Examining the Associations between Walk Score, Perceived Built Environment, and Physical Activity Behaviors among Women Participating in a Community-Randomized Lifestyle Change Intervention Trial: Strong Hearts, Healthy Communities

Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults

BACKGROUND/OBJECTIVES

Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults.

METHODS

A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses.

RESULTS

Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actually assess walkability (χ2 = 78.7, p < .001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents.

CONCLUSION

When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.

Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review

BACKGROUND

According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking.

METHODS

We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results.

RESULTS

Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting).

CONCLUSIONS

Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults.

TRIAL REGISTRATION

PROSPERO: CRD42021283508.

Walkability assessment of metro catchment area: A machine learning method based on the fusion of subject-objective perspectives

China's metro system is developing rapidly. Walking is the most frequently adopted mode to connect to the metro, the attributes of the pedestrian-built environment around the stations directly influence people's willingness to use the metro. However, few studies have paid attention to the comprehensive assessments of the built environment in the metro catchment area. Thus, this paper attempts to construct a walkability evaluation model that combines subjective and objective perspectives. We collected field data of the built environment factors affecting on walkability in the 800 m buffer zone of eight case metro stations in Dalian city, China. We also collected on-site interviews from 867 passengers to evaluate the walkability. A machine learning-based approach was developed to calculate the weights of walkability variables, followed by constructing a Score-Effectiveness framework to identify the built environment factors in the metro catchment area that need to be improved. The study found that the shading facilities, obstacle barriers, and resting seats around pedestrian walkways are the most efficient and imbalanced variables recognized by the crowd. The convenience of overpasses and underpasses are additional efficient imbalance-type variables for leisure and commuting populations, respectively. This indicates that the current level of construction of the above five built environment factors is relatively low, but the construction has a significant impact on the degree of friendliness in supporting pedestrian walkability. In this paper, improvement measures are proposed in a targeted manner in order to achieve the effect of effectively improving the current level of metro catchment area's walkability. The results of the study can provide references to provide strategies for precise pedestrian planning in the metro catchment area, leading to a pedestrian environment with high walking quality.

A novel method to map community- and neighborhood-level access to rural physical activity built environments in the United States

Physical activity (PA) built environments may support PA among rural youth and families. In the United States (U.S.), differences between rural and urban PA built environments are assessed using coarse scale, county-level methods. However, this method insufficiently examines environmental differences within rural counties. The present study uses rural-specific geospatial mapping techniques and a fine scale, within-rural grouping strategy to identify differing levels of access to the PA built environment among a rural sample. First, PA infrastructure variables (parks, sidewalks) within a rural region of the Midwest U.S. were mapped. Then, households (N = 112) of participants in the NU-HOME study, a childhood obesity prevention trial, were categorized to community-level and neighborhood-level PA built environment groups using two access indicators; Rural-Urban Commuting Area (RUCA) codes and Walk Scores®, respectively. Finally, households were categorized to new groups that combined community-level RUCA codes and neighborhood-level Walk Scores® to indicate the diverse ways in which rural families might access PA built environments, including by vehicle travel and pedestrian commuting. Household access to PA infrastructure (per geospatial proximity and density analyses), parent perceptions of the PA environment, and child PA were examined across the new combined access groups. All measures of household access to PA infrastructure significantly differed by group (p <.0001). Several parent PA perceptions differed by group; child PA did not. The present study provides future researchers with innovative strategies to map and examine how access to the PA built environment differs within a rural area. Due to the public availability of the access indicators used (RUCA codes, Walk Scores®), study methods can be replicated.

Differential Effects of a Global Public Health Crisis on Physical Activity: Evidence From a Statewide Survey From the United States

AIM

We aimed to identify how the COVID-19 lockdown affected changes, including the potential for longer term sustained changes, in physical activity, as compared to immediately prior to the pandemic.

BACKGROUND

Physical activity's significant role in overall health is known to be influenced by the surrounding environment, such as one's neighborhood, prompting this study of physical activity and its relationship with individual-level and neighborhood-level factors within the pandemic timeline.

