www.activelivingresearch.org
fax 619-260-1510
San Diego, California 92103 tel 619-260-5534
3900 Fifth Avenue, Suite 310
San Diego State University
James F. Sallis, Ph.D., Director
alr@projects.sdsu.edu
Leslie S. Linton, JD, MPH, Deputy Director
llinton@projects.sdsu.edu
Introduction to the Active Living Research Reference List for 2004-2005
The following pages are a summary of the literature studying the relationships between
the built environment, physical activity, and obesity for 2004-2005. We understand how
difficult it can be to keep track of the literature in a transdisciplinary field, so we hope you
find the information useful. We found 101 references in 2004 and 160 in 2005. The
articles were published in 100 different journals.
To create this list of references, a group of researchers at ALR conducted systematic
literature searches. To collect information represented in the fields of public health,
transportation/planning, and recreation/leisure studies, we used the following databases:
Medline, PubMed, SportDiscus, Leisure Tourism Database, and Web of Science. A
comprehensive list of search terms was developed by the team and is provided on the
following page. The physical activity-related terms were entered in the first search field
and the environment-related terms were entered in the second field. Terms within fields
were separated with “OR.” The two separate fields were combined with “AND.” The
physical activity-related terms were limited to use in the title only, while the environmentrelated terms were limited to use in the title, abstract, or key words field depending on
the database. Additional known references were also added. Relevant articles were
agreed upon by two researchers and included in the following list. The citations and
abstracts will be posted at: www.activelivingresearch.org.
While we have intended for this list to be comprehensive for 2004 and 2005, we are
certain to have missed some articles. For this reason, we welcome feedback about our
procedures, search terms and the databases utilized. Also, please let us know if we
missed any relevant articles so we can add them to the posted list. We plan to continue
compiling, emailing, and posting updated literature searches twice per year, with the
hope that they assist your research. Please join our mailing list at
www.activelivingresearch.org to receive these updates. Your feedback will help us
improve this service.
If you have questions or comments please contact Chad Spoon at
cspoon@projects.sdsu.edu.
Sincerely,
The Active Living Research Staff
An Active Living program supported by The Robert Wood Johnson Foundation and administered by San Diego State
University.
Active Living Research Literature Summary 2004 & 2005
Published February 2006
Physical Activity Related Terms
Non motorized transport OR multimodal
transportation OR active transportation OR
driving OR NMT OR active living OR
inactivity OR fit* OR body mass index OR
BMI OR car OR leisure OR television OR
obes* OR weight OR journey* OR
automobile OR inactive OR travel OR walk*
OR cycl* OR bik* OR sedentary OR
commut* OR exercise* OR physical* activ*
Environment Related Terms
Environment OR sprawl OR neighbor* OR recreation*
OR metropolitan OR rural OR suburban OR pedestrian*
OR equipment OR geograph* OR aesthet* OR conven*
OR urban form OR destination* OR trail OR park OR
path OR distance OR access OR planning OR location
OR transport* OR feature* OR polic* OR facilities OR
crime OR architecture OR building OR transit OR street
OR stairs OR playground* OR urban design OR
neighborhood development OR smart growth OR
outdoor OR indoor OR connectivity OR accessibility OR
new urbanism OR healthy places OR healthy
communities OR greenway OR rail-trail OR home OR
school OR land use OR saf*
Please note:
These terms were our "original" search terms. This list of terms will be expanded based on the
additional articles that we found while preparing this summary and based on additional articles
that we receive following publication of this summary.
Search terms varied slightly depending on the database being searched.
For more specific information please contact Chad Spoon at cspoon@projects.sdsu.edu.
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Active Living Research Literature Summary 2004 & 2005
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List of Journals and number of articles per journal
ACHPER Healthy Lifestyles Journal – 1
Acta Paediatrics – 1
Adolescence – 1
Age Ageing – 1
American Journal Of Health Promotion – 15
American Journal Of Preventive Medicine – 35
American Journal Of Public Health – 8
American Journal of Health Behavior – 1
Annals Of Behavioral Medicine – 5
Annals of Human Biology – 1
Annual Review of Public Health – 2
Anthropologischer Anzeiger – 1
Australia and New Zealand Journal of Public Health – 1
BMC Public Health – 1
British Medical Journal – 1
British Journal Of Sports Medicine – 2
Canadian Journal of Dietetic Practice and Research – 1
Canadian Journal of Nursing Research -1
Canadian Journal of Public Health -1
Child Care Health Development -1
Diabetes Care -1
Disability and Rehabilitation -2
Ecological Economics -1
Environmental Health Perspective -1
Environmental Science-1
Ethnicity & Disease -1
Evaluation and the Health Professions -1
Exercise Sport Science Review -3
Gerontologist -1
Health & Place -11
Health Education Research -3
Health Education & Behavior -1
Health Promotion Journal of Australia -1
Health Promotion Practice -8
Indian Heart Journal -1
International Journal of Behavioral Medicine -1
International Journal of Behavioral Nutrition and Physical Activity -5
International Journal of Epidemiology -1
International Journal of Obesity -1
International Journal of Obesity and Related Metabolic Disorders -2
International Journal of Environmental Health Research -1
International Journal of Health Promotion and Education -1
International Regional Science Review -1
International Review for the Sociology of Sport -1
Journal of Adolescent Health-2
Journal of Aging and Physical Activity -3
Journal of Allergy and Clinical Immunology -1
Journal of Allied Health -1
Journal of American College Health -1
Journal of the American Dietetic Association -1
Journal of Cardiopulmonary Rehabilitation -1
Journal of Environmental Psychology -1
Journal of Epidemiological Community Health -7
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Active Living Research Literature Summary 2004 & 2005
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Journal of Korean Medical Science- 1
Journal of Leisure Research -2
Journal of Oklahoma State Medical Association -1
Journal of park and recreation administration -2
Journal of Physical Activity and Health -10
Journal of Planning Literature -2
Journal of Public Health Management and Practice -1
Journal of Regional Analysis & Policy -1
Journal of Rural Health -4
Journal of Science & Medicine in Sports -2
Journal of The American Planning Association -1
Journal of Sports Science -2
Journal of Urban Health -2
Journal of Urban Health-Bulletin of The New York Academy Of Medicine -3
Journal of Women & Aging -2
Landscape and Urban Planning -2
Leisure Sciences -6
Medicine and Science in Sports And Exercise -4
Morbidity and Mortality Weekly Report -1
Obesity Research -5
Occupational Therapy International -1
Parks & Recreation-3
Patient Education and Counseling -1
Pediatric exercise science-1
Pediatrics -2
Pediatrics International -1
Physical Therapy -1
Physiology & Behavior -1
Postgraduate Medical Journal -1
Preventing Chronic Disease- 4
Preventive Medicine – 12
Psychology of Sport And Exercise -1
Public Health -1
Public Health Nursing -1
Public Health Nutrition -3
Public Health Reports -2
Quest -1
Research Quarterly For Exercise and Sport -2
Social Science & Medicine -2
Sozial- und Praventivmedizin -2
Traffic Injury Prevention -1
Transportation - 1
Transportation Research Part A-Policy and Practice -3
Transportation Research Part B-Methodological -1
Transportation Research Part D-Transport and Environment -7
Travel Demand and Land Use 2004 -1
Youth Studies Australia -1
4
Active Living Research Literature Summary 2004 & 2005
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Titles and Abstracts
2004
Addy, C. L., D. K. Wilson, et al. (2004). "Associations of perceived social and physical
environmental supports with physical activity and walking behavior." American Journal of Public
Health 94(3): 440-3.
We evaluated perceived social and environmental supports for physical activity and
walking using multivariable modeling. Perceptions were obtained on a sample of households in a
southeastern county. Respondents were classified according to physical activity levels and
walking behaviors. Respondents who had good street lighting; trusted their neighbors; and used
private recreational facilities, parks, playgrounds, and sports fields were more likely to be
regularly active. Perceiving neighbors as being active, having access to sidewalks, and using
malls were associated with regular walking.
Adkins, S., N. E. Sherwood, et al. (2004). "Physical activity among African-American girls: the
role of parents and the home environment." Obesity Research 12 Suppl: 38S-45S.
OBJECTIVES: African-American girls are at increased risk for becoming overweight.
Increased physical activity may prevent this. This study examines measurements of girls' physical
activity and associations with: BMI, parent's reported self-efficacy and support for helping
daughters be active, girl's perceived support from parents for physical activity, parent's and girl's
perceived neighborhood safety and access to facilities, and family environment. RESEARCH
METHODS AND PROCEDURES: Fifty-two 8- to 10-year-old African-American girls and their
primary caregiver in the Minneapolis/St. Paul area participated in the Girls Health Enrichment
Multisite Studies pilot intervention to prevent weight gain by promoting healthy eating and
physical activity. Data collected included height, weight, physical activity level, and physical
activity-related psychosocial measures from girl and parent. Girls wore an activity monitor for 3
days to assess activity level. Correlations were computed among the average minutes per day of
moderate to vigorous activity between 12 pm and 6 pm and BMI and psychosocial measures.
RESULTS: BMI was inversely correlated with moderate to vigorous activity (r = -0.35, p < 0.01),
whereas parent's self-efficacy for supporting daughter to be active was positively correlated with
activity (r = 0.45, p < 0.001). There was a trend for parent's reported support of daughter's activity
level to be associated with activity (r = 0.26, p < 0.06). Girl's perception of parent's support for
physical activity, perceived neighborhood safety and access to facilities, and family environment
were not associated with girl's activity levels. DISCUSSION: Interventions to increase physical
activity among preadolescent African-American girls may benefit from a parental component to
encourage support and self-efficacy for daughters' physical activity.
Aronson, R. E. and R. F. Oman (2004). "Views on exercise and physical activity among ruraldwelling senior citizens." Journal Of Rural Health 20(1): 76-79.
Context: This study was conducted with senior citizens in the 2 rural communities of Ada
and Lindsay, Oklahoma. These communities are both predominantly white, with the largest
minority population being American Indian. Both communities are more than 60 miles from a
metropolitan area and have a history of farming and ranching. Purpose: The purpose of this study
was to explore contextual factors related to physical activity among senior citizens living in rural
communities. Methods: Two focus groups were conducted. The groups were conducted in mixedsex sessions and were audiotaped and transcribed verbatim for the purpose of analysis.
Findings: Themes from the focus groups included the following: (1) the types of daily activities
engaged in by seniors; (2) the meaning and connotation of the words exercise and physical
activity, with physical activity connoting for some the negative imagery of physical labor, and (3)
the availability and suitability of settings for physical activity. For seniors living in rural settings in
Oklahoma, the lack of indoor facilities and the sometimes extreme climatic conditions serve as
significant barriers to physical activity. Conclusion: This study suggests that programs seeking to
encourage physical activity among seniors in rural areas could benefit from an assessment of
resources and settings for physical activity and the avoidance of language that may have
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
negative connotations for this population.
Bauer, K. W., Y. W. Yang, et al. (2004). ""How can we stay healthy when you're throwing all of
this in front of us?" - Findings from focus groups and interviews in middle schools on
environmental influences on nutrition and physical activity." Health Education & Behavior 31(1):
34-46.
This study aimed to identify factors in school physical and social environments that may
facilitate or compete with programs and policies to improve student physical activity and nutrition.
Focus groups and interviews were conducted with students, faculty, and staff of two public middle
schools. Participants identified numerous aspects of the school environments as significant.
Competition, teasing and bullying, time, and safety were described as major barriers for students
to be physically active during physical education class, on sports teams, and before and after
school. The quality of the food served, easy access to nonnutritious snacks, limited time for lunch
period, and weight concerns emerged as significant reasons why students do not eat nutritious
meals in school. When developing programs and policies to improve the health of students,
environmental influences that undermine efforts to improve student health behaviors must be
addressed.
Bertrais, S., P. Preziosi, et al. (2004). "Sociodemographic and geographic correlates of meeting
current recommendations for physical activity in middle-aged French adults: the Supplementation
en Vitamines et Mineraux Antioxydants (SUVIMAX) Study." American Journal of Public Health
94(9): 1560-6.
OBJECTIVE: We evaluated the characteristics of French subjects meeting current public
health recommendations for physical activity. METHODS: We assessed leisure-time physical
activity cross-sectionally in 7404 adults aged 45 to 68 years with applied logistic regression
models. RESULTS: Meeting the recommended physical activity levels was more likely in subjects
aged 60 years and older and in women with higher education levels or living in rural areas and
was less likely in smokers. No association was found with time spent watching television. The
contribution of vigorous activity to total time spent being active was approximately 2 times higher
in subjects meeting recommendations. CONCLUSIONS: Participation in some vigorous activity
may be viewed as a "facilitator" to attain physical activity recommendations. Relationships with
physical environment variables in Europe need further investigation.
Bhat, R. C. and A. Lockwood (2004). "On distinguishing between physically active and physically
passive episodes and between travel and activity episodes: an analysis of weekend recreational
participation in the San Francisco Bay area." Transportation Research Part A-Policy And Practice
38(8): 573-592.
This paper examines the out-of-home recreational episode participation of individuals
over the weekend, with a specific focus on analyzing the determinants of participation in
physically active versus physically passive pursuits and travel versus activity episodes (travel
episodes correspond to recreational pursuits without any specific out-of-home location, such as
walking, bicycling around the block, and joy-riding in a car, while activity episodes are pursued at
a fixed out-of-home location, such as playing soccer at the soccer field and swimming at an
aquatics center). The above disaggregation of recreational episodes facilitates the better analysis
and modeling of activity-travel attributes, such as travel mode, episode duration, time-of-day of
participation and location of participation. From a broader societal standpoint, the disaggregation
of recreational episodes provides important information to encourage active participatory
recreational pursuits, which can serve to relieve mental stress, improve the physical health of the
population, and contribute to a socially vibrant society through increased interactions among
individuals. The paper employs a mixed multinomial logit formulation for examining out-of-home
recreational episode type participation using the 2000 San Francisco Bay area travel survey. A
variety of variables, including individual and household sociodemographics, location attributes,
and day of week and seasonal effects, are considered in the model specification. Individualspecific unobserved factors affecting the propensity to participate in different types of recreational
episodes are also accommodated. (C) 2004 Elsevier Ltd. All rights reserved.
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Active Living Research Literature Summary 2004 & 2005
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Boslaugh, S. E., D. A. Luke, et al. (2004). "Perceptions of neighborhood environment for physical
activity: is it "who you are" or "where you live"?" Journal of Urban Health 81(4): 671-81.
Lack of physical activity among American adults is a serious public health concern. Many
factors influence activity levels, and most research has focused on either individual factors, such
as race and income, or on characteristics of the physical environment, such as the availability of
parks. Our study used a cross-sectional multilevel design to examine the influences of individualand neighborhood-level characteristics on participant's perceptions of their neighborhood as an
appropriate venue for physical activity. Study participants were 1,073 African American and white
adults living in the St. Louis, Missouri, metropolitan area. Individual-level information was
gathered from self-administered questionnaires; neighborhood-level data for these same
individuals were obtained from the 2000 US Census. We found that both individual and
neighborhood characteristics were significant predictors of how individuals perceived physical
activity opportunities in their neighborhood, and that African Americans perceived their
neighborhoods as less safe and less pleasant for physical activity than did whites, regardless of
the racial composition of the neighborhood. We suggest that any evaluation of opportunities for
physical activity within a neighborhood should include consideration of resident's perceptions of
the safety and pleasantness of using them, and that the role of perceived and actual
neighborhood conditions in explaining disparities in physical activity between African American
and other populations should be examined further.
Braza, M., W. Shoemaker, et al. (2004). "Neighborhood design and rates of walking and biking to
elementary school in 34 California communities." American Journal of Health Promotion 19(2):
128-36.
PURPOSE: This study evaluates the relationship between neighborhood design and
rates of students walking and biking to elementary school. DESIGN: Pairwise correlations and
multiple regression models were estimated based on a cross-sectional study of elementary
schools and their surrounding neighborhoods. Setting and Subjects. Thirty-four (23%) of 150
California public elementary schools holding October 1999 Walk to School Day events
participated in the study. MEASURES: Teachers asked fifth-grade students how they arrived to
school 1 week before Walk to School Day. 1990 U.S. Census data measured population density
and number of intersections per street mile, whereas 1998-1999 California Department of
Education data measured school size, the percentage of students receiving public welfare, and
the percentage of students of various ethnicities. RESULTS: Population density (p =.000) and
school size (p =.053) were significantly associated with walking and biking rates in regression
models controlling for number of intersections per street mile, the percentage of students
receiving public welfare, and the percentage of students of various ethnicities. The number of
intersections per street mile was associated with walking and biking rates in pairwise correlations
(p =.003) but not in regression models. CONCLUSIONS: The results support the hypothesis that
the walking and biking rates are higher in denser neighborhoods and to smaller schools but do
not support the hypothesis that rates are higher in neighborhoods with a high number of
intersections per street mile. We suggest that detailed data for a larger sample of students would
allow statistical models to isolate the effect of specific design characteristics.
Brownson, R. C., E. A. Baker, et al. (2004). "A community-based approach to promoting walking
in rural areas." American Journal of Preventive Medicine 27(1): 28-34.
BACKGROUND: Ecologic models are often recommended to promote physical activity,
yet sparse data exist on their effectiveness. DESIGN: A quasi-experimental design examined
changes in walking behavior in six rural intervention communities in the Missouri "bootheel"
region and in six comparison communities in Arkansas and Tennessee. SETTING/
PARTICIPANTS: The communities ranged in population from 2399 to 17,642; interventions
focused on adults aged >/=18 years. INTERVENTION: Interventions were developed with
community input and included individually tailored newsletters, interpersonal activities that
stressed social support, and community-wide events such as walk-a-thons. MAIN OUTCOME
MEASURES: Primary outcomes were rates of walking-trail use, total number of minutes walked in
the past week, and total minutes walked for exercise. RESULTS: Among persons who used trails
at baseline (16.9% of the total population), 32.1% reported increases in physical activity since
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
they began using the trail. From community-wide samples, two subgroups indicated a positive net
change in rates of 7-day total walking: people with high school degrees or less and people living
in households with annual incomes of <==$20,000. However, no studied group showed a
statistically significant net intervention effect. CONCLUSIONS: Although there was an increase in
the rate of walking-trail use, a community-wide change in walking rates in rural communities was
not documented. Results of this study should provide guidance for future projects.
