Integrating the Perceived Neighborhood Environment and the Theory of Planned Behavior When Predicting Walking in a Canadian Adult Sample

Effects of housing layout and perceived behavioral control over social distancing in relation between social isolation and psychological distress during pandemic of COVID-19

Due to the results of the COVID-19 epidemic on health, the positive effect of social distancing has been highlighted. Nevertheless, the effect of housing layouts on resident's perceived behavioral control over social distancing in shared open spaces have been rarely investigated in the context of pandemic. Filling this gap, the current study examines the moderating effect of perceived behavioral control on the relationship between social isolation and psychological distress. Data from 1349 women residing in 9 gated communities during the Iranian national lockdown were collected. The results of ANOVA indicate that there is a significant difference between various housing layouts in terms of residents' perceived behavioral control. Respondent in courtyard blocks layout reported higher perceived behavioral control over social distancing than in linear and freestanding blocks. The findings of structural equation modeling identified perceived behavioral control as a buffer against the effect of social isolation on psychological distress.

I Sit but I Don't Know Why: Investigating the Multiple Precursors of Leisure-Time Sedentary Behaviors

Background: Precursors driving leisure-time sedentary behaviors remain poorly investigated, despite their detrimental consequences. This study aimed to investigate the predictive validity of controlled and automatic motivational precursors toward reducing sedentary behaviors and being physically active on leisure-time sedentary behaviors. The influence of demographic, physical, socio-professional, interpersonal, and environmental variables was also examined and compared with the associations of motivational precursors. Methods: 125 adults completed questionnaires measuring controlled motivational precursors (i.e., intentions, perceived competence), demographical (i.e., sex and age), physical (i.e., body mass index), and interpersonal (i.e., number of children) variables. Regarding automatic motivational precursors, habit strength and approach-avoidance tendencies were captured using the Self-Report Behavioral Automaticity Index and a manikin task. Time at work was computed as a socio-professional variable, days of the week and weather conditions were recorded as environmental precursors. Participants wore an accelerometer for 7 days and leisure time was identified using notebooks. Associations between the different precursors and the leisure-time sedentary behaviors were examined in linear mixed effect models. Results: Intention to be physically active and habit strength toward physical activity were negatively associated with leisure-time sedentary behaviors. Sex, body mass index, time at work, number of children, day of the week, and weather conditions were more strongly associated with leisure-time sedentary behaviors. Conclusion: Our findings show that, in comparison with other variables, the influence of motivational precursors on leisure-time sedentary behaviors is limited. This study supports the adoption of a broad-spectrum of precursors when predicting sedentary behaviors.

Perceived Neighborhood Environment Impacts on Health Behavior, Multi-Dimensional Health, and Life Satisfaction

The impacts of perceived neighborhood environment on adults' health and life satisfaction have drawn increasing academic attention. However, previous studies usually examine multi-dimensional (physical, mental, and perceived) health and life satisfaction separately, and few studies dealt with them simultaneously. Moreover, limited research revealed the mechanisms behind the effects of perceived neighborhood environment on health and life satisfaction, as well as how such effects are moderated by socio-demographics. Therefore, employing the 2016 China Family Panel Study Dataset and using structural equation modeling, this study delves into the complicated relationships among perceived neighborhood environment, health behavior, health outcomes (i.e., body mass index, self-rated health status, and depression), and life satisfaction. Notably, it considers mediation and moderation simultaneously. It finds: (1) Better perceived neighborhood environment significantly promotes physical activity and reduces sedentary behavior, smoking, and drinking; (2) Health behavior fully mediates the effects of perceived neighborhood environment on health; (3) Perceived neighborhood environment significantly affects life satisfaction both directly and indirectly (through health behavior and health outcomes); (4) Socio-demographics moderate the above relationships. This study disentangles the complicated impacts of perceived neighborhood environment on adults' multi-dimensional health and life satisfaction, thus providing policy makers and practitioners with nuanced knowledge for intervention.

The Influence of Street Microenvironment on the Walking Activities of Older Adults: A Longitudinal Study Based on the Structural Equation Model and Manipulated Photos

There is growing evidence of an association between the built environment and walking activity, but knowledge of street microenvironmental factors and older adults’ walking is limited and inconsistent. We used a socio-ecological model as the theoretical framework for this study, aiming to investigate longitudinally the important influences of the street microenvironment on older people’s walking by manipulated street photographs and whether there are different groups of older people with different environmental preferences, and to determine the influence of environmental factors in the socio-ecological model. The clustering analysis method was used to divide the samples into four groups, and those four subgroups were put in a comparative analysis regarding their street environments by methods of semantic differential (SD). The preferences of various subgroups were checked by the variance analysis and post hoc tests, and the structural equation model (SEM) was applied to discuss the relations of correlation and influence among each factor. The results showed that “parking on the sidewalk” was rated the lowest in the pre-intervention photos, and “shaded” and “hedge” were rated the highest in the post-intervention photos, and the environmental requirements were different for the older, poorer and higher income and education subgroups. There was a significant positive relationship between residential status and architectural interventions as well as self-efficacy and physical condition. These findings suggest that when developing environmental interventions to promote walking among older adults, priority should be given to those factors that need to be improved most. In addition, attention should be paid to the differences in walking needs among different groups of older adults, with particular attention on the impact of self-selected living environments on street-level environmental interventions.

What Predicts the Physical Activity Intention-Behavior Gap? A Systematic Review

BACKGROUND

Intention is theorized as the proximal determinant of behavior in many leading theories and yet intention-behavior discordance is prevalent.

PURPOSE

To theme and appraise the variables that have been evaluated as potential moderators of the intention-physical activity (I-PA) relationship using the capability-opportunity-motivation- behavior model as an organizational frame.

METHODS

Literature searches were concluded in August 2020 using seven common databases. Eligible studies were selected from English language peer-reviewed journals and had to report an empirical test of moderation of I-PA with a third variable. Findings were grouped by the moderator variable for the main analysis, and population sample, study design, type of PA, and study quality were explored in subanalyses.

RESULTS

The search yielded 1,197 hits, which was reduced to 129 independent studies (138 independent samples) of primarily moderate quality after screening for eligibility criteria. Moderators of the I-PA relationship were present among select variables within sociodemographic (employment status) and personality (conscientiousness) categories. Physical capability, and social and environmental opportunity did not show evidence of interacting with I-PA relations, while psychological capability had inconclusive findings. By contrast, key factors underlying reflective (intention stability, intention commitment, low goal conflict, affective attitude, anticipated regret, perceived behavioral control/self-efficacy) and automatic (identity) motivation were moderators of I-PA relations. Findings were generally invariant to study characteristics.

CONCLUSIONS

Traditional intention theories may need to better account for key I-PA moderators. Action control theories that include these moderators may identify individuals at risk for not realizing their PA intentions. Prospero # CRD42020142629.