METHODS

A statewide online survey assessed adults' self-reported weekly minutes of moderate-to-vigorous physical activity (MVPA) comparing a typical week immediately prior to the pandemic and during the pandemic (prewidespread vaccination) using negative binomial models.

RESULTS

Overall, MVPA decreased during the pandemic, though the decrease was driven largely by the reduction in MVPA outside one's neighborhood. In contrast, MVPA done within one's neighborhood increased over time. This change in MVPA done within one's neighborhood was not uniform across several characteristics including income level favoring those with the highest income (p < .05) and race/ethnicity favoring those self-reporting as non-Hispanic White (p < .05). While several factors, including higher Walk Scores, were associated with higher levels of MVPA without evidence of change over time, evidence of a differential effect over time was seen for other key indicators of social and structural determinants of health including income and race/ethnicity.

CONCLUSIONS

This study can add to the existing literature surrounding not only COVID-19 but also neighborhood built environmental research seeking to identify factors associated with changes in MVPA, a known indicator of overall health and health-related outcomes.

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

Background

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

Methods

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

Results

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

Conclusion

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

Supplementary Information

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

Examining multilevel neighborhood socioeconomic characteristics associated with colorectal cancer screening in Vietnamese Americans residing in Philadelphia County

Colorectal cancer (CRC) is one of the most predominant cancers in the USA and ranks third among all cancers in incidence and mortality. Vietnamese Americans exhibit persistently lower screening rates compared to the general U.S. population, due to cultural, economic, and environmental barriers. The impact of environmental factors in particular is not well known, and lack of geographical access may be a significant barrier to accessing screening. This study aims to elucidate build and neighborhood environmental factors affecting CRC screening rates among Vietnamese Americans. A total of 517 Vietnamese Americans 50 years and older residing in Philadelphia County were included in the study. Surveys were collected to determine CRC screening behavior and sociodemographic characteristics. Individual neighborhood characteristics, which included the Walk Score, was obtained based on the participant's address. Neighborhood characteristics were calculated using census-tract level data for the social deprivation index, ethnic composition, and presence of hospitals or federally qualified health centers (FQHC). The generalized linear mixed model revealed that residing in an ethnically dense neighborhood was negatively associated with CRC screening (β = -0.67, SE = 0.29, p = .01), while social deprivation (β = 0.30, SE = 0.27, p = .27) and presence of FQHCs or hospitals (β = 0.16, SE = 0.30, p = .58) were not. Individual neighborhood characteristics including the Walk Score (β = 0.21, SE = 0.26, p = .43) was not associated with CRC screening behavior. Neighborhood characteristics, specifically ethnic density is associated with lower uptake of screening in this population. Future interventions should aim to target specific Vietnamese American and other Asian ethnic neighborhoods that may experience disparities in screening.

A longitudinal examination of objective neighborhood walkability, body mass index, and waist circumference: the REasons for Geographic And Racial Differences in Stroke study

Background

Studies have shown neighborhood walkability is associated with obesity. To advance this research, study designs involving longer follow-up, broader geographic regions, appropriate neighborhood characterization, assessment of exposure length and severity, and consideration of stayers and movers are needed. Using a cohort spanning the conterminous United States, this study examines the longitudinal relationship between a network buffer-derived, duration-weighted neighborhood walkability measure and two adiposity-related outcomes.

Methods

This study included 12,846 Black/African American and White adults in the REasons for Geographic And Racial Differences in Stroke study. Body mass index (BMI) and waist circumference (WC) were assessed at baseline and up to 13.3 years later (M (SD) = 9.4 (1.0) years). BMI and WC were dichotomized. Walk Score® was duration-weighted based on time at each address and categorized as Very Car-Dependent, Car-Dependent, Somewhat Walkable, Very Walkable, and Walker’s Paradise. Unadjusted and adjusted logistic regression models tested each neighborhood walkability-adiposity association. Adjusted models controlled for demographics, health factors, neighborhood socioeconomic status, follow-up time, and either baseline BMI or baseline WC. Adjusted models also tested for interactions. Post-estimation Wald tests examined whether categorical variables had coefficients jointly equal to zero. Orthogonal polynomial contrasts tested for a linear trend in the neighborhood walkability-adiposity relationships.