Brownson, R. C., J. J. Chang, et al. (2004). "Measuring the environment for friendliness toward
physical activity: a comparison of the reliability of 3 questionnaires." American Journal of Public
Health 94(3): 473-83.
OBJECTIVES: We tested the reliability of 3 instruments that assessed social and
physical environments. METHODS: We conducted a test-retest study among US adults (n = 289).
We used telephone survey methods to measure suitableness of the perceived (vs objective)
environment for recreational physical activity and nonmotorized transportation. RESULTS: Most
questions in our surveys that attempted to measure specific characteristics of the built
environment showed moderate to high reliability. Questions about the social environment showed
lower reliability than those that assessed the physical environment. Certain blocks of questions
appeared to be selectively more reliable for urban or rural respondents. CONCLUSIONS: Despite
differences in content and in response formats, all 3 surveys showed evidence of reliability, and
most items are now ready for use in research and in public health surveillance.
Brownson, R. C., C. Hoehner, et al. (2004). "Reliability of two instruments for auditing the
environment for physical activity." Journal of Physical Activity and Health 1(3): 191-208.
Purpose: To understand the relationships between street-scale environments and rates
of physical activity, it is crucial to develop reliable methods of measurement. Community audits
are commonly used to test the walkability and bikability of environments, yet few have been
tested for reliability. Methods: Audit tools were collected from the peer-reviewed literature, the
Internet, and experts from a variety of backgrounds. Two versions of an audit instrument were
created: an “analytic_221? (with Likert-scale and ordinal-response choices) and a “checklist_21?
(with dichotomous response choices) audit tool. Audits were conducted in St Louis, MO for 147
street segments, representing both higher and lower income neighborhoods. The same segments
were re-audited to assess interrater reliability. Results: Characteristics of the physical
environment varied considerably across lower and higher income segments. For example, in the
checklist audit, physical disorder was present for 67 segments in lower income segments,
compared with 0 segments in higher income segments. Among 8 questions from each audit tool
designed to broadly capture environmental attributes, most had moderate to poor agreement.
Most of the transportation and land-use items demonstrated high (substantial or perfect)
agreement, and the aesthetics and social environment items showed reliability in the moderate to
fair range. Conclusions: A community audit tool can be relatively easy and quick to administer
and, for many domains, is reliable. Our audit tools appear particularly well suited for capturing
elements in the transportation and land-use environments.
Burdette, H. L. and R. C. Whitaker (2004). "Neighborhood playgrounds, fast food restaurants, and
crime: relationships to overweight in low-income preschool children." Preventive Medicine 38(1):
57-63.
BACKGROUND: We examined the relationship between overweight in preschool children
and three environmental factors--the proximity of the children's residences to playgrounds and to
fast food restaurants and the safety of the children's neighborhoods. We hypothesized that
children who lived farther from playgrounds, closer to fast food restaurants, and in unsafe
neighborhoods were more likely to be overweight. METHODS: This was a cross-sectional study
of 7,020 low-income children, 36 through 59 months of age living in Cincinnati, OH. Overweight
was defined as a measured body mass index > or =95th percentile. The distance between each
child's residence and the nearest public playground and fast food restaurant was determined with
geographic information systems. Neighborhood safety was defined by the number of policereported crimes per 1,000 residents per year in each of 46 city neighborhoods. RESULTS:
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Active Living Research Literature Summary 2004 & 2005
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Overall, 9.2% of the children were overweight, 76% black, and 23% white. The mean (+/- SD)
distances from a child's home to the nearest playground and fast food restaurant were 0.31 (+/0.22) and 0.70 (+/- 0.38) miles, respectively. There was no association between child overweight
and proximity to playgrounds, proximity to fast food restaurants, or level of neighborhood crime.
The association between child overweight and playground proximity did not differ by
neighborhood crime level. CONCLUSIONS: Within a population of urban low-income
preschoolers, overweight was not associated with proximity to playgrounds and fast food
restaurants or with the level of neighborhood crime.
Cawley, J. (2004). "An economic framework for understanding physical activity and eating
behaviors." American Journal of Preventive Medicine 27(3 Suppl): 117-25.
This paper offers an economic framework of human behavior with respect to physical
activity and nutrition. Economics offers useful insights into these behaviors because it is the study
of how people allocate their scarce resources of time and money to maximize their lifetime
happiness. This paper outlines the criteria for policy interventions from an economic perspective
and also considers arguments for policy intervention that are not based on economic
considerations. The implications of the economic framework are summarized and its limitations
are described.
Chambliss, H. O. (2004). "Behavioral approaches to obesity treatment." Quest 56(1): 142.
Obesity is at the forefront of the public health agenda. Why, with all the emphasis on the
health risks of obesity and the availability of multiple treatment options, is it so difficult for people
to successfully lose and maintain weight? The answer is simple: Most obesity treatment plans tell
people what to do but not how to change their behavior. Furthermore, many people attempting
weight loss focus on narrow aspects of weight loss behaviors (e.g., specific eating or exercise
plans, over-the-counter weight loss products, medication, and in growing numbers, gastric
surgery). However, weight gain is ultimately a consequence of multiple environmental and
biologic factors that encourage behaviors that result in positive energy balance. It is unlikely that
most obesity treatments will be successful unless people learn to address the environmental,
biologic, and behavioral barriers that influence their ability to make eating and physical activity
choices that promote long-termweight management. Behavioral approaches to obesity treatment
help people develop the skills they need to successfully manage their weight in a way that is
consistent with their individual barriers, goals, and lifestyles.
Cohen, S. J., J. S. Meister, et al. (2004). "Special action groups for policy change and
infrastructure support to foster healthier communities on the Arizona-Mexico border." Public
Health Reports 119(1): 40-47.
Coogan, P. F. and M. A. Coogan (2004). "When worlds collide: observations on the integration of
epidemiology and transportation behavioral analysis in the study of walking." American Journal of
Health Promotion 19(1): 39-44.
Since obesity has emerged as a public health crisis in the United States, the factors that
influence physical activity are of interest to both epidemiologists and transportation researchers.
This article describes different approaches taken by the two disciplines to this issue. "Utilitarian"
walking to accomplish a task, as opposed to structured exercise, could be a highly sustainable
way for people to achieve recommended levels of physical activity. Transportation planners have
begun to investigate factors of urban form and transportation services that influence the choice to
walk. Epidemiologists have become more aware of the importance of factors in the built and
social environment that could influence health behaviors like walking. Few transportation studies
focus on the generation of the utilitarian walk trip as the key variable; rather, they include it in
more general discussions of urban form. Likewise, most epidemiologic studies have not focused
on utilitarian walking, but have folded it into an overall measure of physical activity that
emphasizes structured exercise. Further transportation research should examine the effects of
improved mobility services in addition to alterations of the built environment. Integration of
epidemiologic and transportation behavioral research could enhance our understanding of the
role of urban and transportation factors on physical activity.
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Active Living Research Literature Summary 2004 & 2005
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Crombie, I. K., L. Irvine, et al. (2004). "Why older people do not participate in leisure time physical
activity: a survey of activity levels, beliefs and deterrents." Age Ageing 33(3): 287-92.
BACKGROUND: Regular physical activity has been shown to have many health benefits.
However, many older people are physically inactive. OBJECTIVE: To investigate why older
people are reluctant to participate in leisure time physical activity and to identify strategies to
encourage increased activity. DESIGN: Cross-sectional survey. SETTING: 16 general practices
in Dundee, Scotland. METHODS: 409 randomly selected older people (65-84 years) who lived
independently were interviewed at home. Forty-six percent of those invited to take part were
recruited into the study. RESULTS: Levels of knowledge about the specific health benefits of
physical activity were high. Almost all participants (95%) believed that physical activity was
beneficial and 79% believed that they did enough to keep healthy. However, 36% did no leisure
time physical activity and a further 17% did less than 2 hours per week. Regression modelling
identified 11 factors that exerted significant independent effects on levels of leisure time physical
activity. The most powerful deterrent was lack of interest (OR = 7.8). Other factors included lack
of daily access to a car, shortness of breath, joint pain, dislike of going out alone or in the
evening, perceived lack of fitness, lack of energy, doubting that exercise can lengthen life, not
belonging to a group and doubting that meeting new people is beneficial. CONCLUSIONS:
Increasing leisure time physical activities poses major challenges. Beliefs about desirable levels
of activity in older people would need to be changed. Action would be needed to relieve physical
symptoms and address fears about perceived ability to undertake physical activity. Finally, easily
accessible facilities would be needed to encourage participation in physical activity.
Croteau, K. A. (2004). "Strategies used to increase lifestyle physical activity in a pedometerbased intervention." Journal of Allied Health 33(4): 278-81.
The purpose of this study was to determine the self-selected strategies participants used
to increase physical activity during an 8-week, pedometer-based lifestyle intervention.
Participants were 34 employees of a small northeastern private college, with a mean age of 44.3
(+/- 9.3) years. The intervention consisted of a counseling session (goal setting, strategy
selection), daily pedometer usage, and self-monitoring. Measures included height, weight, and
pedometer-assessed ambulatory activity. Participants were placed in body mass index (BMI) and
weekly physical activity improvement tertiles. BMI categories included normal weight (BMI 18.624.9), overweight (BMI 25-29.9), and obese (BMI > or =30). Weekly physical activity improvement
categories included small/no improvement (<1%/wk), moderate improvement (1-5%/wk), and
large improvement (>5%/wk). Data analysis consisted of descriptive and nonparametric
inferential statistics (chi2). Participants in this study used 11 primary strategies on a regular basis
to increase daily physical activity. The percentage of participants who used these strategies was
as follows: walked to a meeting or work-related errand (64.7%), after work (50.0%), before work
(35.3%), at lunch (47.1%), on the weekend (32.4%), while traveling (32.4%), with the dog
(32.4%), or to a destination (work/store) (29.4%). Additionally, participants parked farther away
(50%), used the stairs rather than an elevator (23.5%), and performed other cardiovascular
activity (52.9%). Differences among BMI groups were found for the parking further strategy (p <
0.05), with obese participants using this strategy significantly more than overweight participants.
No significant differences were found among weekly physical activity improvement groups. This
study indicates that participants in a pedometer-based lifestyle physical activity intervention used
a variety of strategies to increase daily physical activity.
Cunningham, G. O. and Y. L. Michael (2004). "Concepts guiding the study of the impact of the
built environment on physical activity for older adults: a review of the literature." American Journal
of Health Promotion 18(6): 435-43.
OBJECTIVE: To identify theoretical models and key concepts used to predict the
association between built environment and seniors' physical activity on the basis of a
comprehensive review of the published literature. DATA SOURCE: Computer searches of
Medline (1966-2002), PubMed (1966-2002), and Academic Search Elite (1966-2002) were
conducted, and 27 English-language articles were found. Search terms included built
environment, physical activity, exercise, walking, neighborhood, urban design, seniors, aging,
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Active Living Research Literature Summary 2004 & 2005
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aging in place, and physical environment. STUDY INCLUSION AND EXCLUSION CRITERIA:
The primary inclusion criterion included the relation between the built environment and the
physical activity among seniors living in neighborhoods. Studies assessing physical activity or
overall health of a community-based population were included if underlying theoretical models
and concepts were applicable to a senior population. Studies solely assessing social or
psychosocial characteristics of place were excluded, as were review articles. DATA
EXTRACTION: Extracted data included theoretical model, aspect of built environment studied,
methods, and outcomes. DATA SYNTHESIS: Tables present key definitions and summarize
information from empirical studies. RESULTS: Twenty-seven articles that focused on the
environment-behavior relation in neighborhoods, six specific to seniors, were found. This area of
research is in its infancy, and inconsistent findings reflect difficulties in measurement of the built
environment. CONCLUSIONS: The relation between the built environment and the physical
activity among seniors has been the subject of a limited number of studies. The choice of
theoretical model drives the selection of concepts and variables considered. Safety, microscale
urban design elements, aesthetics, and convenience of facilities are consistently studied across
models. Few validated instruments have been developed and tested to measure neighborhood
built environment.
Dempsey, T., A. Miller, et al. (2004). "Let's get physical: a policy on increasing physical activity in
school-aged children." Journal of Oklahoma State Medical Association 97(3): 119-21; quiz 122-3.
Childhood obesity has reached epidemic proportions. One of the major reasons is the
lack of physical activity due to time spent watching television or using computers. This lack
coupled with poor dietary habits has led to significant increases in the number of children with
Type II diabetes and predisposition to hypertension, coronary artery disease and others.
Physicians can help reduce this trend.
Dubbert, P. M., M. W. Vander Weg, et al. (2004). "Evaluation of the 7-day physical activity recall
in urban and rural men." Medicine and Science in Sports and Exercise 36(9): 1646-54.
PURPOSE: To assess reliability and validity of the 7-d physical activity recall (PAR) in
60- to 80-yr-old men from urban and rural homes in the southeastern United States. METHODS:
Two hundred twenty 60- to 80-yr-old men (29% minority ethnicity) from Veterans Affairs primary
care clinics completed two PAR interviews at 2- to 4-wk intervals. The PAR included
modifications to elicit and score light-moderate (2-3 METs) as well as moderate (3-6 METs) and
hard (>/=7 METs) physical activity. Reliability was assessed using intraclass correlations from the
two interviews. Validity was assessed using Spearman correlations of PAR variables with 6-min
walk performance, and with treadmill performance and accelerometer activity counts from
subsamples, as well as measures of gait, balance, activities of daily living, and perceived quality
of life. Results were examined separately for urban and rural participants. RESULTS: Reliability
coefficients were acceptable and PAR measures of estimated energy expenditure, and time spent
in hard, moderate, and light-moderate activity correlated as hypothesized with the fitness and
health measures. CONCLUSION: Reliability and validity coefficients were generally similar to
those found in studies of the PAR with younger samples and with instruments designed
specifically for use with elders. The PAR is a useful and flexible instrument for assessing physical
activity of varying intensity in older men living in both urban and rural home settings.
Duncan, S. C., T. E. Duncan, et al. (2004). "A multilevel approach to youth physical activity
research." Exercise Sport Science Review 32(3): 95-9.
Social environment factors are hypothesized to interact with individual-level factors to
influence youth physical activity. Multilevel analytic approaches are ideal for examining the
influence of the social environment on youth physical activity as they allow examination of
research questions across multiple contexts and levels (e.g., individual, family, and neighborhood
levels).
Echeverria, S. E., A. V. Diez-Roux, et al. (2004). "Reliability of self-reported neighborhood
characteristics." Journal Of Urban Health-Bulletin Of The New York Academy Of Medicine 81(4):
682-701.
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The majority of studies examining the relation between neighborhood environments and
health have used census-based indicators to characterize neighborhoods. These studies have
shown that neighborhood socioeconomic characteristics are associated with a range of health
outcomes. Establishing if these associations reflect causal relations requires testing hypotheses
regarding how specific features of neighborhoods are related to specific health outcomes.
However, there is little information on the reliability of neighborhood measures. The purpose of
this study was to estimate the reliability of a questionnaire measuring various self-reported
measures of the neighborhood environment of possible relevance to cardiovascular disease. The
study consisted of a face-to-face and telephone interview administered twice to 48 participants
over a 2-week period. The face-to-face and telephone portions of the interview lasted an average
of S and 11 minutes, respectively. The questionnaire was piloted among a largely Latino and
African American study sample recruited from a public hospital setting in New York City. Scales
were used to assess six neighborhood domains: aesthetic quality, walking exercise environment,
safety from crime, violence, access to healthy foods, and social cohesion. Cronbach's alpha's
ranged from.77 to.94 for the scales corresponding to these domains, with test-retest correlations
ranging from 0.78 to 0.91. In addition, neighborhood indices for presence of recreational facilities,
quality of recreational facilities, neighborhood participation, and neighborhood problems were
examined. Test-retest reliability measures for these indices ranged from 0.73 to 0.91. The results
from this study suggested that self-reported neighborhood characteristics can be reliably
measured.
Evenson, K. R. and A. P. McGinn (2004). "Availability of school physical activity facilities to the
public in four U.S. communities." American Journal of Health Promotion 18(3): 243-50.
PURPOSE: This study documents the public availability of school physical activity
facilities, reasons facilities were not made available to the public, and the barriers and benefits
associated with having facilities available. DESIGN: Cross-sectional. SETTING: All schools
located in four geographic locations (Washington County, Maryland; northwest suburbs of
Minneapolis, Minnesota; Jackson, Mississippi; and Forsyth County, North Carolina). SUBJECTS:
The survey was completed by 289 school representatives for a response rate of 82.3% (289/351
schools). For the nonrespondents, 61 of 62 schools were visited to obtain information on outdoor
facilities. MEASURES: Information on indoor and outdoor physical activity facilities available to
the public was collected for all schools (public, private, and colleges) using a telephone survey.
Site visits were made to schools that did not participate in the survey to collect information on
outdoor facilities only. RESULTS: The schools in the four geographic areas owned a wide range
and number of physical activity facilities for their students. For the schools, 27% had no indoor
facilities and 11% had no outdoor facilities. Private schools and colleges were less likely to have
indoor or outdoor facilities compared to public schools. Outdoor facilities were available more
often to the public than indoor facilities overall, across sites, and by school type (public, private,
college). Among the 313 schools with outdoor facilities, 240 (77%) allowed at least some public
use, and among the 210 schools with indoor facilities, 134 (64%) allowed at least some public
use. Some reasons that facilities were not made available included: for student use only,
supervision and personnel requirements, safety concerns, insurance, liability, and a private or
church-owned status. The most common benefits of allowing the public to use the facilities
included providing a space to keep youth active and good publicity for the school. CONCLUSION:
These findings suggest that safety, insurance, and liability concerns are barriers that need to be
addressed with schools before indoor and outdoor facilities can be made available to the public.