Understanding of Physical Activity in Social Ecological Perspective: Application of Multilevel Model

In the social ecological model, personal characteristics are important determinants of health behaviors, however, multi-dimensional approaches that consider social and physical environments must be utilized to gain a broader picture. Accordingly, this study examines the effects of personal, social, and physical environment variables as factors affecting levels of physical activity (METs). Our findings are based on 72,916 responses from the 2015 Community Health Survey in South Korea. Individual characteristics considered included sex, education level, marital status, age, and income. The social environment variables considered were trust between neighbors and the social network with neighbors. The physical environment variables were satisfaction with living environment and satisfaction with public transportation. The analysis was conducted using a multilevel model in order to accurately consider the characteristic differences of the variables. Regarding personal characteristics, sex, education level, and age have a significant effect on physical activity. Of the social and physical environment variables, social network with neighbors and satisfaction with public transportation have a significant effect on physical activity. This study confirms that a macroscopic understanding is needed to explain individual levels of physical activity; the results of this study will be helpful for public health interventions concerning physical activity.

Navigating an Identity Playground: Using sociomateriality to build a theory of identity play

The construct of identity play, which involves the exploration and experimentation with possible future selves, is underexplored in organizational literature. To extend theory on identity play, we take a narrative inquiry approach and examine qualitative interview data in the context of virtual environments. Using a sociomateriality perspective, we contribute to theory on identity play in three ways. First, we reveal how identity play unfolds via the sociomaterial intertwining of not just human agency, but also material agency, situated work practices, and self-representations. Second, we offer a new definition of identity play that goes beyond the exploration of possible selves and uncover identity play narratives on the possible self, the improbable self, and the impossible self. We demonstrate how identity play, particularly with impossible selves, shapes others’ experiences and thus has implications beyond the self. Finally, three identity play affordances emerged: plasticity of appearance, plasticity of behavior, and plasticity of perspective.

Direct and Indirect Relationships Between the Built Environment and Individual-Level Perceptions of Physical Activity: A Systematic Review

Background

Socioecological models highlight the potential direct and indirect effects of multiple levels of influence in explaining physical activity (PA). Social cognitive theories, however, position individual cognitions as the mediator of external factors such as the built environment when explaining PA.

Purpose

To appraise the evidence for direct and indirect associations between the built environment and social cognition to predict PA.

Methods

Literature searches were concluded in February 2019 using five common databases. Eligible studies were in the English language that included any direct and indirect tests of individual perceptions and the built environment with PA.

Results

The initial search yielded 18,521 hits, which was reduced to 46 independent studies of primarily medium quality after screening for eligibility criteria. Findings were grouped by type of PA then grouped by the type of individual and built environment constructs within the model, and subdivided by adult and youth samples. There was evidence that self-efficacy/perceived control accounted for the covariance between environmental accessibility/convenience and total PA, while habit accounted for the covariance in this relationship for transport PA, particularly in adult samples. There was no evidence that the built environment had a direct association with PA after controlling for individual-level factors.

Conclusions

The results provide initial support for the mediation tenet in social cognition models for the relationship between individual, built environment, and PA. In practice, these findings highlight the need for coordinated interventions of individual and environmental change.

Physical Activity in Peri-Urban Communities: Testing Intentional and Implicit Processes within an Ecological Framework

BACKGROUND

Given the substantive health inequalities in peri-urban communities and the potential for physical activity to promote health in these communities, identifying modifiable physical activity determinants in this population is important. This study explored effects of the peri-urban environment and psychological constructs on physical activity intentions and behavioural automaticity guided by an integrated theoretical framework.

METHODS

Peri-urban Australians (N = 271) completed self-report measures of environmental (i.e. physical/social environment, and neighbourhood selection), motivational (i.e. autonomous motivation), and social cognition (i.e. attitudes, norms, and perceived behavioural control [PBC]) constructs, past behaviour, intentions, and automaticity.

RESULTS

A well-fitting path analytic model revealed that: autonomous motivation predicted all social cognition constructs; subjective norms and PBC, but not attitudes; autonomous motivation predicted intentions and automaticity; and subjective norms and PBC mediated effects of autonomous motivation on intentions. Of the environmental constructs, only neighbourhood selection was related to intentions, mediated by PBC.

CONCLUSIONS

Autonomous motivation is an important correlate of physical activity intentions and automaticity, and subjective norms and PBC also related to intentions. Individuals perceiving a supportive environment were more likely to report positive PBC and intentions. Targeting change in autonomous motivation, and normative and control beliefs may help enhance physical activity intentions and automaticity in peri-urban communities.

Socioecological Correlates of Park-based Physical Activity in Older Adults: A Comparison of Hong Kong and Leipzig Parks

AIMS

The present study aimed to examine and compare the socioecological correlates of park-based physical activity (PA) among Hong Kong and Leipzig older adults in terms of types of activity areas, perceived park environment, psychosocial factors, and the interactions between the perceived park environmental and psychosocial factors.

METHODS

Based on the SOPARC, systematic observations were conducted in six randomly selected urban parks in each city. A total of 317 Hong Kong (Mage = 69.96; SD = 6.81) and 311 Leipzig (Mage = 72.06; SD = 6.78) older adults from these six parks completed an interviewer-delivered survey measuring their perceived park environment, psychosocial variables, and park-based PA.

RESULTS

In both cities, the types of activity areas were positively associated with the number of older adults observed being active in parks. Psychosocial factors, especially self-efficacy and perceived barriers, had larger associations with park-based PA compared with the perceived park environment. The interaction between perceived park features and self-efficacy in the association with park-based PA was found in Leipzig, but not in Hong Kong.

CONCLUSION

Findings of the current study contribute to the cross-cultural understanding of the socioecological correlates of park-based PA among older adults.

Environmental and Motivational Determinants of Physical Activity among Canadian Inuit in the Arctic

Background: Canadian Inuit have transited from a physically active hunter-gatherer subsistence lifestyle into sedentary ways of life. The purpose of the current study was to measure physical activity levels among Nunavut Inuit adults, and explore the socio-cognitive and environmental factors influencing the number of steps taken per day. Method: Inuit and non-Inuit adults (N = 272) in Nunavut participated in a seven-day pedometer study during summer and winter seasons. Participants were asked to complete the Neighbourhood Environmental Walkability Scale (NEWS) and Behavioral Regulation in Exercise Questionnaire (BREQ-3). Data analyses included descriptive statistics, hierarchical linear regression, and tests of mediation effects. Results: Participants had limited to low activity at a rate of 5027 ± 1799 and 4186 ± 1446 steps per day, during summer and winter, respectively. There were no seasonal and age effects on the number of steps. Gender effects and community differences were observed. Perceived infrastructure and safety as well as land use mix diversity were found to be positive environmental correlates of steps taken, which were partially mediated by identified motivational regulation. Conclusion: Physical activity levels among Nunavut adults are generally low, but can be promoted by improving the external physical environment and internal motivational regulation.

The Impact of the Community Built Environment on the Walking Times of Residents in a Community in the Downtown Area of Fuzhou

By means of on-site and network investigation, we collected data relevant to residents of communities, point of interest (POI) data, and land-use data of Fuzhou. We set traffic walking time and leisure walking time as an independent variable, built environment as dependent variable, and gender, age, education level and income level as control variables. Six linear regression models were established using Statistical Product and Service Solutions (SPSS). The results showed that in the 5D (i.e., Density, Diversity, Design, Destination and Distance) elements of the built environment, the density was negatively correlated with the traffic walking time, whereas other elements were positively correlated with the walking time, but the degree of influence was different.

