Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths

Exposure to useable green space and physical activity during active travel: A longitudinal GPS and accelerometer study before and after retirement

Green spaces may serve as population level interventions encouraging active travel. We examined the associations between exposure to useable green space (CORINE Land Cover categories) and physical activity during active travel (GPS and accelerometer) among late middle-aged participants from the Finnish Retirement and Aging study (n = 102). Greater proportion of useable green space was associated with higher physical activity during active travel on days off (+11 min/day per 1 SD increase in exposure) and on retirement days (+12 min/day), but not on workdays. Thus, it appears that in leisure time, people prefer to engage into active travel in green spaces.

The co-benefits of active travel interventions beyond physical activity: a systematic review

Active travel is a widely recognised strategy for promoting active living but its co-benefits beyond increasing physical activity, such as broader health, environmental, and social benefits, have rarely been synthesised. We conducted a systematic review to examine the co-benefits of active travel interventions. Following a preregistered protocol (PROSPERO CRD42022359059), we identified 80 studies for the search period from Jan 1, 2000, to Sept 13, 2022. Across studies, there was consistent evidence that active travel interventions offered co-benefits beyond physical activity. Particularly, 25 (71%) of 35 studies favoured improved safety outcomes, 20 (67%) of 30 showed improved health, 17 (85%) of 20 supported economic benefits, 16 (84%) of 19 highlighted improved transport quality, 12 (92%) of 13 showed environmental benefits, and four (80%) of five documented social benefits. Despite the overall low-certainty evidence, mostly limited by the quasi-experimental design and natural-experimental design of many of the studies, active travel interventions offer unique opportunities to engage stakeholders across sectors to jointly address major societal issues, such as physical inactivity, traffic safety, and carbon emissions. This evidence can inform the design, implementation, and evaluation of active travel interventions.

Mobility Infrastructures and Health: Scoping Review of studies in Europe

Objectives

Movement-friendly environments with infrastructure favouring active mobility are important for promoting physical activity. This scoping literature review aims at identifying the current evidence for links between mobility infrastructures and (a) behaviour regarding active mobility, (b) health outcomes and (c) co-benefits.

Method

This review was conducted in accordance with the PRISMA scoping review guidelines using PubMed and EMBASE databases. Studies included in this review were conducted in Europe, and published between 2000 and March 2023.

Results

146 scientific articles and grey literature reports were identified. Connectivity of sidewalks, walkability, and accessibility of shops, services and work are associated with walking. Cycling is positively associated with cycle-paths, separation of cycling from traffic and proximity to greenspaces, and negatively associated with traffic danger. Increased active transportation has a protective effect on cardiovascular and respiratory health, obesity, fitness, and quality of life. Co-benefits result from the reduction of individual motorized transportation including reduced environmental pollution and projected healthcare expenditure.

Conclusion

Mobility infrastructure combined with social and educational incentives are effective in promoting active travel and reducing future healthcare expenses. A shift to active transportation would increase both individual and community health and decrease greenhouse gas emissions.

Does work-related and commuting physical activity predict changes in physical activity and sedentary behavior during the transition to retirement? GPS and accelerometer study

We examined how GPS and accelerometer measured work-related and commuting physical activity contribute to changes in physical activity and sedentary behavior during the retirement transition in the Finnish Retirement and Aging study (n = 118). Lower work-related activity was associated with a decrease in sedentary time and an increase in light physical activity during retirement. Conversely, higher work-related activity was associated with an increase in sedentary time and a decrease in light physical activity, except among those active workers who also were active commuters. Thus, both work-related and commuting physical activity predict changes in physical activity and sedentary behavior when retiring.

Impact of structural-level environmental interventions on physical activity: a systematic review

OBJECTIVE

To determine the effectiveness of structural-level environmental interventions on the changes in PA levels in the populations examined.

METHODS

Natural experiments that involve environmental intervention with structural modification were included. The primary outcome PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL up to January 2022. Two reviewers screened titles and abstracts, selected studies, extracted relevant data, and examined study quality. A qualitative synthesis was performed.

RESULTS

Twenty-six articles were included. The structural-level environmental interventions included 4 fundamental areas: schools, work environments, streets or cities, and neighborhoods or parks. Of the 26 studies, 21 examined outdoor environments like parks, cities, pedestrian walkways, or steps, while 5 examined indoor or closed environments like schools and workplaces revealing that structural-level environmental interventions improve PA levels with the greatest effect in parks and active transportation. A risk of bias is inherent in natural experiments which is a limitation of this study. In schools and work areas, there is evidence of both decrease in sedentary time and an increase in PA related to environmental modifications.

