Introduction to the Active Living Research Reference List January – July 2008


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James F. Sallis, Ph.D., Director

Carmen L. Cutter, MPH, Deputy Director
Introduction to the Active Living Research Reference List January – July 2008
The following pages are citations of studies of the relationships between the environment, physical activity, and obesity published during the first half of 2008.  We have organized the publications into 9 categories to make them easier to review. The categories are:

  1. Built Environment – Child Physical Activity/Obesity,

  2. Built Environment – Adult Physical Activity/Obesity,

  3. Policy – Physical Activity/Obesity,

  4. Social, Cultural & Family Environments – Child Physical Activity/Obesity,

  5. Social, Cultural & Family Environments – Adult Physical Activity/Obesity,

  6. Measurement,

  7. Community Based Interventions – Physical Activity and Obesity,

  8. Childhood Obesity – General

  9. Other

The searches were conducted using several databases and were designed to represent the multiple disciplines in the active living research field. The number of citations continues to grow, especially as there is an extraordinary amount of literature on built environment and policy related to physical activity and obesity. Some citations do not include a journal issue or page numbers; these are articles that are available online ahead of print publication.

We have improved upon our search terms and hope that this list is inclusive. Please send us relevant citations we have missed. Studies that focus on food environments will be covered by the RWJF Healthy Eating Research program.

We will continue to publish twice yearly literature updates as the literature is expanding so rapidly. The abstracts for the current 2008 update and the 2004-2007 abstracts can be found at:
Papers that specifically report environmental correlates of physical activity behavior or obesity will be included in the online ALR literature database (
If you have questions or comments please contact Chad Spoon at
We would like acknowledgement the hard work of Ding Ding (Melody), Dori Rosenberg, and the Active Living Research staff for searching several databases and compiling the 2008 reference list.

2008 Search Terms

Physical Activity/Obesity terms (abstract only)

Environment terms (title or abstract)

non motorized OR NMT OR multimodal transportation OR active transport* OR driving OR active living OR inactivity OR inactive OR fit OR fitness OR body mass index OR BMI OR car OR cars OR automobile OR leisure OR television OR TV OR obese OR obesity OR weight OR overweight OR journey OR travel* OR walk OR walking OR cycle OR cycling OR bike OR bikers OR biking OR bicycle OR bicycling OR sedentary OR commuter* OR commuting OR exercise OR exercising OR exerciser* OR physical activity OR physically active OR play OR playground* OR playing OR vehicle OR obesogenic

environment OR environments OR environmental OR sprawl OR neighbourhood* OR neighborhood* OR recreation* OR metropolitan OR rural OR urban* OR pedestrian OR pedestrians OR equipment OR geograph* OR aesthet* OR convenient OR convenience OR urban form OR destination* OR trail OR trails OR park OR parks OR path OR paths OR distance* OR density OR access* OR planning OR location* OR feature* OR polic* OR facility OR facilities OR crime OR architecture OR building* OR transit OR street* OR stair* OR playground OR playgrounds OR urban design OR neighborhood development OR neighbourhood development OR smart growth OR outdoor OR indoor OR connectivity OR new urbanism OR healthy places OR healthy communities OR greenway OR greenways OR rail-trail OR home OR school OR schools OR land use OR safe OR safety OR route OR routes OR workplace OR community OR communities OR attractive* OR green space* OR public space* OR open space* OR place OR places OR site OR sites OR siting OR greenery OR amenity OR amenities OR attribute* OR walkable OR walkability OR residential OR residence OR sidewalks OR availability

Databases used in the literature searches included Pub Med, ISI Web of Science, Leisure and Recreation Journals and other non-indexed journals.

For more specific information please contact Chad Spoon at
Journal Counts:

These may indicate journals more interested in built environment research where you could send your manuscripts. Note that only journals with more than one count were included.

Acta Paediatrica- 3

American Journal of Epidemiology- 3

American Journal of Health Promotion- 9

American Journal of Preventive Medicine- 28

Annals of Behavioral Medicine- 2

Applied Physiology Nutrition and Metabolism- 4

Archives of Diseases in Childhood- 5

Archives of Pediatrics and Adolescent Medicine- 3

BMC Public Health- 10

British Journal of Sports Medicine- 2

Canadian Journal of Public Health- 2

Child Care and Health Development- 4

Contemporary Clinical Trials- 2

East Mediterranean Health Journal- 2

Eating Behaviors- 2

Environment and Planning B- 3

Ethnicity and Disease- 2

European Journal of Clinical Nutrition- 2

Health and Place- 6

Health Education and Behavior- 2

Health Education Research- 6

Health Psychology- 2

IDEA Fitness Journal- 2

International Journal of Behavioral Nutrition and Physical Activity- 14

International Journal of Obesity- 5

International Journal of Pediatric Obesity- 8

The Journal of Physical Education, Recreation & Dance- 4

Journal of Adolescent Health- 6

Journal of American Dietetics Association- 6

Journal of Community Health - 2

Journal of Education Behavior-2

Journal of Epidemiology and Community Health- 6

Journal of Health Politics, Policy and Law- 6

Journal of Nutrition Education and Behavior- 4

Journal of Pediatrics and Child Health-2

Journal of Physical Activity and Health- 23

Journal of Public Health- 2

Journal of Public Health Management and Practice- 4

Journal of Rural Health- 3

Journal of School Health- 5

Journal of School Nursing- 2

Journal of Teaching in Physical Education- 3

Journal of Urban Health- 2

Leisure Sciences- 3

Medicine and Science in Sports and Exercise- 8

Nutrition Reviews-2

Obesity- 13

Obesity Reviews- 12

Pediatric Exercise Science- 3

Physiology & Behavior- 3

Preventing Chronic Disease- 5

Preventive Medicine- 17

Public Health- 3

Public Health Nutrition- 4

Research Quarterly For Exercise and Sport- 5

Rural and Remote Health- 2

Social Science and Medicine- 2

Transport Reviews- 2

Transportation- 4

Transportation Research- 4

Urban Studies- 2

(2008). Examining Active Commuting to School. JOPERD: The Journal of Physical Education, Recreation & Dance. 79, 4.

The article offers information on two studies in 2007 with regards to the status of active commuting, such as by walking or by means of bicycles, to school. The first study, published in the August 2007 American Journal of Preventive Medicine, surveys a national sample of 7, 433 children, ages nine to 15 years in 2007, where in the result showed that 47.9 percent of the 35 percent living within a mile of school actively commutes at least one day per week. The second study, reported at the 54th Annual Meeting of the American College of Sports Medicine, reveals that a study in Georgia indicates that substantial physical barriers may inhibit students from walking to school.

(2008). Have playgrounds become boring? JOPERD: The Journal of Physical Education, Recreation & Dance. 79, 11.

The article offers the contentions of various sports authorities which underscore the steady decline in children's participation on play structures. One of them said that the Consumer Product Safety Commission, as well as the American Society for Testing and Materials, have put forward the standard of care within the playground field. One of them said that playgrounds built after the 1980s are relatively safer as compared to those built earlier. Another said that playgrounds still serve their purposes in child development.

K. N. Ahlport, L. Linnan, A. Vaughn, K. R. Evenson and D. S. Ward. (2008). Barriers to and Facilitators of Walking and Bicycling to School: Formative Results From the Non-Motorized Travel Study. Health Education & Behavior. 35, 221.

Barriers to and facilitators of walking and bicycling to school were explored through 12 focus groups made up of fourth- and fifth-grade students and their parents who lived near their respective schools. The barriers and facilitators reported by parents and children generally fell into one of three categories: intrapersonal and interpersonal characteristics of parents and children, environmental characteristics of the neighborhood, and environmental and policy characteristics of the school. Findings indicate that a supportive environment is a necessary but insufficient condition to increase walking and biking to school. Initiatives to increase active school travel may need to include multiple levels of intervention to be effective.

M. Alm, N. Soroudi, J. Wylie-Rosett, C. R. Isasi, S. Suchday, J. Rieder and U. Khan. (2008). A qualitative assessment of barriers and facilitators to achieving behavior goals among obese inner-city adolescents in a weight management program. Diabetes Educator. 34, 277-284.

Purpose The purpose of this study was (1) to examine the reasons for managing weight, (2) to investigate the barriers and facilitators to achieving behavior goals, and (3) to assess how a behavior coach affects the goal-setting process of obese inner-city adolescents in a weight management program. Methods Obese adolescents participating in a pilot study assessing the role of a behavior coach on successful weight management (n = 18) were interviewed to identify barriers and facilitators to reaching behavior goals. Data were analyzed using descriptive statistics and the constant comparative method of qualitative analysis. Results In the rationale for weight control, adolescent girls and boys reported a desire to improve physical appearance and physical conditioning, respectively. Barriers to reaching physical activity goals among girls included unsafe neighborhoods and a negative body image. Maintaining unrealistic behavior and weight goals hindered satisfaction with behavior change and weight loss (in both genders. Overall, coaching provided support that helped the obese teens feel more successful in the goal-setting process and address issues related to their disruptive environments. Conclusions Diabetes educators can include a behavior coach as part of a weight management program to help teens set behavior goals and overcome barriers to reaching behavior goals.

