Introduction to the Active Living Research Reference List 2007

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G. F. Dunton, C. K. Whalen, L. D. Jamner and J. N. Floro. (2007). Mapping the social and physical contexts of physical activity across adolescence using ecological momentary assessment. Annals of behavioral medicine.

BACKGROUND: Research has sought to understand how environmental factors influence adolescent physical activity, yet little is known about where and with whom adolescents are physically active. PURPOSE: This study used electronic ecological momentary assessment (e.EMA) to map the social and physical contexts of exercise and walking across adolescence. Differences in physical activity contexts by gender, grade in school, day of the week, and season were examined. METHODS: Twice a year between 9th and 12th grade, 502 adolescents (51% female) of mixed ethnicity (55% White) participated in 4-day e.EMA intervals (Thursday-Sunday) where their primary activity (e.g., exercise, TV, homework), social company (e.g., friends, family, class), and physical location (e.g., home, school, outdoors) were assessed every 30 (+/-10) min during waking hours. RESULTS: Overall, greater proportions of exercise and walking were reported with friends, outdoors, and at school. However, boys were more likely to report exercising and walking in outdoor locations than girls. Exercising with classmates, family, and at school decreased across high school. Walking with family, friends, and outdoors also decreased. On weekdays compared to weekends, students reported a greater proportion of their exercise and walking at school. Students were more likely to report exercising and walking outdoors in the fall and the spring than in the winter. CONCLUSION: e.EMA showed that the social and physical contexts of adolescent exercise and walking vary as a function of gender, grade in school, day of the week, and season. Understanding the contexts of physical activity during the high school years can be helpful in designing interventions during adolescence.

A. Ellaway, A. Kirk, S. Macintyre and N. Mutrie. (2007). Nowhere to play? The relationship between the location of outdoor play areas and deprivation in Glasgow. Health & Place.

Childhood obesity is rising and this rise has been linked to a decrease in physical activity. Access to appropriate facilities for physical activity is a key determinant of participation. This paper investigates the provision of outdoor play areas for children in relation to area deprivation in Glasgow, Scotland. Analysis of the distribution of outdoor play areas showed significantly higher mean number of play areas per 1000 child population in more deprived areas. However, despite the apparent advantage of deprived areas in terms of actual number of play areas, the quality of play areas in different types of areas may warrant further exploration. (c) 2006 Elsevier Ltd. All rights reserved.

H. E. Erwin, A. M. Woods, M. K. Woods and D. M. Castelli. (2007). Children's environmental access in relation to motor competence, physical activity, and fitness. Journal Of Teaching In Physical Education.

K. R. Evenson, M. M. Scott, D. A. Cohen and C. C. Voorhees. (2007). Girls' perception of neighborhood factors on physical activity, sedentary behavior, and BMI. Obesity (Silver Spring).

OBJECTIVE: The purpose of this study was to examine the association of perceived physical neighborhood factors with physical activity, sedentary behavior, and BMI among adolescent girls. RESEARCH METHODS AND PROCEDURES: Sixth grade girls (n = 1554) completed a questionnaire on neighborhood factors (e.g., safety, esthetics, access to physical activity resources). The dependent variables included non-school metabolic equivalent weighted moderate to vigorous physical activity (MW-MVPA) and non-school sedentary behavior, both measured using accelerometry, and BMI. RESULTS: The following neighborhood factors were associated with lower BMI: seeing walkers and bikers on neighborhood streets, not having a lot of crime in the neighborhood, seeing other children playing outdoors, having bicycle or walking trails in the neighborhood, and access to physical activity facilities. The absolute contribution for the average girl for each of these neighborhood factors was relatively small, with none of these factors exceeding 0.8 kg/m(2) BMI units. The following neighborhood factors were associated with higher MW-MVPA: having well-lit streets at night, having a lot of traffic in the neighborhood, having bicycle or walking trails in the neighborhood, and access to physical activity facilities. Girls with > or = 9 places to go for physical activity had 14.0% higher non-school MW-MVPA than girls with < or = 4 places. DISCUSSION: This study identified several neighborhood factors associated with non-school MW-MVPA and BMI, but none of the factors explored were associated with non-school sedentary behavior. Of all of the neighborhood factors we examined, reporting more physically active destinations contributed the largest absolute amount to the average girl's non-school MW-MVPA, according to this cross-sectional study.