CONCLUSION

Structural-level environmental modifications in parks and active transportation demonstrated greater effects in promoting PA. Environmental modifications can impact physical activity in the population. Given that the economic and cultural setting is a key variable when considering the effectiveness of structural interventions, and since only 1 of the 26 reviewed articles included such data, more studies examining economic factors are needed especially in low- and middle-income countries like in South America.

TRIAL REGISTRATION

PROSPERO CRD42021229718.

Impact of environmental interventions based on social programs on physical activity levels: A systematic review

Background

The design of social programs at the environmental level such as in schools, parks, bicycle paths, or workspaces generates changes in the behavior of individuals and modifies lifestyles by increasing physical activity (PA) levels.

Objective

To determine the effectiveness of environmental interventions based on social programs by changing the population's level of PA.

Methodology

Natural experiment studies that involved environmental intervention programs at a social level were included. The primary outcome was PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL databases up to January 2022 with two reviewers screening titles and abstracts and selecting studies for full-text reading. Two reviewers also acquired relevant data and evaluated study quality using the ROBINS I tool. A qualitative analysis was performed.

Results

Three thousand eight hundred and sixty-five articles were found in the 4 consulted databases. After eliminating duplication (200), two reviewers screened 3,665 titles and abstracts and excluded 3,566 that did not meet the inclusion criteria, leaving 99 articles to be read in full text. The 99 full texts were reviewed of which 24 papers met the eligibility criteria. All were natural experiments published between 2011 and 2020 and all evaluated environmental social programs revealing that social programs at the environmental level promoted PA in various populations at the community level worldwide.

Conclusion

The 24 reviewed studies suggest innovative proposals for social programs that seek to increase PA and promote healthy lifestyles related to public activity policies developed in the countries in which they were generated. Environmental social programs can positively impact PA levels among children and adults.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=229718, identifier: CRD42021229718.

A social-ecological model of working from home during COVID-19

Working from Home (WFH) is emerging as a critical measure for reducing transport demand. Indeed, the COVID-19 pandemic has revealed that trip avoidance measures, especially WFH, could help address Sustainable Development Goal 11.2 (creating sustainable transport systems in cities) by decreasing commuter trips by private motor vehicles. This study aimed to explore and identify the attributes that supported WFH during the pandemic and construct a Social-Ecological Model (SEM) of WFH within the context of travel behaviour. We conducted in-depth interviews with 19 stakeholders from Melbourne, Australia and found that WFH during COVID-19 has fundamentally changed commuter travel behaviour. There was a consensus among participants that a hybrid-work model will emerge post-COVID-19 (e.g., working three days in the office and two days at home). We identified 21 attributes that influenced WFH and mapped these attributes across the five traditional SEM levels (intrapersonal, interpersonal, institutional, community and public policy). In addition, we proposed a sixth higher-order level: "global", to reflect the worldwide phenomena of COVID-19 and computer programs that also supported WFH. We found that WFH attributes were concentrated at the intrapersonal (individual) and institutional (workplace) levels. Indeed, workplaces are key to supporting WFH in the long-term. Whereby, workplace provision of laptops, office equipment, internet connection and flexible work policies enable WFH, and unsupportive organisational cultures and managers are potential barriers to WFH. This SEM of WFH benefits both researchers and practitioners by providing guidance of the key attributes required to sustain WFH behaviours post-COVID-19.

InterMob: a 24-month randomised controlled trial comparing the effectiveness of an intervention including behavioural change techniques and free transport versus an intervention including air pollution awareness-raising on car use reduction among regular car users living in Grenoble, France

Background

Frequent car use contributes to health and environmental issues such as air pollution, climate change and obesity. Active and sustainable mobility (bike, walk, public transport, car sharing) may address these issues. Different strategies have been implemented in past research, involving hard levers, aimed at modifying the economical or geographical context (e.g., free public transport), and soft levers, aimed at modifying psychological processes (e.g., personalised transport advice). However, few studies have combined both hard and soft levers. In addition, few have used robust methodologies (e.g., randomised controlled trials), followed behavioural changes in the long-term, and been anchored in behaviour change theories. InterMob aims to address these limits by implementing a 24-month randomised controlled trial including hard and soft levers. The objectives of InterMob are to a) evaluate the effectiveness of an experimental arm versus an active controlled arm, and b) identify the processes of mobility change.

Methods

Regular car users living in Grenoble (N = 300) will be recruited and randomised to one of the two arms. The experimental arm consists in a six-month intervention combining hard levers (free access to transport/bikes), and soft levers (e.g., personalised transport advice). The control arm consists in a six-month intervention aimed at raising awareness on air pollution and its health effects. Both arms will include eight evaluation weeks (spread out over 24 months) based on a GPS, an accelerometer, and a pollution sensor. Moreover, participants will complete mobility logbooks and surveys measuring psychological constructs, socio-economical, and socio-spatial characteristics.