S. H. Babey, T. A. Hastert, H. J. Yu and E. R. Brown. (2008). Physical activity among adolescents - When do parks matter? American Journal Of Preventive Medicine. 34, 345-348.

Background: The availability of places to engage in physical activity may influence physical activity levels. This study examined whether the relationship between physical activity and access to parks differs depending on adolescents' sociodemographic, housing, and neighborhood characteristics. Methods: Data were analyzed from 4010 adolescents who responded to the 2003 California Health Inter-view Survey (CHIS). Analyses were conducted in 2005-2006. Five sets of logistic regressions were conducted to examine the relationship between physical activity and access to a safe park among adolescents living in (1) urban versus rural areas; (2) apartment buildings versus houses, (3) neighborhoods perceived as unsafe versus safe; (4) lower-versus higher-income families; and (5) adolescents who were Latino, African American, Asian, or white. Analyses also examined interactions between park access and these factors. Results: Access to a safe park was positively associated with regular physical activity and negatively associated with inactivity for adolescents in urban areas, but not rural areas. Additionally, adolescents with access to a safe park were less likely to be inactive than those without access among those living in (1) apartment buildings, (2) unsafe neighborhoods, and (3) lower-income families. Park access was not associated with regular physical activity for these groups. The association between park access and physical activity varied by race/ethnicity. Conclusions: These findings suggest that the relationship between physical activity and access to parks differs depending on adolescents' sociodemographic, housing, and neighborhood characteristics, and that parks may be particularly important for promoting physical activity among urban adolescents.

H. Baslington. (2008). School travel plans: Overcoming barriers to implementation. Transport Reviews. 28, 239-258.

The number of primary school children travelling to school by car has almost doubled in 20 years. A governmental policy response is to introduce school travel plans. The paper raises and discusses important issues identified during a literature review, documentary analysis, and an empirical evaluation of school travel plans. These are: (1) barriers to their implementation, extensiveness and longevity, and (2) the behavioural approach which underpins school travel plan promotional literature. A comparative methods design was used for the empirical evaluation that measured the effectiveness of the travel initiatives operating at three schools. Quantitative and qualitative data were collected using questionnaires and travel diaries (n = 555, ages 7-11 years) and interviews (22 parents, four key persons). The output measures were: 'levels of walking to and from school' and 'awareness and attitudes' towards initiatives. In one of the schools a Walking Bus scheme operated successfully. The findings from the research form the backdrop for a discussion of potential measures to overcome the social, geographic, and financial restrictions imposed on some schools. A recommendation is made regarding data collection and the analysis of evaluation data. The general conclusion from the review is that a wide variation in the effectiveness of travel initiatives can be expected.

M. W. Beets and J. T. Foley. (2008). Association of Father Involvement and Neighborhood Quality with Kindergartners' Physical Activity: A Multilevel Structural Equation Model. American Journal of Health Promotion. 22, 195.

Purpose. Examine the effects of father-child involvement and neighborhood characteristics with young children's physical activity (PA) within a multilevel framework. Design. Cross-sectional analysis of the Early Childhood Longitudinal Study—Kindergarten Cohort 1998. Setting. Nationally representative sample. Subjects. Data were available for 10,694 kindergartners (5-6 years; 5240 girls) living in 1053 neighborhoods. Measures. Parental report of child's PA level, father characteristics (e.g., time spent with child, age, education, socioeconomic status, hours worked), family time spent doing sports/activities together, and neighborhood quality (e.g., safety, presence of crime violence, garbage). Child weight status, motor skills, ethnicity, and television viewing were used as covariates. Analysis. Multilevel structural equation modeling with children nested within neighborhoods. Results. At the child level father-child time and family time doing sports together were positively associated with children's PA. At the neighborhood level parental perception of a neighborhood's safety for children to play outside fully mediated the effect of neighborhood quality on children's PA. Overall 19.1% and 7.6% of the variance in PA was explained at the child and neighborhood levels, respectively. Conclusions. Family-based interventions for PA should consider father-child time, with this contributing to a child's overall PA level. Further, neighborhood quality is an important predictor of PA only to the extent by which parents perceive it to be unsafe for their child to play outdoors.

A. Beighle, B. Alderman, C. Morgan and G. L. Masurier. (2008). Seasonality in children's pedometer-measured physical activity levels. Res Q Exerc Sport. 79, 256-260.

J. K. Bower, D. P. Hales, D. F. Tate, D. A. Rubin, S. E. Benjamin and D. S. Ward. (2008). The childcare environment and children's physical activity. American Journal Of Preventive Medicine. 34, 23-29.

Background: With increased numbers of children attending child care, this setting presents an ideal opportunity to promote physical activity and the early development of healthy behaviors. The purpose of this study was to examine the relationships between the childcare environment and physical activity behavior of preschool children. Methods: Aspects of the environment hypothesized to influence children's physical activity were assessed in 20 childcare centers using the Environment and Policy Assessment and Observation (EPAO) instrument. Physical activity behavior was assessed over 2 days using direct observation. Results: Children in centers with supportive environments achieved more moderate-to-vigorous physical activity (15% of observations vs 9%; effect size [ESJ=1.17), spent less time in sedentary activities (50% vs 61%; ES=-1.52), and had higher mean physical activity levels (2.68 vs 2.43; ES=1.41) compared to centers with less supportive environments. Facets of the physical and social environment related to physical activity behavior included active opportunities, portable play equipment, fixed play equipment, sedentary environment, and physical activity training and education. Conclusions: Previous research indicates that the childcare center that children attend significantly affects physical activity behavior. The current findings extend this evidence by identifying aspects of the childcare environment that relate to the physical activity behavior of children. These factors should be considered when identifying determinants of physical activity and designing interventions.

B. Bringolf-Isler, L. Grize, U. Mader, N. Ruch, F. H. Sennhauser and C. Braun-Fahrlander. (2008). Personal and environmental factors associated with active commuting to school in Switzerland. Preventive Medicine. 46, 67-73.

Objective. To assess whether prevalence of active commuting and regular car trips to school varies across communities and language regions in Switzerland and to determine personal and environmental correlates. Methods. During the school year 2004/2005, 1345 parental questionnaires (response rate 65%) of children attending 1st, 4th and 8th grades were completed, 1031 could be linked to a GIS environmental database. A German-speaking, a French-speaking and a bilingual study area were included. Usual mode of transportation and frequency of regular car trips to school were assessed. Associations with personal and environmental factors were evaluated with multivariate regression models. Results. Seventy-eight percent of the children actively traveled to school. Twelve percent were regularly driven at least once a week by car. Major road crossings and distance were significantly related to usual mode of transportation, but not to regular car trips. Age, daycare attendance, parental safety concerns, number of cars in the household and belonging to French-speaking population were significantly associated with increased regular car trips. Conclusion. Objective predictors are main deciding factors for active commuting to school as main mode of transport whereas personal and lifestyle factors are important factors associated with frequency of car use. Not only objective but also differing cultural attitudes should be considered when promoting non-motorized travel.

K. Butcher, J. F. Sallis, J. A. Mayer and S. Woodruff. (2008). Correlates of physical activity guideline compliance for adolescents in 100 US cities. Journal Of Adolescent Health. 42, 360-368.

Purpose: This study assessed the rates and correlates of adolescents' compliance with national guidelines for physical activity. Methods: A cross-sectional phone survey of adolescents and their parents was conducted in the 100 largest cities in the United States in 2005. Adolescents ages 14-17 years (n = 6125) were asked how many days during the previous week and during a typical week they were physically active for at least 60 minutes. Compliance was defined as 5 + days per week. Parents provided data on teen's age and race/ethnicity, parental education level, annual household income, and region of residence. Associations among these variables and compliance with physical activity guidelines were examined. Results: Approximately 40% of the females and 57% of the males complied with the national physical activity guidelines. Logistic regression indicated that for both genders, compliance was significantly associated with having higher household income and that, for females only, compliance declined significantly with age. Region of residence did not predict compliance for either gender. Conclusion: A majority of the girls and a large portion of the boys failed to meet the current guidelines, thereby increasing their risks of multiple health problems. Targeting intervention resources for low income teens and older adolescent teen girls is recommended.