Predicting Physical Activity Among Children: Investigating Interaction Effects in the Theory of Planned Behavior

PURPOSE

The theory of planned behavior (TPB) has been criticized for not including interactions between the variables assumed to predict behavior. This study sought to test how TPB variables interact to predict physical activity (PA) in children.

METHOD

Four hundred thirty-eight children (M_age = 8.6 years, SD = 1.6 years) completed a TPB questionnaire and a PA questionnaire at Time 1. The PA measure was repeated 2 months later. Path analyses were performed to test the hypothesized model including interaction terms between TPB variables. Simple slopes analyses were also carried out to examine the statistically significant interaction terms.

RESULTS

Path analyses confirmed the classical hypotheses of TPB (R² for intentions = .39, R² for PA = .12) and also demonstrated only statistically significant Attitudes × Perceived Behavioral Control and Subjective Norms × Attitudes interactions (R² change for intentions = .01, p = .009). Simple slopes analyses revealed that the strength of the association between perceived behavioral control and intentions was only statistically significantly higher (t = 2.18, p = .05, d = 0.34, 95% CI  [0.03, 0.65]) when attitudes were high compared with when attitudes were low. The link between attitudes and intentions was only statistically significant at a low level of subjective norms but not at a high level.

CONCLUSION

The integration of interaction effects between TPB variables did not increase for the variance of PA explained by the model. More research appears to be necessary to explore how the TPB could be augmented to better predict PA in children.

Understanding Physical Activity through Interactions Between the Built Environment and Social Cognition: A Systematic Review

BACKGROUND

Few people in most developed nations engage in regular physical activity (PA), despite its well-established health benefits. Socioecological models highlight the potential interaction of multiple factors from policy and the built environment to individual social cognition in explaining PA.

OBJECTIVE

The purpose of this review was to appraise this interaction tenet of the socioecological model between the built environment and social cognition to predict PA.

METHODS

Eligible studies had to have been published in peer-reviewed journals in the English language, and included any tests of interaction between social cognition and the built environment with PA. Literature searches, concluded in October 2017, used five common databases. Findings were grouped by type of PA outcomes (leisure, transportation, total PA and total moderate-vigorous PA [MVPA]), then grouped by the type of interactions between social cognitive and built environment constructs.

RESULTS

The initial search yielded 308 hits, which was reduced to 22 independent studies of primarily high- to medium-quality after screening for eligibility criteria. The interaction tenet of the socioecological model was not supported for overall MVPA and total PA. By contrast, while there was heterogeneity of findings for leisure-time PA, environmental accessibility/convenience interacted with intention, and environmental aesthetics interacted with affective judgments, to predict leisure-time PA. Interactions between the built environment and social cognition in PA for transport are limited, with current results failing to support an effect.

CONCLUSIONS

The results provide some support for interactive aspects of the built environment and social cognition in leisure-time PA, and thus highlight potential areas for integrated intervention of individual and environmental change.

A qualitative evaluation of a physician-delivered pedometer-based step count prescription strategy with insight from participants and treating physicians

AIMS

The integration of pedometers into clinical practice has the potential to enhance physical activity levels in patients with chronic disease. Our SMARTER randomized controlled trial demonstrated that a physician-delivered step count prescription strategy has measurable effects on daily steps, glycemic control, and insulin resistance in patients with type 2 diabetes and/or hypertension. In this study, we aimed to understand perceived barriers and facilitators influencing successful uptake and sustainability of the strategy, from patient and physician perspectives.

METHODS

Qualitative in-depth interviews were conducted in a purposive sample of physicians (n = 10) and participants (n = 20), including successful and less successful cases in terms of pedometer-assessed step count improvements. Themes that achieved saturation in either group through thematic analysis are presented.

RESULTS

All participants appreciated the pedometer-based monitoring combined with step count prescriptions. Accountability to physicians and support offered by the trial coordinator influenced participant motivation. Those who increased step counts adopted strategies to integrate more steps into their routines and were able to overcome weather-related barriers by finding indoor alternative options to outdoor steps. Those who decreased step counts reported difficulty in overcoming weather-related challenges, health limitations and work constraints. Physicians indicated the strategy provided a framework for discussing physical activity and motivating patients, but emphasized the need for support from allied professionals to help deliver the strategy in busy clinical settings.

CONCLUSION

A physician-delivered step count prescription strategy was feasibly integrated into clinical practice and successful in engaging most patients; however, continual support is needed for maximal engagement and sustained use.

Associations of Residential Socioeconomic, Food, and Built Environments With Glycemic Control in Persons With Diabetes in New York City From 2007-2013

In the present study, we examined the longitudinal associations between residential environmental factors and glycemic control in 182,756 adults with diabetes in New York City from 2007 to 2013. Glycemic control was defined as a hemoglobin A1c (HbA1c) level less than 7%. We constructed residential-level measures and performed principle component analysis to formulate a residential composite score. On the basis of this score, we divided residential areas into quintiles, with the lowest and highest quintiles reflecting the least and most advantaged residential environments, respectively. Several residential-level environmental characteristics, including more advantaged socioeconomic conditions, greater ratio of healthy food outlets to unhealthy food outlets, and residential walkability were associated with increased glycemic control. Individuals who lived continuously in the most advantaged residential areas took less time to achieve glycemic control compared with the individuals who lived continuously in the least advantaged residential areas (9.9 vs. 11.5 months). Moving from less advantaged residential areas to more advantaged residential areas was related to improved diabetes control (decrease in HbA1c = 0.40%, 95% confidence interval: 0.22, 0.55), whereas moving from more advantaged residential areas to less advantaged residential areas was related to worsening diabetes control (increase in HbA1c = 0.33%, 95% confidence interval: 0.24, 0.44). These results show that residential areas with greater resources to support healthy food and residential walkability are associated with improved glycemic control in persons with diabetes.

The Development of Three Questionnaires to Assess Beliefs about Green Exercise

Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals’ thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current research was to develop questionnaires using the Theory of Planned Behaviour as a framework that could both directly and indirectly assess attitudes, subjective norms and perceived behaviour control, along with intention toward green exercise. Confirmatory factor analyses confirmed that the indirect, direct, and intention measures all had good overall model fits when tested on a refinement (n = 253) and validation (n = 230) sample. The questionnaires will contribute towards helping to better understanding individuals’ beliefs about green exercise, how these influence behaviour, and ultimately to enable the development of effective interventions promoting green exercise.