Furthermore, emphasizing the benefits that we found, such as providing a space to keep youth
active and good publicity for the school, would also be important.
Fein, A. J., R. C. Plotnikoff, et al. (2004). "Perceived environment and physical activity in youth."
International Journal of Behavioral Medicine 11(3): 135-42.
The examination of physical environments to explain and promote physical activity is an
important yet under-investigated area of research inquiry. This study explored relationships
between the perceived availability of physical environmental resources and the perceived
importance of these resources in relation to physical activity levels amongst youth. A self-report
questionnaire was completed by 610 students (mean age = 15.5 years old; 62% female
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participants) from four high schools (grades 9-12) in rural Alberta, Canada. Perceived physical
environment constructs explained 5% of the variance in physical activity, with home,
neighborhood, and school as significant domains. Perceived importance constructs explained 8%
of the variance in physical activity with school context showing the only significant relationship
with physical activity. A hierarchical regression analysis entered sex, grade, self-efficacy, peer,
family and physical education teacher relationships, as the first block and eight environmental
constructs as the second block. The first block variables accounted for 22% of the variance and
environmental constructs accounted for an added 4% of the variance in physical activity.
Perceived importance of the school environment was the only environment variable significantly
associated with physical activity (beta =.14; p <.05) after taking into account the impact of these
traditional predictors. These findings reinforce the need to provide and support school physical
environments related to physical activity.
Fisher, K. J., F. Li, et al. (2004). "Neighborhood-level influences on physical activity among older
adults: a multilevel analysis." Journal of Aging and Physical Activity 12(1): 45-63.
There is a need for greater understanding of setting-specific influences on physical
activity to complement the predominant research paradigm of individual-centered influences on
physical activity. In this study, the authors used a cross-sectional multilevel analysis to examine a
range of neighborhood-level characteristics and the extent to which they were associated with
variation in self-reported physical activity among older adults. The sample consisted of 582
community-dwelling residents age 65 years and older (M = 73.99 years, SD = 6.25) recruited
from 56 neighborhoods in Portland, OR. Information collected from participants and neighborhood
data from objective sources formed a two-level data structure. These hierarchical data (i.e.,
individuals nested within neighborhoods) were subjected to multilevel structural-equationmodeling analyses. Results showed that neighborhood social cohesion, in conjunction with other
neighborhood-level factors, was significantly associated with increased levels of neighborhood
physical activity. Overall, neighborhood-level variables jointly accounted for a substantial variation
in neighborhood physical activity when controlling for individual-level variables.
Fisher, K. J. and F. Z. Li (2004). "A community-based walking trial to improve neighborhood
quality of life in older adults: A multilevel analysis." Annals Of Behavioral Medicine 28(3): 186194.
Background: Few studies have considered the neighborhood as a context in which to
examine the physical activity and quality of life relationship. Purpose: The goal of this study was
to evaluate the effects of a neighborhood walking program on quality of life among older adults. It
was designed as a randomized trial involving a multilevel design with neighborhoods
corresponding to primary sampling units and residents to secondary units. Methods: Five hundred
eighty-two community dwelling senior residents (65 years of age or older) in neighborhoods in the
northeast metropolitan area of Portland, Oregon, were recruited through telephone, direct mail,
and referrals. The walking intervention was delivered at the neighborhood level. Neighborhoods
(N = 56) were randomly assigned to a 6-month. 3 times per week, leader- led walking group
activity (n = 28) or an information-only control group (n = 28). Primary outcome measures
includedSF-12 (Physical, Mental summary scores) and 1 life satisfaction (SWLS); the secondary,
outcome measure was neighborhood walking activity, assessed at baseline, 3 months, and 6
months of the study period. Results: Compared to the control neighborhoods, results from
multilevel, longitudinal analyses indicated significant improvements in the primary, outcomes of
SF-12 Physical (p<.05), SF-12 Mental (p<.05) summary scores, and SWLS (p<. 05), over the
course of the 6-month intervention. A significant increase was also observed in the secondary
outcome of walking activity (p<.05). Conclusions: Implementing a neighborhood-based walking
program of low to moderate intensity is feasible and beneficial for promoting quality of life among
senior residents at a community level.
Fleury, J., S. M. Lee, et al. (2004). "Barriers to physical activity maintenance after cardiac
rehabilitation." Journal of Cardiopulmonary Rehabilitation 24(5): 296-305; quiz 306-7.
PURPOSE: Little is known about the contextual determinants for the maintenance of
physical activity after cardiac rehabilitation. This study aimed to examine perceived social,
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psychological, and health-related barriers to the maintenance of physical activity among phase 2
cardiac rehabilitation graduates. METHODS: Researchers using an open-ended format asked
160 participants (121 men and 39 women) 6 months after rehabilitation to identify perceived
barriers to physical activity maintenance. The content of the participant responses was analyzed
through categorization and coding of data, with independent review used to assess accuracy and
reliability of decision rules. A social ecologic perspective was used for secondary coding and
categorization. A chi analysis of categories was conducted to explore differences by gender,
ethnicity, education, and employment. RESULTS: Four categories were developed from the
coded responses: intrapersonal, interpersonal, environmental, and organizational. In their
responses, 93% of the participants reported intrapersonal barriers, with 24% reporting
interpersonal barriers, 18% reporting environmental barriers, and 11% reporting organizational
barriers. Years of education contributed significantly to acceptance of an inactive lifestyle among
those less educated (chi = 32.489; P =.028). Employment status showed significant differences
for work as a barrier among those employed full-time (chi = 13.570, P =.004). Barriers to physical
activity by gender showed significant differences for interpersonal barriers as a whole (chi =
6.804; P =.009). CONCLUSIONS: The open-ended format provided rich narrative data regarding
barriers to the maintenance of physical activity. The acknowledgment of barriers, particularly from
a social ecologic perspective, is needed to guide innovative, multilevel interventions for promoting
physical activity maintenance among those with diagnosed coronary heart disease.
Foster, C. and M. Hillsdon (2004). "Changing the environment to promote health-enhancing
physical activity." Journal of Sports Science 22(8): 755-69.
Supportive environments have been used to change and influence health behaviours like
smoking. While psychological and ecological theories and models demonstrate the possible
influences of the environment on health-enhancing physical activity (HEPA), little is known about
the effectiveness of the environmental interventions. This paper presents the results of a
systematic review of studies that used environmental interventions to increase health-enhancing
physical activity. Two groups of studies were found, studies that changed the physical
environment by creating new HEPA facilities, policies and supporting mechanisms, and studies
that used the elements of the environment as an active or sedentary 'point of choice', via
educational materials to promote stair use. Environmental change studies showed a small
increase on HEPA behaviour, but the relative impact of environment changes was not evaluated.
A number of before and after studies have observed a weak effect of a simple environmental
change to stimulate stair climbing while travelling or shopping. Current national policy has
embraced the environment as an option for promoting health-enhancing physical activity,
especially active travel, in spite of the lack of effectiveness data. It is recommended that existing
or planned public health environment and HEPA initiatives should use appropriate evaluation
methods to assess their efficacy and effectiveness. Further developmental research into the
nature of the relationship of the environment to particular HEPA behaviours is strongly
recommended before developing new environmental interventions.
Foster, C., M. Hillsdon, et al. (2004). "Environmental perceptions and walking in English adults."
Journal of Epidemiology & Community Health 58(11): 924-928.
Study objective: To examine the relation between adults' perceptions of the social and
physical environment and their self reported walking behaviour. Design: Cross sectional survey.
Setting: England, UK. Participants: A national sample of 4265 adults aged 16-74 years. Main
outcome measures: Self reported walking behaviour was categorized into two dichotomous
variables: (a) any reported walking in past four weeks, (b) reported walking more than or equal to
150 minutes per week in the past four weeks. Perceptions of the social environment covered
safety of walking alone and social support for walking. Perceptions of the physical environment
covered attractiveness of local area for walking, access to shops, leisure centres, parks, cycle
paths, and traffic density. Main results: In women, perceived safety of walking during the day
(OR=0.53; 95% CI: 0.31 to 0.88), and no shop within walking distance (OR=0.72; 95% CI: 0.52 to
0.99) were associated with any reported walking occasions. Perceptionsof the environment were
not related to women walking more than or equal to 150 minutes/week. In men, having a park
within walking distance was associated with walking more than or equal to 150 minutes/week
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(OR=2.22; 95% CI: 1.18 to 4.35). No other significant associations were found. Conclusions:
Women seem to be more concerned about walking for utility and in safety. Men are more likely to
walk more than or equal to 150 minutes/week if they have access to a local park but their walking
is not influenced by concerns about safety. Future research should focus on the relation between
objective measures rather than perceptions of the environment and physical activity.
Frank, L. D. (2004). "Economic determinants of urban form: resulting trade-offs between active
and sedentary forms of travel." American Journal of Preventive Medicine 27(3 Suppl): 146-53.
Economic factors have an impact on how the built environment is shaped, which in turn
affects how we choose to travel. Regional transportation investment decisions are firmly rooted in
economic "cost-benefit" trade-off considerations. The placement (central or outlying) and mode of
transportation in which investments are made (transit, highway, sidewalks, or bikeways) influence
where homes, businesses, schools, and other types of uses are located. Transportation
investments create or limit access and establish a set of economic trade-offs that help determine
if an area will be compact or dispersed, and mixed use or single use. Developers consider cost
trade-offs between constructing connected street grids versus disconnected cul-de-sac networks,
which determines if residents can walk to services and transit. Taken collectively, transportation
investments and resulting land-use patterns determine if destinations are far apart or close
together and linked with direct and safe sidewalks or bikeways. The end result is a built
environment that determines whether walking and biking is feasible or perceived as more
beneficial than driving or taking transit. This paper assesses (1) the economic forces that shape
transportation investment decisions, (2) the economic impact of these investments on land use,
and (3) how we as consumers choose to travel as a result of these transportation investment and
land-use decisions.
Frank, L. D., M. A. Andresen, et al. (2004). "Obesity relationships with community design,
physical activity, and time spent in cars." American Journal of Preventive Medicine 27(2): 87-96.
BACKGROUND: Obesity is a major health problem in the United States and around the
world. To date, relationships between obesity and aspects of the built environment have not been
evaluated empirically at the individual level. OBJECTIVE: To evaluate the relationship between
the built environment around each participant's place of residence and self-reported travel
patterns (walking and time in a car), body mass index (BMI), and obesity for specific gender and
ethnicity classifications. METHODS: Body Mass Index, minutes spent in a car, kilometers walked,
age, income, educational attainment, and gender were derived through a travel survey of 10,878
participants in the Atlanta, Georgia region. Objective measures of land use mix, net residential
density, and street connectivity were developed within a 1-kilometer network distance of each
participant's place of residence. A cross-sectional design was used to associate urban form
measures with obesity, BMI, and transportation-related activity when adjusting for
sociodemographic covariates. Discrete analyses were conducted across gender and ethnicity.
The data were collected between 2000 and 2002 and analysis was conducted in 2004.
RESULTS: Land-use mix had the strongest association with obesity (BMI >/= 30 kg/m(2)), with
each quartile increase being associated with a 12.2% reduction in the likelihood of obesity across
gender and ethnicity. Each additional hour spent in a car per day was associated with a 6%
increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was
associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was
significantly associated with urban form for white cohorts. Relationships among urban form, walk
distance, and time in a car were stronger among white than black cohorts. CONCLUSIONS:
Measures of the built environment and travel patterns are important predictors of obesity across
gender and ethnicity, yet relationships among the built environment, travel patterns, and weight
may vary across gender and ethnicity. Strategies to increase land-use mix and distance walked
while reducing time in a car can be effective as health interventions.
Freestone, R. and D. Nichols (2004). "Realising new leisure opportunities for old urban parks: the
internal reserve in Australia." Landscape and Urban Planning 68(1): 109-120.
The internal reserve-community space at the rear of residential lots with no street
frontage was a conspicuously innovative feature of the 'town-planned' or 'garden' suburb in the
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Active Living Research Literature Summary 2004 & 2005
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first three decades of the 20th century in many countries. Often intended as a playground for
children, designers also suggested the internal reserve as an ideal locus for community building
through leisure-time activities such as sport, agriculture, and passive recreation. Within a decade
they were increasingly viewed as nuisance, or even dangerous, spaces. Many retain this stigma,
unhelped by community apathy and governmental disinterest amid the broader neglect of the
public realm. Drawing on the Australian experience, this paper acknowledges some of the
shortcomings of internal reserves but points toward a more positive set of leisure futures. Many of
these small, semi-private spaces may yet prove to be valuable community assets in the new
millennium.
Gielen, A. C., S. DeFrancesco, et al. (2004). "Child pedestrians: the role of parental beliefs and
practices in promoting safe walking in urban neighborhoods." Journal Of Urban Health-Bulletin Of
The New York Academy Of Medicine 81(4): 545-555.
The Purpose of this study was to describe parents' child pedestrian safety practices,
knowledge, risk perceptions, and beliefs. We surveyed 732 parents from four elementary schools
in urban neighborhoods that differed in income, and child pedestrian injury risks. Findings
indicated that most parents taught their children street safety. Few (16%) knew basic pedestrian
safety facts; 46% believed children younger than 10 years could safely cross streets alone; 50%
believed a child pedestrian crash was likely. Parents in lower income neighborboods reported the
highest rates of unpleasant walking environments and concerns about drug dealers, crime,
violence, and trash. We conclude that education should focus on children's risk, developmental
capabilities, and supervision needs. Promoting physical activity in urban neighborboods,
especially lower income ones, must address concerns about the physical and social environment.
Gomez, J. E., B. A. Johnson, et al. (2004). "Violent crime and outdoor physical activity among
inner-city youth." Preventive Medicine 39(5): 876-881.
Background. Previous studies have shown poor correlation between subjective
assessments of neighborhood safety and physical activity. This study was performed to model
relationships between adolescents' outdoor physical activity and objectively measured violent
crime densities, along with other key environmental variables. Methods. Participants' physical
activity was measured using a validated questionnaire. Multiple regression analysis was
performed using outdoor physical activity away from school (OPA) as the dependent variable.
Environmental factors included the density of violent crime within 1/2 mi of each participant's
home, distance to nearest open play space, per capita income, and participants' subjective
assessment of neighborhood safety. Results. Multiple regression analysis showed that distance
to nearest open play space was inversely and significantly associated with boys' OPA, while
density of violent crime within 1/2 mi of home was inversely and significantly associated with girls'
OPA. Girls' perceptions that their neighborhood was safe for physical activity were also
associated with higher levels of OPA, while boys' assessments of neighborhood safety were not
significantly related to OPA. Conclusions. Neighborhood violent crime may be a significant
environmental barrier to outdoor physical activity for urban dwelling Mexican-American
adolescent girls. Future studies of physical activity and the environment should use objective
measures of environmental factors. (C) 2004 The Institute For Cancer Prevention and Elsevier
Inc. All rights reserved.
Granner, M. L. and P. A. Sharpe (2004). "Monitoring physical activity: uses and measurement
issues with automated counters." Journal of Physical Activity and Health 1(2): 131-141.
Background: Promotion of physical activity is a public health priority, and environmental
factors influence physical activity behavior. Valid and reliable automated measurement tools of
physical activity for assessment and evaluation within public settings are needed. Methods:
Searches of the research literature and governmental reports from physical activity,
transportation, and recreation fields were conducted to identify methods of automated counting
and validation studies. The article provides a summary of (a) current methods and uses of
automated counters, (b) information about validity and reliability where available, (c) strengths
and limitations of each method, and (d) measurement issues. Results: Existing automated
counting technology has strengths and limitations. Infrared sensors have been the most
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Active Living Research Literature Summary 2004 & 2005
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commonly used type of monitor and can mark date and time of passage, but are vulnerable to
errors due to environmental conditions; cannot detect more than one person passing at a time;
cannot identify mode of activity or distinguish among individuals; and lack consistent and
adequate reliability for use in open spaces. Seismic devices and inductive loops may be useful for
specific applications. More information is needed concerning the validity and reliability of infrared
sensors, seismic devices, and inductive loops for confined areas. Computer imaging systems
hold potential to address some of the limitations of other automated counters and for applications
in both confined and open areas, but validation research is in the initial stages. Conclusions:
Although automated monitoring is a promising method for measurement of physical activity, more
research is necessary to determine the acceptable parameters of performance for each type of
automated monitor and for which applications each is best suited.
Hill, J. O., J. F. Sallis, et al. (2004). "Economic analysis of eating and physical activity: a next step
for research and policy change." American Journal of Preventive Medicine 27(3 Suppl): 111-6.
Poor nutrition and physical inactivity are among the leading causes of morbidity and
mortality in the United States, and widespread behavior modification is needed to improve health
now and in the future. There is growing evidence that modifications in the physical environment
and in social policies will be required to accomplish this goal. There is also growing recognition
that economic factors have contributed to current eating and physical activity patterns, and that
economic factors need to be considered when developing strategies for improving these
behaviors. Identifying where economic and public health priorities converge could suggest new
avenues for sustainable policy changes, which will, in turn, promote healthy choices on both an
individual and population-wide level. To review the effect that economics has on eating and
physical activity behaviors, the Partnership to Promote Healthy Eating and Active Living
convened an Economic Analysis Forum. Two working groups were formed-one focusing on
eating behaviors and one on physical activity, and both with equal representation from healthrelated and economic disciplines. The groups examined how economics has contributed to
present eating and physical activity patterns and how economics could be used to develop
interventions to improve these patterns. This article describes the challenges the groups faced in
their work, the way in which the public health and economic approaches were integrated, and the
questions left unanswered.
Hotz, G., S. Cohn, et al. (2004). "WalkSafe: a school-based pedestrian safety intervention
program." Traffic Injury Prevention 5(4): 382-9.