G. Cardon, E. Van Cauwenberghe, V. Labarque, L. Haerens and I. De Bourdeaudhuij. (2008). The contribution of preschool playground factors in explaining children's physical activity during recess. International Journal Of Behavioral Nutrition And Physical Activity. 5,

Background: Low levels of physical activity are characteristic in preschoolers. To effectively promote physical activity, it is necessary to understand factors that influence young children's physical activity. The present study aimed to investigate how physical activity levels are influenced by environmental factors during recess in preschool. Methods: Preschool playground observations and pedometry during recess were carried out in 39 randomly selected preschools (415 boys and 368 girls; 5.3 +/- 0.4 years old). In order to examine the contribution of playground variables to physical activity levels, taking adjustment for clustering of subjects within preschools into account, multilevel analyses were conducted. Results: During recess boys took significantly more steps per minute than girls (65 +/- 36 versus 54 +/- 28 steps/ min). In both genders higher step counts per minute were significantly associated with less children per m(2) and with shorter recess times. Only in boys a hard playground surface was a borderline significant predictor for higher physical activity levels. In girls higher step counts were associated with the presence of less supervising teachers. Playground markings, access to toys, the number of playing or aiming equipment pieces and the presence of vegetation or height differences were not significant physical activity predictors in both genders. Conclusion: In preschool children physical activity during outdoor play is associated with modifiable playground factors. Further study is recommended to evaluate if the provision of more play space, the promotion of continued activity by supervisors and the modification of playground characteristics can increase physical activity levels in preschoolers.

A. Carver, A. Timperio and D. Crawford. (2008). Playing it safe: The influence of neighbourhood safety on children's physical activity - A review. Health & Place. 14, 217-227.

Compared with previous generations, children spend less time playing outdoors and have lower participation rates in active transport. Many studies have identified lack of neighbourhood safety as a potential barrier to children's physical activity. This review describes concerns regarding 'stranger danger' and road safety, and discusses empirical studies that examine associations between neighbourhood safety and physical activity among youth. Variability of perceptions of safety between parents and youth are examined; 'social traps' are identified; and physical/social environmental interventions aimed at improving neighbourhood safety are discussed. A research agenda is suggested for further study of perceived and objective measures of neighbourhood safety and their associations with children's physical activity.

A. Carver, A. Timperio and D. Crawford. (2008). Perceptions of Neighborhood Safety and Physical Activity Among Youth: The CLAN Study. Journal of Physical Activity & Health. 5, 430.

Background: The purpose of this study was to examine associations between perceptions of neighborhood safety and physical activity among youth. Methods: We completed a cross-sectional study of children age 8 to 9 years (n = 188) and adolescents age 13 to 15 years (n = 346) in areas of varying socioeconomic status in Melbourne, Australia. Parents and adolescents completed questionnaires on perceptions of neighborhood safety. Scores were computed for perceptions of road safety, incivilities, and personal safety of the child or adolescent. Moderate-to-vigorous physical activity (MVPA) before or after school, on evenings, and on weekends was recorded using accelerometers. Results: There were no associations between parental perceptions of neighborhood safety and children's MVPA outside school hours. Parental perception of personal safety was positively associated with adolescent boys' MVPA after school. Adolescent girls' concern about road safety was negatively associated with their MVPA during evenings and outside school hours. Conclusion: Perceptions of neighborhood safety might influence physical activity among youth in different ways according to age group and sex.

A. Carver, A. F. Timperio and D. A. Crawford. (2008). Neighborhood road environments and physical activity among youth: The CLAN study. Journal Of Urban Health-Bulletin Of The New York Academy Of Medicine. 85, 532-544.

We examined associations between objective measures of the local road environment and physical activity (including active transport) among youth. There is little empirical evidence of the impact of the road environment on physical activity among children/adolescents in their neighborhoods. Most recent studies have examined perceptions rather than objective measures of the road environment. This was a cross-sectional study of children aged 8-9 years (n=188) and adolescents aged 13-15 years (n=346) who were participants in the 3-year follow-up of the Children Living in Active Neighborhoods (CLAN) longitudinal study in Melbourne, Australia. At baseline (2001), they were recruited from 19 state primary schools in areas of varying socioeconomic status across Melbourne. Habitual walking/cycling to local destinations was parent-reported for children and self-reported for adolescents, while moderate-to-vigorous physical activity (MVPA) outside school hours was recorded using accelerometers. Road environment features in each participant's neighborhood (area of radius 800 m around the home) were measured objectively using a geographical information system. Regression analyses found no associations between road environment variables and children's likelihood of making at least seven walking/cycling trips per week to neighborhood destinations. Adolescent girls residing in neighborhoods with two to three traffic/pedestrian lights were more likely to make seven or more walking/cycling trips per week as those whose neighborhoods had fewer traffic lights (OR: 2.7; 95% CI: 1.2-6.2). For adolescent boys, residing on a cul-de-sac, compared with a through road, was associated with increases in MVPA of 9 min after school, 5 min in the evenings, and 22 min on weekend days. Speed humps were positively associated with adolescent boys' MVPA during evenings. The road environment influences physical activity among youth in different ways, according to age group, sex and type of physical activity.

J. L. Chen, V. Unnithan, C. Kennedy and C. H. Yeh. (2008). Correlates of physical fitness and activity in Taiwanese children. International Nursing Review. 55, 81-88.

Aim: This cross-sectional study examined factors related to children's physical fitness and activity levels in Taiwan. Methods: A total of 331 Taiwanese children, aged 7 and 8, and their mothers participated in the study. Children performed physical fitness tests, recorded their physical activities during two weekdays and completed self-esteem questionnaires. Research assistants measured the children's body mass and stature. Mothers completed demographic, parenting style and physical activity questionnaires. Results: Attending urban school, lower body mass index (BMI), older age and better muscular endurance contributed to the variance in better aerobic capacity, and attending rural school and better aerobic capacity contributed to the variance in better muscular endurance in boys. Attending urban school, lower BMI and better athletic competence contributed to the variance in better aerobic capacity, and younger age, rural school and higher household income contributed to the variance in better flexibility in girls. Conclusion: Despite the limitations of the study, with many countries and regions, including Taiwan, now emphasizing the importance of improving physical fitness and activity in children, an intervention that is gender-, geographically, and developmentally appropriate can improve the likelihood of successful physical fitness and activity programmes.

D. Cohen, M. Scott, F. Z. Wang, T. L. McKenzie and D. Porter. (2008). School design and physical activity among middle school girls. Journal of Physical Activity and Health. 5, 719-731.

D. Crawford, A. Timperio, K. Campbell, C. Hume, M. Jackson, A. Carver, K. Hesketh, K. Ball and J. Salmon. (2008). Parent's views of the importance of making changes in settings where children spend time to prevent obesity. Asia Pacific Journal Of Clinical Nutrition. 17, 148-158.

Aim: To examine the kinds of changes parents would like to see in those settings where children spend time (kindergartens and schools, child care centres and after-school care facilities, and the local neighbourhood) in policies and practices that impact on children's risk of obesity, and to establish whether parents might be willing to advocate for changes in these settings. Materials and Methods: 175 parents from five randomly selected primary schools and five randomly selected kindergartens located in suburbs of metropolitan Melbourne completed a questionnaire in which they rated the importance of a number of potential changes to promote healthy eating and increase physical activity in their children. Results: Parents of children in kindergarten most commonly rated changes to the eating environment as important. In contrast, parents of primary school children believed changes related to both eating and physical activity in school were important. Ninety-five per cent of parents of kindergarten children and 89% of parents of primary school children believed it was possible for parents to bring about change to provide more opportunities for their child to eat more healthily and be more physically active. One in four parents reported that they had thought about or had tried to bring about changes in their community. Conclusions: The findings suggest that mobilising parents to take an active role in advocating for change in those settings that have the potential to shape their children's physical activity and eating behaviours may be feasible.

A. M. Davis, R. E. Boles, R. L. James, D. K. Sullivan, J. E. Donnelly, D. L. Swirczynski and J. Goetz. (2008). Health behaviors and weight status among urban and rural children. Rural Remote Health. 8, 810.

INTRODUCTION: Pediatric overweight is currently reaching epidemic proportions but little information exists on differences in weight related behaviors between urban and rural children. OBJECTIVE: To assess health behaviors and weight status among urban and rural school-age children. METHODS: Fifth-grade children at two urban and two rural schools were invited to participate in an assessment study of their health behaviors and weight status. A total of 138 children (mean age = 10 years; % female = 54.6) chose to participate. RESULTS: Children in rural and urban areas consumed equivalent calories per day and calories from fat, but rural children ate more junk food and urban children were more likely to skip breakfast. Urban children engaged in more metabolic equivalent tasks and had slightly higher total sedentary activity than rural children. The BMI percentile was equivalent across rural and urban children but rural children were more often overweight and urban children were more often at risk for overweight. CONCLUSIONS: Although some variables were equivalent across urban and rural children, results indicate some key health behavior differences between groups. Results should be interpreted with caution as the sample size was small and there were demographic differences between urban and rural samples.