Interactions of psychosocial factors with built environments in explaining adolescents' active transportation

The present study examined independent and interacting associations of psychosocial and neighborhood built environment variables with adolescents' reported active transportation. Moderating effects of adolescent sex were explored. Mixed-effects regression models were conducted on data from the Teen Environment and Neighborhood observational study (N=928) in the Seattle, WA and Baltimore regions 2009-2011. Frequency index of active transportation to neighborhood destinations (dependent variable) and 7 psychosocial measures were reported by adolescents. Built environment measures included home walkability and count of nearby parks and recreation facilities using GIS procedures and streetscape quality from environmental audits. Results indicated all 3 environmental variables and 3 psychosocial variables (self-efficacy, social support from peers, and enjoyment of physical activity) had significant positive main effects with active transportation (Ps<0.05). Three of 21 two-way interactions were significant in explaining active transportation (Ps<0.1): self-efficacy×GIS-based walkability index, barriers to activity in neighborhood×MAPS streetscape scores, and self-efficacy×GIS-based counts of parks and recreation facilities. In each two-way interaction the highest active transportation was found among adolescents with the combination of activity-supportive built environment and positive psychosocial characteristics. Three-way interactions with sex indicated similar associations for girls and boys, with one exception. Results provided modest support for the ecological model principle of interactions across levels, highlight the importance of both built environment and psychosocial factors in shaping adolescents' active transportation, demonstrated the possibility of sex-specific findings, and suggested strategies for improving adolescents' active transportation may be most effective when targeting multiple levels of influence.

Understanding caregivers' intentions for their child to walk to school: Further application of the theory of planned behavior

Increases in childhood obesity have coincided with declines in active transportation to school. This research builds on largely atheoretical extant literature examining factors that influence walk-to-school behavior through application of the theory of planned behavior (TPB). Understanding caregivers' decision for their child to walk to/from school is key to developing interventions to promote this cost-effective and accessible health behavior. The results from an online survey of 512 caregivers provide support for the TPB, highlighting the important role of subjective norms. This suggests marketers should nurture caregivers' perception that important others approve of walking to school.

Adults’ Daily Walking for Travel and Leisure: Interaction Between Attitude Toward Walking and the Neighborhood Environment

Purpose:

Studies on how the interaction of psychological and environmental characteristics influences walking are limited, and the results are inconsistent. Our aim is to examine how the attitude toward walking and neighborhood environments interacts to influence walking.

Design:

Cross-sectional phone and mail survey.

Setting:

Participants randomly sampled from 6 study sites including Los Angeles, Chicago, Baltimore, Minneapolis, Manhattan, and Bronx Counties in New York City, and Forsyth and Davidson Counties in North Carolina.

Participants:

The final sample consisted of 2621 persons from 2011 to 2012.

Measures:

Total minutes of walking for travel or leisure, attitude toward walking, and perceptions of the neighborhood environments were self-reported. Street Smart (SS) Walk Score (a measure of walkability derived from a variety of geographic data) was obtained for each residential location.

Analysis:

Linear regression models adjusting for age, gender, race/ethnicity, education, and income.

Results:

Attitude toward walking was positively associated with walking for both purposes. Walking for travel was significantly associated with SS Walk Score, whereas walking for leisure was not. The SS Walk Score and selected perceived environment characteristics were associated with walking in people with a very positive attitude toward walking but were not associated with walking in people with a less positive attitude.

Conclusion:

Attitudes toward walking and neighborhood environments interact to affect walking behavior.

A dynamic framework on travel mode choice focusing on utilitarian walking based on the integration of current knowledge

Recently, research on utilitarian walking has gained momentum due to its benefits on both health and the environment. However, our overall understanding of how built and social environments affect travel mode choice (walking or not) is still limited, and most existing frameworks on travel mode choice lack dynamic processes. After a review of several mainstream theories and a number of frameworks, we propose an integrated framework. The basic constructs in the travel mode choice function are utilities, constraints, attitudes, and habits. With a hierarchical structure and heuristic rules, the travel mode choice function is modified by individual characteristics and travel characteristics. The framework explicitly presents several dynamic processes, including the perception process on the environment, attitude formation process, habit formation process, interactions among an individual's own behaviors, interactions among travelers, feedback from travel to the built and social environments, and feedback from other behaviors to the built and social environments. For utilitarian walking, the framework may contribute to the study design, data collection, adoption of new research methods, and provide indications for policy interventions.

Physical and social environmental changes to promote walking among Dutch older adults in deprived neighbourhoods: the NEW.ROADS study

BACKGROUND

Physical activity is important for healthy ageing, and daily walking is seen as a feasible way to be active at older ages. Yet, many older persons, particularly in lower socioeconomic groups and residing in deprived neighbourhoods, are insufficiently active. Creating a physical and social neighbourhood environment that is more supportive for walking has the potential to improve walking behaviour. Current evidence of the impact of changes to the physical and/or social environmental on walking behaviour is scarce. The aim of the NEW.ROADS study is to design, implement and evaluate changes to the physical and social environment for the purpose of increasing walking behaviour among older residents of deprived neighbourhoods.

METHODS

Physical and social environmental interventions were developed by matching scientific evidence on environmental determinants of walking, with input from the target population and stakeholders, and ongoing neighbourhood activities. Specifically, a neighbourhood walking route was designed and marked, and neighbourhood walking groups were organised. These environmental interventions were evaluated in a four-armed experimental study. In addition, the design of the study to evaluate the effect of these environmental changes on walking behaviour is described.

DISCUSSION

Designing and implementing environmental interventions is a complex endeavour, challenged by limited available theory and evidence. Input from the target population and professional stakeholders is essential, but may also put constraints on the evaluation.

TRIAL REGISTRATION

NTR3800 (registered 9/1/2013).

Causal pathways linking environmental change with health behaviour change: Natural experimental study of new transport infrastructure and cycling to work

BACKGROUND

Mechanisms linking changes to the environment with changes in physical activity are poorly understood. Insights into mechanisms of interventions can help strengthen causal attribution and improve understanding of divergent response patterns. We examined the causal pathways linking exposure to new transport infrastructure with changes in cycling to work.

METHODS

We used baseline (2009) and follow-up (2012) data (N=469) from the Commuting and Health in Cambridge natural experimental study (Cambridge, UK). Exposure to new infrastructure in the form of the Cambridgeshire Guided Busway was defined using residential proximity. Mediators studied were changes in perceptions of the route to work, theory of planned behaviour constructs and self-reported use of the new infrastructure. Outcomes were modelled as an increase, decrease or no change in weekly cycle commuting time. We used regression analyses to identify combinations of mediators forming potential pathways between exposure and outcome. We then tested these pathways in a path model and stratified analyses by baseline level of active commuting.

RESULTS

We identified changes in perceptions of the route to work, and use of the cycle path, as potential mediators. Of these potential mediators, only use of the path significantly explained (85%) the effect of the infrastructure in increasing cycling. Path use also explained a decrease in cycling among more active commuters.

CONCLUSION

The findings strengthen the causal argument that changing the environment led to changes in health-related behaviour via use of the new infrastructure, but also show how some commuters may have spent less time cycling as a result.

Perceived neighborhood environments and leisure-time walking among korean adults: an application of the theory of planned behavior

OBJECTIVE

To examine personal, social, and perceived environmental factors related to leisure-time walking behavior among Korean adults using the framework of the Theory of Planned Behavior (TPB).

BACKGROUND

Sedentary lifestyle and physical inactivity contribute to rising obesity rates and chronic diseases among Korean adults. Understanding correlates of walking is necessary to develop effective interventions to promote regular walking.