Discussion

InterMob will assess the effectiveness of two interventions aimed at reducing car use within regular car users in the short-, mid- and long-term. Moreover, InterMob will allow to better understand the psychological processes of behaviour change, and the socio-economical and geographical conditions under which the intervention is efficient in reducing car use. Finally, the benefits of mobility change in terms of physical activity, quality of life, and exposure to pollution will be quantified.

Trial registration

ClinicalTrials.gov: NCT05096000 on 27/10/2021 (retrospectively registered).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14099-4.

Preliminary Results of a Bicycle Training Course on Adults' Environmental Perceptions and Their Mode of Commuting

This study was designed to analyze the effects of a bicycle training course on both adults’ environmental perceptions and their mode of commuting. Four bicycle training courses for adults were conducted in Granada, Spain in April 2015 and May 2016. The course program was focused on developing practical skills and attitudes on road. From the initial 65 adults who started the course, only 35 adults met the inclusion criteria and were included in the study. Participants completed twice (i.e., before and after the course) a questionnaire about their perceptions of the environment, usual mode of commuting to daily destinations, and sociodemographic characteristics. After finishing the initial questionnaire, the participants completed a bicycle training course based on the methodology “Bikeability” with a duration of 6 h. The results suggest that participants improved their safety perception in relation to the level of crime in the participants’ neighborhood after the bicycle training course. Cycling training courses should last longer in order to produce changes in the mode of commuting and in the environmental perceptions.

Changes in physical activity by context and residential greenness among recent retirees: Longitudinal GPS and accelerometer study

This study examined the changes in accelerometer-measured physical activity by GPS-measured contexts among Finnish retirees (n = 45 (537 measurement days)) participating in a physical activity intervention. We also assessed whether residential greenness, measured with Normalized Difference Vegetation Index, moderated the changes. Moderate-to-vigorous physical activity (MVPA) increased at home by 7 min/day, (P < 0.001) and during active travel by 5 min/day (P = 0.03). The participants with the highest vs. lowest greenness had 25 min/day greater increase in MVPA over the follow-up (P for Time*Greenness interaction = 0.04). In conclusion, retirees participating in the intervention increased their MVPA both at home and in active travel, and more so if they lived in a greener area.

Contexts of sedentary time and physical activity among ageing workers and recent retirees: cross-sectional GPS and accelerometer study

OBJECTIVES

We examined sedentary time and physical activity in different contexts among ageing workers, between their workdays and days off, and recent retirees, between their weekdays and weekend days.

DESIGN

Cross-sectional study.

SETTING

Finnish Retirement and Aging study and Enhancing physical activity and healthy ageing among recent retirees-Randomised controlled in-home physical activity trial.

PARTICIPANTS

137 workers (544 measurement days) and 53 retirees (323 days), who provided data for at least 1 workday/weekday and 1 day off/weekend day.

PRIMARY AND SECONDARY OUTCOME MEASURES

Physical activity behaviour was measured with a combined Global Positioning System and accelerometer device (SenseDoc V.2.0), providing information on sedentary time, light physical activity and moderate-to-vigorous physical activity (MVPA) by locations (home or non-home) and trips (active travel, ie, speed <20 km/hour and passive travel, ie, speed ≥20 km/hour).

RESULTS

Workers accumulated more sedentary time and physical activity at non-home locations than at home on workdays, while the opposite was confirmed for days off (p<0.01). Workers accrued more MVPA on days off than on workdays (34 vs 28 min, p<0.05), of which 9 min on workdays and 14 min on days off was accrued during active travel. Retirees' physical activity behaviour did not differ between weekdays and weekend days (p>0.05). Regardless of the day, retirees accumulated 33 min of daily MVPA, of which 14 min was accrued during active travel.

CONCLUSIONS

Workers accumulated more MVPA on days off than on workdays, and their activity behaviour varied between workdays and days off at different locations. Our results showed that a large proportion of the MVPA was accumulated during travel at slower speeds, which suggests that active travel could be a feasible way to increase MVPA among older adults.

TRIAL REGISTRATION NUMBER

NCT03320746.

A systematic review of the effect of infrastructural interventions to promote cycling: strengthening causal inference from observational data

Background

Previous reviews have suggested that infrastructural interventions can be effective in promoting cycling. Given inherent methodological complexities in the evaluation of such changes, it is important to understand whether study results obtained depend on the study design and methods used, and to describe the implications of the methods used for causality. The aims of this systematic review were to summarize the effects obtained in studies that used a wide range of study designs to assess the effects of infrastructural interventions on cycling and physical activity, and whether the effects varied by study design, data collection methods, or statistical approaches.

