Neighborhood Built Environment and Socioeconomic Status are Associated with Active Commuting and Sedentary Behavior, but not with Leisure-Time Physical Activity, in University Students

Prevalence and association of compliance with the Canadian 24-hour movement guidelines with sociodemographic aspects in Brazilian adults: a cross-sectional epidemiological study

BACKGROUND

The physical inactivity is a global health concern, so that recommendations on sufficient physical activity levels are elaborated worldwide, such as in Brazil. However, the Canadian 24-Hour Movement Guidelines were first in the world to consider time-specific recommendations for physical activity, sedentary behavior and sleep, which is still not developed for Latin-American population. The present study aimed to verify the adherence to Canadian 24-hour guidelines in a Brazilian inner city and to analyze its association with sociodemographic aspects.

METHODS

A cross-sectional epidemiological study, with a sample composed by 250 adults (140 women), with a median age of 41.0 years. Objective measures of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were collected by accelerometry. Sleep duration and sociodemographic aspects (ethnicity, gender, age, educational attainment and socioeconomic level) were obtained through a face-to-face questionnaire. Canadian 24-hour guidelines considered ≥ 150 min/week of MVPA, <8 h/day of sedentary behavior and daily sleep time between 7 and 9 h, being analyzed separately and in combination. Poisson regression with robust variance estimator was used to analyze the prevalence ratio (PR) of meeting the 24-hour guidelines according to the categories of sociodemographic variables, being performed by the software IBM SPSS version 25.0.

RESULTS

The complete 24-hour guidelines were met only by 24.4% of sample (n = 61). Sedentary behavior was the most met guideline (88%), followed by MVPA (56.8%) and sleep (53.2%), without significant difference according to sex. When compared to elderly participants, those participants in younger groups (18-39 years and 40-59 years) were more likely to meet MVPA guideline (PR = 2.51 [95%CI = 1.47; 4.28] and PR = 2.60 [95%CI = 1.52; 4.45], respectively), as well as the combination of MVPA and sedentary behavior (PR = 1.98 [95%CI = 1.13; 3.44] and PR = 2.17 [95%CI = 1.25; 3.79], respectively) and MVPA with the sleep guideline (PR = 2.39 [95%CI = 1.09; 5.27] only for 18-39 years group). Men were more likely to meet MVPA guideline than women (PR = 1.29 [95%CI = 1.04; 1.59]).

CONCLUSION

Younger aged and male adults were more likely to meet the Canadian 24-hour guidelines in a small Brazilian city. However, further studies with larger and representative samples of sociodemographic stratum are still needed.

Socioeconomic differences in associations between living in a 20-min neighbourhood and diet, physical activity and self-rated health: Cross-sectional findings from ProjectPLAN

The 20-min neighbourhood (20MN) concept aims to enable residents to meet daily needs using resources within a 20-min trip from home noting that there is no single definition of what services and amenities are required for daily needs nor what modes of transport constitute a 20 min trip. Whether 20MNs promote better health and whether associations differ by socio-economic status (SES) is unknown. Using cross-sectional data from adults randomly sampled in 2018-19 from Melbourne or Adelaide, Australia, we examined whether associations between neighbourhood type (20MN/non-20MN) and diet, physical activity or self-rated health vary according to individual- or area-level SES. We found no consistent patterns of interactions. The results do not consistently support the often assumed belief that 20MNs support more healthful behaviour and that these relationships vary by SES.

County characteristics associated with refusing breast cancer surgery: Evidence from the Surveillance, Epidemiology, and End Results program

BACKGROUND

Individuals' communities impact cancer disparities and are intimately related to social determinants of health. Studies show that personal factors affect treatment refusals for a potentially curable cancer, but few studies have investigated whether community-based characteristics affect the receipt of surgery.

METHODS

We used Surveillance Epidemiology and End Results Program registries from 2010 to 2015 to examine differences in rates of surgery refusal among non-Hispanic White, non-Hispanic Black, and Hispanic women diagnosed with nonmetastatic breast cancer. The community factor measures were based on county-level factors. Sociodemographic and community differences were analyzed using Pearson's χ2 tests and analysis of variance. Multivariate logistic regression of predictors of surgery refusal and the Cox proportional hazard model of disease-specific mortality were performed.