J. Duncan, W. Hopkins, G. Schofield and E. Duncan. (2008). Effects of weather on pedometer-determined physical activity in children. Med Sci Sports Exerc. 40, 1432-1438.

The effects of weather conditions on children's physical activity have not been

well described. PURPOSE: To evaluate the effects of meteorological variables on

the number of pedometer steps accumulated by children. METHODS: Between August

and December 2004 (winter to summer), 1115 Auckland children (536 boys, 579

girls; aged 5-12 yr) from 27 socioeconomically and ethnically diverse schools

wore sealed multiday memory pedometers for five consecutive days (three weekdays

and two weekend days). Values of daily (7 a.m. to 7 p.m.) mean ambient

temperature, mean wind speed, precipitation, and duration of bright sunshine were

obtained from local meteorological stations. The independent effects of each of

these variables on step counts were estimated using composite mixed linear

models. Effects were standardized for interpretation of magnitudes. RESULTS:

Weekday and weekend-day step counts for boys were 16,100 +/- 5000 and 12,900+/-

5900 (mean +/- SD), whereas those for girls were 14,200 +/- 4200 and 11,300 +/-

4800. A 10 degrees C rise in mean ambient temperature was associated with a small

increase in weekday steps [1700; 90% confidence intervals (CI) +/-1300] and a

moderate increase in weekend-day steps (3400; 90% CI +/-1500) for boys, whereas

for girls the effects were small (2300; 90% CI +/-1000) and unclear (-300; 90% CI

+/-1200), respectively. There were substantial decreases in weekday and

weekend-day steps during moderate rainfall (1.1-4.9 mm) for both sexes. Most

effects of day length, wind speed, and hours of bright sunshine on step counts

were trivial or unclear. CONCLUSIONS: Ambient temperature and rainfall have

substantial effects on children's daily step counts and should therefore be

considered when comparing physical activity across different locations or

periods. Strategies to increase activity on cold or rainy days may also be


J. Dwyer, L. Needham, J. R. Simpson and E. S. Heeney. (2008). Parents report intrapersonal, interpersonal, and environmental barriers to supporting healthy eating and physical activity among their preschoolers. Applied Physiology, Nutrition & Metabolism. 33, 338.

There is an increasing trend in childhood obesity in Canada and many preschool children are overweight or obese. The objective of this study was to explore parents’ experiences and challenges in supporting healthy eating and physical activity among their preschool children. A qualitative descriptive study involving 5 focus groups was conducted. A convenience sample of 39 parents from 3 childcare centres in Hamilton, Ontario, participated. Parents were English speaking and had a child aged 2-5 years attending the childcare centre for at least 3 months. The research team read transcripts of the audio-taped sessions and used a constant comparison approach to develop themes, which involved coding comments by continually referring to previously coded comments for comparison. The social ecological model was used to organize the themes into 3 higher-level categories: (i) intrapersonal (individual): preschoolers’ preferences and health; (ii) interpersonal (interactions): parents’ and others’ different views and practices, influence of the childcare centre, parents’ lack of time, and family structure; and (iii) physical environment: accessibility of healthy foods, preschoolers with special needs, media influence, weather, lack of safety, and inaccessible resources. Parents perceived that there are various intrapersonal, interpersonal, and environmental barriers to supporting healthy eating and physical activity among their children. Program planners and health professionals can consider these barriers when developing interventions to promote healthy bodyweights among preschoolers

T. A. Farley, R. A. Meriwether, E. T. Baker, J. C. Rice and L. S. Webber. (2008). Where Do the Children Play? The Influence of Playground Equipment on Physical Activity of Children in Free Play. Journal of Physical Activity & Health. 5, 319.

Background: Promotion of physical activity in children depends on an understanding of how children use play equipment. Methods: We conducted observations over 2 years of children in 2nd through 8th grades in a schoolyard with 5 distinct play areas with different amounts of play equipment. Results: Children were more likely to play in areas with more installed play equipment, with densities of children in equipped areas 3.3 to 12.6 times higher than in an open grassy field. There were no significant differences by play area in the percent of children who were physically active at all, but children were more likely to be very active in areas with basketball goals and an installed play structure than in an open field. Conclusions: Playground equipment appeared to have a strong influence on where children played and a moderate influence on levels of activity. To maximize physical activity in children, playgrounds should be designed with ample and diverse play equipment.

H. Forman, J. Kerr, G. J. Norman, B. E. Saelens, N. H. Durant, S. K. Harris and J. F. Sallis. (2008). Reliability and validity of destination-specific barriers to walking and cycling for youth. Preventive Medicine. 46, 311-316.

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 these destinations. 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: l) 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.

S. A. Ham, S. Martin and I. I. I. H. W. Kohl. (2008). Changes in the Percentage of Students Who Walk or Bike to School--United States, 1969 and 2001. Journal of Physical Activity & Health. 5, 205.

Background: This report describes changes in the percentage of US students (age 5 to 18 years) who walked or bicycled to school and in the distance that they lived from or traveled to their school in 1969 and 2001 and travel patterns in 2001. Methods: Data were from the 1969 National Personal Transportation Survey report on school travel and the 2001 National Household Transportation Survey. Results: A smaller percentage of students lived within 1 mile of school in 2001 than in 1969. The percentage of students who walked or biked any distance decreased from 42.0% to 16.2%. Nearly half of students used more than 1 travel mode or went to an additional destination en route between home and school in 2001. Conclusion: Multidisciplinary efforts are needed to increase the percentage of students who walk or bike to school, as well as decrease the distances that students travel.

N. Harten, T. Olds and J. Dollman. (2008). The effects of gender, motor skills and play area on the free play activities of 8-11 year old school children. Health Place. 14, 386-93.

Two studies were conducted to examine the interactions between gender, play area, motor skills and free play activity in 8-11 year old school children. In both studies, boys were more active than girls. In boys, but not in girls, energy expenditure was greater for high-skill than for low-skill children (p = 0.0002), and increased as play area increased (p = 0.01). These results suggest that motor skills and play space are important variables in determining the free play activity of boys, but not of girls. This may be related to widely different play styles among boys and girls.

T. Hinkley, D. Crawford, J. Salmon, A. D. Okely and K. Hesketh. (2008). Preschool children and physical activity - A review of correlates. American Journal Of Preventive Medicine. 34, 435-441.

Background: Several reviews have summarized the research on correlates of older children's and adolescents' physical activity behaviors, but none have been published on preschool children. Over the past 27 years, a number of studies have investigated the correlates of preschool children's physical activity behaviors. It is timely and necessary to review the extant literature in this area. This paper reviews articles investigating correlates of preschool children's physical activity behaviors published in peer-reviewed journals between 1980 and March 2007. Methods: A literature search was conducted to identify studies that investigated correlates of preschool children's physical activity. Data were collected and analyzed in 2007. Results: Twenty-four articles were identified that met the inclusion criteria. From those articles, 39 variables were identified across five domains. Results showed that boys were more active than girls, that children with active parents tended to be more active, and that children who spent more time outdoors were more active than children who spent less time outdoors. Age and BMI were consistently shown to have no association with preschool children's physical activity. Other variables produced largely inconclusive results. Conclusions: The influences on the physical activity behaviors of preschool children are multidimensional. Further research is required to enhance an understanding of these influences.

N. L. Holt, J. C. Spence, Z. L. Sehn and N. Cutumisu. (2008). Neighborhood and developmental differences in children's perceptions of opportunities for play and physical activity. Health & Place. 14, 2-14.

The purposes of this study were to examine perceptions of places to play and be physically active among children from two different urban neighborhoods, and evaluate these perceptions for age-related developmental differences. One hundred and sixty-eight children from grades K-6 (aged 6-12 years old) completed mental maps depicting places where they could play and be physically active. The children were recruited from schools in two neighborhoods-one a highwalkability (H-W) grid-style neighborhood, the other a low-walkability (L-W) lollipop-style (i.e., cul-de-sacs) neighborhood. Analysis revealed that children in the H-W neighborhood depicted more active transportation and less non-active transportation than children in the L-W neighborhood. Children in the lowest grades (K-2) in the L-W neighborhood depicted more play in the home/yard environment than the oldest children, more good weather image events than children in Grades 3-6, and less play outside the home/yard environment than children in Grades 3 and 4. In the H-W neighborhood, the youngest children (K-2) depicted significantly less play in the home/yard environment and less play outside the home/yard environment than older children (Grades 3-6). Thus, both the type of urban neighborhood and children's age moderated perceptions of places to play and be physically active.

M. L. Humbert, K. E. Chad, M. W. Bruner, K. S. Spink, N. Muhajarine, K. D. Anderson, T. M. Girolami, P. Odnokon and C. R. Gryba. (2008). Using a Naturalistic Ecological Approach to Examine the Factors Influencing Youth Physical Activity Across Grades 7 to 12. Health Education & Behavior. 35, 158.