OBJECTIVE: To evaluate the effectiveness of the WalkSafe program, an elementary
school-based pedestrian safety program in a single high-risk district in Miami-Dade County.
METHODS: Sixteen elementary schools were identified in a single high-risk district and enrolled
in a one-year study. All schools implemented the WalkSafe program on the last week of January
2003. A pre, post, and three-month post testing of pedestrian safety knowledge was conducted.
An observational component was also implemented at four schools that were randomly chosen.
Engineering recommendations and law enforcement initiatives were also performed. RESULTS:
A total of 6467 children from K-5th grade from 16 elementary schools participated in the program.
Of these 5762 tests were collected over three different testing times. A significant difference (pvalue < 0.001) was found between the pre and post testing conditions across all grade levels.
There was no significant difference found between the post and three-month post testing
conditions across all grade levels (p-value > 0.05). The observational data collected at four
schools across the different testing times demonstrated a significant difference found between
pre and post testing conditions for Group A (stop at the curb and look left, right, left) and also for
Group B (midstreet crossing and darting out) (p-value < 0.05). There was no difference found
between comparing the pre-test or post-test condition with the three-month post-test time. There
were many environmental modifications that were recommended and actually performed.
CONCLUSION: The WalkSafe program implemented in a single high-risk district was shown to
improve the pedestrian safety knowledge of elementary school children. The observational data
demonstrated improved crossing behaviors from pre-test to post-testing conditions. Future
research will focus on sustaining the program in this district and expanding the program
throughout our county.
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Humpel, N., A. L. Marshall, et al. (2004). "Changes in neighborhood walking are related to
changes in perceptions of environmental attributes." Annals Of Behavioral Medicine 27(1): 60-67.
Background: Several studies have found significant cross-sectional associations of
perceived environmental attributes with physical activity behaviors. Prospective relations with
environmental factors have been examined for vigorous activity, but not for the moderate-intensity
activities that environmental and policy initiatives are being designed to influence. Purpose: To
examine prospective associations of changes in perceptions of local environmental attributes with
changes in neighborhood walking. Methods: Baseline and 10-week follow-up telephone
interviews with 512 adults (49% men). Results: Men who reported positive changes in aesthetics
and convenience were twice as likely to increase their walking. Women who reported positive
changes in convenience were more than twice as likely to have increased their walking. There
were contrasting findings for men and women who reported traffic as less of a problem: Men were
61% less likely to have increased walking; however women were 76% more likely to have done
so. Conclusions: Further studies are needed to determine the possibly causal nature of such
environment-behavior relations and to elucidate relevant gender differences. Such evidence will
provide underpinnings for public health initiatives to increase participation in physical activity.
Humpel, N., N. Owen, et al. (2004). "Perceived environment attributes, residential location, and
walking for particular purposes." American Journal Of Preventive Medicine 26(2): 119-125.
Background: Identifying environmental factors that can influence physical activity is a
public health priority. We examined associations of perceived environmental attributes with
walking for four different purposes: general neighborhood walking, walking for exercise, walking
for pleasure, and walking to get to and from places. Methods: Participants (n =399; 57% women)
were surveyed by mail. They reported place of residence, walking behaviors, and perceptions of
neighborhood environmental attributes. Results: Men with the most positive perceptions of
neighborhood "aesthetics" were significantly more likely (odds ratio [OR] =7.4) to be in the
highest category of neighborhood walking. Men who perceived the weather as not inhibiting their
walking were much more likely (OR= 4.7) to be high exercise walkers. Women who perceived the
weather as not inhibiting their walking were significantly more likely to be high neighborhood
walkers (OR=3.8) and those with moderate perceptions of "accessibility" were much more likely
to do more walking for pleasure (OR=3.5). Conclusions: Different environmental attributes were
associated with different types of walking and these differed between men and women.
Approaches to increasing physical activity might usefully focus on those attributes of the local
environment that might influence particular subsets of walking behavior.
Humpel, N., N. Owen, et al. (2004). "Associations of location and perceived environmental
attributes with walking in neighborhoods." American Journal Of Health Promotion 18(3): 239-242.
Purpose. Ecological models highlight the importance of environmental influences. We
examined associations of coastal versus noncoastal location and perceived environmental
attributes with neighborhood walking, total walking, and total activity. Methods. Telephone
interviews with 800 faculty and general staff of an Australian university. Results. Men were
significantly more likely to walk in their neighborhood if they lived in a coastal location (odds ratio
[OR] = 1.66), and they highly rated environmental "aesthetics" (OR = 1.91), "convenience" of
facilities (OR = 2.20), and "access" to facilities (OR = 1.98). For women, neighborhood walking
was associated with high ratings of "convenience" (OR = 3.78) but was significantly less likely if
they had high ratings for "access" (OR = 0.48). For total walking and total physical activity, few
significant associations emerged. Conclusions. Environmental attributes were related to walking
in the neighborhood but not to more general activity indices. Understanding gender-specific
environmental correlates of physical activity should be a priority.
Krenichyn, K. (2004). "Women and physical activity in an urban park: Enrichment and support
through an ethic of care." Journal Of Environmental Psychology 24(1): 117-130.
Women's presence in public space is frequently understood within a "separate spheres"
framework, but this framework does not fully account for women's presence in public spaces and
their experiences there. An ethic of care (In a different voice (1982) Harvard university press; J.
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Active Living Research Literature Summary 2004 & 2005
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Env. Psych. 20 (2000) 103) has been proposed as an alternative framework for understanding
both constraints and possibilities for women in public space. An ethic of care also helps to
understand women's experiences of leisure, particularly physical activity. I explore themes of
relationships and caring in interviews with women who did physical activities in Prospect Park in
Brooklyn. Women found enrichment and support for both relationships and activities among
family, friends, acquaintances, and strangers in the park, which provided feelings of safety and
enjoyment. The presence of others and chance meetings in the park also provided emotional
social support and more long-term affiliations to support athletic interests such as team sports.
This study informs research regarding the influence of the environment on physical activity and
supports the assertion that an ethic of care provides a more comprehensive framework for
theories of public space. However, other aspects of the environment should also be considered in
further discussion of a theoretical framework for women and public space. (C) 2003 Elsevier Ltd.
All rights reserved.
Krizek, K. J., A. S. Birnbaum, et al. (2004). "A schematic for focusing on youth in investigations of
community design and physical activity." American Journal of Health Promotion 19(1): 33-8.
This paper provides a first step in addressing special considerations for youth in a
relatively new area of physical activity research. After reviewing the urgent need for novel
approaches to increasing physical activity, the growing interest in the effects of community design
are discussed. Although most discussion on this topic has focused on adults, there are important
differences between youth and adults that warrant a special focus on youth and need to be
accounted for This article presents a schematic that accounts for how and where youth spend
their time, decomposing the day into time spent in travel and time spent at destinations, and
identifying portions of those times that are spent engaged in physical activity. By focusing on both
spatial and behavioral dimensions of youth time, the schematic may help organize and advance
scientific inquiry into the relationships between community design and physical activity specifically
for youth.
Lachenmayr, S. and G. Mackenzie (2004). "Building a foundation for systems change: increasing
access to physical activity programs for older adults." Health Promotion Practice 5(4): 451-8.
Although 25% of U.S. adults are physically inactive, this percentage increases
dramatically for older adults. Organizational change theory guided a state health department in
identifying system gaps and developing strategies to expand programming for seniors. A survey
of provider agencies in New Jersey assessed (a) capacity for physical activity programs for older
adults, (b) accessibility of programs, and (c) barriers to providing programs. One hundred sixty
agencies provided physical activity programs to almost 184,000 individuals annually. Fewer than
one half of the agencies provided exercise programs for people with disabilities, and only 44%
provided in-home programs. Eighty-two percent of program providers wanted to expand
programming but cited lack of trained instructors and peer leaders, inadequate facility space,
insufficient funding, and limited transportation resources as barriers. Sustaining older adult
behavior change requires infrastructure that will ensure access to diverse physical activities. This
article provides strategies to expand access to physical activity programs for older adults.
Lee, C. and A. V. Moudon (2004). "Physical activity and environment research in the health field:
Implications for urban and transportation planning practice and research." Journal Of Planning
Literature 19(2): 147-181.
This article reviews literature from the health field investigating the characteristics of
environments that support or hinder physical activity. This literature shows that physical activity is
associated with objective and subjective measures of accessibility to recreational facilities and
local destinations, as well as with neighborhood safety and visual quality. Walking and biking
emerge as prominent forms of physical activity and occur primarily in neighborhood streets and
public facilities, suggesting that building walkable and bikable communities can address health as
well as transportation concerns. The studies help advance environment-behavior research related
to urban and transportation planning. They identify behavioral and environmental determinants of
physical activity and employ rigorous data collection methods and theoretical frameworks that are
new to the planning field. The article concludes that multidisciplinary research will likely yield
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Active Living Research Literature Summary 2004 & 2005
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promising results in identifying the aspects of environments that can be modified to encourage
physical activity and physically active travel.
Levins, S. M., D. M. Redenbach, et al. (2004). "Individual and societal influences on participation
in physical activity following spinal cord injury: a qualitative study." Physical Therapy 84(6): 496509.
BACKGROUND AND PURPOSE: Despite evidence that physical activity, a tool of
rehabilitation, affects health and improves functional ability in people following spinal cord injury
(SCI), such people are often physically inactive. We used a qualitative method to explore the
experiences of individuals with SCI during participation in physical activity. SUBJECTS: The
participants were 8 adults (5 male, 3 female), ranging from active to inactive, who were 2 to 27
years post-rehabilitation following SCI (paraplegic). METHODS: We used semistructured
ethnographic interviews to explore barriers and enablers to participation in physical activity
following SCI. Emerging themes were derived from the participants' experiences. RESULTS: Two
themes were identified: (1) individual influences, defined as a period of loss of "able identity" and
subsequent redefinition of self in which participation in physical activity may be a vehicle or an
outcome, and (2) societal influences, which included environmental and attitudinal barriers.
DISCUSSION AND CONCLUSION: The participants' experiences offer insight for therapists
regarding physical activity following SCI.
Li, F. and K. J. Fisher (2004). "A multilevel path analysis of the relationship between physical
activity and self-rated health in older adults." Journal of Physical Activity and Health 1(4).
Objectives. This study examined the relationship between physical activity and self-rated
health of older adults at both the neighborhood level and the resident level. Methods. A multilevel
design was used that involved neighborhoods as the primary sampling unit and residents nested
within each neighborhood. Residents (N = 582, mean age = 73.99 years, SD = 6.26) from 56
neighborhoods in Portland, Oregon, were surveyed on neighborhood physical activity and health
status. Results. Multilevel path analysis showed a positive relationship between physical activity
and health status at the neighborhood level. In addition, perceptions of neighborhood social
cohesion, access to physical activity facilities, safety for walking, and importance of physical
activity involvement, were positively related to high levels of physical activity. At the resident level,
education and walking efficacy were positively associated with older adult physical activity.
Conclusions. The results provide evidence that neighborhood-level physical activity is positively
linked to neighborhood-level self-rated health in older adults.
Lindsey, G., J. Man, et al. (2004). "Property values, recreation values, and urban greenways."
Journal of park and recreation administration 22(3): 69.
Planners propose multi-use urban greenways to enhance urban form, promote
conservation of habitat and biodiversity, provide opportunities for fitness, recreation, and
transportation, and promote economic development. This paper presents a taxonomy of the
values of greenways and illustrates how two particular types of values can be measured using
complementary techniques. Impacts of greenways on property values in Indianapolis, Indiana are
measured with geographic information systems (GIS) and hedonic price modeling using
residential real estate sales data from 1999. Recreation values are measured for a greenway trail
in Indianapolis with the travel cost method using data from a 2000 survey of trail users and counts
of trail traffic taken in 1996. We show that some but not all greenways have a positive, significant
effect on property values and that the recreation benefits of a trail exceed costs. Limitations of the
approaches are reviewed, and the importance of values notamenable to quantification is
discussed. The paper concludes with discussion of the implications of our findings. Planners can
use the findings to illustrate the benefits of greenways, to address concerns about negative
impacts of greenway systems, and to inform and design research studies.
Lindsey, P. and G. Lindsey (2004). "Using Pedestrian Count Models to Estimate Urban Trail
Traffic." Journal of Regional Analysis & Policy 34(1): 51-68.
Many cities are developing multiuse urban greenway trails to be used for recreation,
exercise, and transportation. Analysts need many kinds of data about these new trails, but
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Active Living Research Literature Summary 2004 & 2005
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especially trail traffic because of its implications for the efficient allocation of resources for trail
management. This paper addresses this need by presenting new information about the use of
trails. We adapt and test the validity of a previously reported model that predicts hourly pedestrian
crosswalk volume from shorter sampling intervals, and we apply the model to greenway trails.
Based on 166 hours of data collection on an Indianapolis, Indiana trail system, we develop
expansion equations for sampling intervals of five, ten, fifteen, and thirty minutes. We find that
both the equations from the previous study and our new equations provide reasonably accurate
hourly predictions. Trail managers can use these findings to make decisions about current trail
maintenance and promotion.
Lopez, R. (2004). "Urban sprawl and risk for being overweight or obese." American Journal of
Public Health 94(9): 1574-9.
OBJECTIVES: I examined the association between urban sprawl and the risk for being
overweight or obese among US adults. METHODS: A measure of urban sprawl in metropolitan
areas was derived from the 2000 US Census; individual-level data were obtained from the
Behavioral Risk Factor Surveillance System. I used multilevel analysis to assess the association
between urban sprawl and obesity. RESULTS: After I controlled for gender, age, race/ethnicity,
income, and education, for each 1-point rise in the urban sprawl index (0-100 scale), the risk for
being overweight increased by 0.2% and the risk for being obese increased by 0.5%.
CONCLUSIONS: The current obesity epidemic has many causes, but there is an association
between urban sprawl and obesity.
Loucaides, C. A., S. M. Chedzoy, et al. (2004). "Differences in physical activity levels between
urban and rural school children in Cyprus." Health Education Research 19(2): 138-47.
This study attempted to examine differences in physical activity levels between urban and
rural primary school children. The sample consisted of 256 Greek-Cypriot children and their
parents from two schools representing urban areas and three schools representing rural areas.
Children's activity levels were assessed for 4 weekdays in the winter and for 4 weekdays in the
summer using a pedometer (DW-200; Yamax, Tokyo, Japan). Daily step counts were used to
describe children's activity levels. Parents completed a questionnaire assessing environmental
variables in both seasons. Two-way ANOVAs indicated that urban school children were
significantly more active in winter than rural school children (means = 13,583 +/- 4,313 versus 12
436 +/- 3610, P < 0.001) and that rural school children were significantly more active in the
summer (means = 16,450 +/- 5134 versus 14,531 +/- 4,901, P < 0.001). Parents of children in
rural schools reported more space available in the garden and in the neighbourhoods, and safer
neighbourhoods than parents of children in urban schools, whereas children in urban schools had
more exercise equipment available at home and were transported more frequently to places
where they could be physically active. Results of this study suggest that intervention programmes
to promote physical activity need to consider seasonal and geographical location differences in
physical activity levels.
Loucaides, C. A., S. M. Chedzoy, et al. (2004). "Correlates of Physical Activity in a Cypriot
Sample of Sixth-Grade Children." Pediatric exercise science 16(1): 25.
This study examined the association between self-reported physical activity and a
number of potential correlates in a sample of 256 Grade 6 children. Physical activity was
assessed in both summer and winter, and children and parents completed questionnaires
assessing potential correlates of physical activity. Analyses revealed that gender, time spent
playing outside, self-efficacy in overcoming barriers, and number of items of exercise equipment
at home were variables associated with physical activity in both seasons. School location was a
variable associated with physical activity only in the summer, whereas private-lesson attendance,
sports-club attendance, and best friend's physical activity were variables associated with physical
activity only in winter. Variance explained in physical activity were 42 % and 51 % in winter and
summer, respectively. [ABSTRACT FROM AUTHOR]
McCormack, G., B. Giles-Corti, et al. (2004). "An update of recent evidence of the relationship
between objective and self-report measures of the physical environment and physical activity
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Active Living Research Literature Summary 2004 & 2005
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behaviours." Journal of Science and Medicine in Sports 7(1 Suppl): 81-92.
The physical environment has the potential to influence the physical behaviours of large
numbers of people; hence creating supportive environments has the potential to increase
physical activity (PA). During the last decade, there has been growing interest in how the physical
environment shapes PA behaviour. This area of research is important given that levels of PA
participation are declining globally. Literature was reviewed that examined the association
between physical environmental attributes and PA behaviours. The environmental attributes were
grouped into four categories based on a conceptual framework of environmental factors that
might influence PA and included functionality, safety, aesthetics and destinations. Positive
associations were found between both perceived and objectively measured environmental factors
and PA behaviour. The availability, accessibility and convenience of destinations and facilities, as
well as the general functionality of the neighbourhood (eg, the presence of sidewalks, traffic
conditions) and aesthetics were positively associated with various levels of PA. The review
highlights the need for future studies: to examine behaviour-specific environmental attributes, to
collect objectively-measured environmental data and to include both objective and perceived
environmental data in the same studies, and to adopt prospective study designs to allow causal
relationships to be established.
Mohan, B., N. Kumar, et al. (2004). "Prevalence of sustained hypertension and obesity in urban
and rural school going children in Ludhiana." Indian Heart Journal 56(4): 310-4.
