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Reid Ewing, Susan Handy, Ross C. Brownson, Otto Clemente and Emily Winston

Background:

In active living research, measures used to characterize the built environment have been mostly gross qualities such as neighborhood density and park access. This project has developed operational definitions and measurement protocols for subtler urban design qualities believed to be related to walkability.

Methods:

Methods included: 1) recruiting an expert panel; 2) shooting video clips of streetscapes; 3) rating urban design qualities of streetscapes by the expert panel; 4) measuring physical features of streetscapes from the video clips; 5) testing inter-rater reliability of physical measurements and urban design quality ratings; 6) statistically analyzing relationships between physical features and urban design quality ratings, 7) selecting of qualities for operationalization, and 8) developing of operational definitions and measurement protocols for urban design qualities based on statistical relationships.

Results:

Operational definitions and measurement protocols were developed for five of nine urban design qualities: imageability, visual enclosure, human scale, transparency, and complexity.

Conclusions:

A field survey instrument has been developed, tested in the field, and further refined for use in active living research.

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Susan A. Carlson, Roxanna Guide, Thomas L. Schmid, Latetia V. Moore, Danielle T. Barradas and Janet E. Fulton

Background:

Street-scale urban design policies are recommended to increase physical activity in communities. Our purpose was to examine U.S. public support for local street-scale urban design features and policies.

Methods:

Analysis is based on a cross-sectional national sample of adults (n = 4682) participating in the 2006 HealthStyles mail survey.

Results:

About 57% of adults rated local street-scale urban design as highly important in determining the amount of physical activity they obtain. Adjusted odds of rating neighborhood features as having high importance were higher in people aged ≥65 years versus those <65 and minority racial/ethnic groups versus non-Hispanic whites. Two-thirds of adults were willing to take civic action to support local street-scale urban design policy. Adjusted odds of being willing to take any action versus none was higher in non-Hispanic blacks and Hispanics versus non-Hispanic whites, was higher in those with household incomes ≥$60,000 versus ≤$15,000 per year, and increased as education and perceived importance of neighborhood features increased.

Conclusions:

There are high levels of public support for local street-scale urban design policies; however, demographic differences exist in the level of support. These differences are important considerations for policymakers and for those designing community programs targeting street-scale urban design features and policies.

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Gregory W. Heath, Ross C. Brownson, Judy Kruger, Rebecca Miles, Kenneth E. Powell, Leigh T. Ramsey and the Task Force on Community Preventive Services

Background:

Although a number of environmental and policy interventions to promote physical activity are being widely used, there is sparse systematic information on the most effective approaches to guide population-wide interventions.

Methods:

We reviewed studies that addressed the following environmental and policy strategies to promote physical activity: community-scale urban design and land use policies and practices to increase physical activity; street-scale urban design and land use policies to increase physical activity; and transportation and travel policies and practices. These systematic reviews were based on the methods of the independent Task Force on Community Preventive Services. Exposure variables were classified according to the types of infrastructures/policies present in each study. Measures of physical activity behavior were used to assess effectiveness.

Results:

Two interventions were effective in promoting physical activity (community-scale and street-scale urban design and land use policies and practices). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess transportation policy and practices to promote physical activity.

Conclusions:

Because community- and street-scale urban design and land-use policies and practices met the Community Guide criteria for being effective physical activity interventions, implementing these policies and practices at the community-level should be a priority of public health practitioners and community decision makers.

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Hannah M. Badland and Grant M. Schofield

Background:

Leisure time physical activities have been a priority in recent years for many health practitioners, with transport-related physical activity (TPA) largely ignored. The urban environment has altered in the last few decades, increasing the reliance on automobiles. Simultaneously we have seen increases in obesity and other non-communicable diseases related to sedentary lifestyles.

Methods:

Information was sourced from major health databases. The remainder of the literature was directed from citations in articles accessed from the initial search.

Results:

Clear health benefits result from regular TPA engagement, with opportunities closely linked to accessible urban design infrastructure. Much of the existing evidence, however, has been extracted from cross-sectional research, rather than interventions. As such, drawing causal relationships is not yet possible.

Conclusions:

Existing evidence necessitates TPA research and promotion should be public health and urban design priorities. Collaborative research needs to incorporate prospective study designs to understand TPA behavior.

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Kate Heelan, H. Jason Combs, Bryce M. Abbey, Paul Burger and Todd Bartee

Background:

The decline in active commuting to and from school in the United States is, in part, due to urban design standards and public policies that promote automobile travel and discourage pedestrian activity.

Purpose:

The current investigation examines active commuting at neighborhood schools and how it is altered by distance to school, student age and its potential impact on Body Mass Index.

Methods:

Demographic and transportation datasets were obtained for 5367 elementary students (K−5th grade) and middle school students (6th−8th grade) in 2 Midwestern communities.

Results:

4379 (81.6%) students were successfully geocoded and 21.9% actively commute to school at least half of the time meeting the Healthy People 2010 objective 22−14. Of those students who could potentially actively commute to school (0.5 mile for grades K−5 and 1 mile for grades 6−8) 36.6% are passive commuters. No significant negative associations were found between BMI z-score or BMI percentile with accumulation of activity through active commuting (frequency × distance) for elementary (r = −0.04, P = .27) or middle school students (r = .027, P = .56).

Conclusion:

Many elementary students living within 0.3−0.4 miles are being driven to school. Promoting pedestrian-friendly communities and making healthy and sustainable transportation choices should be priorities for community leaders and school administrators.

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Luis F. Gómez, Olga L. Sarmiento, Diego I. Lucumí, Gladys Espinosa, Roberto Forero and Adrian Bauman

Background:

Utilitarian physical activity confers health benefits, but little is known about experiences in developing countries. The objective was to examine the prevalence and factors associated with walking and bicycling for transport in adults from Bogotá.