High levels of inactivity in youth have led researchers and practitioners to focus on identifying the factors that influence physical activity behaviors in young people. The present study employed a qualitative ecological framework to examine the intrapersonal, social, and environmental factors influencing youth physical activity. In grade-specific focus group settings, 160 youth in grades 7 through 12 (aged 12 to 18) were asked how they would increase the physical activity levels of youth their age. Participants identified eight factors that they felt should be addressed in programs and interventions designed to increase the physical activity behaviors of youth. These factors included the importance of fun, having the time to be physically active, the benefits of activity, being active with friends, the role of adults, and the importance of being able to access facilities in their neighborhood.

S. U. Jensen. (2008). How to obtain a healthy journey to school. Transportation Research Part A-Policy And Practice. 42, 475-486.

Danish children walk and cycle a lot and at the same time have one of the best child road safety records in the western part of world. Based on several studies, the paper describes how Denmark has obtained a good child road safety and why Danish children choose to walk and cycle. Child road safety has predominantly been improved due to higher seat belt use and many implemented local safety measures such as campaigns and physical safe routes to school projects. It is mostly safe routes to school projects that include speed reducing measures and signalisation of junctions that are successful. The distance from home to school is an important factor in children's transport mode choice. Since about half of Danish children have less than 1.5 km to school the decentralised school structure with many fairly small schools is an important reason to the many walking and bicycle journeys. Road design and motorised traffic volumes do influence children's mode choice, but to a rather limited extent.

R. R. Joens-Matre, G. J. Welk, M. A. Calabro, D. W. Russell, E. Nicklay and L. D. Hensley. (2008). Rural-urban differences in physical activity, physical fitness, and overweight prevalence of children. Journal Of Rural Health. 24, 49-54.

Context: The increasing prevalence of overweight in youth has been well chronicled, but less is known about the unique patterns and risks that may exist in rural and urban environments. A better understanding of possible rural-urban differences in physical activity profiles may facilitate the development of more targeted physical activity interventions. Methods: Participants (1,687 boys; 1,729 girls) were recruited from fourth, fifth, and sixth grade classes in schools from urban areas, small cities, and rural areas. Multilevel modeling analysis was used to examine rural-urban differences in physical activity and prevalence of overweight. Physical activity was assessed by self-report and body mass index was calculated from measured height and weight. Findings: Prevalence of overweight was higher among rural children (25%; P <.001) than children from urban areas (19%) and small cities (17%). Urban children were the least active overall (Cohens' d = -0.4), particularly around lunchtime while at school (d = -0.9 to -1.1). Children from small cities reported the highest levels of physical activity. Conclusions: The results of this study suggest there are rural-urban differences in children's prevalence of overweight and physical activity even within a fairly homogenous Midwestern state.

J. A. Kahn, B. Huang, M. W. Gillman, A. E. Field, S. B. Austin, G. A. Colditz and A. L. Frazier. (2008). Patterns and determinants of physical activity in US adolescents. Journal Of Adolescent Health. 42, 369-377.

Purpose: The objectives of this study were to describe longitudinal trends in adolescent physical activity in a sample of U.S. adolescents and to assess the effect of multiple individual, parental, and environmental factors on initial level and rates of change in adolescent physical activity. Methods: Study subjects were 12,812 boys and girls 10 to 18 years of age who were participating in the Growing Up Today Study and their mothers. We used accelerated longitudinal analysis to describe trajectories of physical activity from 1997-1999, and random effects linear mixed models to determine which factors were independently associated with baseline physical activity and changes in physical activity over time. Results: Mean hours of physical activity ranged from 7.3-11.6 hours per week in boys and from 8.0-11.2 hours per week in girls. Physical activity was best modeled as a quadratic function of age, increasing until early adolescence and declining after age 13 in boys and girls. Multivariable modeling demonstrated that variables associated with physical activity level at baseline in boys and girls were age, body mass index, psychosocial variables, personal attitudes about body shape, perceived peer attitudes about body shape/fitness, parental attitudes about physical activity, parental physical activity, and environmental barriers to physical activity. Age was the only factor that predicted change in physical activity over time. Conclusions: Interventions to increase physical activity in adolescents should begin before adolescence. Interventions may be more effective if they are multimodal and focus on modifiable individual, parental, and environmental factors.

J. Kerr, G. J. Norman, J. F. Sallis and K. Patrick. (2008). Exercise Aids. Neighborhood Safety, and Physical Activity in Adolescents and Parents. Medicine & Science in Sports & Exercise. 40, 1244.

The article presents a study which investigates whether physical activity levels of parents and their adolescent children were related to neighborhood safety and availability of personal exercise aids designed to be used either at home or outdoors. It also investigates the interaction between safety and home exercise aids, such that perceived neighborhood safety or outdoor-use equipment with physical activity levels. The results show that the number of home-use and outdoor-use exercise equipment was significantly related to physical activity in adolescent girls. Also, parents living in neighborhoods perceived to be safe benefit from having exercise aids that they can use outside.

P. L. Kristensen, L. Korsholm, N. C. Moller, N. Wedderkopp, L. B. Andersen and K. Froberg. (2008). Sources of variation in habitual physical activity of children and adolescents: the European youth heart study. Scandinavian Journal Of Medicine & Science In Sports. 18, 298-308.

The present study examined the influence of gender, maturity state, seasonality, type of measurement day and socioeconomic status (SES) on habitual physical activity in 8-10-year-old children and 14-16-year-old adolescents (n=1318). Physical activity was assessed objectively by accelerometry. The results showed a significant effect of the type of measurement day on physical activity with a general pattern of lower activity levels in weekends compared with weekdays. Furthermore, higher physical activity levels were observed during the months of spring/summer compared with the months of autumn/winter for the 8-10-year-olds, whereas no significant effect of months was observed for the 14-16-year-olds, possibly due to exam preparations and lack of physical activity registration during the months of summer for this cohort. SES was unrelated to physical activity in the 8-10-year-olds, whereas an inverse association was observed in the 14-16-year-olds. However, a post hoc analysis provided strong evidence that this latter result was biased by the accelerometers inability to pick up bicycling activities. Finally, boys were more physically active compared with girls, and maturity state was unrelated to physical activity. The results could prove useful for working out strategies to prevent inactivity and for adjusting for temporal sources of variation in physical activity in future studies.

C. Lazarou, D. B. Panagiotakos, G. Panayiotou and A. L. Matalas. (2008). Overweight and obesity in preadolescent children and their parents in Cyprus: prevalence and associated socio-demographic factors - the CYKIDS study. Obesity Reviews. 9, 185-193.

Obesity status differs by socio-demographic factors, but data for Cyprus are scarce. An in-depth understanding of this relationship may be useful in designing public health programmes. The objective of the present study is to estimate overweight and obesity (OW/OB) prevalence among children and adults in Cyprus and identify related socio-demographic variables. National cross-sectional study of 1140 children (mean age 11 +/- 0.98 years) and their parents (mean age 42.5 +/- 5.8 years, total n = 1954). Obesity was defined according to the World Health Organization classification for adults and according to IOTF (International Obesity Task Force) criteria for children. Overweight and obesity prevalence among girls was 18.3% and 2.9%, respectively, while in boys, 19.0% and 6.0%. Among parents, OW/OB prevalence was, respectively, women, 22.6% and 5.8%; men, 47.1% and 14.1%. Logistic regression analysis in both children and adults revealed that the most important socio-demographic predictors of obesity status are factors of built environment. Higher prevalence of OW/OB was observed in adults living in a house as opposed to an apartment, in older adults, in younger children, and in men, irrespective of age. There is a severe obesity problem in the Cypriot population; almost one in two adults and at least one in four preadolescent children are overweight or obese. Prevalence of OW/OB was related to socio-demographic factors, especially among adults and women.

M. Li, M. J. Dibley, D. Sibbritt and H. Yan. (2008). Factors associated with adolescents' overweight and obesity at community, school and household levels in Xi'an City, China: results of hierarchical analysis. European Journal Of Clinical Nutrition. 62, 635-643.