METHODS

A cross-sectional survey was conducted in 2008 among 424 Korean adults. Participants completed a questionnaire on perceived neighborhood environment, the TPB constructs, and leisure-time walking behavior.

RESULTS

Those who participated in leisure-time walking had more positive perceptions of aesthetics and expressed greater perceived behavioral control (PBC) and intention of walking than nonwalkers. Also, walking correlated with intention and PBC, and perceived crime safety. Intentions were moderately to strongly associated with attitude, PBC, and subjective norm. Integrating TPB constructs and the perceived environment variable (crime safety) resulted in a moderate fit of the data [χ(2)= 2.372, df = 5; p = 0.796; NFI = 0.99; RMSEA = 0.00] with approximately 45.6% variance of intention and 19.4% of the response variance of walking explained. The model showed that perceived safety from crime was not directly related to leisure-time walking, but indirectly predicted walking through the TPB model.

CONCLUSIONS

Perceived safety was identified as an important environmental variable among Korean adults, and the TPB offered a good prediction of walking behavior. Identifying individual, social, and neighborhood environmental correlates of walking can help develop policies to promote public health for a more active and healthier community.

Natural Environments and Childhood Experiences Promoting Physical Activity, Examining the Mediational Effects of Feelings about Nature and Social Networks

The importance of natural environments (NEs) for physical activity (PA) has been studied extensively. However, there is scant evidence to explain the motivational processes underlying the NE-PA relation. The aim of this study was to investigate the NE-PA relation using an ecological framework, focusing on perception of NEs, childhood experiences and possible intra- and inter-individual mediators. Data were retrieved from a cross-sectional survey among 2168 adults from all over Norway. In addition, the coverage of NEs by municipalities was retrieved from national registers. Logistic regression showed that, unlike the self-reported proximity to NEs, higher ratings of perceived supportiveness of NEs for PA predicted participation in NE-based PA for at least 60 min/week or 150 min/week, before and after controlling for socio-demographic characteristics. Reporting frequent experiences in nature during childhood was also an important predictor of higher levels of NE-based PA. Furthermore, a mediational analysis showed that the effect of both predictors was mediated by "feelings about nature" and "social networks". These findings indicate that to encourage the use of local NE for PA, not only should environmental perceptions be taken into account, positive feelings towards nature alongside opportunities to share activity in nature with others should also be promoted.

To walk or not to walk: insights from a qualitative description study with women suffering from fibromyalgia

Walking improves health outcomes in fibromyalgia; however, there is low adherence to this practice. The aim of this research was to explore the beliefs of women suffering from fibromyalgia toward walking, and the meaning that they attribute to the behavior of walking as part of their fibromyalgia treatment. This study is a qualitative description research. Forty-six (46) women suffering from fibromyalgia and associated with local fibromyalgia associations located in four different Spanish cities (Elche, Alicante, Madrid, and Talavera de la Reina) participated in focus group discussions in the summer 2012. Thematic content analysis was performed in transcribed verbatim from interviews. Participants perceived several inhibitors for walking even when they had positive beliefs toward its therapeutic value. Whereas participants believed that walking can generate improvement in their disease and their health in general, they did not feel able to actually do so given their many physical impediments. Furthermore, participants struggled with social isolation and stigma, which was lessened through the conscious support of family. Advice from family doctors was also a very important facilitator to participants. In a health care delivery context that favors person-centered care, and in order to foster adherence to walking-based fibromyalgia treatments, it is recommended that therapeutic walking programs be tailored to each woman' individual circumstances, and developed in close collaboration with them to help them increase control over their health and their condition.

Interactions of individual perceived barriers and neighbourhood destinations with obesity-related behaviours in Europe

Perceived barriers towards physical activity and healthy eating as well as local availability of opportunities (destinations in the neighbourhood) are important determinants of obesity-related behaviours in adults. Little is known, however, about how these factors interact with the behaviours. Data were analysed from 5,205 participants of the SPOTLIGHT survey, conducted in 60 neighbourhoods in urban regions of five different countries across Europe. A virtual audit was conducted to collect data on the presence of destinations in each neighbourhood. Direct associations of, and interactions between, the number of individual perceived barriers and presence of destinations with obesity-related behaviours (physical activity and dietary behaviours) were analysed using multilevel regression analyses, adjusted for key covariates. Perceiving more individual barriers towards physical activity and healthy eating was associated with lower odds of physical activity and healthy eating. The presence of destinations such as bicycle lanes, parks and supermarkets was associated with higher levels of physical activity and healthier dietary behaviours. Analyses of additive interaction terms suggested that the interaction of destinations and barriers was competitive, such that the presence of destinations influenced obesity-related behaviours most among those perceiving more barriers. These explorative findings emphasize the interest and importance of combining objective (e.g. virtual neighbourhood audit) methods and subjective (e.g. individual perceived barriers collected in a survey) to better understand how the characteristics of the residential built environment can shape obesity-related behaviours depending on individual characteristics.

Neighbourhood environment and physical activity in older adults

RATIONALE

The neighbourhood socio-physical environment has effects on health in later life including health behaviours, chronic illnesses, mental health and mortality. Few studies have examined the relationship of both physical environmental features and social aspects of neighbourhood with older adults' physical activity.

OBJECTIVE

This study examined the relationship of neighbourhood physical and social environment with physical activity among older adults.

METHODS

A cross-sectional telephone survey was conducted with 434 older adults in eight neighbourhoods in greater Vancouver, Canada and Portland, United States. Data included participants' perceptions of their neighbourhood built and social environment factors and levels of physical activity. A logistic regression analysis was conducted to understand the relationship between these factors.

RESULTS

Participants engaged in physical activity most frequently at home (87.1%) or in close proximity of home (76.5%). Neighbourhood walkability, presence of amenities and accessibility were not significantly associated with meeting physical activity requirements. Participation in a recreational program with friends was associated with increased likelihood of physical activity.

CONCLUSION

The home and its immediate physical environmental context has potentially important relevance in supporting physical activity in older adults. Also, neighbourhood social aspects have a positive influence on activity levels.

THE POTENTIAL OF USING EXERCISE IN NATURE AS AN INTERVENTION TO ENHANCE EXERCISE BEHAVIOR: RESULTS FROM A PILOT STUDY

According to attention-restoration theory (ART), natural environments can provide restorative experiences. In this pilot study, a mixed-methods approach was used to examine the potential of using exercise in a natural environment to enhance exercise behaviors. The study included an assessment study and an intervention study (overall n = 19). The participants underwent a standardized exercise program including biking and circuit strength training, either indoors or outdoors in nature. Measurements included connectedness to nature, perceived exertion, perceived environmental restorativeness, enjoyment, affect, future exercise intention, and self-reported exercise behavior. The participants also wrote a brief text describing the way in which the environment influenced their feelings while exercising. Quantitative data were analyzed using the Spearman rank correlation and linear mixed-effects modeling. The qualitative information was analyzed thematically. The integrated results indicated that, in accordance with ART, exercising in nature was associated with a greater potential for restoration and affective responses, which in some participants led to enhanced intention to exercise and increased exercise behavior. However, some perceived that the indoor exercise provided a more effective workout. Further studies on larger samples are needed.