RESULTS

Surgery refusers among non-Hispanic Black and Hispanic all races lived in counties with lower rates of educational attainment, median family and household income, and higher rates of poverty, unemployment, foreign-born, language isolation, urban population, and women more than 40 years old having mammography in last 2 years. Multivariate analysis shows surgery refusal rates increased in counties having a high percentage of urban population and declined in counties with an increased percentage of less than high school level education, unemployment, and median household income. Breast cancer-specific mortality increased significantly with surgery refusal.

CONCLUSION

Residence in counties with the lowest socioeconomic status and disproportionately populated by racial and ethnic minorities is associated with surgery refusal. Given the high mortality associated with refusing surgery, culturally sensitive education on the benefits of care may be appropriate.

Videos using different message strategies to promote the interruption of sedentary behavior in university students during online lectures - A pilot study

Background

Sedentary behavior (SB) is highly prevalent among university students and has increased during COVID-19 pandemic. As SB is associated with negative health outcomes, appropriate prevention measures in the university setting are needed.

Objective

This pilot study aimed at investigating the effects of videos using different message strategies to interrupt SB in the collective of university students during online lectures.

Methods

During online lectures, university students (N = 96) were shown one of three videos on the interruption of SB. The videos differed in their message strategies with regard to evidence type (statistical vs. narrative) and vividness (static vs. animated images). Demographics, health variables (SB intentions, SB attitudes) and selected media reception variables (identification, homophily, counterarguing) were examined as possible influence factors on the interruption of SB evoked by watching the video.

Results

Approximately half of the students interrupted sedentary behavior during watching the videos and students of the older age group (cut-off: median = 22 years) interrupted SB significantly more often (p = 0.046). The interruption of SB was predicted by SB intentions (p < 0.05). Identification with characters significantly predicted the intentions to reduce SB (p < 0.001), with a large effect of the overall regression model (R2corr = 0.47).

Conclusion

Considering the increased digitalization in general and restrictions due to COVID-19 pandemic, videos seem to be a useful tool to interrupt SB among university students during online lectures. Narrative formats could facilitate the intention to reduce SB, which in turn could have a positive impact on the interruption of SB. However, further research on effective communication and message strategies is needed.

The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults

BACKGROUND

Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project.

METHODS

This study (2020-2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25-65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously.

DISCUSSION

The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.

Multivariate Analysis on Physical Activity, Emotional and Health Status of University Students Caused by COVID-19 Confinement

Confinement as a result of COVID-19 had a strong impact around the world and restricted mobility. The university community started to take routine classes in a virtual and sedentary way, causing negative effects on their health and habits. The objective of this research is to analyze the impact of confinement through surveys of students and interviews with university professors, in order to study the effects of confinement on physical activity, emotional state, and health. The methodology was as follows: (i) preliminary data; (ii) survey development, interviews, and information collection; (iii) data processing and multivariate presentation of the results, using multiple correspondence analysis (MCA) and multiple factor analysis (MFA). The results of 375 respondents show that there is a low level of physical activity (<300 METs, 49.6%), where women register sedentary behavior (73%). Emotionally, most of them show feeling bored. Some express anxiety, depression, discomfort, and frustration. In terms of health, there are rheumatic, circulatory, respiratory, and other diseases related to obesity. It is essential to create programs that promote physical exercise to reduce the consequences of sedentary lifestyles on the physical, social, and mental health of university students, especially engineering students, who experienced greater effects of confinement than those studying nutrition and social sciences.