Objective: To identify personal and environmental factors associated with adolescent overweight and obesity in Xi'an city, China. Subjects/Methods: A total of 1804 adolescents from 30 junior high schools in six districts in Xi'an City. Community, school, household and individual characteristics were self reported by parents, school doctors and students. Factors associated with adolescent overweight and obesity were identified using a hierarchical logistic regression. Results: In all adolescents, after adjustment for age and gender, factors significantly associated with overweight and obesity were: living in urban districts (odds ratio (OR): 4.0, 95% confidence interval (CI): 2.7 - 6.0); limited use of school sports facilities (OR: 1.7, 95% CI: 1.1 - 2.6); wealthy households (OR: 1.7, 95% CI: 1.1 - 2.6); parental restrictions on purchasing snacks (OR: 1.5, 95% CI: 1.03 - 2.0); having an overweight/obese parent (OR: 1.8, 95% CI: 1.3 - 2.5); having soft drinks more than four times per week (OR: 1.6, 95% CI: 1.02 - 2.5) and not fussy about foods (OR: 1.7, 95% CI: 1.2 - 2.2). Eating sweets was negatively associated with overweight/obesity (OR: 0.6, 95% CI: 0.4 - 0.9). Separate gender analyses revealed that in boys, low physical activity (OR: 2.0, 95% CI: 1.1 - 3.8) and higher energy intake (OR: 1.8, 95% CI: 1.1 - 2.9) were also associated with overweight/obesity. In girls, less school sports meetings (OR: 2.3, 95% CI: 1.3 - 4.0); parental decisions about eating fast foods (OR: 1.8, 95% CI: 1.1 - 2.9) and availability of home video games (OR: 1.7, 95% CI: 1.1 - 2.5) were also significant. Conclusions: Preventive strategies for adolescent overweight and obesity in Xi'an should address the community and school environments to reinforce behavioral change. Gender differences also need to be considered when planning interventions.

J. Mathieu. (2008). Safe play and its effect on childhood obesity. J Am Diet Assoc. 108, 774-5.

N. C. McDonald. (2008). Critical factors for active transportation to school among low-income and minority students - Evidence from the 2001 national household travel survey. American Journal Of Preventive Medicine. 34, 341-344.

Background: Walking to school may be an important source of daily physical activity in children's lives, and government agencies are supporting programs to encourage walking to school (e.g., Safe Routes to School and the CDC's KidsWalk programs). However, little research has looked at differences in behavior across racial/ethnic and income groups. Methods: This cross-sectional study used data from the 2001 National Household Travel Survey to document rates of walking and biking to school among low-income and minority youth in the U.S. (N= 14,553). Binary models of the decision to use active transport to school were developed to simultaneously adjust for trip, individual, household, and neighborhood correlates. All analyses were conducted in 2007. Results: The data showed that low-income and minority groups, particularly blacks and Hispanics, use active travel modes to get to school at much higher rates than whites or higher-income students. However, racial variation in travel patterns is removed by controlling for household income, vehicle access, distance between home and school, and residential density. Conclusions: Active transportation to school may be an important strategy to increase and maintain physical activity levels for low-income and minority youth. Current policy interventions such as Safe Routes to School have the opportunity to provide benefits for low-income and minority students who are the most likely to walk to school.

N. C. McDonald. (2008). Children's mode choice for the school trip: the role of distance and school location in walking to school. Transportation. 35, 23-35.

Rising levels of childhood obesity in the United States and a 75% decline in the proportion of children walking to school in the past 30 years have focused attention on school travel. This paper uses data from the US Department of Transportation's 2001 National Household Travel Survey to analyze the factors affecting mode choice for elementary and middle school children. The analysis shows that walk travel time is the most policy-relevant factor affecting the decision to walk to school with an estimated direct elasticity of -0.75. If policymakers want to increase walking rates, these findings suggest that current policies, such as Safe Routes to School, which do not affect the spatial distribution of schools and residences will not be enough to change travel behavior. The final part of the paper uses the mode choice model to test how a land use strategy-community schools-might affect walking to school. The results show that community schools have the potential to increase walking rates but would require large changes from current land use, school, and transportation planning practices.

N. M. Nelson, E. Foley, D. J. O'Gorman, N. M. Moyna and C. B. Woods. (2008). Active commuting to school: How far is too far? International Journal Of Behavioral Nutrition And Physical Activity. 5,

Background: Walking and cycling to school provide a convenient opportunity to incorporate physical activity into an adolescent's daily routine. School proximity to residential homes has been identified as an important determinant of active commuting among children. The purpose of this study is to identify if distance is a barrier to active commuting among adolescents, and if there is a criterion distance above which adolescents choose not to walk or cycle. Methods: Data was collected in 2003-05 from a cross-sectional cohort of 15-17 yr old adolescents in 61 post primary schools in Ireland. Participants self-reported distance, mode of transport to school and barriers to active commuting. Trained researchers took physical measurements of height and weight. The relation between mode of transport, gender and population density was examined. Distance was entered into a bivariate logistic regression model to predict mode choice, controlling for gender, population density socio-economic status and school clusters. Results: Of the 4013 adolescents who participated (48.1% female, mean age 16.02 +/- 0.661), one third walked or cycled to school. A higher proportion of males than females commuted actively (41.0 vs. 33.8%,chi(2) (1) = 22.21, p < 0.001, r = -0.074). Adolescents living in more densely populated areas had greater odds of active commuting than those in the most sparsely populated areas (chi(2) (df = 3) = 839.64, p < 0.001). In each density category, active commuters travelled shorter distances to school. After controlling for gender and population density, a 1-mile increase in distance decreased the odds of active commuting by 71% (chi(2) (df = 1) = 2591.86, p < 0.001). The majority of walkers lived within 1.5 miles and cyclists within 2.5 miles. Over 90% of adolescents who perceived distance as a barrier to active commuting lived further than 2.5 miles from school. Conclusion: Distance is an important perceived barrier to active commuting and a predictor of mode choice among adolescents. Distances within 2.5 miles are achievable for adolescent walkers and cyclists. Alternative strategies for increasing physical activity are required for individuals living outside of this criterion.

J. R. Panter, A. P. Jones and E. M. F. van Sluijs. (2008). Environmental determinants of active travel in youth: A review and framework for future research. International Journal Of Behavioral Nutrition And Physical Activity. 5,

Background: Many youth fail to meet the recommended guidelines for physical activity. Walking and cycling, forms of active travel, have the potential to contribute significantly towards overall physical activity levels. Recent research examining the associations between physical activity and the environment has shown that environmental factors play a role in determining behaviour in children and adolescents. However, links between the environment and active travel have received less attention. Methods: Twenty four studies were identified which examined the associations between the environment (perceived or objectively measured) and active travel among youth aged 5-18 years. Findings were categorised according to the location of the environmental measure examined; attributes of the neighbourhood, destination and the route between home and destination. Results: Results from the reviewed studies indicated that youth active travel is positively associated with social interactions, facilities to assist active travel and urban form in the neighbourhood as well as shorter route length and road safety en-route. A conceptual framework is presented which highlights the associations between active travel behaviours and environmental factors, drawing upon both existing and hypothesised relationships. Conclusion: We provide a review of the available literature and present a novel theoretical framework that integrates the environment into the wider decision making process around travel choices for children and adolescents. Further work should explore associations where gaps in understanding have been identified, and account for the main moderators of behaviour so hypothesised associations can be confirmed.

R. R. Pate, N. Colabianchi, D. Porter, M. Almeida, F. Lobelo and M. Dowda. (2008). Physical activity and neighborhood resources in high school girls. American Journal Of Preventive Medicine. 34, 413-419.

Background: Physical activity behavior is influenced by a person's physical environment, but few studies have used objective measures to study the influences of the physical environment on physical activity behavior in youth. The purpose of this study was to examine the relationship between selected neighborhood physical activity resources and physical activity levels in high school girls. Methods: Participants were students in schools that had participated in a large physical activity intervention trial. The 3-Day Physical Activity Recall was completed by 1506 12th-grade girls. Data on physical activity facilities and resources in the participating communities were collected using a variety of methods. Physical activity resources within a 0.75-mile street-network buffer around each girl's home were counted using ArcGIS, version 9.1. Mixed-model regression models were used to determine if there was a relationship between three physical activity variables and the number of physical activity resources within the 0.75-mile buffer. Data were collected in 2002-2003 and analyzed in 2006-2007. Results: On average, 3.5 physical activity resources (e.g., schools, parks, commercial facilities) were located within the 0.75-mile street-network buffer. Thirty-six percent of the girls had no physical activity resource within the buffer. When multiple physical activity resources were considered, the number of commercial physical activity facilities was significantly associated with reported vigorous physical activity, and the number of parks was associated with total METs in white girls. Conclusions: Multiple physical activity resources within a 0.75-mile street-network buffer around adolescent girls' homes are associated physical activity in those girls. Several types of resources are associated with vigorous physical activity and total activity in adolescent girls. Future studies should examine the temporal and causal relationships between the physical environment, physical activity, and health outcomes related to physical activity.

A. V. Ries, J. Gittelsohn, C. C. Voorhees, K. M. Roche, K. J. Clifton and N. M. Astone. (2008). The environment and urban adolescents' use of recreational facilities for physical activity: a qualitative study. American Journal of Health Promotion. 23, 43-50.

A. V. Ries, C. C. Voorhees, J. Gittelsohn, K. M. Roche and N. M. Astone. (2008). Adolescents' perceptions of environmental influences on physical activity. American Journal Of Health Behavior. 32, 26-39.