Results

The odds of being overweight/obese at follow-up were lower for residents with duration-weighted Walk Score® values in the Walker’s Paradise range and residents with values in the Very Walkable range compared to residents with values in the Very Car-Dependent range. Residents with duration-weighted Walk Score® values classified as Very Walkable had significantly lower odds of having a moderate-to-high risk WC at follow-up relative to those in the Very Car-Dependent range. For both outcomes, the effects were small but meaningful. The negative linear trend was significant for BMI but not WC.

Conclusion

People with cumulative neighborhood walkability scores in the Walker’s Paradise range were less likely to be overweight/obese independent of other factors, while people with scores in the Very Walkable range were less likely to be overweight/obese and less likely to have a moderate-to-high risk WC. Addressing neighborhood walkability is one approach to combating obesity.

Leisure-Time and Transport-Related Physical Activity and the Risk of Mortality: The CRONICAS Cohort Study

BACKGROUND

The long-term health association of the leisure-time and transport-related physical activity domains of the International Physical Activity Questionnaire have not been established in Latin American settings. The authors aimed to quantify the 7-year all-cause mortality risk associated with levels of leisure-time and transport-related physical activity.

METHODS

Ongoing prospective cohort study conducted in 4 sites in Peru. People ≥35 years were randomly selected from the general population in each study site. The exposures were leisure-time and transport-related physical activity (International Physical Activity Questionnaire) at baseline. The outcome was all-cause mortality based on information retrieved from national records. Cox regression and sensitivity analyses were conducted.

RESULTS

There were 3601 people (mean age 55.8 y, 51.5% women). Greater levels of physical activity were associated with lower risk of all-cause mortality, an observation confirmed in sensitivity analyses. Compared with those with low levels of physical activity, leisure-time (≥500 metabolic equivalent of task minutes per week) and transport-related (500-1499 and ≥1500 metabolic equivalent of task minutes per week) physical activity were associated with 70% (95% confidence interval, 3%-90%), 43% (95% confidence interval, 18%-61%), and 42% (95% confidence interval, 8%-63%) lower all-cause mortality, respectively.

CONCLUSIONS

Greater levels of leisure-time and transport-related physical activity were associated with a strong reduction in the risk of all-cause mortality across different geographical sites.

When physical activity meets the physical environment: precision health insights from the intersection

BACKGROUND

The physical environment can facilitate or hinder physical activity. A challenge in promoting physical activity is ensuring that the physical environment is supportive and that these supports are appropriately tailored to the individual or group in question. Ideally, aspects of the environment that impact physical activity would be enhanced, but environmental changes take time, and identifying ways to provide more precision to physical activity recommendations might be helpful for specific individuals or groups. Therefore, moving beyond a "one size fits all" to a precision-based approach is critical.

MAIN BODY

To this end, we considered 4 critical aspects of the physical environment that influence physical activity (walkability, green space, traffic-related air pollution, and heat) and how these aspects could enhance our ability to precisely guide physical activity. Strategies to increase physical activity could include optimizing design of the built environment or mitigating of some of the environmental impediments to activity through personalized or population-wide interventions.

CONCLUSIONS

Although at present non-personalized approaches may be more widespread than those tailored to one person's physical environment, targeting intrinsic personal elements (e.g., medical conditions, sex, age, socioeconomic status) has interesting potential to enhance the likelihood and ability of individuals to participate in physical activity.