A. A. Eyler, R. C. Brownson, M. P. Doescher, K. R. Evenson, C. E. Fesperman, J. S. Litt, D. Pluto, L. E. Steinman, J. L. Terpstra, P. J. Troped and T. L. Schmid. (2007). Policies related to active transport to and from school: a multisite case study. Health Education Research.

Active transportation to and from school (ATS) is a viable strategy to help increase physical activity among youth. ATS can be challenging because initiatives require transdisciplinary collaboration, are influenced by the built environment and are affected by numerous policies. The purpose of this study is to identify policies and factors that influence ATS initiatives. Nine elementary schools in seven states participated in this case study. Sixty-nine stakeholders were interviewed. The interviews were transcribed, coded and analyzed using a master thematic codebook. This study identified two distinct aspects of policies: 'influential factors' which are factors that might impact policies related to ATS and 'policy actions' which are policies reported by people involved in ATS initiatives that directly affected their success. Influential factors included sidewalks, crosswalks/crossing guards, funding, personal safety concerns, advocacy group involvement and others. Policy actions included policies on school speed zone, drop-off, no-transport zones, school siting, school start/dismissal time and school choice. Despite the diversity of the schools studied, similarities included influence of built environment, safety concerns, funding and transdisciplinary collaboration. Stakeholders need to work together to stimulate action and ensure successful initiatives. Influential factors appear to be important to this process.

M. D. Falb, D. Kanny, K. E. Powell and A. J. Giarrusso. (2007). Estimating the proportion of children who can walk to school. American Journal Of Preventive Medicine.

Background: Walking to school can be an important contributor to the daily physical activity of children. However, little is known about the percentage of children who could reasonably be expected to walk to school. The purpose of this study was to estimate the percentage of children in Georgia who live within a safe and reasonable walking distance from school and to identify demographic, school, and neighborhood connectivity characteristics associated with the potential to walk to school. Methods: Geographic information systems techniques were used to estimate the number of school-age children living 1 mile and 0.5 mile from public schools in Georgia. Potential walkers were estimated by dividing the number of children living in the specified distances from school in the 2000 U.S. Census by the number of children enrolled at the school in the 1999-2000 school year. Safety parameters were based on posted speed limits. Results: The percentage of potential walkers ranged from 1% to 51% depending on grade group and parameters of distance and safety. Using preferred parameters of distance and safety we estimated that 6% of elementary school students (K-5), 11% of middle school students (6 to 8), and 6% of high school students could walk to school. High population density, small enrollment size, and high street connectivity were associated with higher percentages of potential walkers. Conclusions: While few children could reasonably be expected to walk, this does not reduce the value of walking to school. Increasing the percentage of students who walk will require both educational efforts and changes to the built environment.

T. A. Farley, R. A. Meriwether, E. T. Baker, L. T. Watkins, C. C. Johnson and L. S. Webber. (2007). Safe play spaces to promote physical activity in inner-city children: results from a pilot study of an environmental intervention. American Journal of Public Health.

OBJECTIVES: We evaluated the effect of providing a safe play space on the physical activity level of inner-city schoolchildren. METHODS: In 1 of 2 matched neighborhoods, we opened a schoolyard and provided attendants to ensure children's safety. Over the next 2 years we directly observed the number of children and their physical activity levels in the school-yard, as well as in the surrounding intervention and comparison neighborhoods. We also surveyed children in the schools in the intervention and comparison neighborhoods regarding sedentary activities. RESULTS: After the schoolyard was opened, a mean of 71.4 children used it on weekdays and 25.8 used it on weekends during the school year. When observed, 66% of these children were physically active. The number of children who were outdoors and physically active was 84% higher in the intervention neighborhood than the comparison neighborhood. Survey results showed that children in the intervention school reported declines relative to the children in the comparison school in watching television, watching movies and DVDs, and playing video games on weekdays. CONCLUSION: When children were provided with a safe play space, we observed a relative increase in their physical activity. Provision of safe play spaces holds promise as a simple replicable intervention.