Objectives: To examine African American adolescents' perceptions of environmental influences on physical activity and identify physical activity promotion strategies. Methods: Concept mapping with 50 adolescents was used to obtain cluster maps of conceptual domains affecting physical activity. Results: Seven domains were identified, including physical activity settings, social support, negative social influences, parental control, negative environmental influences, transportation and technology issues, and financial issues. Their relative importance to physical activity varied by gender. Conclusions: This research identified salient environmental characteristics that can be measured in future studies as well as strategies for increasing physical activity in urban youths.

J. E. Robertson-Wilson, S. T. Leatherdale and S. L. Wong. (2008). Social-ecological correlates of active commuting to school among high school students. Journal Of Adolescent Health. 42, 486-495.

Purpose: It has been suggested that health benefits from physical activity may be accrued through active commuting to school. Considering that active commuting is modifiable via policy and that there is limited research examining active commuting among high school students, this is a domain that warrants further investigation. The purpose of this study is to explore the relationships between demographic, behavioral, social/psychological, and environmental correlates of active commuting to school among a sample of high school students. Methods: Students (N = 21,345) from 76 Ontario high schools (grades 9-12) completed the School Health Action, Planning and Evaluation System Physical Activity Module between 2005-2006. Demographic (gender, grade, body mass index), behavioral (smoking status, physical activity, sedentary time), social/psychological (perceived athletic ability, weight status, parental encouragement), and environmental (school location, type, weather) predictors of active commuting (daily or mixed mode) were assessed. Results: Only 42.5% of high school students reported actively commuting to school. Students were less likely to actively commute to school if they were girls, in grade 12, smoked daily, were low-moderate in physical activity, or attended a rural school. Conclusions: Patterns of active commuting to school are influenced by multiple factors, some of which are modifiable through intervention. This has important implications for future school-based programming designed to enhance health and physical activity of adolescents through using active modes of transportation to school.

G. K. Singh, M. D. Kogan, M. Siahpush and P. C. van Dyck. (2008). Independent and joint effects of socioeconomic, behavioral, and neighborhood characteristics on physical inactivity and activity levels among US children and adolescents. Journal Of Community Health. 33, 206-216.

This study examines the independent and joint associations between several socioeconomic and behavioral characteristics and physical activity (PA) and inactivity prevalence among 68,288 US children aged 6-17 years. The 2003 National Survey of Children's Health was used to estimate PA prevalence. Multivariate logistic regression was used to estimate odds of activity and inactivity and adjusted prevalence, while least squares regression was used to model mean number of days of physical inactivity (PIA) in past month. The prevalence of PA varied substantially by socioeconomic and behavioral characteristics, with older, female, non-English speaking, and metropolitan children and those with lower socioeconomic status (SES) and neighborhood social capital having higher inactivity and lower activity levels. Children who watched television <3 h/day had 60% higher adjusted odds of PIA and 30% lower odds of PA than those who watched television < 3 h/day. Children experiencing inadequate sleep during the entire week had 55% higher odds of PIA and 29% lower odds of PA than those who experienced >= 5 nights of adequate sleep during the week. Children whose both parents were physically inactive had 147% higher odds of PIA and 46% lower odds of PA than children whose parents were both physically active. Differentials in PIA by ethnicity, SES, television viewing, and parental inactivity were greater for younger than for older children. Subgroups such as older, female adolescents, children from socially disadvantaged households and neighborhoods, and those in metropolitan areas should be targeted for the promotion of regular physical activity and reduced television viewing time.

J. C. Spence, N. Cutumisu, J. Edwards and J. Evans. (2008). Influence of neighbourhood design and access to facilities on overweight among preschool children. International Journal Of Pediatric Obesity. 3, 109-116.

Objective. Studies of the role of the built environment in relation to obesity in young children have reported inconsistent results. Methods. We explored the association of objective measures of neighbourhood design (dwelling density, land use mix, intersection density, availability of facilities) with the bodyweight status of 501 preschool children (girls =262; boys = 239) residing in Edmonton, Canada. Results. Approximately 21 % of the children were classified as overweight or at-risk of being overweight according to the Centers for Disease Control (CDC) growth charts, while 15% of the children were considered overweight or obese according to the International Obesity Task Force (IOTF) criteria. Controlling for measures of physical activity, junk food consumption and neighbourhood-level social class, significant interactions were found between sex of the child and walkability of the neighbourhood (composite index of dwelling density, land use mix, and intersection density) and sex of the child and intersection density regardless of the bodyweight status criteria. The odds of girls being overweight or obese were lower if they lived in walkable neighbourhoods (OR =0.78, 95%CI, 0.66-0.91 CDC; OR =0.73, 95%CI, 0.61-0.88 IOTF) with more intersections (OR =0.57, 95%CI, 0.39-0.86 CDC; OR =0.48, 95%CI, 0.30-0.76 IOTF). No significant associations were observed for boys. Conclusion. Thus, aspects of the built environment may differentially influence the bodyweight status of children depending upon sex.

N. J. Spurrier, A. A. Magarey, R. Golley, F. Curnow and M. G. Sawyer. (2008). Relationships between the home environment and physical activity and dietary patterns of preschool children: a cross-sectional study. International Journal Of Behavioral Nutrition And Physical Activity. 5,

Objective: To assess relationships between characteristics of the home environment and preschool children's physical activity and dietary patterns. Methods: Homes of 280 preschool children were visited and information obtained by direct observation and parent interview regarding physical and nutritional characteristics of the home environment. Children's physical activity, sedentary behaviour and dietary patterns were measured using standardised parent-report questionnaires. Associations were analysed using analysis of variance and correlation. Results: Parental physical activity (p = 0.03-0.008), size of backyard (p = 0.001) and amount of outdoor play equipment (p = 0.003) were associated with more outdoor play. Fewer rules about television viewing (p < 0.001) and presence of playstation (p = 0.02) were associated with more indoor sedentary time. Higher fruit and vegetable intake was associated with restricting children's access to fruit juice (p = 0.02) and restricting high fat/sugar snacks (p = 0.009). Lower intake of non-core foods was associated with restricting children's access to fruit juice (p = 0.007), cordial/carbonated drinks (p < 0.001) and high fat/sugar snacks (p = 0.003). Lower fruit and vegetable intake was associated with reminding child to 'eat up' (p = 0.007) and offering food rewards to eat main meal (p = 0.04). Higher intake of non-core foods was associated with giving food 'treats' (p = 0.03) and offering food rewards to eat main meal (p = 0.04). The availability of food groups in the home was associated with children's intake of these foods (fruit and vegetables, p < 0.001; fat in dairy, p = < 0.001; sweetened beverages, p = 0.004 -< 0.001; non-core foods, p = 0.01 -< 0.001). Conclusion: Physical attributes of the home environment and parental behaviours are associated with preschool children's physical activity, sedentary behaviour and dietary patterns. Many of these variables are modifiable and could be targeted in childhood obesity prevention and management.

A. Timperio, J. Salmon, K. Ball, L. A. Baur, A. Telford, M. Jackson, L. Salmon and D. Crawford. (2008). Family physical activity and sedentary environments and weight change in children. International Journal Of Pediatric Obesity. 3, 160-167.

Objective. To examine associations between family physical activity and sedentary environment and changes in body mass index (BMI) z-scores among 10-12-year-old children over three years. Method. Design. Longitudinal (three-year follow-up). Subjects. In total, 152 boys and 192 girls aged 10-12 years at baseline. Measurements. Measured height and weight at baseline and follow-up (weight status, BMI z-scores); aspects of the family physical activity and sedentary environment (parental and sibling modelling, reinforcement, social support, family-related barriers, rules/restrictions, home physical environment) measured with a questionnaire completed by parents at baseline. Results. At baseline, 29.6% of boys and 21.9% of girls were overweight or obese, and mean (standard deviation, SD) BMI z-scores were 0.44 (0.99) and 0.28 (0.89), respectively. There was a significant change in BMI z-score among girls (mean change=0.19, SD=0.55, p < 0.001), but not boys. Among boys, the number of items at home able to be used for sedentary behaviour (B=0.11, p=0.037) was associated with relatively greater increases in BMI z-score. Among girls, sibling engagement in physical activity at least three times/wk (B=-0.17, p=0.010) and the number of physical activity equipment items at home (B=-0.05, p=0.018) were associated with relatively greater decreases in BMI z-score. Conclusion. Sibling physical activity and environmental stimuli for sedentary behaviours and physical activity within the home may be important targets for prevention of weight gain during the transition from childhood to adolescence.

G. F. Ulfarsson and V. N. Shankar. (2008). Children's travel to school: discrete choice modeling of correlated motorized and nonmotorized transportation modes using covariance heterogeneity. Environment And Planning B-Planning & Design. 35, 195-206.