The impact of perceived risk and disease prevention efficiency on outdoor activities and avoidance behaviors in the urban parks during COVID 19 pandemic

Purpose

COVID 19 has had a profound effect on peoples’ activities and the use of public spaces. Before the COVID 19 pandemic urban parks, as healthy places, were of the most favorable places for urban citizens, but nowadays no vitality is found in urban parks due to the absence of people. The perceived risk seems to affect peoples’ decision-making for the visit to urban parks. This study aims to examine the impact of COVID 19 perceived severity and vulnerability on peoples’ visit to the urban parks and further exercise avoidance. It is expected that the result of this study would shed light on the people’s perception of healthy urban parks to exercise during COVID 19.

Design/methodology/approach

The participants were recruited from a neighborhood with the greenest and largest parks in Iran that were selected for the study. It was to assure that participants have access to the urban parks within their walkable distance. The mixed-method approach was applied to achieving the research goals. A total of 404 participants attended the survey. A series of semi-structured interviews were conducted to examine the strategies that reduce peoples’ worries about using urban parks during the COVID 19. Data were analyzed using SmartPLS.

Findings

The study hypothesized that peoples’ awareness of COVID 19 affects their perceived risk and disease prevention efficiency. Besides, it was hypothesized that perceived risk and efficacy effects outdoor activities worries exercise avoidance and behavioral avoidance in the urban parks. The result of the study supported the research hypothesis. The more knowledge people acquire of COVID 19 and the lack of efficacy of treatments, the higher they will avoid outdoor activities and exercise. The means of knowledge and perceived risk were higher than previously reported studies.

Originality/value

The result of this study is very important, as it statistically proves that peoples’ priorities and factors that affect their willingness to use public spaces are very much affected by their perception of a healthy environment. It also canonizes the role of facility managers in bringing peoples’ trust in the use of public spaces and more specifically urban parks during pandemic disease distributions.

The relationship between walk score® and perceived walkability in ultrahigh density areas

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Walk Score® was positively correlated with several perceived walkable environmental attributes.

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There was a large correlation between Walk Score® and access to shops.

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There was a medium correlation between Walk Score® and overall perceived walkability.

Walk Score® is a free web-based tool that provides a walkability score for any given location. A limited number of North American studies have found associations between Walk Score® and perceived built environment attributes, yet it remains unknown whether similar associations exist in Asian countries. The study’s objective is to examine the covariate-adjusted correlations between the Walk Score® metric and measures of the perceived built environment in ultrahigh density areas of Japan. Cross-sectional data were obtained from a randomly selected sample of adult residents living in two Japanese urban localities. There was a large correlation between Walk Score® and access to shops (0.58; p < 0.001). There were medium correlations between Walk Score® and population density (0.38; p < 0.001), access to public transport (0.34; p < 0.001), presence of sidewalks (0.41; p < 0.001), and access to recreational facilities (0.37; p < 0.001), and there was a small correlation between Walk Score® and presence of bike lanes (0.16; p < 0.001). There was a small negative correlation between Walk Score® and traffic safety (-0.13; p < 0.001). There was a medium correlation between Walk Score® and overall perceived walkability (0.48; p < 0.001). This study's findings highlight that Walk Score® was correlated with several perceived walkable environment attributes in the context of ultrahigh density areas in Asia.

Weather and climate in the assessment of tourism-related walkability

Walking is an important outdoor recreational and tourism activity, both in natural surroundings and in urban settings. Walkability is the extent to which the built environment promotes walking, and addresses issues such as comfort, connectivity, safety and aesthetic values. The paper explores a relatively overlooked domain of recreation- and tourism-related walkability: the extent to which weather and climatic conditions are incorporated into assessments of walkability and their influence on walking behaviour. Following a discussion of the assessment of walkability, the results of a scoping review of weather- and climate-related variables in walkability articles published up to June 2018 are presented. The review indicates there is little research on walkability from a tourist perspective, although there is substantial interest in walking for leisure and recreation. Four major themes were identified. The descriptive theme focuses on the general importance of weather and climate to walkability; the passive analyses the weather and climate conditions as barriers to, or as promoters of, walking; proactive studies refer to adapting to and managing weather, such as provision of shade or snow-clearing. The proactive perspective gains less attention than the passive analysis. Finally, statistical controlling was only employed by a minority of studies that adjusted their results to the impacts of weather conditions. The work concludes that the sub-field has been poorly served with respect to concept and variable definition and consistency of use mean that present knowledge is of limited scientific value. Strategies for future research are suggested.