I. Ferreira, K. van der Horst, W. Wendel-Vos, S. Kremers, F. J. van Lenthe and J. Brug. (2007). Environmental correlates of physical activity in youth - a review and update. Obesity Reviews.

Obesogenic environments are thought to underlie the increased obesity prevalence observed in youth during the past decades. Understanding the environmental factors that are associated with physical activity (PA) in youth is needed to better inform the development of effective intervention strategies attempting to halt the obesity epidemic. We conducted a systematic semi-quantitative review of 150 studies on environmental correlates of youth PA published in the past 25 years. The ANalysis Grid for Environments Linked to Obesity (ANGELO) framework was used to classify the environmental correlates studied. Most studies retrieved used cross-sectional designs and subjective measures of environmental factors and PA. Variables of the home and school environments were especially associated with children's PA. Most consistent positive correlates of PA were father's PA, time spent outdoors and school PA-related policies (in children), and support from significant others, mother's education level, family income, and non-vocational school attendance (in adolescents). Low crime incidence (in adolescents) was characteristic of the neighbourhood environment associated with higher PA. Convincing evidence of an important role for many other environmental factors was, however, not found. Further research should aim at longitudinal and intervention studies, and use more objective measures of PA and its potential (environmental) determinants.

P. Ford, R. Bailey, D. Coleman, K. Woolf-May and I. Swaine. (2007). Activity levels, dietary energy intake, and body composition in children who walk to school. Pediatric Exercise Science.

Although differences in daily activity levels have been assessed in cross-sectional walk-to-school studies, no one has assessed differences in body composition and dietary energy intake at the same time. In this study of 239 primary school children, there were no significant differences in daily activity levels, body composition, or estimated dietary energy intake between those who walk to school (WALK) and those who travel by car (CAR; p <.05). WALK children were more active between 8 a.m. and 9 a.m. and 3 p.m. and 4 p.m. than CAR children (p <.05). In addition, there were no significant differences in the main analysis when participants were subgrouped by gender and age.

H. Forman, J. Kerr, G. J. Norman, B. E. Saelens, N. H. Durant, S. K. Harris and J. F. Sallis. (2007). Reliability and validity of destination-specific barriers to walking and cycling for youth. Preventive Medicine.

OBJECTIVE: To investigate the psychometric properties of a new measure of barriers youth encounter while walking to specific destinations and to validate the measure with self-reported walking to theSEestinations. METHODS: In 2005 in Boston, Cincinnati and San Diego, parents of youth (n = 289, aged 5-18) and adolescents (n = 189, aged 12-18) completed surveys in a two-week test-retest study design. Seventeen items assessed participant agreement with the influence of different barriers to walking or cycling to three types of destinations: 1) parks, 2) shops and restaurants and 3) school. Participants also reported whether or not they walked or cycled to the destinations at least once a week. RESULTS: Principal components analysis identified three barrier subscales labeled 'environmental', 'psychosocial/planning', and 'safety', which were consistent across the three destinations and two respondent groups. Internal consistency for the subscales was good (alphas >.70) and two-week test-retest reliability was moderately high (ICCs.56-.81) for both parents and adolescents for all destinations. Psychosocial and environmental barriers were higher in adolescents who did not walk (p <.003). Parents of younger children reported high environmental barriers. CONCLUSION: The three barrier subscales to active commuting to multiple destinations demonstrated good reliability and some initial evidence of validity.

A. Forsyth, J. M. Oakes, K. H. Schmitz and M. Hearst. (2007). Does residential density increase walking and other physical activity? Urban Studies.