Prevalence and Associated Factors of Physical Activity among Medical Students from the Western Balkans

The student population includes young adults who need nutrition and regular physical activity (PA) for mental, cognitive, and physical development. It is estimated that, globally, only 25–40% of the university student population is involved in regular PA. To date, no research has been conducted in the Western Balkans to address the PA of medical students. The aim of this study was to investigate the prevalence and factors influencing PA among medical students from the Western Balkans. A cross-sectional study included 2452 students from 14 medical faculties in five countries (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia and Serbia). There were significantly more students who engaged than those who did not engage in some type of regular (daily) PA. Gender, overweight or obesity, and household income are significantly associated with students’ PA. Students who are more often involved in regular daily PA and have higher daily PA levels are more likely to be males whose household income is above average. In order to improve the health of the student population, the public health authorities need to continuously investigate the PA of students and introduce appropriate activities to increase their level of PA.

Spatial distribution of sedentary behavior and unhealthy eating habits in Belo Horizonte, Brazil: the role of the neighborhood environment

The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.

Effects of Large-Scale Municipal Safe Routes to School Infrastructure on Student Active Travel and Physical Activity: Design, Methods, and Baseline Data of the Safe Travel Environment Evaluation in Texas Schools (STREETS) Natural Experiment

Past evaluations of Safe Routes to School (SRTS) programs have been relatively small in scope and have lacked objective measurements of physical activity. A 2016 Mobility Bond in Austin, Texas, USA, allocated USD 27.5 million for infrastructure changes to facilitate active commuting to schools (ACS). The Safe TRavel Environment Evaluation in Texas Schools (STREETS) study aims to determine the health effects of these infrastructure changes. The purpose of this paper is to describe the STREETS study design, methods, and selected baseline results. The STREETS study is comprised of two designs: (1) a serial cross-sectional design to assess changes in ACS prevalence, and (2) a quasi-experimental, prospective cohort to examine changes in physical activity. Differences between study arms (Austin SRTS and comparison) were assessed for school demographics, ACS, and school programs. At baseline, 14.3% of school trips were made by ACS, with non-significant differences between study arms. Only 26% of schools implemented ACS-related programs. Some significant differences across SRTS and comparison schools were identified for several school- and neighborhood-level characteristics. Substantial changes are needed across area schools and neighborhoods to promote optimum ACS. STREETS study longitudinal findings will be critical for informing optimal future implementations of SRTS programs.

Role of Sociodemographic Variables and the Mother's Active Behavior on Active Commuting to School in Children and Adolescents

The main objective of the current study was to analyze how parents' sociodemographic characteristics, mode of commuting and physical activity (PA) act as indicators of active commuting to school (ACS) in their children and adolescents. A total of 684 paired parents (52.8% mothers) and their respective offspring (33.7% girls) were included. The participants self-reported their sociodemographic characteristics, mode of commuting, and PA. Logistic regression analyses were performed using a stepwise approach, including, as indicators, parental characteristics, mode of commuting and PA. The main outcome was child and adolescent ACS. The odds ratio (OR) and R² of Nagelkerke were obtained for each step. Parental sociodemographic characteristics were greater indicators of child ACS than the parental mode of commuting and PA. In children, the greatest predictive variables of ACS explained 38% of the variance and were as follows: car availability (OR = 0.24), father's educational level (OR = 0.47), mother's educational level (OR = 1.95), mother's active commuting to work (OR = 4.52) and mother's salary/month (OR = 0.67). In adolescents, the greatest predictive variables of ACS explained 40% of the variance and were as follows: socioeconomic level (OR = 0.43) and father's active commuting (OR = 10.6). In conclusion, sociodemographic factors are better indicators of ACS than parents' physical activity and active commuting to work.

Hybrid Bayesian Network Models to Investigate the Impact of Built Environment Experience before Adulthood on Students’ Tolerable Travel Time to Campus: Towards Sustainable Commute Behavior

This present study developed two predictive and associative Bayesian network models to forecast the tolerable travel time of university students to campus. This study considered the built environment experiences of university students during their early life-course as the main predictors of this study. The Bayesian network models were hybridized with the Pearson chi-square test to select the most relevant variables to predict the tolerable travel time. Two predictive models were developed. The first model was applied only to the variables of the built environment, while the second model was applied to all variables that were identified using the Pearson chi-square tests. The results showed that most students were inclined to choose the tolerable travel time of 0–20 min. Among the built environment predictors, the availability of residential buildings in the neighborhood in the age periods of 14–18 was the most important. Taking all the variables into account, distance from students’ homes to campuses was the most important. The findings of this research imply that the built environment experiences of people during their early life-course may affect their future travel behaviors and tolerance. Besides, the outcome of this study can help planners create more sustainable commute behaviors among people in the future by building more compact and mixed-use neighborhoods.