Social-ecological correlates of physical activity in kidney cancer survivors

PURPOSE

Previous studies in cancer survivors have examined behavioral correlates of physical activity (PA), but no study to date has adopted a broader social-ecological framework in understanding PA. This study examined the associations among demographic, medical, social-cognitive, and environmental correlates of meeting PA guidelines among kidney cancer survivors (KCS).

METHODS

All 1985 KCS diagnosed between 1996 and 2010 identified through a Canadian provincial registry were mailed a survey that consisted of medical, demographic, and social-cognitive measures, as well as PA as measured by the Godin Leisure Time Exercise Questionnaire. Environmental constructs were also assessed for both self-report and objective measures using geographic information systems (GIS). A series of binary logistic regression analyses were conducted in this cross-sectional study.

RESULTS

Completed surveys with geographical information were received from 432 KCS with M age = 64.4 ± 11.1 years, 63.2 % male, and 82.2 % having localized kidney cancer. In the final multivariate model, meeting PA guidelines was associated with disease stage (OR = 0.25, p = .005), having drug therapy (OR = 3.98, p = .009), higher levels of instrumental attitudes (OR = 1.66, p = .053), higher levels of intention (OR = 1.72, p = .002), and the perceived presence of many retail shops in the neighborhood (OR = 1.37, p = .032).

CONCLUSIONS

Meeting PA guidelines in KCS were associated with various aspects of the social-ecological model.

IMPLICATIONS FOR CANCER SURVIVORS

Understanding the social-ecological correlates for PA can provide insight into future interventions designed to increase PA in KCS. Prime targets for PA promotion should consider treatment-related factors, promote the benefits of PA, and enhance positive perceptions of the built environment.

Interactions between psychological and environmental characteristics and their impacts on walking

Due to walking's benefits to physical and mental health as well as to environmental and economic sustainability, numerous studies have examined psychological and environmental characteristics on their impacts on walking. However, understanding of how the interactions between psychological and environmental characteristics influence walking remains limited. Recently, both competitive mechanism and synergetic mechanism have been proposed, and a number of empirical studies have examined the interactions between psychological and environmental characteristics, but the results were inconsistent. We reviewed 11 recent studies and discussed their difference in terms of studies population, outcomes, environmental characteristics, and psychological characteristics. We propose a framework that integrate both mechanisms and provides an explanation to the inconsistency. More important, the framework may stimulate further empirical researches and provide implications for policy intervention to promote walking.

Models accounting for intention-behavior discordance in the physical activity domain: a user's guide, content overview, and review of current evidence

There is a growing concern among researchers with the limited effectiveness and yet subsequent stagnation of theories applied to physical activity (PA). One of the most highlighted areas of concern is the established gap between intention and PA, yet the considerable use of models that assume intention is the proximal antecedent of PA. The objective of this review was to: 1) provide a guide and thematic analysis of the available models that include constructs that address intention-behavior discordance and 2) highlight the evidence for these structures in the PA domain. A literature search was conducted among 13 major databases to locate relevant models and PA studies published before August 2014. Sixteen models were identified and nine overall themes for post-intentional constructs were created. Of the 16 models, eight were applied to 36 PA studies. Early evidence supported maintenance self-efficacy, behavioral regulation strategies, affective judgments, perceived control/opportunity, habit, and extraversion as reliable predictors of post-intention PA. Several intention-behavior discordance models exist within the literature, but are not used frequently. Further efforts are needed to test these models, preferably with experimental designs.

The impact of the natural environment on the promotion of active living: an integrative systematic review

Background

An understanding of how the living environment influences physical activity (PA) is of great importance for health promotion. Researchers have reported increased PA when there is a greater availability of nature within people’s living environment. However, little has been said about underlying motivational processes. The aim of this study was to review the existing literature on the relationship between the natural environment (NE) and PA, integrating it into a conceptual model that depicts the motivational process underlying this relationship.

Methods

Through a systematic literature search in line with PRISMA guidelines, peer-reviewed articles were sought using PubMed (search updated to October 2013) and scrutiny of reference lists. In addition, we contacted experts within our network. We reviewed papers in which the research question(s) concerned: 1) Effects of PA in NE on individuals’ feelings and beliefs; 2) Relationships between PA and availability of NEs; and 3) Motivational processes underlying visits to NEs in association with PA. Analysis and integration of the 90 selected studies were performed using the theory of planned behaviour (TPB).

Results

People’s experiences in using the NE can enhance attitudes toward PA and perceived behavioural control via positive psychological states and stress-relieving effects, which lead to firmer intentions to engage in PA. Individual and environmental barriers, as expressions of social support and actual behavioural control, impact the process via subjective norm and perceived behavioural control. Instrumental beliefs such as a desire to enjoy nature and the expected health benefits also influence the process via attitudes. Different patterns have been identified for neighbourhood-based PA and outdoor recreations that take place in a NE.

Conclusions

The availability of a NE and attractive views of nature within an individual’s living environment are important contributors to PA, yet attention should focus on personal characteristics and environmental barriers. Policy and infrastructural interventions should aim to guarantee access and maintenance of the NE, as well as information and programming of social activities. Social campaigns via media and health institutions should highlight how nature can be a source of motivation for maintaining a PA routine, reducing stress and achieving aesthetic and health goals.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-873) contains supplementary material, which is available to authorized users.

The associations between objectively-determined and self-reported urban form characteristics and neighborhood-based walking in adults

Background

Self-reported and objectively-determined neighborhood built characteristics are associated with physical activity, yet little is known about their combined influence on walking. This study: 1) compared self-reported measures of the neighborhood built environment between objectively-determined low, medium, and high walkable neighborhoods; 2) estimated the relative associations between self-reported and objectively-determined neighborhood characteristics and walking and; 3) examined the extent to which the objectively-determined built environment moderates the association between self-reported measures of the neighborhood built environment and walking.

Methods

A random cross-section of 1875 Canadian adults completed a telephone-interview and postal questionnaire capturing neighborhood walkability, neighborhood-based walking, socio-demographic characteristics, walking attitudes, and residential self-selection. Walkability of each respondent’s neighborhood was objectively-determined (low [LW], medium [MW], and high walkable [HW]). Covariate-adjusted regression models estimated the associations between weekly participation and duration in transportation and recreational walking and self-reported and objectively-determined walkability.

Results

Compared with objectively-determined LW neighborhoods, respondents in HW neighborhoods positively perceived access to services, street connectivity, pedestrian infrastructure, and utilitarian and recreation destination mix, but negatively perceived motor vehicle traffic and crime related safety. Compared with residents of objectively-determined LW neighborhoods, residents of HW neighborhoods were more likely (p < .05) to participate in (odds ratio [OR] = 3.06), and spend more time, per week (193 min/wk) transportation walking. Perceived access to services, street connectivity, motor vehicle safety, and mix of recreational destinations were also significantly associated with transportation walking. With regard to interactions, HW x utilitarian destination mix was positively associated with participation, HW x physical barriers and MW x pedestrian infrastructure were positively associated with minutes, and HW x safety from crime was negatively associated with minutes, of transportation walking. Neither neighborhood type nor its interactions with perceived measures of walkability were associated with recreational walking, although perceived aesthetics was associated with participation (OR = 1.18, p < .05).