Many agree that increasing physical activity will improve public health. This paper reports on empirical findings on the relationship between the density of the residential environment, walking and total physical activity. Using multiple objective and self-reported measures for 715 participants in the US, and improved techniques for sampling and analysis, it finds that density is associated with the purpose of walking (travel, leisure) but not the amount of overall walking or overall physical activity, although there are sub-group differences by race/ethnicity. Overall, higher densities have many benefits in terms of efficient use of infrastructure, housing affordability, energy efficiency and possibly vibrant street life. But higher densities alone, like other built environment features, do not appear to be the silver bullet in the public health campaign to increase physical activity.

L. D. Frank, B. E. Saelens, K. E. Powell and J. E. Chapman. (2007). Stepping towards causation: Do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity? Social Science & Medicine.

Evidence documents associations between neighborhood design and active and sedentary forms of travel. Most studies compare travel patterns for people located in different types of neighborhoods at one point in time adjusting for demographics. Most fail to account for either underlying neighborhood selection factors (reasons for choosing a neighborhood) or preferences (neighborhoods that are preferred) that impact neighborhood selection and behavior. Known as self-selection, this issue makes it difficult to evaluate causation among built form, behavior, and associated outcomes and to know how much more walking and less driving could occur through creating environments conducive to active transport. The current study controls for neighborhood selection and preference and isolates the effect of the built environment on walking, car use, and obesity. Separate analyses were conducted among 2056 persons in the Atlanta, USA based Strategies for Metropolitan Atlanta's Regional Transportation and Air Quality (SMARTRAQ) travel survey on selection factors and 1466 persons in the SMARTRAQ community preference sub-survey. A significant proportion of the population are "mismatched" and do not live in their preferred neighborhood type. Factors influencing neighborhood selection and individual preferences, and current neighborhood walkability explained vehicle travel distance after controlling for demographic variables. Individuals who preferred and lived in a walkable neighborhood walked most (33.9% walked) and drove 25.8 miles per day on average. Individuals that preferred and lived in car dependent neighborhoods drove the most (43 miles per day) and walked the least (3.3%). Individuals that do not prefer a walkable environment walked little and show no change in obesity prevalence regardless of where they live. About half as many participants were obese (11.7%) who prefer and live in walkable environments than participants who prefer car dependent environments (21.6%). Findings suggest that creating walkable environments may result in higher levels of physical activity and less driving and in slightly lower obesity prevalence for those preferring walkability. (C) 2007 Elsevier Ltd. All rights reserved.

L. Frank, J. Kerr, J. Chapman and J. Sallis. (2007). Urban form relationships with walk trip frequency and distance among youth. American Journal of Health Promotion.

PURPOSE: To assess the relationship among objectively measured urban form variables, age, and walking in youth. DESIGN: Cross-sectional analyses of travel diary data mapped against urban form characteristics within a 1-km buffer of participant's place of residence. Setting. Youth in the Atlanta, Georgia region with selection stratified by income, household size, and residential density. SUBJECTS: A total of 3161 5- to 20-year-olds who completed 2-day travel diaries. Diaries of those under 15 years were completed by a parent or legal guardian. MEASURES: Walking distances were calculated from a 2-day travel diary. Residential density, intersection density, land use mix, and commercial and recreation space were assessed within a 1-km network distance around residences. Analysis. Logistic regression analyses were performed for each urban form variable by age groups controlling for the demographic variables. All variables were then entered simultaneously into an analysis of the whole sample. RESULTS: All five urban form variables tested were related to walking. Recreation space was the only variables associated with walking across the four different age groups. All the urban form variables were related to walking in the 12 to 15 years age cohort. For this group, the odds of walking were 3. 7 times greater for those in highest- versus lowest-density tertile and 2.6 times greater for those with at least one commercial and 2.5 times greater for those with at least one recreational destination within 1 km from home. In the analysis of the full sample, number of cars, recreation space, and residential density were most strongly related to walking. CONCLUSIONS: Access to recreation or open space was the most important urban form variable related to walking for all age groups. Children aged 12 to 15 years old may be particularly influenced by urban form.