Neighborhood and Individual Socioeconomic Disadvantage and Survival Among Patients With Nonmetastatic Common Cancers

IMPORTANCE

Disadvantaged neighborhood-level and individual-level socioeconomic status (SES) have each been associated with suboptimal cancer care and inferior outcomes. However, independent or synergistic associations between neighborhood and individual socioeconomic disadvantage have not been fully examined, and prior studies using simplistic neighborhood SES measures may not comprehensively assess multiple aspects of neighborhood SES.

OBJECTIVE

To investigate the associations of neighborhood SES (using a validated comprehensive composite measure) and individual SES with survival among patients with nonmetastatic common cancers.

DESIGN, SETTING, AND PARTICIPANTS

This prospective, population-based cohort study was derived from the Surveillance, Epidemiology, and End Results-Medicare database from January 1, 2008, through December 31, 2011, with follow-up ending on December 31, 2017. Participants included older patients (≥65 years) with breast, prostate, lung, or colorectal cancer.

EXPOSURES

Neighborhood SES was measured using the area deprivation index (ADI; quintiles), a validated comprehensive composite measure of neighborhood SES. Individual SES was assessed by Medicare-Medicaid dual eligibility (yes vs no), a reliable indicator for patient-level low income.

MAIN OUTCOMES AND MEASURES

The primary outcome was overall mortality, and the secondary outcome was cancer-specific mortality. Hazard ratios (HRs) for the associations of ADI and dual eligibility with overall and cancer-specific mortality were estimated via Cox proportional hazards regression. Statistical analyses were conducted from January 23 to April 15, 2021.

RESULTS

A total of 96 978 patients were analyzed, including 25 968 with breast, 35 150 with prostate, 16 684 with lung, and 19 176 with colorectal cancer. Median age at diagnosis was 76 years (IQR, 71-81 years) for breast cancer, 73 years (IQR, 70-77 years) for prostate cancer, 76 years (IQR, 71-81 years) for lung cancer, and 78 years (IQR, 72-84 years) for colorectal cancer. Among lung and colorectal cancer patients, 8412 (50.4%) and 10 486 (54.7%), respectively, were female. The proportion of non-Hispanic White individuals among breast cancer patients was 83.7% (n = 21 725); prostate cancer, 76.8% (n = 27 001); lung cancer, 83.5% (n = 13 926); and colorectal cancer, 81.1% (n = 15 557). Neighborhood-level and individual-level SES were independently associated with overall mortality, and no interactions were detected. Compared with the most affluent neighborhoods (ADI quintile 1), living in the most disadvantaged neighborhoods (ADI quintile 5) was associated with higher risk of overall mortality (breast: HR, 1.34; 95% CI, 1.26-1.43; prostate: HR, 1.51; 95% CI, 1.42-1.62; lung: HR, 1.21; 95% CI, 1.14-1.28; and colorectal: HR, 1.24; 95% CI, 1.17-1.32). Individual socioeconomic disadvantage (dual eligibility) was associated with higher risk of overall mortality (breast: HR, 1.22; 95% CI, 1.15-1.29; prostate: HR, 1.29; 95% CI, 1.21-1.38; lung: HR, 1.14; 95% CI, 1.09-1.20; and colorectal: HR, 1.23; 95% CI, 1.17-1.29). A similar pattern was observed for cancer-specific mortality.

CONCLUSIONS AND RELEVANCE

In this cohort study, neighborhood-level deprivation was associated with worse survival among patients with nonmetastatic breast, prostate, lung, and colorectal cancer, even after accounting for individual SES. These findings suggest that, in order to improve cancer outcomes and reduce health disparities, policies for ongoing investments in low-resource neighborhoods and low-income households are needed.