BACKGROUND: Increasing trend of hypertension is a worldwide phenomenon. The data
on sustained hypertension in school going children is scanty in India. The present study was
conducted to evaluate the prevalence of sustained hypertension and obesity in apparently healthy
school children in rural and urban areas of Ludhiana using standard criteria. METHODS AND
RESULTS: A total of 2467 apparently healthy adolescent school children aged between 11-17
years from urban area and 859 students from rural area were taken as subjects. Out of total 3326
students, 189 were found to have sustained hypertension; in urban areas prevalence of sustained
hypertension was 6.69% (n=165) and in rural area it was 2.56% (n=24). Males outnumbered
females in both rural and urban areas. The mean systolic and diastolic blood pressure of
hypertensive population in both urban and rural population was significantly higher than systolic
and diastolic blood pressure in their normotensive counterparts (urban normotensive systolic
blood pressure:115.48+/-22.74 mmHg, urban hypertensive systolic blood pressure: 137.59+/11.91 mmHg, rural normotensive systolic blood pressure: 106.31+/-19.86 mmHg, rural
hypertensive systolic blood pressure: 131.63+/-10.13 mmHg, urban normotensive diastolic blood
pressure: 74.18+/-17.41 mmHg, urban hypertensive diastolic blood pressure: 84.58+/-8.14
mmHg, rural normotensive diastolic blood pressure: 68.84+/-16.96 mmHg, rural hypertensive
diastolic blood pressure: 79.15+/-7.41 mmHg). Overweight populationwas significantly higher in
urban area. There were 287 (11.63%) overweight students and 58 (2.35%) were obese. In rural
population overweight and obese students were 44 (4.7%) and 34 (3.63%) respectively. There
was significant increase in prevalence of hypertension in both rural and urban population with
increased body mass index in urban students; those with normal body mass index had
prevalence of hypertension of 4.52% (n=96), in overweight it was 15.33% (n=44) and in obese it
was 43.10% (n=25). In rural area, the overweight students showed prevalence of sustained
hypertension in 6.82% (n=3) and in obese group it was 61.76% (n=21). None of the student with
normal body mass index in rural area was found to be hypertensive. The mean body mass index
of hypertensive population in both rural and urban areas was significantly higher than respective
normotensive population (mean body mass index in urban normotensive group: 20.34+/-3.72
kg/m2, hypertensive group: 24.91+/-4.92 kg/m2; mean body mass index in rural normotensive
group: 18.41+/-3.41 kg/m2, hypertensive group: 21.37+/-3.71 kg/m2, p<0.01). CONCLUSIONS:
Prevalence of sustained hypertension is on the rise in urban area even in younger age groups.
Blood pressure is frequently elevated in obese children as compared to lean subjects. This is
possibly related to their sedentary lifestyle, altered eating habits, increased fat content of diet and
decreased physical activities.
Molnar, B. E., S. L. Gortmaker, et al. (2004). "Unsafe to play? Neighborhood disorder and lack of
safety predict reduced physical activity among urban children and adolescents." American
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Active Living Research Literature Summary 2004 & 2005
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Journal of Health Promotion 18(5): 378-86.
PURPOSE: Lack of physical activity is associated with increased risk of overweight and
cardiovascular disease, conditions associated with lower socioeconomic status (SES).
Associations between activity levels of urban youth and limited access to safe recreation areas in
their neighborhoods of residence were investigated. DESIGN: Analyses of data from the Project
on Human Development in Chicago Neighborhoods, a multilevel longitudinal study of families and
communities, are reported. SETTING: Chicago, Illinois. SUBJECTS: Individual-level data were
obtained from 1378 youth 11 to 16 years old and caregivers living in 80 neighborhood clusters.
Neighborhood-level data were collected from 8782 community residents and videotapes of
15,141 block faces. MEASURES: Parental estimates of hours youth spent in recreational
programming were used to estimate physical activity. A scale of residents' assessment of
neighborhood safety for children's play was created; disorder measures came from videotaped
observations. RESULTS: Physical activity averaged 2.7 hours/week (SD = 5.0), varying
significantly across neighborhoods. Using hierarchical linear regression, SES, age, and male
gender, but not body mass index, were independently associated with physical activity. Lower
neighborhood safety and social disorder were significantly associated with less activity,
controlling for demographics. CONCLUSIONS: One mechanism for reduced physical activity
among youth may be the influence of unsafe neighborhoods. Neighborhood interventions to
increase safety and reduce disorder may be efficacious in increasing physical activity, thereby
reducing risk of overweight and cardiovascular disease.
Moody, J. S., J. J. Prochaska, et al. (2004). "Viability of parks and recreation centers as sites for
youth physical activity promotion." Health Promotion Practice 5(4): 438-43.
This descriptive study explored the potential for public parks and recreation centers as
intervention sites for promoting physical activity among youth. Directors (55% women) of 44
recreation centers in San Diego County completed a survey of their centers' physical activity
programming for youths ages 3 to 17 years (response rate = 60%). On an average weekday, 373
(SD = 782) youths participated in physical activity at a center. More boys attended than girls (p
<.05). Some centers sponsored after-school programs at elementary (41%) and middle (11%)
schools but not at high schools (0%). Primary barriers to providing physical activity programs
were inadequate staffing (54%), funding (39%), and facilities (32%). Girls and low-income youth
were identified as the most difficult populations to reach. Directors reported considerable interest
in collaborating on interventions to improve youth activity programs. Public parks and recreation
centers are understudied settings with the potential for substantial involvement in efforts to
promote youth physical activity.
Moreno, L. A., C. Tomas, et al. (2004). "Micro-environmental and socio-demographic
determinants of childhood obesity." International Journal of Obesity and Related Metabolic
Disorders 28 Suppl 3: S16-20.
AIM: To review the available data in Spain about the socio-demographic and home
environmental determinants in children and adolescents. METHOD: Review of the main studies
conducted in Spain that have analysed the relationship between overweight and socio-economic
and environmental determinants in children and adolescents. RESULTS: In children aged 6-7 y
from Aragon (Spain), the socio-demographic determinants of childhood overweight were size of
municipality, year of examination, gender, and province; in adolescents aged 13-14 y, the sociodemographic determinants were year of examination, type of school, size of municipality, gender,
and province; overweight showed a significant positive main effect with public schools and low
municipality size. In a nationally representative sample of Spanish adolescents from 13 to 18.5 y
(AVENA Study), there was a significant relationship between overweight and socio-economic
status in males but not in females; in males, the lowest overweight prevalences were observed in
both extreme socio-economic groups; moreover, overweight prevalences increased when socioeconomic status decreased, from the high to the medium-low socio-economic group. The studied
variables related with family environment did not show any significant effect in overweight
prevalence. CONCLUSION: Better knowledge of the relationship between social class and
childhood obesity would lead to clearer hypotheses for the relationship in adults and might
improve the preventive measures by identifying children at risk.
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Active Living Research Literature Summary 2004 & 2005
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Morrison, D. S., H. Thomson, et al. (2004). "Evaluation of the health effects of a neighbourhood
traffic calming scheme." Journal of Epidemiological Community Health 58(10): 837-40.
STUDY OBJECTIVE: To assess the secondary health impacts of a traffic calming
scheme on a community. METHODS: Prospective cohort study of a randomly selected sample of
the local community using postal questionnaires and pedestrian counts on the affected road six
months before and six months after the implementation of the scheme. The setting was a
community in which a traffic calming scheme was built in the main road (2587 households). The
Short Form 36 version 2 was included in the questionnaire and summary measures of physical
health (physical component summary) and mental health (mental component summary)
calculated. A random sample of 750 households was initially posted the pre-intervention
questionnaire. MAIN RESULTS: There were increases in observed pedestrian activity in the area
after the introduction of the traffic calming scheme. Physical health improved significantly but
mental health did not change. Traffic related problems improved, while other local nuisances
were reported to be worse. CONCLUSIONS: The introduction of a traffic calming scheme is
associated with improvements in health and health related behaviours. It is feasible to
prospectively evaluate broader health impacts of similar transport interventions although poor
response rates may limit the validity of results.
Norman, G. J. and P. J. Mills (2004). "Keeping it simple: encouraging walking as a means to
active living." Annals of Behavioral Medicine 28(3): 149-51.
Ogilvie, D., M. Egan, et al. (2004). "Promoting walking and cycling as an alternative to using cars:
systematic review." British Medical Journal 329(7469): 763.
OBJECTIVES: To assess what interventions are effective in promoting a population shift
from using cars towards walking and cycling and to assess the health effects of such
interventions. DATA SOURCES: Published and unpublished reports in any language identified
from electronic databases, bibliographies, websites, and reference lists. REVIEW METHODS:
Systematic search and appraisal to identify experimental or observational studies with a
prospective or controlled retrospective design that evaluated any intervention applied to an urban
population or area by measuring outcomes in members of the local population. RESULTS: 22
studies met the inclusion criteria. We found some evidence that targeted behaviour change
programmes can change the behaviour of motivated subgroups, resulting (in the largest study) in
a shift of around 5% of all trips at a population level. Single studies of commuter subsidies and a
new railway station also showed positive effects. The balance of best available evidence about
publicity campaigns, engineering measures, and other interventions suggests that they have not
been effective. Participants in trials of active commuting experienced short term improvements in
certain measures of health and fitness, but we found no good evidence on effects on health of
any effective intervention at population level. CONCLUSIONS: The best available evidence of
effectiveness in promoting a modal shift is for targeted behaviour change programmes, but the
social distribution of their effects is unclear and some other types of intervention have yet to be
rigorously evaluated.
Owen, N., N. Humpel, et al. (2004). "Understanding environmental influences on walking; Review
and research agenda." American Journal of Preventive Medicine 27(1): 67-76.
BACKGROUND: Understanding how environmental attributes can influence particular
physical activity behaviors is a public health research priority. Walking is the most common
physical activity behavior of adults; environmental innovations may be able to influence rates of
participation. METHOD: Review of studies on relationships of objectively assessed and perceived
environmental attributes with walking. Associations with environmental attributes were examined
separately for exercise and recreational walking, walking to get to and from places, and total
walking. RESULTS: Eighteen studies were identified. Aesthetic attributes, convenience of
facilities for walking (sidewalks, trails); accessibility of destinations (stores, park, beach); and
perceptions about traffic and busy roads were found to be associated with walking for particular
purposes. Attributes associated with walking for exercise were different from those associated
with walking to get to and from places. CONCLUSIONS: While few studies have examined
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Active Living Research Literature Summary 2004 & 2005
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specific environment-walking relationships, early evidence is promising. Key elements of the
research agenda are developing reliable and valid measures of environmental attributes and
walking behaviors, determining whether environment-behavior relationships are causal, and
developing theoretical models that account for environmental influences and their interactions
with other determinants.
Patterson, P. D., C. G. Moore, et al. (2004). "Obesity and physical inactivity in rural America."
Journal Of Rural Health 20(2): 151-159.
Context and Purpose: Obesity and physical inactivity are common in the United States,
but few studies examine this issue within rural populations. The present study uses nationally
representative data to study obesity and physical inactivity in rural populations. Methods: Data
came from the 1998 National Health Interview Survey Sample Adult and Adult Prevention
Module. Self-reported height and weight were used to calculate body mass index. Physical
inactivity was defined using self-reported leisure-time physical activity. Analyses included
descriptive statistics, chi(2) tests, and logistic regression. Findings: Obesity was more common
among rural (20.4%, 95% CI 19.2%-21.6%) than urban adults (17.8%, 95% CI 17.2%-18.4%).
Rural residents of every racial/ethnic group were at higher risk of obesity than urban whites, other
factors held equal. Other predictors of obesity included being male, age 25-74, lacking a high
school diploma, having physical limitations, fair to poor health, and a history of smoking.
Proportionately more rural adults were physically inactive than their urban peers (62.8% versus
59.3%). Among rural residents, minorities were not significantly more likely to be inactive than
whites. Males and younger adults were less likely to be inactive. Rural adults who were from the
Midwest and South, had less than a high school education, had fair to poor health, and currently
smoked were more likely to be inactive compared to their respective referent group. Conclusions:
The high prevalence of obesity and inactive lifestyles among rural populations call for research
into effective rural interventions.
Patterson, P. K. and N. J. Chapman (2004). "Urban form and older residents' service use,
walking, driving, quality of life, and neighborhood satisfaction." American Journal Of Health
Promotion 19(1): 45-52.
Purpose. This study explored the relationship between pedestrian-friendly urban form as
reflected in new urbanism design guidelines, and neighborhood service use, walking, driving,
quality of life, and neighborhood satisfaction among older women. Design. A cross-sectional
survey compared residents of census tracts similar in demographic characteristics but differing in
urban form. Setting. The setting was urban and suburban areas of Portland, Oregon. Subjects.
The sample consisted of 372 females living alone over age 70 in six census tracts; 133 (36%)
completed surveys. Measures. The New Urbanism Index rated the physical features of
respondents' neighborhoods. The Neighborhood Resident Survey assessed travel modes and
neighborhood satisfaction. The Quality of Life Index measured resident well-being. The
Dartmouth COOP Functional Health Charts measured health status. Group comparisons were
made with t-tests and regression analysis. Results. Although limited by the cross-sectional
design, the study showed that new urbanism partially explained several differences in service use
and activity: distance to a grocery store (r(2) change 11, p = 001), number of services used within
1 mile, from home (r(2) change =.06, p =.007), number of walking activities (r(2) chang, =.08, p
=.001), number of services accessed by walking (r(2) change =.14, p =.000), and number of
services accessed by driving (r(2) change =.05, p =.001). Conclusions. Traditional urban
neighborhoods with mixed services and good pedestrian access were associated with increased
walking among older residents.
Plaut, P. O. (2004). "Non-commuters: The people who walk to work or work at home."
Transportation 31(2): 229-255.
The paper focuses on the socioeconomic characteristics of workers at home and those
who walk to work and these are compared with commuters (those who travel to work by
motorized transportation). Understanding of such characteristics of these people is useful for
purposes of designing policies that encourage these forms of "travel" to work, if it is believed
desirable for planning or environmental purposes. For example, subsidizing public transportation
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Active Living Research Literature Summary 2004 & 2005
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may also have an impact on the proclivity to work at home or walk to work. Using a large census
data set for Israel, separate subsamples are analyzed for heads of household and for their
spouses. Metropolitan areas as well as peripheral urbanized areas are analyzed separately. Logit
analysis is used to identify those variables that affect the likelihood of different groups of people
to walk to work or to work at home. It is shown that walkers to work tend to be lower-income, lesseducated people with lower asset ownership rates. Females are over-represented amongst them,
while "high-status" professionals are underrepresented. Workers at home appear to be a more
complex group. They tend to have higher levels of education and wealth than commuters, but
earn less on average. They include proportionately more females. The likelihood of working at
home increases with home size and with ownership of some durable goods. The workers at home
may in fact be comprised of two or more differing groups with contrasting characteristics, one
higher-income and higher-educated, the other with lower socioeconomic indicators. Because they
may be a heterogeneous group, development of planning policies to encourage non-vehicle
commuting may require different policy tools for the different subgroups.
Plotnikoff, R. C., K. Bercovitz, et al. (2004). "Physical activity, smoking, and obesity among
Canadian school youth. Comparison between urban and rural schools." Canadian Journal of
Public Health 95(6): 413-8.
BACKGROUND: More information is needed to document the prevalence of health risk
factors in youth. The purpose of this study is to compare the prevalence of physical inactivity,
smoking and overweight/obesity among youth in urban and rural schools. METHODS: Data were
obtained from a Student Physical Activity and Smoking Survey of 2,697 high school students in
four urban schools in Ontario and four rural schools in Alberta. Prevalence of physical inactivity
was assessed by examining compliance with Canada's Physical Activity Guide to Healthy Active
Living, and with daily energy expenditure classification values. Prevalence of smoking was
assessed by examining current smoking status. Overweight and obesity prevalences were
examined by comparing BMI values to the BMI index for age and sex percentiles set by the
Centers for Disease Control and Prevention. RESULTS: Physical activity prevalence was found
to be low in our study, with only 57.0% of youth achieving Canada's Physical Activity Guidelines,
and with 26.0% classified as sedentary based on the daily energy expenditure classification
values. A higher proportion of rural students reported "trying smoking" than urban school students
(73.0% versus 64.4%, p<0.001). A significantly higher proportion of rural males were 'overweight'
than urban males, and a significantly higher proportion of rural females were 'obese' in
comparison to urban females. CONCLUSION: Our findings add further support for an urgent
need to promote physical activity among Canadian youth. Additionally, our results suggest that it
is especially important to target rural students, particularly girls, for smoking prevention programs.
Future studies are required to examine such rural and urban differences within provinces.
Plotnikoff, R. C., A. Mayhew, et al. (2004). "Age, gender, and urban-rural differences in the
correlates of physical activity." Preventive Medicine 39(6): 1115-25.
BACKGROUND: The majority of the population is inactive, and strategies to date for
promoting regular physical activity have been limited in their effectiveness. Further research is
needed to identify correlates of physical activity in different subgroups to design more efficacious
interventions. This study sought to identify correlates of physical activity across men and women,
urban and rural geographical locations, and four distinct age groups (18-25; 26-45; 46-59; and
60+). METHODS: This study employed data from a large provincial household random sample (N
= 20,606) of Canadians. Analyses were utilized to examine the amount of variance explained in
self-reported physical activity by a number of demographic and/or biological, psychological,
behavioral, social, and environmental variables within each subgroup. RESULTS: Proportion of
friends who exercise, injury from past physical activity, educational level, perceived health status,
and alcohol consumption were among the strongest correlates across subgroups.
CONCLUSIONS: A number of correlates were identified as being significant across all subgroups
examined. Most differences in the correlates of physical activity were found within different age
groups rather than among urban and rural residents and gender.
Porter, D. E., K. A. Kirtland, et al. (2004). "Considerations for using a geographic information
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Active Living Research Literature Summary 2004 & 2005
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system to assess environmental supports for physical activity." Preventing Chronic Disease 1(4):
A20.
The use of a geographic information system (GIS) to study environmental supports for
physical activity raises several issues, including acquisition and development, quality, and
analysis. We recommend to public health professionals interested in using GIS that they
investigate available data, plan for data development where none exists, ensure the availability of
trained personnel and sufficient time, and consider issues such as data quality, analyses, and
confidentiality. This article shares information about data-related issues that we encountered
when using GIS to validate responses to a questionnaire about environmental supports for
physical activity.
Pratt, M., C. A. Macera, et al. (2004). "Economic interventions to promote physical activity:
application of the SLOTH model." American Journal of Preventive Medicine 27(3 Suppl): 136-45.