Conclusions

Objectively-determined and self-reported built characteristics are associated with neighborhood-based transportation walking. The objectively-determined built environment might moderate associations between perceptions of walkability and neighborhood-based transportation walking. Interventions that target perceptions in addition to modifications to the neighborhood built environment could result in increases in physical activity among adults.

Psychological theory in an interdisciplinary context: psychological, demographic, health-related, social, and environmental correlates of physical activity in a representative cohort of community-dwelling older adults

BACKGROUND

Physical activity (PA) in older adults is influenced by a range of environmental, demographic, health-related, social, and psychological variables. Social cognitive psychological models assume that all influences on behaviour operate indirectly through the models constructs, i.e., via intention and self-efficacy. We evaluated direct, indirect, and moderating relationships of a broad range of external variables with physical activity levels alongside intention and self-efficacy.

METHODS

We performed a cross-sectional survey of a representative and stratified (65-80 and 80+ years; deprived and affluent) sample of 584 community-dwelling people, resident in Scotland. Objectively measured physical activity and questionnaire data were collected.

RESULTS

Self-efficacy showed unique relationships with physical activity, controlling for demographic, mental health, social, environmental, and weather variables separately, but the relationship was not significant when controlling for physical health. Overall, results indicating support for a mediation hypothesis, intention and self-efficacy statistically mediate the relationship of most domain variables with physical activity. Moderation analyses show that the relationship between social cognitions and physical activity was stronger for individuals with better physical health and lower levels of socio-economic deprivation.

CONCLUSIONS

Social cognitive variables reflect a range of known environmental, demographic, health-related and social correlates of physical activity, they mediate the relationships of those correlates with physical activity and account for additional variance in physical activity when external correlates are controlled for, except for the physical health domain. The finding that the social cognition-physical activity relationship is higher for participants with better health and higher levels of affluence raises issues for the applicability of social cognitive models to the most disadvantaged older people.

Why some walk and others don't: exploring interactions of perceived safety and social neighborhood factors with psychosocial cognitions

Although physical activity is often believed to be influenced by both environmental and individual factors, little is known about their interaction. This study explores interactions of perceived safety and social neighborhood factors with psychosocial cognitions for leisure-time walking. Cross-sectional data were obtained from residents (age 25-75 years) of 212 neighborhoods in the South-East of the Netherlands, who participated in the Dutch GLOBE study in 2004 (N = 4395, survey response 64.4%). Direct associations of, and interactions between perceived neighborhood safety, social neighborhood factors (social cohesion, social network and feeling at home) and psychosocial cognitions (attitude, self-efficacy, social influence and intention) on two outcomes of leisure-time walking [yes versus no (binary), and among walkers: minutes per week (continuous)] were analyzed in multilevel regression models. The association between attitude and participating in leisure-time walking was stronger in those who felt less at home in their neighborhood. Social influence and attitude were stronger associated with participation in leisure-time walking in those who sometimes felt unsafe in their neighborhood. A positive intention was associated with more minutes walked in those who perceived their neighborhood as unsafe among those who walked. Only limited support was found for interactions between neighborhood perceptions and psychosocial cognitions for leisure-time walking.

Talking the talk, walking the walk: examining the effect of neighbourhood walkability and social connectedness on physical activity

BACKGROUND

Few studies have considered the joint effects of social and physical environments on physical activity (PA). The primary purpose of this study was to examine the compounding effects of neighbourhood walkability and social connectedness on PA.

METHODS

Data were collected from adults (n = 380) in Waterloo, Ontario, Canada. Perceptions of neighbourhood social connectedness and walkability were measured via survey. Minutes of neighbourhood PA for recreation and transportation were captured with a detailed 7-day log booklet. Four groups were created (e.g. high walkability/low social connectedness) and two factorial ANOVAs examined group differences in minutes of recreational and transport-related PA.

RESULTS

There were significant differences across the four walkability/social connectedness groups for both recreational (F = 11.36, P < 0.01) and transport-related PA (F = 8.12, P < 0.01). Participants perceiving both high walkability and social connectedness displayed the greatest levels of both recreational (130.6 min) and transport-related PA (24.5 min). The high walkability/low social connectedness group had greater transport-related PA than the two low walkability groups, while the high social connectedness/low walkability group had greater recreational PA than the two low social connectedness groups.

CONCLUSIONS

These findings underscore the relationship between physical and social dimensions of urban form and their association with health behaviours. PA promotion efforts should take into account both physical (e.g. land-use planning) and social (e.g. walking group) environments.

Interactions between psychosocial and built environment factors in explaining older adults' physical activity

OBJECTIVE

To evaluate ecological model predictions of cross-level interactions among psychosocial and environmental correlates of physical activity in 719 community-dwelling older adults in the Baltimore, Maryland and Seattle, Washington areas during 2005-2008.

METHOD

Walkability, access to parks and recreation facilities and moderate-to-vigorous physical activity (MVPA) minutes per week (min/week) were measured objectively. Neighborhood aesthetics, walking facilities, social support, self-efficacy, barriers and transportation and leisure walking min/week were self-reported.

RESULTS

Walkability interacted with social support in explaining total MVPA (B=13.71) and with social support (B=7.90), self-efficacy (B=7.66) and barriers (B=-8.26) in explaining walking for transportation. Aesthetics interacted with barriers in explaining total MVPA (B=-12.20) and walking facilities interacted with self-efficacy in explaining walking for leisure (B=-10.88; Ps<.05). Summarizing across the interactions, living in a supportive environment (vs. unsupportive) was related to 30-59 more min/week of physical activity for participants with more positive psychosocial attributes, but only 0-28 more min/week for participants with less positive psychosocial attributes.

CONCLUSION

Results supported synergistic interactions between built environment and psychosocial factors in explaining physical activity among older adults. Findings suggest multilevel interventions may be most effective in increasing physical activity.

Do individual cognitions mediate the association of socio-cultural and physical environmental factors with adolescent sports participation?

OBJECTIVE

To examine the associations of perceived physical environmental factors (availability of physical activity (PA) attributes at home, PA facilities in the neighbourhood, neighbourhood pleasantness and safety) and social environmental factors (parental sports behaviour and parental rule regarding sports participation) with adolescent leisure-time sports participation, and to explore whether the associations found were mediated by individual cognitions as derived from the theory of planned behaviour (TPB).

DESIGN

Cross-sectional study.

SETTING

In school-year 2005/2006 adolescents from seventeen schools in Rotterdam, the Netherlands, completed a questionnaire during school hours that included self-reported measures of leisure-time sports participation, perceived physical environmental factors and TPB variables. Information about parental sports behaviour and parental rule was obtained from a questionnaire that was completed by one parent of the adolescents.

SUBJECTS

Data were collected from 584 adolescent-parent combinations.