Change in GPS-assessed walking locations following a cluster-randomized controlled physical activity trial in older adults, results from the MIPARC trial

This study employed novel GPS methods to assess the effect of a multilevel physical activity (PA) intervention on device-measured walking locations in 305 community dwelling older adults, ages 65+ (mean age = 83, 73% women). Retirement communities were randomized to a 1-year PA intervention that encouraged neighborhood walking, or to a healthy aging control condition. Total time and time spent walking in four life-space domains were assessed using GPS and accelerometer devices. The intervention increased the time spent walking as a proportion of total time spent in the Campus, Neighborhood and Beyond Neighborhood domains. Intervention effects on walking location were observed in both genders and across physical and cognitive functioning groups. Results demonstrate that an intervention providing individual, social and environmental support for walking can increase PA in larger life-space domains for a broad spectrum of older adults.

Associations between objectively-measured and self-reported neighbourhood walkability on adherence and steps during an internet-delivered pedometer intervention

BACKGROUND

Accumulating evidence suggests that the built environment is associated with physical activity. The extent to which the built environment may support adherence to physical activity interventions is unclear. The aim of this study was to investigate whether the neighbourhood built environment constrains or facilitates adherence and steps taken during a 12-week internet-delivered pedometer-based physical activity intervention (UWALK).

METHOD

The study was undertaken in Calgary (Canada) between May 2016 and August 2017. Inactive adults (n = 573) completed a telephone survey measuring sociodemographic characteristics and perceived neighbourhood walkability. Following the survey, participants were mailed a pedometer and instructions for joining UWALK. Participants were asked to report their daily pedometer steps into the online program on a weekly basis for 12 weeks (84 days). Walk Score® estimated objective neighbourhood walkability and the Neighbourhood Environment Walkability Scale-Abbreviated (NEWS-A) measured participants self-reported neighbourhood walkability. Regression models estimated covariate-adjusted associations of objective and self-reported walkability with: 1) adherence to the UWALK intervention (count of days with steps reported and count of days with 10000 steps reported), and; 2) average daily pedometer steps.

RESULTS

On average, participants undertook 8565 (SD = 3030) steps per day, reported steps on 67 (SD = 22.3) of the 84 days, and achieved ≥10000 steps on 22 (SD = 20.5) of the 84 days. Adjusting for covariates, a one-unit increase in self-reported walkability was associated on average with 45.76 (95CI 14.91, 76.61) more daily pedometer steps. Walk Score® was not significantly associated with steps. Neither objective nor self-reported walkability were significantly associated with the UWALK adherence outcomes.

CONCLUSION

The neighbourhood built environment may support pedometer-measured physical activity but may not influence adherence to pedometer interventions. Perceived walkability may be more important than objectively-measured walkability in supporting physical activity during pedometer interventions.

Walkability and Fitness Center Prices, Opening Hours, and Extra Services: The Case of Madrid, Spain

Walkability has been associated with urban development and political plans, contributing to more connected cities with improvements in communication, shopping, and pedestrian base. Among these services, fitness centers are becoming important elements for communities due to their impact on the health and welfare of citizens. The present study aims to examine how an area’s Walk Score^® affects fitness center services, specifically membership costs, opening hours, and aquatic services. Data from 193 fitness centers were retrieved, representing all the areas of the municipality of Madrid, Spain, including fitness centers in the 21 city districts. A nonlinear relationship between an area’s Walk Score^® and fitness centers’ monthly fees is observed. Only in premium fitness centers, a weak curvilinear model is observed, following a quadratic equation, showing that fitness centers with higher prices are in less walkable areas. Additionally, the association between Walk Score^® and a fitness center’s opening hours reveals that fitness centers with wider hours of operation tend to be in moderately to highly walkable locations. Lastly, the existence of a swimming pool is related to a lower Walk Score^®. Thus, fitness centers in less walkable areas try to offer additional services as differentiation from competitors, whereas centers in walkable locations use this advantage as a strength.