Children's school travel mode is changing, especially away from walking and bicycling and towards private automobiles. Simultaneously we see warning signs from a public health standpoint as children are becoming less active. It has been suggested that walking and bicycling to or from school could help shift this trend, moving it towards greater activity, and researchers are therefore exploring choices of school-trip mode in relation to the pedestrian friendliness of the built environment. Mode-choice models are generally framed as multinomial logit (MNL) models. However, the limitations of MNL models can cause unrealistic effects when walking and bicycling are included with motorized modes. In this paper the focus is on accounting for individual-specific heterogeneity, since different children or families may have very different tastes or tolerances, such as travel time, when it comes to choosing between driving a private automobile, taking the school bus, bicycling, or walking to or from school. The results show that such heterogeneity exists, and that it is more important for nonmotorized modes than for the motorized modes. The results show that accounting for correlation across modes leads to more realistic marginal rates of substitution (cross-elasticities) across modes-in particular, an increase in the walking distance negatively affects the probability both of walking and of bicycling.

K. van der Horst, A. Oenema, P. van de Looij-Jansen and J. Brug. (2008). The ENDORSE study: Research into environmental determinants of obesity related behaviors in Rotterdam schoolchildren. Bmc Public Health. 8,

Background: Children and adolescents are important target groups for prevention of overweight and obesity as overweight is often developed early in life and tracks into adulthood. Research into behaviors related to overweight (energy balance-related behaviors) and the personal and environmental determinants of these behaviors is fundamental to inform prevention interventions. In the Netherlands and in other countries systematic research into environmental determinants of energy balance related behaviors in younger adolescents is largely lacking. This protocol paper describes the design, the components and the methods of the ENDORSE study (Environmental Determinants of Obesity in Rotterdam SchoolchildrEn), that aims to identify important individual and environmental determinants of behaviors related to overweight and obesity and the interactions between these determinants among adolescents. Methods: The ENDORSE study is a longitudinal study with a two-year follow-up of a cohort of adolescents aged 12-15 years. Data will be collected at baseline (2005/2006) and at two years follow-up (2007/2008). Outcome measures are body mass index (BMI), waist circumference, time spent in physical activity and sedentary behaviors, and soft drink, snack and breakfast consumption. The ENDORSE study consists of two phases, first employing qualitative research methods to inform the development of a theoretical framework to examine important energy balance related behaviors and their determinants, and to inform questionnaire development. Subsequently, the hypothetical relationships between behavioral determinants, energy balance related behaviors and BMI will be tested in a quantitative study combining school-based surveys and measurements of anthropometrical characteristics at baseline and two-year follow-up. Discussion: The ENDORSE project is a comprehensive longitudinal study that enables investigation of specific environmental and individual determinants of overweight and obesity among younger adolescents. The project will result in specific recommendations for obesity prevention interventions among younger adolescents.

P. Veugelers, F. Sithole, S. Zhang and N. Muhajarine. (2008). Neighborhood characteristics in relation to diet, physical activity and overweight of Canadian children. International Journal Of Pediatric Obesity. 3, 152-159.

Background. Neighborhood infrastructure may provide an important opportunity to prevent overweight among children. In the present study we investigated whether access to shops for modestly priced fresh produce, access to parks and playgrounds, access to recreational facilities and neighborhood safety are related to children's diet, physical and sedentary activities, and body weights. Methods. Data were obtained from the Children's Lifestyle and School-performance Study, a survey including 5471 grade five students and their parents in the province of Nova Scotia, Canada. Students completed the Harvard Food Frequency Questionnaire and had their height and weight measured. Parents completed questions on socio-economic background and how they perceived their neighborhood. We applied multilevel regression methods to relate these neighborhood characteristics with children's fruit and vegetable consumption, dietary fat intake, diet quality, frequency of engaging in sports with and without a coach, screen time, overweight and obesity. Results. Children in neighborhoods with greater perceived access to shops had healthier diets and were less likely to be overweight or obese. Children in neighborhoods with good access to playgrounds, parks and recreational facilities were reportedly more active and were less likely to be overweight or obese, whereas children in safe neighborhoods engaged more in unsupervised sports. Conclusions. The study demonstrated associations between neighborhood characteristics, health behaviors and childhood overweight. This contributes to the knowledge base that is still too narrow to justify informed preventative public health policy. We advocate the evaluation of natural experiments created by new policy that affect neighborhood infrastructures as the optimal opportunity to enlarge this knowledge base.

L. M. Wen, D. Fry, C. Rissel, H. Dirkis, A. Balafas and D. Merom. (2008). Factors associated with children being driven to school: implications for walk to school programs. Health Education Research. 23, 325-334.

In this study, we examined factors associated with children being driven to school. Participants were 1603 students (aged 9-11 years) and their parents from 24 public primary schools in inner western Sydney, Australia. Students recorded their modes of travel to and from school for 5 days in a student survey. Parents recorded their demographic data, their attitudes to travel, and their modes of travel to work, using a self-administered survey. An analysis of the two linked data sets found that 41% of students travelled by car to or from school for more than 5 trips per week. Almost a third (32%) of students walked all the way. Only 1% of students rode a bike and 22% used more than one mode of travel. Of those who were driven, 29% lived less than 1 km and a further 18% lived between 1 and 1.5 km from school. Factors associated with car travel (after adjusting for other potential confounders) were mode of parents' travel to work, parent attitudes, number of cars in the household, and distance from home to school. To be effective, walk to school programs need to address the link between parent journey to work and student journey to school.

A. K. Yarlagadda and S. Srinivasan. (2008). Modeling children's school travel mode and parental escort decisions. Transportation. 35, 201-218.

Understanding of the activity-travel patterns of children is becoming increasingly important to various policy makers. Further, there is also a growing recognition that intra-household interactions need to be explicitly accommodated in travel models for realistic forecasts and policy evaluation. In the light of these issues, this paper contributes towards an overall understanding of the school-travel behavior of children and the related interdependencies among the travel patterns of parents and children. An econometric model is formulated to simultaneously determine the choice of mode and the escorting person for children's travel to and from school. The 2000 San Francisco Bay Area Travel Survey (BATS) data are used in the model estimation process. Empirical results indicate that the characteristics of child like age, gender, and ethnicity, and employment and work flexibility characteristics of the parents have strong impacts on the mode choice decisions. In addition, the impacts of some of these attributes on the choice of mode to school are different from the corresponding impacts on the choice of mode from school. The distance between home and school is found to strongly and negatively impact the choice of walking to and from school, with the impact being stronger for walking to school. Several land-use and built-environment variables were explored, but were found not to be statistically significant predictors.

J. Yeung, S. Wearing and A. P. Hills. (2008). Child transport practices and perceived barriers in active commuting to school. Transportation Research Part A-Policy And Practice. 42, 895-900.

This study evaluated the transport practices of school children and perceived factors that influenced parental decisions regarding their child's use of active transport to commute to school. A self-administered parental questionnaire (n = 324) was used to determine the transport practices of school children and factors that influence parental decisions regarding their child's use of active transport to school. The relationship between transportation modes (active vs. passive), distance and descriptive variables were evaluated. Despite a median commuting distance of 2.5 km (0.1-28.0 km), only one-third of school trips involved active transport. Children using active transport commuted shorter distances (1.5 vs. 3.6 km), were older (10 vs. 8 years) and more likely to be male than those using motorised transport (P < 0.05). While logistic regression revealed only commuting distance was significantly associated with an increased odds of active transport (OR 0.29, 95% CI 0.17-0.48), the most frequently reported factors influencing parental decisions regarding their child's use of active transport were: (1) the age of child; (2) provision of safe walking paths; (3) adult supervision; (4) commuting distance, and (5) child's fitness level. While the majority of these factors have been identified within the literature, their validity has yet to be established.

J. Ziviani, D. Wadley, H. Ward, D. Macdonald, D. Jenkins and S. Rodger. (2008). A place to play: Socioeconomic and spatial factors in children's physical activity. Australian Occupational Therapy Journal. 55, 2-11.

Background and aims: Concerns about physical inactivity in children and growing levels of obesity are expressed by politicians, health economists and those involved with the health and well-being of children. As this has the potential to be a major health issue, the aim of this investigation was to explore any contributing socioenvironmental considerations. Methods and results: Census-matched survey data were analysed from 318 parents of 6- to 7-year-old children, revealing that family socioeconomic status (SES) influenced the places where children engaged in physical activity. Children from low SES backgrounds spent significantly more time playing close to their homes, and their families were less able to afford access to commercial physical-activity facilities, than those from middle and high SES families. Although neighbourhood-based activities are generally associated with more spontaneous free play, such activities may not provide the same opportunities for supervision and physical skill building available through commercial-based activities. Conclusions: Given that access to 'enriching' physicalactivity spaces may be limited by the capacity to pay, these findings have implications for professionals such as occupational therapists who can take on a role in advocating for equity in access and promotion of a more engaging urban design. Dialogue with urban planners is central to this process.

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