quality: results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

BACKGROUND

The study explores associations between perceived neighbourhood characteristics, physical activity and diet quality, which in Latin America and Brazil have been scarcely studied and with inconsistent results.

METHODS

We conducted a cross-sectional analysis of 14,749 individuals who participated in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil) baseline. The study included current and retired civil servants, aged between 35 and 74 years, from universities and research institutes in six Brazilian states. The International Physical Activity Questionnaire (IPAQ) long form was used to characterize physical activity during leisure time and commuting; additional questions assessed how often fruit and vegetables were consumed, as a proxy for diet quality. Neighbourhood characteristics were evaluated by the "Walking Environment" and "Availability of Healthy Foods" scales originally used in the Multi-Ethnic Study of Atherosclerosis (MESA). Associations were examined using multinomial logistic regression.

RESULTS

Perceiving a more walkable neighbourhood was positively associated with engaging in leisure time physical activity and doing so for longer weekly. Compared with those who saw their neighbourhood as less walkable, those who perceived it as more walkable had 1.69 (95 % CI 1.57-1.83) and 1.39 (1.28-1.52) greater odds of engaging in leisure time physical activity for more than 150 min/week or up to 150 min/week (vs. none), respectively. Perceiving a more walkable neighbourhood was also positively associated with transport-related physical activity. The same pattern was observed for diet: compared with participants who perceived healthy foods as less available in their neighbourhood, those who saw them as more available had odds 1.48 greater (1.31-1.66) of eating fruits, and 1.47 greater (1.30-1.66) of eating vegetables, more than once per day.

CONCLUSIONS

Perceived walkability and neighbourhood availability of healthy food were independently associated with the practice of physical activity and diet quality, respectively, underlining the importance of neighbourhood-level public policies to changing and maintaining health-related habits.

Perceived Neighborhood and Home Environmental Factors Associated with Television Viewing among Taiwanese Older Adults

This study examined the associations between perceived neighborhood and home environmental factors and excessive television (TV) viewing time among Taiwanese older adults. The sample data was collected by administering computer-assisted telephone interviewers to 980 Taiwanese older adults (aged ≥ 65 years) living in two regions. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine the associations between self-reported perceived neighborhood and home environmental attributions and TV viewing time by using logistic regression analyses. The results showed that perceived neighborhood and home environmental factors were associated with excessive TV viewing time (≥2 h/day) after adjusting for potential confounders. Compared with a reference group, older adults who perceived their neighborhoods to have unsafe traffic were more likely to report excessive TV viewing time (OR = 1.36, 95%CI = 1.02–1.82). Older adults who reported having two or more TV sets in the home (OR = 1.77, CI = 1.28–2.44) and having a TV in the bedroom (OR = 1.55, CI = 1.18–2.03) were also more likely to report excessive TV viewing time. Further longitudinal research can confirm these findings, and tailored interventions focusing on the perceptions of neighborhood traffic safety and TV access at home for older adults might be effective means of preventing excessive TV viewing time.

Gender differences in the associations between perceived environment and walking for recreation in Taiwanese adults

This study examined gender differences in the associations between perceived environmental factors and walking for recreation in Taiwanese adults. In 2014, a telephone-based, cross-sectional survey targeting Taiwanese adults (20-64 years) was conducted. Data on nine items about environmental perception, time spent in walking for recreation, and socio-demographic variables were obtained from 1,065 adults using the International Physical Activity Questionnaire-long version and its environmental module. Adults who perceived good aesthetics (adjusted odds ratio [AOR] = 1.74; 95% confidence interval [CI]: 1.36-2.23) and reported seeing people being active (AOR = 1.58; 95% CI: 1.21-2.06) were more likely to perform 150 minutes of recreational walking per week. Furthermore, significant interactions regarding walking for recreation were observed between gender and five environmental correlates: access to shops (p = .046), the presence of sidewalks (p < .001), access to recreational facilities (p = .02), seeing people being active (p = .001), and aesthetics (p < .001). These five perceived environmental factors were positively associated with recreational walking in women but not in men. Gender is a potential modifier between perceived environment and walking for recreation in adults. Perceived environmental factors appear to be more critical for women in performing health-enhancing levels of recreational walking than they are for men.

Association of Sociodemographic and Perceived Environmental Factors with Public Bicycle Use among Taiwanese Urban Adults

Background: This study examined the sociodemographic and perceived environmental factors associated with public bicycle use among Taiwanese urban adults. Methods: A random-digit-dialing telephone-based cross-sectional survey was administered to Taiwanese urban adults aged 20–64 years in 2015. Data on sociodemographic variables, perceived environmental factors (for attributes identified in the International Physical Activity Questionnaire-Environmental Module), and public bicycle use were obtained from 1002 adults in three cities. Adjusted logistic regression was used. Results: After adjustment for potential confounders, the results showed that adults aged 20–29 years (odds ratio (OR) = 4.42) with a university degree or higher (OR = 2.03) were more likely to use public bicycles. In addition, adults living in Kaohsiung City were less likely to use public bicycles (OR = 0.24). Adults who saw people being active (OR = 1.76; 95% CI: 1.05–2.86) and had positive aesthetic experiences of their environment (OR = 1.69) were more likely to use public bicycles. Conclusions: Our findings suggest that seeing physically active people and positive aesthetic perceptions of the environment are key factors for developing transportation policies and intervention strategies for promoting public bicycle use among Taiwanese urban adults.