Physical inactivity is responsible for major health and economic costs in the United
States. Despite widespread recognition of the scope and importance of the problem of physical
inactivity, only modest progress has been made in improving overall physical activity in the U.S.
population. This paper applies a combined economic and public health perspective to better
understand physical activity behavior and to guide a search for promising new economically
oriented interventions to increase physical activity at the population level. This perspective is
operationalized as the SLOTH model-a time-budget model incorporating Sleep, Leisure,
Occupation, Transportation, and Home-based activities. Key economic forces that may influence
individuals' choices about utilization of time and physical activity are identified. Potential
interventions are proposed in response to each of the important forces and are evaluated on four
criteria: (1) economic efficiency, (2) equity, (3) effectiveness, and (4) feasibility. The SLOTH
model provides guidance regarding interventions that might increase physical activity in each of
the four nonsleep domains. Economic intervention strategies are proposed and compared to
economic and public health criteria. The results provide a starting point for selecting and
evaluating potentially effective and feasible economic interventions that might be implemented as
part of a larger effort to address the health crisis of inactive lifestyles and obesity.
Prodaniuk, T. R., R. C. Plotnikoff, et al. (2004). "The influence of self-efficacy and outcome
expectations on the relationship between perceived environment and physical activity in the
workplace." International Journal of Behavioral Nutrition and Physical Activity 1(1): 7.
BACKGROUND: Recent research and commentary contends that ecological approaches
may be particularly useful for understanding and promoting physical activity participation in
various settings including the workplace. Yet within the physical activity domain there is a lack of
understanding of how ecological environment factors influence behaviour. Thus, the purpose of
this study was to examine the relationships between perceived environment, social-cognitive
variables, and physical activity behaviour. METHODS: Participants (N = 897) were employees
from three large worksites who completed self-report inventories containing measures of selfefficacy, outcome expectations, perceptions of the workplace environment (PWES), and physical
activity behaviour during both leisure-time and incorporated throughout the workday. RESULTS:
Results of both bivariate and multiple regression analyses indicated the global PWES scores had
a limited association with leisure-time physical activity (R2adj =.01). Sequential regression
analyses supported a weak association between physical activity incorporated in the workplace
and PWES (R2adj =.04) and the partial mediation of self-efficacy on the relationship between
PWES and workplace physical activity (variance accounted for reduced to R2adj =.02 when selfefficacy was controlled). CONCLUSION: Overall, the results of the present investigation indicate
that self-efficacy acted as a partial mediator of the relationship between perceived environment
and workplace physical activity participation. Implications of the findings for physical activity
promotion using ecological-based approaches, and future directions for research from this
perspective in worksite settings are discussed.
Rasmussen B, Lyons W. 2004. “Annotated Bibliography on Health and Physical Activity in
Transportation Planning.” U.S. Department of Transportation
Available at: http://www.planning.dot.gov/Documents/Health/Bibliography.htm
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Active Living Research Literature Summary 2004 & 2005
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Ravenscroft, N. (2004). "Tales from the tracks - discourses of constraint in the use of mixed cycle
and walking routes." International Review for the Sociology of Sport 39(1): 27-44.
This article examines the constraints facing those wishing to use non-motorized cycle
and walking routes for sport and recreation activities. Using transcripts from six group interviews
in the UK, the article identifies an emergent 'discourse of constraints', based on the development
of conventional constraints models. The theoretical frame of the article is informed by Gidden's
ontological uncertainty, mediated by Beck's work on individuation and the risk society. The article
argues that, rather than being structural, as much policy implies, constraints are largely
articulated in intrapersonal and interpersonal terms, as people's response to the increasing
mistrust that they experience in most external environments. As a result, the constraints can only
be successfully addressed through the development of new forms of social integration that place
the individual within a group or 'companion' context. It is recognized that these types of social
forms are at odds with wider processes in sport and recreation, in which people are shifting away
from group and club affiliations.
Reed, J. A., B. E. Ainsworth, et al. (2004). "Awareness and use of community walking trails."
Preventive Medicine 39(5): 903-908.
Background. Community trail development is an emerging strategy to increase physical
activity (PA) among community residents. The purpose of this study was to assess awareness
and use of trails and compare perceptions to objective data. Methods. A telephone survey was
administered to a stratified sample of adults (<i>N</i>=1,112) in a southeastern county in the
United States. Respondents' home addresses and the locations of trails were entered into a GIS
database. A kappa statistic was used to measure agreement between awareness and presence
of trails. Differences in reported trail use patterns by sex, race, education, and PA levels were
evaluated. Results. There was no agreement between the awareness and presence of trails
(kappa=0.07). Fifty-six percent of the respondents reported having trails; however, only 33%
reported using the trails. Of the trail users, 42% reported being regularly active in moderate-tovigorous PA (30+ min/day for 5+ days/week), and 51% reported being less active
(<i>P</i><0.003). Among walkers (more than or equal to 30 min/day for more than or equal to 5
days/week), 49% of regular walkers and 35% of irregular walkers (< walkers) reported using the
trails (<i>P</i><0.04). Conclusions. Awareness of existing trails in this community and levels of
use were low. Marketing programs should promote awareness and use of trails among older
adults and irregularly active adults.
Reis, J. P., H. R. Bowles, et al. (2004). "Nonoccupational physical activity by degree of
urbanization and U.S. geographic region." Medicine and Science in Sports and Exercise 36(12):
2093-8.
PURPOSE: To estimate levels of nonoccupational leisure-time physical activity (LTPA)
by degree of urbanization and geographic region of the United States. METHODS: Participants
were respondents to the Behavioral Risk Factor Surveillance System (BRFSS) in 2001 (N =
137,359). Moderate- and vigorous-intensity LTPA was categorized as meeting recommended
levels, insufficient, or inactive. The U.S. Department of Agriculture rural-urban continuum codes
were used to describe degrees of urbanization (metro, large urban, small urban, and rural).
Geographic regions were defined by the U.S. Bureau of the Census (Northeast, Midwest, South,
and West). Prevalence estimates were calculated using sample weights to account for the design
of the BRFSS. Multivariate logistic regression analyses examined regional differences in the odds
of physical inactivity (physically inactive vs insufficient or meets) by degree of urbanization after
adjustment for sex, age, race, BMI, education, and occupational physical activity. RESULTS:
Large urban areas (49.0%) and the western United States (49.0%) had the highest prevalence of
recommended levels of LTPA. Rural areas (24.1%) and the southern United States (17.4%) had
the highest prevalence of inactivity. Adults living in the four urbanization categories of the
midwestern (metro (OR = 1.47, 95% CI = 1.31, 1.65), large urban (OR = 1.83, 95% CI = 1.51,
2.23), small urban (OR = 1.99, 95% CI = 1.65, 2.40), and rural (OR = 2.59, 95% CI = 1.35, 4.97));
and southern (metro (OR = 1.70, 95% CI = 1.53, 1.88), large urban (OR = 2.04, 95% CI = 1.72,
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Active Living Research Literature Summary 2004 & 2005
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2.41), small urban (OR = 2.32, 95% CI = 2.02, 2.67), and rural (OR = 5.49, 95% CI = 2.82,
10.68)) U.S. regions were more likely to be inactive than adults living in similar areas of the
western United States. Adults in northeast metro and large urban areas (OR = 1.62, 95% CI =
1.45, 1.81; and OR = 1.37, 95% CI = 1.08, 1.74, respectively) were more likely to be inactive than
those residing in western metro and large urban areas. CONCLUSION: The prevalence of
physical inactivity varies by degree of urbanization and geographic region of the United States.
Rimmer, J., B. Riley, et al. (2004). "Development and validation of AIMFREE: Accessibility
Instruments Measuring Fitness and Recreation Environments." Disability and Rehabilitation
26(18): 1087-95.
PURPOSE: The purpose of this study was to develop and validate a series of 16 survey
instruments measuring fitness and recreation accessibility, collectively referred to as AIMFREE
(Accessibility Instruments Measuring Fitness and Recreation Environments). General domains of
assessment included the built environment, equipment, programmes, policies, and training and
behaviour. METHODS: Fitness and recreation professionals (n=35) assessed fitness
centres/swimming pools (n=35) in nine regions across the US. Rasch analysis was used to
assess the psychometric properties of the instrument. RESULTS: The AIMFREE evidenced
adequate to good fit to the Rasch model and adequate to good internal consistency (r=0.70 0.90). Test-retest reliability ranged from 0.70 (entrance areas) to 0.97 (swimming pools). Analysis
of differential item functioning indicated that item calibrations generally did not differ significantly
between urban and suburban environments. CONCLUSION: The AIMFREE instruments
demonstrated adequate to good fit to the Rasch model with several of the subscales
demonstrating well to excellent separation of facility accessibility.
Rimmer, J. H., B. Riley, et al. (2004). "Development and validation of AIMFREE: Accessibility
instruments measuring fitness and recreation environments." Disability And Rehabilitation 26(18):
1087-1095.
Purpose: The purpose of this study was to develop and validate a series of 16 survey
instruments measuring fitness and recreation accessibility, collectively referred to as AIMFREE
(Accessibility Instruments Measuring Fitness and Recreation Environments). General domains of
assessment included the built environment, equipment, programmes, policies, and training and
behaviour. Methods: Fitness and recreation professionals (n = 35) assessed fitness
centres/swimming pools (n = 35) in nine regions across the US. Rasch analysis was used to
assess the psychometric properties of the instrument. Results: The AIMFREE evidenced
adequate to good fit to the Rasch model and adequate to good internal consistency (r = 0.70 0.90). Test-retest reliability ranged from 0.70 (entrance areas) to 0.97 (swimming pools). Analysis
of differential item functioning indicated that item calibrations generally did not differ significantly
between urban and suburban environments. Conclusion: The AIMFREE instruments
demonstrated adequate to good fit to the Rasch model with several of the subscales
demonstrating well to excellent separation of facility accessibility.
Rimmer, J. H., B. Riley, et al. (2004). "Physical activity participation among persons with
disabilities: barriers and facilitators." American Journal of Preventive Medicine 26(5): 419-25.
BACKGROUND: The purpose of this study was to identify various barriers and facilitators
associated with participation in fitness and recreation programs/facilities among persons with
disabilities. METHODS: Focus groups were conducted in ten regions across the United States in
2001 to 2002 with four types of participants: (1) consumers with disabilities, (2) architects, (3)
fitness and recreation professionals, and (4) city planners and park district managers. Sessions
were tape-recorded and content analyzed; focus group facilitators took notes of identified barriers
and facilitators to access. RESULTS: Content analysis of tape recordings revealed 178 barriers
and 130 facilitators. The following themes were identified: (1) barriers and facilitators related to
the built and natural environment; (2) economic issues; (3) emotional and psychological barriers;
(4) equipment barriers; (5) barriers related to the use and interpretation of guidelines, codes,
regulations, and laws; (6) information-related barriers; (7) professional knowledge, education, and
training issues; (8) perceptions and attitudes of persons who are not disabled, including
professionals; (9) policies and procedures both at the facility and community level; and (10)
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Active Living Research Literature Summary 2004 & 2005
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availability of resources. CONCLUSIONS: The degree of participation in physical activity among
people with disabilities is affected by a multifactorial set of barriers and facilitators that are unique
to this population. Future research should utilize this information to develop intervention
strategies that have a greater likelihood of success.
Rodriguez, D. A. and J. Joo (2004). "The relationship between non-motorized mode choice and
the local physical environment." Transportation Research Part D-Transport And Environment
9(2): 151-173.
Rasmussen B, Lyons W. (2004). “Annotated Bibliography on Health and Physical Activity in
Transportation Planning.” U.S. Department of Transportation
Available at: http://www.planning.dot.gov/Documents/Health/Bibliography.htm
Rutten, A. and K. Abu-Omar (2004). "Perceptions of environmental opportunities for physical
activity in the European Union." Sozial- und Praventivmedizin 49(5): 310-7.
OBJECTIVES: This article is the last in a series of four that present data about physical
activity in 15 member states of the European Union collected by the Eurobarometer 58.2. The
focus of this article is on the perception of environmental opportunities for physical activity across
the European Union. METHODS: Data were collected in 2002 as part of the Eurobarometer by
face-to-face interviews. A total of 16,230 respondents age 15 years and older were interviewed.
Sample sizes ranged about 1,000 respondents in most nations. Physical activity was assessed
with the last 7-days short version of the International Physical Activity Questionnaire (IPAQ).
RESULTS: Results indicate relationships between the perceptions of environmental
opportunities; gross household income and physical activity level (in MET-hours/per week) of
respondents. Respondents who reported lower income and less physical activity had also more
negative perceptions of environmental opportunities. Across nations, respondents in Denmark,
the Netherlands, Luxembourg, and Western Germany had the highest satisfaction with
environmental opportunities for physical activity. In some nations, positive correlations between
the perception of environmental opportunities and physical activity levels could be observed.
CONCLUSION: Results show variations in the perception of environmental opportunities across
the EU. Overall, the majority of respondents rated their environmental opportunities for physical
activity favourable.
Sallis, J. F., L. D. Frank, et al. (2004). "Active transportation and physical activity: opportunities
for collaboration on transportation and public opportunities health research." Transportation
Research Part A-Policy And Practice 38(4): 249-268.
Physically inactive lifestyles are a major public health challenge, and research in the
transportation field on influences on the choice to walk and bike may provide guidance toward
solutions. In the interests of promoting effective collaboration among the transportation, planning,
and health fields, the current paper was written to fulfill three purposes. The first purpose was to
summarize the transportation and planning studies on the relation between community design
and non-motorized ("active") transport and to interpret these studies from a health perspective.
The second purpose was to summarize studies from the health literature that examine the
relation between physical environmental variables and leisure-time physical activity that have
relevance for transportation research. The third purpose was to promote more collaboration
among transportation, planning, and health investigators by identifying opportunities for transdisciplinary research. (C) 2004 Elsevier Ltd. All rights reserved.
Sharpe, P. A., M. L. Granner, et al. (2004). "Association of environmental factors to meeting
physical activity recommendations in two South Carolina counties." American Journal of Health
Promotion 18(3): 251-7.
PURPOSE: The purpose of the study was to examine associations between environment
and policy factors and physical activity. DESIGN: A random-digit-dialed, cross-sectional
telephone survey was administered. SETTING: The setting was a two-county area of eastern
South Carolina. SUBJECTS: Before weighting, the sample included 1936 adults; 36.9% AfricanAmerican, 63.1% white, and 60.1% women. The age group distribution was 28.8% 55+ years,
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Active Living Research Literature Summary 2004 & 2005
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39.3% 35-54 years, and 31.9% 18-34 years of age. The response rate was 62.9%. MEASURES:
Six physical activity questions (2001 Behavioral Risk Factor Surveillance Survey [BRFSS]) were
used to create a dischotomous variable, "meets/does not meet recommendation for moderate or
vigorous physical activity." Self-report items assessed knowledge, presence, and use of
recreational facilities; presence of environmental and worksite supports; perceived safety;
condition of sidewalks; and quality of street lighting. RESULTS: Linear and logistic regression
were used to analyze the data. Unadjusted odds for meeting the recommendation were
significantly greater for well-maintained sidewalks (OR = 1.90); safe areas for walking/jogging
(OR = 1.39); knowledge of routes for bicycling (OR = 1.38) and walking/jogging (OR = 1.32); and
worksites with sports teams (OR = 1.53), exercise facilities (OR = 1.33), flexible time for exercise
(OR = 1.33), and preventive checkups (OR = 1.26). Among persons who met the
recommendation, means were greater for number of known walking/jogging routes (p =.04);
number of known bicycling routes (p <.01); number of days per month uses tracks, trails, routes,
pathways (p <.01); and number of days per month uses outdoor recreation areas (p <.01).
CONCLUSION: The results support an association between level of physical activity and
environmental and policy factors in two southeastern counties in South Carolina. Limitations of
the study include self-reported data and cross-sectional design.
Shinew, K. J., T. D. Glover, et al. (2004). "Leisure spaces as potential sites for interracial
interaction: community gardens in urban areas." Journal of Leisure Research 36(3): 336-355.
Finding ways to alleviate racial tension is an important societal issue. A well-established
strategy is to increase positive contact between members of different racial groups, which is
hypothesized to lead to improved racial attitudes if the contact takes place under certain
conditions. Bridging racial divides, however, has historically been a difficult process. Leisure
settings can be ideal environments for interracial interaction to occur due to qualities of free
choice and self-determination. This study focuses on a specific type of leisure environment,
community gardens located in urban settings. More specifically, the purpose of the study was to
examine whether urban community gardens are perceived as spaces in which people of different
races can successfully integrate. The study also sought to examine race and its relationship to
perceptions, motivations, and benefits of community gardening. The study focused on African
American and White gardeners in St. Louis.
Simon, C., A. Wagner, et al. (2004). "Intervention centred on adolescents' physical activity and
sedentary behaviour (ICAPS): concept and 6-month results." International Journal of Obesity
Related Metabolic Disorders 28 Suppl 3: S96-S103.
OBJECTIVE: To evaluate the 6-month impact of a physical activity (PA) multilevel
intervention on activity patterns and psychological predictors of PA among adolescents. The
intervention was directed at changing knowledge and attitudes and at providing social support
and environmental conditions that encourage PA of adolescents inside and outside school.
SUBJECTS AND DESIGN: Randomised, controlled ongoing field trial (ICAPS) in middle-school's
first-level adolescents from eight schools selected in the department of the Bas-Rhin (Eastern
France) with a cohort of 954 adolescents (92% of the eligible students) initially aged 11.7+/-0.6 y.