The Influence of Socio-Demographic Factors on the Forms of Leisure for the Students at the Faculty of Physical Education and Sports

The study investigates the influences of gender, area of origin and age stage variables and also of the interaction between them, on the free time behavior of the students at the Faculty of Physical Education and Sports from Galati. The questionnaire applied in the academic year 2019–2020 had 85 items and was structured on 4 factors: leisure budget, leisure limiting factors, preferred leisure activities, and leisure sports activities. The multivariate/MANOVA analysis showed statistically significant data for some of the analyzed items, with values of F associated with thresholds p < 0.05. The results support longer screen time for urban areas and for those <25 years and time limitation for the favorite activities of students >25 years, while reading had higher stress scores for men and students <25 years. Men tended to limit their free time working overtime and women limited their free time due to housework. Students from rural areas and men >25 years were more stressed by socializing on the internet and shopping. Financial limitations for preferred activities were higher for women and students <25 years—women read more and visited their friends more often while men had higher scores in relation to involvement in physical activities throughout the week, an aspect also reported for those <25 years. Students >25 years spent more time with their family, while those <25 years socialized more on the internet and had better scores when going out with friends. Those in urban areas did more jogging, men had better scores in relation to playing sports games, higher indicators for the satisfaction generated by sports activity, and women preferred jogging and cycling/rollerblading. Sports games and different types of fitness were the most common variants practiced at the level of the studied group. Conclusion: There was no dominant orientation of the investigated group towards forms of passive leisure and there were no cases of sedentariness, even if the use of technologies (video games, socializing on the Internet and TV) were forms of leisure often used by students.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Insufficient Physical Activity and Sedentary Behaviors among Medical Students during the COVID-19 Lockdown: Findings from a Cross-Sectional Study in Pakistan

Background: The unprecedented COVID-19 pandemic has resulted in social distancing and isolation which leads to insufficient physical activity and thereby increases sedentary behaviors. Hence, this study aimed to assess the prevalence of insufficient physical activity and sedentary behaviors among medical students during the COVID-19 lockdown in Pakistan, and to determine their associated factors. Methods: A cross-sectional online survey was carried out among 407 medical students from the Punjab and Sindh provinces between May and June 2020. To collect data, an e-questionnaire was sent to obtain informed consent along with questions concerning socio-demographics as well as an International Physical Activity Questionnaires–Short Form (IPAQ–SF). Results: As per the IPAQ, almost five in ten participants were physically inactive (48.2%), and 45.2% reported sedentary behaviors. Participants with insufficient physical activity were more likely to report sedentary behaviors than their counterparts (AOR = 2.53; 95% CI = 1.66–3.85, p < 0.001). The odds of insufficient physical activity were higher among the participants who did not strictly follow the COVID-19 preventive measures (AOR = 2.51; 95% CI = 1.35–4.69, p = 0.004); similarly, there were increased odds of sedentary behaviors observed among participants within a normal weight range compared to those who were underweight (AOR = 2.69; 95% CI = 1.76–4.11, p < 0.001). Conclusions: Insufficient physical activity and sedentary behavior are prevalent among medical students in Pakistan during the COVID-19 pandemic. These findings indicate the importance of establishing tailored policies and programs to encourage young adults to engage in physical activity.

Healthly Urban Environmental Features for Poverty Resilience: The Case of Detroit, USA

Within the existing relationship among urban environment, health, and poverty, it is necessary to clarify and characterize the influence that the physical environment has on community socioeconomic outcomes. Given that Detroit has one of the highest poverty rates among large metropolitan areas in the United States, this study aims to identify environmental and urban features that have influenced poverty in this city by assessing whether changes in household income are associated with characteristics of the built environment. The difference of median household income (DMHI) between 2017 and 2013 and 27 environmental and urban variables were investigated using both geographic distribution mapping and statistical correlation analysis. Results suggest that proximity of housing to job opportunity areas, as well as to certain educational and health-related facilities, were positively related to increasing household incomes. These findings outline a healthy urban design that may benefit community socioeconomic outcomes-specifically a design with dense and mixed-use areas, good accessibility, high presence of urban facilities, and features that promote a healthy lifestyle (involving physical activity and a healthy diet). In this sense, urban planning and public health may be important allies for poverty resilience.