Methods:

A cross-sectional study including 1464 adults age 18 to 29 y during the year 2002.

Results:

16.7% reported bicycling for at least 10 min during the last week and 71.7% reported walking for at least 90 min during the last week. Bicycling was more likely among adults living in Tunjuelito (flat terrain), who use the “ciclovía” (car-roads for recreational bicycling on holidays/Sundays) or reporting physical activity during leisure-time and less likely among women, or adults with college education. Walking was more likely among adults reporting physical activity during leisure time and less likely among housewives/househusbands or those living in Tunjuelito.

Conclusion:

Programs that promote walking or bicycling in Bogotá should consider differences in individual and environmental factors.

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Deborah A. Cohen, Scott Ashwood, Molly Scott, Adrian Overton, Kelly R. Evenson, Carolyn C. Voorhees, Ariane Bedimo-Rung and Thomas L. McKenzie

Background:

Proximity to routine destinations is an important correlate of physical activity. We examined the association between distance from school and physical activity in adolescent girls.

Methods:

We mapped the addresses of 1554 sixth-grade girls who participated in the Trial of Activity for Adolescent Girls (TAAG) Study and calculated the shortest distance from home to school along the street network. Using a hierarchical design we examined the association between MET-weighted moderate to vigorous physical activity (MW- MVPA) and distance to school, while controlling for potential confounders.

Results:

Distance to school was inversely associated with weekday MW- MVPA for middle school girls. For every mile the girls lived from their schools, they engaged in an average of 13 fewer MET-weighted minutes per week.

Conclusions:

Distance to school is inversely associated with MW-MVPA. The most adversely affected girls lived more than 5 miles from school. Time spent commuting could explain reduced time for physical activity.

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Gavin R. McCormack, Christine M. Friedenreich, Billie Giles-Corti, Patricia K. Doyle-Baker and Alan Shiell

Background:

The built and social environments may contribute to physical activity motivations and behavior. We examined the extent to which the Theory of Planned Behavior (TPB) mediated the association between neighborhood walkability and walking.

Methods:

Two random cross-sectional samples (n = 4422 adults) completed telephone interviews capturing walking-related TPB variables (perceived behavioral control (PBC), attitudes, subjective norm, intention). Of those, 2006 completed a self-administered questionnaire capturing walkability, social support (friends, family, dog ownership), and neighborhood-based transportation (NTW) and recreational walking (NRW). The likelihood of undertaking 1) any vs. none and 2) sufficient vs. insufficient levels (≥150 vs. <150 minutes/week) of NTW and NWR, in relation to walkability, social support, and TPB was estimated.

Results:

Any and sufficient NTW were associated with access to services, connectivity, residential density, not owning a dog (any NTW only), and friend and family support. Any and sufficient NRW were associated with neighborhood aesthetics (any NRW only), dog ownership, and friend and family support. PBC partially mediated the association between access to services and NTW (any and sufficient), while experiential attitudes partially mediated the association between neighborhood aesthetics and any NRW.

Conclusions:

Interventions that increase positive perceptions of the built environment may motivate adults to undertake more walking.

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Yung Liao, Takemi Sugiyama, Ai Shibata, Kaori Ishii, Shigeru Inoue, Mohammad Javad Koohsari, Neville Owen and Koichiro Oka

Background:

This study examined associations of perceived and objectively measured neighborhood environmental attributes with leisure-time sitting for transport among middle-to-older aged Japanese adults.

Method:

Data were collected using a postal survey of 998 adults aged 40 to 69 years. Generalized linear modeling with a gamma distribution and a log link was used to examine associations of perceived (International Physical Activity Questionnaire-Environmental module) and Geographic Information Systems (GIS)-derived built environment attributes with self-reported leisure-time sitting for transport.

Results:

Mean leisure-time sitting time for transport was 20.4 min/day. After adjusting for potential confounders, perceived higher residential density, GIS-measured higher population density, better access to destinations, better access to public transport, longer sidewalk length, and higher street connectivity, were associated significantly with lower sitting time for transport.

Conclusion:

Residents living in neighborhoods with attributes previously found to be associated with more walking tended to spend less time sitting for transport during leisure-time. The health benefits of walkability-related attributes may accrue not only through increased physical activity, but also through less sedentary time.

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Kelly R. Evenson, Semra A. Aytur, Sara B. Satinsky, Zachary Y. Kerr and Daniel A. Rodríguez

Background:

We surveyed North Carolina (NC) municipalities to document the presence of municipal walking- and bicycling-related projects, programs, and policies; to describe whether prevalence of these elements differed if recommended in a plan; and to characterize differences between urban and rural municipalities.

Methods:

We surveyed all municipalities with ≥ 5000 persons (n = 121) and sampled municipalities with < 5000 persons (216/420), with a response rate of 54% (183/337). Responses were weighted to account for the sampling design.

Results:

From a list provided, staff reported on their municipality’s use of walking- and bicycling-related elements (8 infrastructure projects, 9 programs, and 14 policies). The most commonly reported were projects on sidewalks (53%), streetscape improvements (51%), bicycle/walking paths (40%); programs for cultural/recreational/health (25%), general promotional activities (24%), Safe Routes to School (24%), and law enforcement (24%); and policies on maintenance (64%), new facility construction (57%), and restricted automobile speed or access (45%). Nearly all projects, programs, or policies reported were more likely if included in a plan and more prevalent in urban than rural municipalities.

Conclusion:

These results provide cross-sectional support that plans facilitate the implementation of walking and bicycling elements, and that rural municipalities plan and implement these elements less often than urban municipalities.