The 6-month changes in participation in leisure organised PA (LOPA), high sedentary (SED)
behaviour (>3 h/day), self-efficacy (SELF) and intention (INTENT) towards PA were analysed
after controlling for baseline measures and different covariables (age, overweight,
socioprofessional occupation), taking into account the cluster randomisation design. RESULTS:
The proportion of intervention adolescents not engaged in organised PA was reduced by 50%
whereas it was unchanged among control students. After adjustment for baseline covariables,
LOPA participation significantly increased among the intervention adolescents (odds ratio (95%
confidence interval) (OR)=3.38 (1.42-8.05) in girls; 1.73 (1.12-2.66) in boys), while high SED was
reduced (OR=0.54 (0.38-0.77) in girls; 0.52 (0.35-0.76) in boys). The intervention improved SELF
in girls, whatever their baseline LOPA (P<10(-4)) and INTENT in girls with no baseline LOPA
(P=0.04). SELF tended to improve in boys with no baseline LOPA, without reaching statistical
significance. When included in the regression, follow-up LOPA was associated with improvement
of SELF in girls (P=0.02) and of INTENT in girls with no baseline PA (P<0.02). The intervention
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effect was then attenuated. CONCLUSION: After 6 months of intervention, ICAPS was
associated with a significant improvement of activity patterns and psychological predictors,
indicating a promising approach for modifying the long-term PA level of adolescents.
Smith, A. and S. Bird (2004). "From evidence to policy: reflections on emerging themes in healthenhancing physical activity." Journal of Sports Science 22(8): 791-9.
Based on a detailed reading of the six preceding papers, in conjunction with a reflection
on the socio-political forces shaping lifestyles in the UK at the turn of the millennium, we come to
four interrelated conclusions. First, sport and exercise science needs to move beyond evidencebased practice to evidence-based policy. Second, sport and exercise science needs to make
health-enhancing physical activity a political issue at both national and local level. Third,
transport, not health policy, may be the key to promoting health-enhancing physical activity. And,
fourth, young people deserve our special attention. In reaching these four interrelated
conclusions, we attempt both to shape evidence based policy and future research agendas in
exercise science. To achieve an international perspective, we also present a short case note from
Australia.
Sobngwi, E., J. C. Mbanya, et al. (2004). "Exposure over the life course to an urban environment
and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon."
International Journal of Epidemiology 33(4): 769-76.
BACKGROUND: This study aimed to assess the association between lifetime exposure
to urban environment (EU) and obesity, diabetes, and hypertension in an adult population of SubSaharan Africa. METHODS: We studied 999 women and 727 men aged > or =25 years. They
represent all the adults aged > or =25 years living in households randomly selected from a rural
and an urban community of Cameroon with a 98% and 96% participation rate respectively.
Height, weight, blood pressure, and fasting blood glucose were measured in all subjects. Current
levels of physical activity (in metabolic equivalents [MET]) were evaluated through the SubSaharan African Activity Questionnaire. Chronological data on lifetime migration were collected
retrospectively and expressed as the total (EUt) or percentage (EU%) of lifetime exposure to
urban environment. RESULTS: Lifetime EUt was associated with body mass index (BMI) (r =
0.42; P < 0.0001), fasting glycaemia (r = 0.23; P < 0.0001), and blood pressure (r = 0.17; P <
0.0001) but not with age. The subjects who recently settled in a city (< or =2 years) had higher
BMI (+2.9 kg/m(2); P < 0.001), fasting glycaemia (+0.8 mmol/l; P < 0.001), systolic (+23 mmHg; P
< 0.001) and diastolic (+9 mmHg; P = 0.001) blood pressure than rural dwellers with a history of 2
years EU. EU during the first 5 years of life was not, on its own, associated with glycaemia or
BMI. However, both lifetime EUt and current residence were independently associated with
obesity and diabetes. The association between lifetime EUt and hypertension was not
independent of current residence and current level of physical activity. CONCLUSIONS: This
study suggests that for the study of obesity and diabetes, in addition to current residence, both
lifetime exposure to an urban environment and recent migration history should be investigated.
Spidel, M. A., M. C. Paquette, et al. (2004). "Linking active living and nutrition counselling:
dietitians' perceptions." Canadian Journal of Diet Practice Research 65(4): 154-60.
Healthy eating and active living have become key concepts in health promotion, and,
increasingly, the two messages are being combined. Dietitians are in an ideal position to promote
physical activity as an adjunct to nutrition counselling. Focus group interviews were used to
identify dietitians' perceptions and needs related to incorporating active living messages into their
practices. Six focus groups, involving 42 participants (40 registered dietitians and two dietetic
interns), were conducted in cities throughout Alberta. Issues explored during the interviews
included the dietitian's role in promoting active living, barriers to promoting physical activity,
opportunities for collaboration between dietitians and exercise professionals, and dietitians'
perceived needs for integrating active living messages into their practices effectively. Findings
indicate strong support for incorporating active living messages into nutrition counselling.
However, lack of knowledge was identified as a barrier to dietitians' proactive role, and concerns
were raised about public and professional perceptions if dietitians counselled on this issue.
Participants felt that they required additional knowledge and training in physical activity in order to
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promote it effectively. Development and implementation of programs designed to meet these
needs would help dietitians integrate active living messages into their practices.
Stettler, N., T. M. Signer, et al. (2004). "Electronic games and environmental factors associated
with childhood obesity in Switzerland." Obesity Research 12(6): 896-903.
Objective: Environmental factors and behaviors associated with obesity have not been
well described in children living in Europe. Although television watching has been repeatedly
associated with obesity, it is unclear whether other sedentary activities, such as use of electronic
games, are independently associated with obesity in children. The hypothesis was that various
types of sedentary activities are associated with obesity in children living in Switzerland.
Research Methods and Procedures: This was a cross-sectional study of children (grades one to
three) from four communities in the Greater Zurich Area (Switzerland). Obesity was defined as a
combination of overweight (BMI) and overfat (skinfold thicknesses). Environmental factors were
assessed by questionnaire. The children's physical activity was estimated by their teacher (scale
0 to 10). Results: Of 922 eligible subjects, 872 (94.6%) took part in the study. Use of electronic
games [odds ratio (OR)=2.03 per hour per day, 95% confidence interval (CI): 1.57 to 2.61,
<i>p</i><0.001], television (OR=2.83 per hour per day, 95% CI: 2.08 to 3.86, <i>p</i><0.001),
physical activity (OR=0.80 per unit, 95% CI: 0.72 to 0.88, <i>p</i><0.001), maternal work
(OR=1.93, 95% CI: 1.13 to 3.29, <i>p</i>=0.02), and paternal smoking (OR=1.78, 95% CI: 1.07
to 2.96, <i>p</i>=0.03) were independently associated with obesity. Further adjustment for
socioeconomic status, when available, did not change these results. Discussion: In this sample of
children living in Switzerland, the use of electronic games was significantly associated with
obesity, independently of confounding factors. The association of obesity with television use and
lack of physical activity confirms results from other populations and points to potential strategies
for obesity prevention.
Sturm, R. (2004). "The economics of physical activity: societal trends and rationales for
interventions." American Journal of Preventive Medicine 27(3 Suppl): 126-35.
What are Americans doing with their time and their money and what has changed in
recent decades? Do changes suggest interventions that will lead to healthier lifestyles? This
paper analyzes several different data sets that reveal some surprising (and some less surprising)
insights. The big growth areas, both in terms of expenditure and time allocation, have been
leisure time and travel/transportation. Leisure-time industries outpace gross-domestic-product
growth for both "active" (sporting goods, dance studios, gyms) and "sedentary" industries
(spectator sports, cable TV), although industries associated with more sedentary lifestyles grow
the fastest. Overall time spent in productive activities, whether at home or work, has declined by
several hours each week for both men and women compared to 40 years ago. Reduced physical
activity by itself is not a reason for intervening, as many changes improved overall quality of life
(even if not necessarily health-related quality of life). But other trends are more likely to reflect
poorly functioning markets, leading to worse economic and health outcomes. Market failures that
lead to less physical activity or unhealthy nutrition justify interventions, both from an economic
and a public health perspective.
Temple, V. and J. O'Connor (2004). "Family day care environments and physical activity."
ACHPER Healthy Lifestyles Journal 51(4): 12-17.
Early childhood lays the foundation for physical activity in later life, therefore movement
experiences should foster enjoyment of physical activity and help young children become
confident and competent movers. This study examined the opportunities and constraints to
physical activity for 3- to 5-year-old children in family day care environments in Australia. Eleven
structured interviews with caregivers and environment analyses of caregivers' homes were
conducted. The major barriers to physical activity reflected a confluence of environmental and
social factors, such as rules governing play indoors during inclement weather. It is suggested that
resources to enable physical activity need to consider the unique characteristics of family day
care environments, where for example, indoor play space is also the caregiver's home.
Thomas, N., E. Alder, et al. (2004). "Barriers to physical activity in patients with diabetes."
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Active Living Research Literature Summary 2004 & 2005
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Postgraduate Medical Journal 80(943): 287-91.
PURPOSE: Two questions were addressed: (1) How much physical activity do patients
with diabetes perform? (2) What are the perceived factors that prevent patients from doing more
physical activity? Research design and methods: Interview based questionnaires were distributed
to consecutive patients attending the Diabetes Clinic, Ninewells Hospital, Dundee over a period of
five months. Exclusion criteria were age below 20 years and inadequate understanding of
English; 428 questionnaires were given out with 406 completed. RESULTS: Physical activity was
undertaken by 34% of patients with diabetes and only 9% of these patients exercised sufficiently
to achieve a large change in heart rate or breathing. The main reasons for inactivity included
perceived difficulty taking part in exercise, feelings of tiredness, and being distracted by
something good on television. Lack of time and lack of local facilities also contributed.
CONCLUSIONS: Few patients with diabetes participate in physical activity, and in those who do
the level of intensity is low. There are many modifiable factors distracting patients from exercise.
Timperio, A., D. Crawford, et al. (2004). "Perceptions about the local neighborhood and walking
and cycling among children." Preventive Medicine 38(1): 39-47.
Background. This study examined associations between perceptions of the local
neighborhood and walking and cycling among children. Methods. Children aged 5-6 years (n =
291) and 10-12 years (n = 919) were recruited from 19 Australian primary schools. Parents
reported their child's usual walking or cycling to local destinations and their perceptions of their
neighborhood. Ten- to twelve-year-olds were asked their perceptions of traffic, strangers, road
safety and sporting venues, and their perceptions of their parent's views on these issues. Results.
Five- to six-year-old boys whose parents believed there was heavy traffic in their area were 2.8
times more likely (95%CI = 1.1 - 6.8), and 5- to 6-year-old girls whose parents owned more than
one car were 70% less likely (95%CI = 0.1-0.8), and whose parents believed that public transport
was limited in their area were 60% less likely (95%CI = 0.2-0.9) than other children to walk or
cycle at least three times per week. Parental belief that there were no lights or crossings was
associated with walking or cycling among 10- to 12-year-old boys (OR 0.4, 95%CI = 0.2-0.7).
Among older girls, parent's belief that their child needed to cross several roads to reach play
areas (OR = 0.4, 95%CI = 0.2-0.8) and that there is limited public transport in their area (OR =
0.7, 95%CI = 0.4-0.97), and child's belief that there were no parks or sports grounds near home
(OR = 0.5, 95%CI = 0.3-0.8) were associated with a lower likelihood of walking or cycling.
Conclusion. Perceptions of the local neighborhood may influence children's physical activity. (C)
2003 American Health Foundation and Elsevier Inc. All rights reserved.
Timperio, A., J. Salmon, et al. (2004). "Evidence-based strategies to promote physical activity
among children, adolescents and young adults: review and update." Journal of Science and
Medicine in Sports 7 (1 Suppl): 20-29.
This paper updates evidence reviewed in the first edition of Getting Australia Active on
effective physical activity (PA) intervention strategies among children, adolescents and young
adults. Intervention studies published between 1999 and September 2003 were identified using
electronic databases and hand searching. A total of 28 discrete studies were identified (31
papers). Six of nine studies reported significant effects on child or youth PA in school settings.
Those that incorporated whole-of-school approaches including curriculum, policy and
environmental strategies appeared to be more effective than those that incorporated curriculumonly approaches. Five of 10 studies with children and two of five studies with adolescents
reported increased PA or decreased sedentary behaviour in other settings. Interventions that
included contact with families generally appeared to be most effective. One study with
adolescents provided some evidence of the potential effectiveness of interventions based in
primary care. Two of four papers reported modest short-term results among young adults,
including increased PA stage of change or a higher likelihood of being adequately physically
active, but none showed any evidence of sustained increases in PA. There is an urgent need for
additional studies examining interventions aimed at young adults. Across the three life stages,
future studies should include objective PA measures, longer-term follow-up, larger sample sizes,
a specific focus on PA (rather than weight) and culturally-specific strategies that build evidence in
Australian populations. Future studies should target high risk groups and a broad range of
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Active Living Research Literature Summary 2004 & 2005
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settings and strategies focusing on reducing sedentary behaviours as well as increasing PA.
Vandegrift, D. and T. Yoked (2004). "Obesity rates, income, and suburban sprawl: an analysis of
US states." Health & Place 10(3): 221-9.
In a decade of economic growth and rising income, obesity has risen dramatically. This is
puzzling when researchers have found that there is an inverse relation between income and
obesity. This paper argues that new location patterns produced by suburban sprawl are an
important cause of rising obesity rates. New location patterns are such that work, school and
social activities are not as easily accessible by foot. Changes in sprawl then drive changes in the
causes of obesity identified by medical researchers (e.g., low activity levels). We define sprawl as
increases in the amount of developed land, holding population constant. Determinants and
outcomes are analyzed on a population basis. We use state-level data from the 1990s on obesity
to show that states that increased the amount of developed land (holding population constant)
showed larger increases in obesity. As a result, town planning efforts to reduce sprawl may be
justified not only on aesthetic grounds but also based on efforts to reduce the costs associated
with treating medical conditions related to obesity.
Vuori, I., B. Lankenau, et al. (2004). "Physical activity policy and program development: the
experience in Finland." Public Health Reports 119(3): 331-345.
This article describes the development of sports and physical activity policies and
programs in Finland during the past 30 years. The past two decades have been marked by a shift
in emphasis from competitive and elite sports to health-enhancing physical activity for all, as seen
most clearly in two successive sports acts and a government resolution. The new, increasingly
multisectoral policies have led to substantial changes in the public funding of sports
organizations, services, and construction of sports sites. Furthermore, three successive five-year
national physical activity promotion programs have been launched. As a result, increased and
new types of opportunities to participate in physical activity have become available, and the
infrastructure and networks for provision of services have been strengthened. Until the mid
1990s, leisure time physical activity increased in Finland, but during the last seven to eight years,
both leisure time and commuting physical activity have been stable. This finding may be an
indication of the difficulty to increase physical activity in an industrialized country with already
relatively high levels of physical activity even when systematic, long-term policies and measures
are applied.
Wakefield, J. (2004). "Fighting obesity through the built environment." Environmental Health
Perspective 112(11): A616-8.
Wang, G. J., C. A. Macera, et al. (2004). "Cost analysis of the built environment: The case of bike
and pedestrian trials in Lincoln, Neb." American Journal Of Public Health 94(4): 549-553.
We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using
construction and maintenance costs provided by the Department of Parks and Recreation of
Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual
construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a
period of useful life of 10, 30, and 50 years. The average cost per mile and per user was
calculated. Trail length averaged 3.6 miles (range= 1.6-4.6 miles). Annual cost in 2002 dollars
ranged from $25 762 to $248479 (mean=$124927; median= $171064). The cost per mile ranged
from $5735 to $54017 (mean=$35355; median=$37994). The annual cost per user was $235
(range= $83-$592), whereas per capita annual medical cost of inactivity was $622. Construction
of trails fits a wide range of budgets and may be a viable health amenity for most communities.
To increase trail cost-effectiveness, efforts to decrease cost and increase the number of users
should be considered.
Wendel-Vos, G. C. W., A. J. Schuit, et al. (2004). "Factors of the physical environment associated
with walking and bicycling." Medicine And Science In Sports And Exercise 36(4): 725-730.
WENDEL-VOS, G. C. W., A. J. SCHUIT, R. DE NIET, H. C. BOSHUIZEN, W. H. M.
SARIS, and D. KROMHOUT. Factors of the Physical Environment Associated with Walking and
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
Bicycling. Med. Sci. Sports Exerc., Vol. 36, No. 4, pp. 725-730, 2004. Purpose: The purpose of
this study was to identify factors of the physical environment that may influence time spent on
walking and bicycling. Methods: Demographic factors and time spent on walking and bicycling
(during leisure time and for commuting purposes) were assessed with a self-administered
questionnaire. GIS databases were used to objectively measure the total square area of green
space and recreational space (woods, parks, sport grounds, allotments for vegetable gardens,
and grounds for day trips) in a circle around the postal code of a respondent with a radius of 300
and 500 m. Multilevel regression analysis was used to study the association between walking and
bicycling on the one hand, and green and recreational space on the other hand. Analyses were
adjusted for gender, age, and educational level. Results: In a neighborhood defined as a circle
with a 300-m radius, the square area of sport grounds was associated with bicycling in general
and the square area of parks was associated with bicycling for commuting purposes. It is,
however, very likely that these results reflect the association of living in the outskirts of town and
time spent on bicycling. Conclusion: The present study showed green and recreational space,
specifically sport grounds and parks, to be associated with time spent on bicycling.
Wilson, D. K., K. A. Kirtland, et al. (2004). "Socioeconomic status and perceptions of access and
safety for physical activity." Annals of Behavioral Medicine 28(1): 20-8.
BACKGROUND: Environmental factors may play an important role on influencing
physical activity (PA) behaviors. PURPOSE: Perceptions of access and safety for PA were
compared among residents who were stratified as low or high in socioeconomic status (SES).