B. F. Fuemmeler, C. Baffi, L. C. Masse, A. A. Atienza and W. D. Evans. (2007). Employer and healthcare policy interventions aimed at adult obesity. American Journal of Preventive Medicine.

BACKGROUND: Increasing rates of obesity in the population have made prevention a high public health priority. Policy strategies for curtailing obesity have been recommended, yet there has been little research on the degree of public support for policy-level interventions. METHODS: Participants for this study included 1139 respondents who were surveyed as part of the Research Triangle Institute Obesity Telephone Survey conducted in September 2004. Participants were asked to indicate to what degree they favor specific healthcare and work policy strategies for treating and preventing adult obesity. Participants were also asked about their beliefs regarding the causes of obesity. RESULTS: A majority (85%) favored a policy change strategy that offered employers tax breaks if they provided adequate exercise facilities in the workplace. Seventy-three percent favored a move by healthcare companies to require obesity treatment and prevention. The same proportion (72%) favored beneficiary discounts by employers or healthcare companies to motivate individuals to maintain or move toward a healthy weight. Majorities endorsed a lack of willpower and the cost of healthy food as causes. Nearly two thirds did not believe genes or lack of knowledge was related to obesity in society, and the sample was split with regard to the belief that obesity is caused by society. CONCLUSIONS: The findings suggest that there is strong support for healthcare and employment policies in obesity prevention and treatment. These findings may be important to policymakers in developing population-based strategies to prevent obesity.

C. Gagliardi, L. Spazzafumo, F. Marcellini, H. Mollenkopf, I. Ruoppila, M. Tacken and Z. Szemann. (2007). The outdoor mobility and leisure activities of older people in five European countries. Ageing & Society.

Many gerontological studies have dealt with the leisure activities of older people and they have generated many important theories. Although outdoor activities and mobility promote good health in old age, both decrease with increasing age as people lose physical and mental functions. This paper examines the outdoor and indoor leisure activities of 3,950 older adults and their variations by personal and environmental characteristics in Germany, Finland, Hungary, The Netherlands and Italy. The main dimensions of activity were established by factor analysis, and in all countries four factors were found: home activities, hobbies, social activities, and sports activities. Both similar and distinctive pursuits characterised each dimension among the five countries. 'Home activities' mainly comprised indoor activities, but the other three dimensions involved more physical mobility. The scores of various socio-environmental characteristics on the factors enabled the attributes of the participants to be profiled. Sports activities and hobbies were performed more often by younger men, by those with good physical functioning and by those who drove cars. Social activities were performed more by women and those who used public transport. Home activities were more frequently performed by those with low physical function and women.

J. Garrard, G. Rose and S. K. Lo. (2008). Promoting transportation cycling for women: The role of bicycle infrastructure. Preventive Medicine.

OBJECTIVE.: Females are substantially less likely than males to cycle for transport in countries with low bicycle transport mode share. We investigated whether female commuter cyclists were more likely to use bicycle routes that provide separation from motor vehicle traffic. METHODS.: Census of cyclists observed at 15 locations (including off-road bicycle paths, on-road lanes and roads with no bicycle facilities) within a 7.4 km radius of the central business district (CBD) of Melbourne, Australia, during peak commuting times in February 2004. RESULTS.: 6589 cyclists were observed, comprising 5229 males (79.4%) and 1360 females (20.6%). After adjustment for distance of the bicycle facility from the CBD, females showed a preference for using off-road paths rather than roads with no bicycle facilities (odds ratio [OR]=1.43, 95% confidence interval [CI]: 1.12, 1.83), or roads with on-road bicycle lanes (OR=1.34, 95% CI: 1.03, 1.75). CONCLUSIONS.: Consistent with gender differences in risk aversion, female commuter cyclists preferred to use routes with maximum separation from motorized traffic. Improved cycling infrastructure in the form of bicycle paths and lanes that provide a high degree of separation from motor traffic is likely to be important for increasing transportation cycling amongst under-represented population groups such as women.

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