Methods

Six databases were searched for studies that evaluated infrastructural interventions to promote cycling in adult populations, such as the opening of cycling lanes, or the expansion of a city-wide cycling network. Controlled and uncontrolled studies that presented data before and after the intervention were included. No language or date restrictions were applied. Data was extracted for any outcome presented (e.g. bikes counted on the new infrastructure, making a bike trip, cycling frequency, cycling duration), and for any purpose of cycling (e.g. total cycling, recreational cycling, cycling for commuting). Data for physical activity outcomes and equity effects was extracted, and quality assessment was conducted following previous methodologies and the UK Medical Research Council guidance on natural experiments. The PROGRESS-Plus framework was used to describe the impact on subgroups of the population.

Studies were categorized by outcome, i.e. changes in cycling behavior, or usage of the cycling infrastructure. The relative change was calculated to derive a common outcome across various metrics and cycling purposes. The median relative change was presented to evaluate whether effects differed by methodological aspects.

Results

The review included 31 studies and all were conducted within urban areas in high-income countries. Most of the evaluations found changes in favor of the intervention, showing that the number of cyclists using the facilities increased (median relative change compared to baseline: 62%; range: 4 to 438%), and to a lesser extent that cycling behavior increased (median relative change compared to baseline: 22%; range: − 21 to 262%). Studies that tested for statistical significance and studies that used subjective measurement methods (such as surveys and direct observations of cyclists) found larger changes than those that did not perform statistical tests, and those that used objective measurement methods (such as GPS and accelerometers, and automatic counting stations). Seven studies provided information on changes of physical activity behaviors, and findings were mixed. Three studies tested for equity effects following the opening of cycling infrastructure.

Conclusions

Study findings of natural experiments evaluating infrastructural interventions to promote cycling depended on the methods used and the approach to analysis. Studies measuring cycling behavior were more likely to assess actual behavioral change that is most relevant for population health, as compared to studies that measured the use of cycling infrastructure. Triangulation of methods is warranted to overcome potential issues that one may encounter when evaluating environmental changes within the built environment.

Trial registration

The protocol of this study was registered at PROSPERO (CRD42018091079).

A systematic review of the effect of infrastructural interventions to promote cycling: strengthening causal inference from observational data

BACKGROUND

Previous reviews have suggested that infrastructural interventions can be effective in promoting cycling. Given inherent methodological complexities in the evaluation of such changes, it is important to understand whether study results obtained depend on the study design and methods used, and to describe the implications of the methods used for causality. The aims of this systematic review were to summarize the effects obtained in studies that used a wide range of study designs to assess the effects of infrastructural interventions on cycling and physical activity, and whether the effects varied by study design, data collection methods, or statistical approaches.

METHODS

Six databases were searched for studies that evaluated infrastructural interventions to promote cycling in adult populations, such as the opening of cycling lanes, or the expansion of a city-wide cycling network. Controlled and uncontrolled studies that presented data before and after the intervention were included. No language or date restrictions were applied. Data was extracted for any outcome presented (e.g. bikes counted on the new infrastructure, making a bike trip, cycling frequency, cycling duration), and for any purpose of cycling (e.g. total cycling, recreational cycling, cycling for commuting). Data for physical activity outcomes and equity effects was extracted, and quality assessment was conducted following previous methodologies and the UK Medical Research Council guidance on natural experiments. The PROGRESS-Plus framework was used to describe the impact on subgroups of the population. Studies were categorized by outcome, i.e. changes in cycling behavior, or usage of the cycling infrastructure. The relative change was calculated to derive a common outcome across various metrics and cycling purposes. The median relative change was presented to evaluate whether effects differed by methodological aspects.

RESULTS

The review included 31 studies and all were conducted within urban areas in high-income countries. Most of the evaluations found changes in favor of the intervention, showing that the number of cyclists using the facilities increased (median relative change compared to baseline: 62%; range: 4 to 438%), and to a lesser extent that cycling behavior increased (median relative change compared to baseline: 22%; range: - 21 to 262%). Studies that tested for statistical significance and studies that used subjective measurement methods (such as surveys and direct observations of cyclists) found larger changes than those that did not perform statistical tests, and those that used objective measurement methods (such as GPS and accelerometers, and automatic counting stations). Seven studies provided information on changes of physical activity behaviors, and findings were mixed. Three studies tested for equity effects following the opening of cycling infrastructure.

CONCLUSIONS

Study findings of natural experiments evaluating infrastructural interventions to promote cycling depended on the methods used and the approach to analysis. Studies measuring cycling behavior were more likely to assess actual behavioral change that is most relevant for population health, as compared to studies that measured the use of cycling infrastructure. Triangulation of methods is warranted to overcome potential issues that one may encounter when evaluating environmental changes within the built environment.

TRIAL REGISTRATION

The protocol of this study was registered at PROSPERO (CRD42018091079).