RESULTS

Data were analysed with multi-level logistic regression analyses. Availability of PA attributes at home (OR = 1·26), parents' sports behaviour (OR = 2·03) and parental rule (OR = 1·64) were associated with a higher likelihood of adolescents' leisure-time sports participation. These associations were partly mediated by attitude and intention.

CONCLUSIONS

Adolescents were more likely to engage in leisure-time sports when PA attributes were available at home, when parents participated in sports activities and had a rule about their offspring participation in sports activities. These associations were partly mediated by attitude and intention. These results suggest that parents can importantly promote sports participation among their offspring by making sports activities accessible and a family routine.

Towards an Understanding of Change in Physical Activity from Pregnancy Through Postpartum

OBJECTIVE: The purpose of this paper was to describe the rationale, data collection, and proposed analyses for examination of mediators of change in physical activity from pregnancy to postpartum among a cohort of pregnant women. METHOD: The Pregnancy Infection and Nutrition 3 (PIN3) Study enrolled 2006 pregnant women into the cohort from 2001 to 2005. All women lived in central North Carolina upon enrollment. Physical activity was assessed using a self-reported one week recall, measured twice during pregnancy and once each at 3- and 12-months postpartum. On a subset of women, one-week accelerometer measures were also collected during the two postpartum time periods. Potential mediators (intrapersonal, interpersonal, community) were collected during pregnancy and postpartum through interviews and take home questionnaires. RESULTS: To assess mediation of physical activity among our cohort, we will first describe change in physical activity and the mediators, as well as their associations, through pregnancy into the postpartum period. Following this, the product of coefficients approach will be applied to examine whether each measure had indirect effects on change in physical activity. Each individual level mediator will be examined one at a time and across the time points in which it was available. The Sobel standard error approximation formula will be used to test for significance of the mediation effect. CONCLUSIONS: This study will provide evidence to develop appropriate interventions targeted at physical activity and will help focus efforts on the appropriate time periods between pregnancy and postpartum.

Environmental, psychological, and social influences on physical activity among Japanese adults: structural equation modeling analysis

Background

An understanding of the contributing factors to be considered when examining how individuals engage in physical activity is important for promoting population-based physical activity. The environment influences long-term effects on population-based health behaviors. Personal variables, such as self-efficacy and social support, can act as mediators of the predictive relationship between the environment and physical activity. The present study examines the direct and indirect effects of environmental, psychological, and social factors on walking, moderate-intensity activity excluding walking, and vigorous-intensity activity among Japanese adults.

Methods

The participants included 1,928 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e.g., gender, age, education level, employment status), psychological variables (self-efficacy, pros, and cons), social variables (social support), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising), and the International Physical Activity Questionnaire were assessed via an Internet-based survey. Structural equation modeling was conducted to determine associations between environmental, psychological, and social factors with physical activity.

Results

Environmental factors could be seen to have indirect effects on physical activity through their influence on psychological and social variables such as self-efficacy, pros and cons, and social support. The strongest indirect effects could be observed by examining the consequences of environmental factors on physical activity through cons to self-efficacy. The total effects of environmental factors on physical activity were 0.02 on walking, 0.02 on moderate-intensity activity excluding walking, and 0.05 on vigorous-intensity activity.

Conclusions

The present study indicates that environmental factors had indirect effects on walking, moderate-intensity activity excluding walking and vigorous-intensity activity among Japanese adults, especially through the effects on these factors of self-efficacy, social support, and pros and cons. The findings of the present study imply that intervention strategies to promote more engagement in physical activity for population-based health promotion may be necessary.

An intervention to promote walking amongst the general population based on an 'extended' theory of planned behaviour: a waiting list randomised controlled trial

Theory of planned behaviour (TPB) studies have identified perceived behavioural control (PBC) as the key determinant of walking intentions. The present study investigated whether an intervention designed to alter PBC and create walking plans increased TPB measures concerning walking more, planning and objectively measured walking. One hundred and thirty UK adults participated in a waiting-list randomised controlled trial. The intervention consisted of strategies to boost PBC, plus volitional strategies to enact walking intentions. All TPB constructs were measured, along with self-reported measures of action planning and walking, and an objective pedometer measure of time spent walking. The intervention increased PBC, attitudes, intentions and objectively measured walking from 20 to 32 min a day. The effects of the intervention on intentions and behaviour were mediated by PBC, although the effects on PBC were not mediated by control beliefs. At 6 weeks follow-up, participants maintained their increases in walking. The findings of this study partially support the proposed causal nature of the extended TPB as a framework for developing and evaluating health behaviour change interventions. This is the first study using the TPB to develop, design and evaluate the components of an intervention which increased objectively measured behaviour, with effects mediated by TPB variables.

Effects of the built environment on physical activity of adults living in rural settings

OBJECTIVE

To conduct a systematic review of the literature to examine the influence of the built environment (BE) on the physical activity (PA) of adults in rural settings.

DATA SOURCE

Key word searches of Academic Search Premier, PubMed, CINAHL, Web of Science, and Sport Discus were conducted.

STUDY INCLUSION AND EXCLUSION CRITERIA

Studies published prior to June 2008 were included if they assessed one or more elements of the BE, examined relationships between the BE and PA, and focused on rural locales. Studies only reporting descriptive statistics or assessing the reliability of measures were excluded.

DATA EXTRACTION

Objective(s), sample size, sampling technique, geographic location, and definition of rural were extracted from each study. Methods of assessment and outcomes were extracted from the quantitative literature, and overarching themes were identified from the qualitative literature.

DATA SYNTHESIS

Key characteristics and findings from the data are summarized in Tables 1 through 3.

RESULTS

Twenty studies met inclusion and exclusion criteria. Positive associations were found among pleasant aesthetics, trails, safety/crime, parks, and walkable destinations.

CONCLUSIONS

Research in this area is limited. Associations among elements of the BE and PA among adults appear to differ between rural and urban areas. Considerations for future studies include identifying parameters used to define rural, longitudinal research, and more diverse geographic sampling. Development and refinement of BE assessment tools specific to rural locations are also warranted.

Psychosocial correlates of leisure-time walking among Australian adults of lower and higher socio-economic status

Adults of lower socio-economic status (SES) participate less in physical activity than those of higher SES. Understanding the correlates of physical activity participation and how these may differ between socio-economic groups can inform policies and physical activity promotion strategies. The psychosocial correlates of leisure-time walking (the most common voluntary physical activity of adults) were assessed using a survey of 2488 randomly sampled Australian adults (response rate = 74.2%). Among respondents of higher SES, there were higher levels of positive cognitions towards physical activity, and walking for leisure was more prevalent than among those of lower SES. Relationships of psychosocial attributes with leisure-time walking differed by SES. The strongest correlate of leisure-time walking was perceived barriers for lower SES adults and enjoyment for those of higher SES. Social support from friends was associated with walking for both groups, while the effect of support from family was significant only for adults of lower SES. Strategies influencing leisure-time walking may have to target the specific needs of different socio-economic groups. For example, removing perceived barriers may be more appropriate to promote walking among lower SES adults. Interventions tailored for lower SES groups may help close the socio-economic gap in physical activity participation.