Environmental and Psychosocial Barriers Affect the Active Commuting to University in Chilean Students

Biking and walking are active commuting, which is considered an opportunity to create healthy habits. Objective: The purpose of this study was to determine the main environmental and psychosocial barriers perceived by students, leading to less Active Commuting (AC) to university and to not reaching the Physical Activity (PA) recommendations. Material and Methods: In this cross-sectional study, 1349 university students (637 men and 712 women) were selected. A self-reported questionnaire was applied to assess the mode of commuting, PA level and barriers to the use of the AC. Results: Women presented higher barriers associated with passive commuting than men. The main barriers for women were “involves too much planning” (OR: 5.25; 95% CI: 3.14–8.78), “It takes too much time” (OR: 4.62; 95% CI: 3.05–6.99) and “It takes too much physical effort “ (OR: 3.18; 95% CI: 2.05–4.94). In men, the main barriers were “It takes too much time” (OR: 4.22; 95% CI: 2.97–5.99), “involves too much planning” (OR: 2.49; 95% CI: 1.67–3.70) and “too much traffic along the route” (OR: 2.07; 95% CI: 1.47–2.93). Psychosocial barriers were found in both sexes. Conclusions: Psychosocial and personal barriers were more positively associated with passive commuting than environmental barriers. Interventions at the university are necessary to improve the perception of AC and encourage personal organization to travel more actively.

Why Do Students Walk or Cycle for Transportation? Perceived Study Environment and Psychological Determinants as Predictors of Active Transportation by University Students

University students are particularly at risk to suffer from physical and psychological complaints and for not fulfilling health-oriented physical activity (PA) recommendations. Since PA is linked with various benefits for health and educational outcomes, the group of students is of particular interest for PA promotion. Although active commuting has been identified as a relevant domain of PA in order to gain the various benefits of PA, little knowledge is available with respect to university students. This study tested conditions in the study environment, as well as personal motivators and barriers, as determinants for the active transportation of university students. Using a cross-sectional convenience sample of a university in the southwest of Germany (n = 997), we applied factor analyses to bundle relevant information on environmental and psychological determinants (adapted NEWS-G; adapted transport-related items from an Australian university survey) and blockwise hierarchical regressions. The objective was to analyze associations between the bundled determinants and self-reports on PA for transport-related walking and cycling (measured by the EHIS-PAQ). Results revealed associations between transport-related cycling and the perceived study environment (e.g., high automobile traffic) as well as certain personal motivators and barriers (e.g., time effort or weather conditions). The study contributes to the knowledge about determinants that are important for the development and improvement of public health interventions for students in a university setting.

Physical Activity and Sedentary Lifestyle in University Students: Changes during Confinement Due to the COVID-19 Pandemic

Regular physical activity is related to many factors in a university student’s environment. The coronavirus pandemic and the resulting lockdown have restricted many elements of our environment. The aim of this study was to evaluate students’ physical activity and sedentary behaviour at two points in time: before and during the coronavirus lockdown. As a secondary aim, we also wanted to look at changes resulting from other factors (alcohol, tobacco, diet, stages of change, symptoms of anxiety/depression and sociodemographic characteristics). We conducted an observational, cross-sectional, pre-post study with two cut-off points. Two hundred and thirteen students took part in the study. The main dependent variables were physical activity and sitting time, measured using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Parametric and non-parametric tests were used for paired and unpaired data, as well as group-stratified analysis. During lockdown, both weekly physical activity (MD: −159.87; CI: −100.44, −219.31) and weekly sitting time increased (MD: −106.76; CI: −71.85, −141.67). In the group analysis, differences were observed in relation to gender, year of study, BMI, alcohol consumption, tobacco use, symptoms of anxiety/depression, Mediterranean diet, living situation and stage of change. The results showed an increase in both physical activity and sitting time globally and by group.