Associations between the National Walkability Index and walking among US Adults - National Health Interview Survey, 2015

The Environmental Protection Agency created the National Walkability Index (Index) to compare and analyze walkability among US communities. Index elements include design, distance to transit, and diversity of land uses. Associations between the Index and walking behavior have not been examined. This study describes associations between the Index and transportation and leisure walking among US adults. Past week self-reported participation in transportation and leisure walking among adults (n = 33,672) was obtained from the 2015 Cancer Control Supplement of the National Health Interview Survey (NHIS) and analysis completed in 2019. Index scores were linked to NHIS data based on the respondent's residence and classified into least, below average, above average, and most walkable communities. Associations between Index categories and walking were examined with regression models. Overall, the Index was associated with a higher likelihood of walking, especially for transportation. Transportation walking was more common in areas with higher walkability (21.6%-51.6%, least to most walkable). Leisure walking was also more common with greater walkability (48.4%-56.5%, least to most walkable). Transportation and leisure walking by Index categories in urban areas were similar to the overall population; however, it was not associated with walking in rural areas. US adults living in more walkable areas report more transportation and leisure walking, especially among urban areas. Consistent with elements in the Index, associations were stronger for transportation than leisure walking. Findings support the use of the Walkability Index by researchers, professionals, and other relevant stakeholders as a viable indicator of walkability.

Study on the Impact of the Objective Characteristics and Subjective Perception of the Built Environment on Residents’ Physical Activities in Fuzhou, China

Many researchers have confirmed a correlation between the built environment and physical activity. However, most studies are based on the objective characteristics of the built environment, and seldom involve the residents’ subjective perception. The purpose of this study is to explore the relationship between the subjective and objective characteristics of the built environment and physical activity at the community scale. Data consists of that collected from a social survey, Points of Interest (POI), the road network, and land use in Fuzhou, China. The duration of moderate-to-vigorous physical activity (MVPA) within a week is used to represent the general physical activity of residents. Security perception is introduced as an intermediary variable. SPSS software is used for factor analysis and Amos software for statistical analysis. Structural equations are set up to analyse the relationship between these variables. The final results show that: (1) The objective characteristics of the built environment have no direct impact on the development of leisure MVPA, but it can indirectly affect leisure MVPA through residents’ subjective perception of the built environment; (2) The subjective perception of residents has a significant impact on the duration of MVPA, the subjective perception of humanized space has a direct impact on the duration of MVPA, and destination accessibility and urban environment maintenance has an indirect impact through community public security perception; and (3) The individuals’ attributes such as gender and self-evaluated socioeconomic status have negative effects on the duration of leisure MVPA, and an individual’s love of sports has a positive effect on MVPA.

Recreational Centres' Facilities and Activities to Support Healthy Ageing in Singapore

Objective: This study examined the physical and social environment (facilities and activities) of Singapore’s Recreational Centres (RCs) and female patrons’ (>50 years) perception of the RC facilities and activities. Materials and Methods: A total of 100 RCs were audited, and 22 face-to-face interviews were undertaken. Results: Physical activity classes were the main activity offered (mean = eight classes per month), with walking (29.8%) and aerobics sessions (17.5%) being the most frequent. Nutrition classes and social activities were offered less often (mean = one class per month). The activities were well received by patrons, offering opportunities to interact while participating in physical activity and nutrition classes. However, the need for staff training, consideration of patron’s abilities and the desire to engage in alternative activities were expressed. Conclusion: Overall, RCs’ facilities and activities were well liked by the patrons but opportunities for improvements were identified. Regular reviews of facilities and activities through consultation with the RC patrons and managers are needed to ensure that the facilities and activities remain relevant and practical to the patrons. This will help to support active lifestyles and healthy eating practices among older adults residing within the community.