Cross-sectional associations of neighbourhood socioeconomic disadvantage and greenness with accelerometer-measured leisure-time physical activity in a cohort of ageing workers

OBJECTIVE

Neighbourhood characteristics may affect the level of physical activity (PA) of the residents. Few studies have examined the combined effects of distinctive neighbourhood characteristics on PA using objective data or differentiated between activity during working or non-working days. We examined the associations of socioeconomic disadvantage and greenness with accelerometer-measured leisure-time PA during working and non-working days.

DESIGN

Cross-sectional study.

SETTING

Finnish Retirement and Aging (FIREA) study.

PARTICIPANTS

708 workers (604 women, mean age 62.4 ranging from 58 to 64 years,) participating in the FIREA study who provided PA measurement data for at least 1 working and non-working day.

PRIMARY AND SECONDARY OUTCOMES

PA was measured with wrist-worn accelerometer on average of 4 working and 2 non-working days. Outcomes were total PA, light PA (LPA) and moderate-to-vigorous PA (MVPA). These measurements were linked to data on neighbourhood socioeconomic disadvantage and greenness within the home neighbourhood (750×750 m). Generalised linear models were adjusted for possible confounders.

RESULTS

On non-working days, higher neighbourhood disadvantage associated with lower levels of total PA (p value=0.07) and higher level of neighbourhood greenness associated with higher level of total PA (p value=0.04). Neighbourhood disadvantage and greenness had an interaction (p value=0.02); in areas of low disadvantage higher greenness did not associate with the level of total PA. However, in areas of high disadvantage, 2 SD higher greenness associated with 46 min/day (95% CI 8.4 to 85) higher total PA. Slightly stronger interaction was observed for LPA (p=0.03) than for the MVPA (p=0.09). During working days, there were no associations between neighbourhood characteristics and leisure-time total PA.

CONCLUSIONS

Of the disadvantaged neighbourhoods, those characterised by high levels of greenness seem to associate with higher levels of leisure-time PA during non-working days. These findings suggest that efforts to add greenness to socioeconomically disadvantaged neighbourhoods might reduce inequalities in PA.

Health and the built environment in United States cities: measuring associations using Google Street View-derived indicators of the built environment

BACKGROUND

The built environment is a structural determinant of health and has been shown to influence health expenditures, behaviors, and outcomes. Traditional methods of assessing built environment characteristics are time-consuming and difficult to combine or compare. Google Street View (GSV) images represent a large, publicly available data source that can be used to create indicators of characteristics of the physical environment with machine learning techniques. The aim of this study is to use GSV images to measure the association of built environment features with health-related behaviors and outcomes at the census tract level.

METHODS

We used computer vision techniques to derive built environment indicators from approximately 31 million GSV images at 7.8 million intersections. Associations between derived indicators and health-related behaviors and outcomes on the census-tract level were assessed using multivariate regression models, controlling for demographic factors and socioeconomic position. Statistical significance was assessed at the α = 0.05 level.

RESULTS

Single lane roads were associated with increased diabetes and obesity, while non-single-family home buildings were associated with decreased obesity, diabetes and inactivity. Street greenness was associated with decreased prevalence of physical and mental distress, as well as decreased binge drinking, but with increased obesity. Socioeconomic disadvantage was negatively associated with binge drinking prevalence and positively associated with all other health-related behaviors and outcomes.

CONCLUSIONS

Structural determinants of health such as the built environment can influence population health. Our study suggests that higher levels of urban development have mixed effects on health and adds further evidence that socioeconomic distress has adverse impacts on multiple physical and mental health outcomes.

Healing Spaces: Designing Physical Environments to Optimize Health, Wellbeing, and Performance

This Special Issue on Healing Spaces includes eight articles consisting of studies at the interface between design and health. The articles address some of the latest findings using state-of-the-art technologies, important outcomes for human health and wellbeing, and suggest exciting directions for the future of this research field.