METHODS: Residents of a U.S. southeastern county (N = 1,194, 18-96 years of age) were
contacted using a random-digit-dial method and asked about neighborhood and community
environmental supports for PA. A Geographic Information System (GIS) was used to identify
trails, sidewalks, public recreation facilities, and violent crime incidents. RESULTS: A cluster
analysis identified 10 census tracts as low SES and 11 census tracts as high SES (median
household income, owner-occupied houses). More African Americans (66.5%) than Whites
(33.5%) were classified as living in low-SES areas. Respondents from low-SES areas also
reported engaging in less PA based on Centers for Disease Control and Prevention and
American College of Sports Medicine recommendations than respondents from high-SES areas
(p <.05). Respondents from low-SES (vs. high-SES) areas reported higher perceptions of
neighborhood crime, unattended dogs, unpleasantness of neighborhoods, untrustworthy
neighbors, and less access to public recreation facilities (ps <.05). GIS data for presence of
sidewalks, recreation facilities, and crime did not support these differences in perceptions;
however, respondents from low-SES (vs. high-SES) areas had substantially fewer trails. Having
and using trails in one's community predicted sufficient PA and walking for 150 min/week for lowSES respondents but not for high SES respondents (ps =.05, adjusted for covariates).
CONCLUSIONS: Having access to trails is an important environmental feature among low-SES
communities and should be the focus of future community-based PA interventions.
Yancey, A. K., S. K. Kumanyika, et al. (2004). "Population-based interventions engaging
communities of color in healthy eating and active living: a review." Preventing Chronic Disease
1(1): A09.
INTRODUCTION: The U.S. obesity epidemic is escalating, particularly among
communities of color. Obesity control efforts have shifted away from individual-level approaches
toward population-based approaches that address socio-cultural, political, economic, and
physical environmental factors. Few data exist for ethnic minority groups. This article reviews
studies of population-based interventions targeting communities of color or including sufficient
samples to permit ethnic-specific analyses. METHODS: Inclusion criteria were established, an
electronic database search conducted, and non-electronically catalogued studies retrieved.
Findings were aggregated for earlier (early 1970s to early 1990s) and later (mid-1990s to
present) interventions. RESULTS: The search yielded 23 ethnically inclusive intervention studies
published between January 1970 and May 2003. Several characteristics of inclusive interventions
were consistent with characteristics of community-level interventions among predominantly white
European-American samples: use of non-interpersonal channels for information dissemination
directed at broad spheres of influence (e.g., mass media), promotion of physical activity, and
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
incorporation of social marketing principles. Ethnically inclusive studies, however, also placed
greater emphasis on involving communities and building coalitions from study inception; targeting
captive audiences; mobilizing social networks; and tailoring culturally specific messages and
messengers. Inclusive studies also focused more on community than individual norms. Later
studies used "upstream" approaches more than earlier studies. Fewer than half of the inclusive
studies presented outcome evaluation data. Statistically significant effects were few and modest,
but several studies demonstrated better outcomes among ethnic minority than white participants
sampled. CONCLUSION: The best data available speak more about how to engage and retain
people of color in these interventions than about how to create and sustain weight loss, regular
engagement in physical activity, or improved diet. Advocacy should be directed at increasing the
visibility and budget priority of interventions, particularly at the state and local levels.
Yancey, A. K., L. B. Lewis, et al. (2004). "Leading by example: a local health departmentcommunity collaboration to incorporate physical activity into organizational practice." Journal of
Public Health Management and Practice 10(2): 116-23.
A multisectoral model promoting sociocultural environmental change to increase physical
activity levels among African Americans in Los Angeles County, California, was developed and
implemented. This model represents a true collaboration between a local health department and
a community lead agency. Community organizations serving targeted areas of the county
participated in one or more interventions incorporating physical activity into routine organizational
practice, which centered around modeling the behaviors promoted ("walking the talk"). In the
current study, level of organizational support for physical activity integration was assessed, as
reflected in the extent of organizational commitment associated with each intervention. Individuallevel data, characterizing the sociodemography, health status, and health behaviors of
organization staff, members, and clients, are presented to document the average risk burden in
the targeted population. Nearly half of the more than 200 participating organizations actively
embraced incorporating physical activity into their regular work routines, with more than 25
percent committed at the highest level of involvement. Broad capacity and support for
organizational integration of physical activity was demonstrated, with the observed level of
commitment varying by organization type. Similar to the successful evolution of tobacco control,
some of the responsibility ("cost") for physical activity adoption and maintenance can and should
be shifted from the individual to organizational entities, such as workplaces.
Yancey, A. K., W. J. McCarthy, et al. (2004). "The Los Angeles Lift Off: a sociocultural
environmental change intervention to integrate physical activity into the workplace." Preventive
Medicine 38(6): 848-56.
PURPOSE: To present the development and feasibility testing of a sociocultural
environmental change intervention strategy aimed at integrating physical activity into workplace
routine. DESIGN: Randomized, controlled, post-test only, intervention trial. Setting. Los Angeles
County Department of Health Services' worksites. PARTICIPANTS: Four hundred forty-nine
employees, predominantly sedentary, overweight, middle-aged women of color, distributed
across 26 meetings. INTERVENTION: A single 10-min exercise break during work time involving
moderate intensity, low-impact aerobic dance and calisthenic movements to music. MEASURES:
Primary-level of participation, particularly among sedentary staff; secondary-self-perceived health
status, satisfaction with current fitness level, and mood/affective state. RESULTS: More than 90%
of meeting attendees participated in the exercises. Among completely sedentary individuals,
intervention participants' self-perceived health status ratings were significantly lower than
controls' (OR = 0.17; 95% CI = 0.05, 0.60; P = 0.0003). Among all respondents not regularly
physically active, intervention participants' levels of satisfaction with fitness were more highly
correlated with self-ranked physical activity stage of change (r = 0.588) than the control
participants' (r = 0.376, z = -2.32, p = 0.02). Among the completely sedentary, control participants
reported significantly higher levels of energy than did intervention participants (P < 0.01).
CONCLUSIONS: Captive audiences may be engaged in brief bouts of exercise as a part of the
workday, regardless of physical activity level or stage of change. This experience may also
appropriately erode sedentary individuals' self-perception of good health and fitness, providing
motivation for adoption of more active lifestyles.
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Active Living Research Literature Summary 2004 & 2005
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Zegras, P. C. (2004). Influence of land use on travel behavior in Santiago, Chile. Travel Demand
And Land Use 2004: 175-182.
Ziviani, J., J. Scott, et al. (2004). "Walking to school: incidental physical activity in the daily
occupations of Australian children." Occupational Therapy International 11(1): 1-11.
Children's participation in physical activity is declining, and nowhere is this more apparent
than in the incidental activity of walking to school. The aim of this pilot study was to examine the
extent to which Australian children walked to and from primary school, and to survey parents to
identify factors influencing this behaviour. Parents of 164 students in Grades 1 7 (mean age 9.1
+/- 2.02 years) from a primary school comprising 360 students responded to a questionnaire
regarding psychosocial and environmental factors thought to influence the means by which their
children went to and from school. Results indicated that parent perception of the importance of
physical activity, parents' individual history of transport to school as well as distance from school
were the most statistically significant factors determining children's involvement in walking to and
from school. The results of this study highlight the attitudes and experiences of parents in
determining the extent to which children are involved in non-motorized access to school. Also
implicated are organizational policies about geographical school regions. While this study is
limited to one school community, further study is recommended with others to better confirm
findings by examining socioeconomic, geographic and policy variables. Occupational therapists
are challenged to examine ways in which incidental physical activity can be increased in the lives
of young children.
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
2005
Ahmed, N. U., G. L. Smith, et al. (2005). "Racial/ethnic disparity and predictors of leisure-time
physical activity among U.S. men." Ethnicity & Disease 15(1): 40-52.
OBJECTIVES: To examine racial/ethnic disparity in and predictors of leisure-time
physical activity (LTPA) among men. METHODS: We used the National Health Interview Surveys
(NHIS) 1999-2000 data, a multistage probability sampling design producing a U.S. representative
sample of 23,459 adult males. Data were analyzed using multinomial logistic regression.
RESULTS: The likelihood of engaging in irregular or regular LTPA was associated with younger
age, being unmarried, lower household sizes, higher levels of education and income, home
ownership, U.S. citizenship, perceived better health status, contact with a health professional
within a year, being a non-smoker, living in the West, and residing in a midsize metropolitan
statistical area. Hispanics were significantly less likely to engage in regular LTPA than Whites and
higher percentages of Hispanics were physically inactive in almost all age and education groups
when compared to other races. Disparity between Whites and Blacks was less pronounced. Noncitizen Hispanics were twice as likely to be inactive than citizens and White non-citizens were
40% more likely to be inactive than citizens. Conversely, Black citizens were 20% more likely to
be inactive than non-citizens. CONCLUSIONS: Racial/ethnic disparities exist after accounting for
socio-demographic characteristics. Not being a citizen exacerbates the disparity between
Hispanic and White men. While disparity did exist between Black and White men, this gap was
not as large as between Hispanic and White men. Health-seeking behaviors, such as contact with
a health professional and non-smoking status are modifiable and influence men of all racial and
ethnic backgrounds to engage in LTPA.
Allen, L. (2005). "Becoming good sports - professionals need to exercise their power by helping
community youth develop through parks and recreation." Parks & Recreation 40(3): 66-72.
This paper first presents an overview of the meaning of youth development and the role
that recreation can play in terms of youth development. It then discusses seven key changes that
will help the recreation profession maximize its effectiveness in helping the youth. These changes
are: (1) building systems for change rather than creating events and programmes for change; (2)
not focusing on events and activities but focusing on their outcomes and impact; (3) focusing on
building community capacity for youth development as much as building programmes for youth
development; (4) adhering to the "best practices" in youth programming; (5) embracing
collaboration with other organizations, agencies and groups to truly address all youth issues and
needs; (6) being a facilitator as much as a programmer; and (7) documenting efficacy through
assessment and evaluation.
Allison, K. R., J. J. Dwyer, et al. (2005). "Male adolescents' reasons for participating in physical
activity, barriers to participation, and suggestions for increasing participation." Adolescence
40(157): 155-70.
This study explored male adolescents' reasons for participating in moderate and vigorous
physical activity, perceived barriers to moderate and vigorous physical activity, and suggestions
as to what can be done to increase participation in physical activity. A total of 26 male 15- and 16year-old adolescents participated in focus group sessions, which were audiotaped and
transcribed verbatim; qualitative software facilitated data analysis. A constant comparison
approach was used to inductively develop themes. It was found that participants engaged in
physical activity for both intrinsic and extrinsic reasons. Their perceived barriers to physical
activity included both internal factors (individual characteristics, lower priority for physical activity,
and involvement in technology-related activities) and external factors (the influence of peers and
family, lack of time, and inaccessibility and cost of facilities). Participants suggested that physical
activity be promoted more in the community and that an environment more supportive of physical
activity be developed. Results suggest that a variety of strategies should be used to help male
adolescents maintain or increase participation in moderate and vigorous physical activity.
Atkinson, J. L., J. F. Sallis, et al. (2005). "The association of neighborhood design and
recreational environments with physical activity." American Journal of Health Promotion 19(4):
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
304-9.
PURPOSE: To determine the association of neighborhood design factors and
recreational environments with physical activity. METHODS: Randomly selected adults (n = 102,
52% female, 81% white, mean age = 48 years) completed a survey of eight neighborhood design
variables, convenient recreational facilities, and availability of home equipment. Physical activity
was measured by self-report and 7 days of accelerometer monitoring. RESULTS: Residential
density and an overall environment index were significantly related to both vigorous-intensity selfreported (r =.35 and.28, respectively) and objectively measured physical activity (r =.39 and.23,
respectively). Home equipment was correlated with self-reported total (r =.34) and vigorous
leisure-time physical activity (r =.27). The vigorous and total activity accelerometer measures
were correlated with street connectivity (r =.25 and.21, respectively). DISCUSSION: Few selfreported neighborhood design factors and recreational environment variables were correlated
with physical activity, and some findings were unexpected.
Badland, H. and G. Schofield (2005). "Transport, urban design, and physical activity: an
evidence-based update." Transportation Research Part D-Transport And Environment 10(3): 177196.
The urban environment and modes of transport are increasingly being linked to physical
activity participation and population health outcomes. Much of the research has been based on
either health or urban design paradigms, rather than from collaborative approaches. Previous
health reviews in the urban design area have been constrained to perceptions of the
neighborhood or walking behaviors, consequently limiting the understanding of built environment
influences on physical activity modalities. This review focuses on existing evidence surrounding
various urban design factors and physical activity behaviors. Based on the available evidence,
fostering suitable urban environments is critical to sustaining physical activity behaviors. In turn,
these environments will provide part of the solution to improving population health outcomes. Key
urban design features attributable to transport-related physical activity are density, subdivision
age, street connectivity, and mixed land use. Future directions for research include consistent use
of transport and health measurement tools, an enhanced understanding of traffic calming
measures, and further collaborative work between the health, transport, and urban design
sectors. Presenting these findings to transport and urban design audiences may influence future
practice, thereby increasing the sustainability of health-related physical activity at the population
level. (c) 2005 Elsevier Ltd. All rights reserved.
Badland, H. and G. Schofield (2005). "Understanding the relationship between town size and
physical activity levels: A population study." Health & Place.
Little is known about the relationship between town size and physical activity levels. A
representative population sample survey was used to identify activity and environmental barrier
differences between residents in diverse town sizes (n=7916). Binary logistic regression analysis
identified residents in large cities (>100000 people) were 15% less likely to be sedentary for
overall activity classifications in comparison to small town dwellers (<1000 people) (OR=0.85;
95%Cl=0.74-0.99). Barriers to physical activity participation differed by town size; smaller town
residents reported a higher prevalence of infrastructural barriers, whereas larger city residents
cited personal constraints. Community physical activity interventions should address issues
associated with town size.
Badland, H. M. and G. M. Schofield (2005). "The built environment and transport-related physical
activity: what we do and do not know." Journal of Physical Activity and Health 2(4): 435-444.
Bauman, A. (2005). "The physical environment and physical activity: moving from ecological
associations to intervention evidence." Journal of Epidemiological Community Health 59(7): 5356.
Bedimo-Rung, A. L., A. J. Mowen, et al. (2005). "The significance of parks to physical activity and
public health: a conceptual model." American Journal of Preventive Medicine 28(2 Suppl 2): 15968.
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Active Living Research Literature Summary 2004 & 2005
Published February 2006
Park-based physical activity is a promising means to satisfy current physical activity
requirements. However, there is little research concerning what park environmental and policy
characteristics might enhance physical activity levels. This study proposes a conceptual model to
guide thinking and suggest hypotheses. This framework describes the relationships between park
benefits, park use, and physical activity, and the antecedents/correlates of park use. In this
classification scheme, the discussion focuses on park environmental characteristics that could be
related to physical activity, including park features, condition, access, aesthetics, safety, and
policies. Data for these categories should be collected within specific geographic areas in or
around the park, including activity areas, supporting areas, the overall park, and the surrounding
neighborhood. Future research should focus on how to operationalize specific measures and
methodologies for collecting data, as well as measuring associations between individual physical
activity levels and specific park characteristics. Collaboration among many disciplines is needed.
Besser, L. M. and A. L. Dannenberg (2005). "Walking to public transit steps to help meet physical
activity recommendations." American Journal Of Preventive Medicine 29(4): 273-280.
Background: Nearly half of Americans do not meet the Surgeon General's
recommendation of >= 30 minutes of physical activity daily. Some transit users may achieve 30
minutes of physical activity daily solely by walking to and from transit. This study estimates the
total daily time spent walking to and from transit and the predictors of achieving 30 minutes of
physical activity daily by doing so. Methods: Transit-associated walking times for 3312 transit
users were examined among the 105,942 adult respondents to the 2001 National Household
Travel Survey, a telephone-based survey sponsored by the U.S. Department of Transportation to
assess American travel behavior. Results: Americans who use transit spend a median of 19
minutes daily walking to and from transit; 29% achieve >= 30 minutes of physical activity a day
solely by walking to and from transit. In multivariate analysis, rail users, minorities, people in
households earning < $15,000 a year, and people in high-density urban areas were more likely to
spend; >= 30 minutes walking to and from transit daily. Conclusions: Walking to and from public
transportation can help physically inactive populations, especially low-income and minority
groups, attain the recommended level of daily physical activity. Increased access to public transit
may help promote and maintain active lifestyles. Results from this study may contribute to health
impact assessment studies (HIA) that evaluate the impact of proposed public transit systems on
physical activity levels, and thereby may influence choices made by transportation planners.
Bhat, C. R. and S. Srinivasan (2005). "A multidimensional mixed ordered-response model for
analyzing weekend activity participation." Transportation Research Part B-Methodological 39(3):
255-278.
Biddle, S. J. H., S. H. Whitehead, et al. (2005). "Correlates of participation in physical activity for
adolescent girls: a systematic review of recent literature." Journal of Physical Activity and Health
2(4).
Background: Many adolescent girls have low levels of physical activity and participation
declines with age. This review identifies recent correlates of physical activity in adolescent girls.
Methods: Systematic review of papers published 1999 to mid-2003. Papers (k = 51) reporting a
measure of physical activity and at least one potential correlate of physical activity in adolescent
girls were analyzed. Results: Demographics related to physical activity were female gender (–),
non-white ethnicity (–), age (–), and socio-economic status (+). Psychological correlates positively
associated with physical activity were enjoyment, perceived competence, self-efficacy, and
physical self-perceptions. Behavioral correlates showed that smoking was associated with lower
and organized sport involvement with greater activity. Physical activity was associated with
parental and family support but we found no consistent trends for environmental variables. Effects
were small-to-moderate. Conclusions: Modifiable correlates for adolescent girls clustered around
“positive psychology,” organized sport involvement, and the family.
Blanchard, C. M., K. R. McGannon, et al. (2005). "Social ecological correlates of physical activity
in normal weight, overweight, and obese individuals." International Journal of Obesity 29(6): 720-
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Active Living Research Literature Summary 2004 & 2005
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6.
OBJECTIVE: Research is limited concerning the moderating influence of weight status (ie
normal, over, and obese) on the social ecological correlates of physical activity (PA) in adults.
Therefore, the present study attempted to shed light on this issue. DESIGN: In 2001, a national
cross-sectional mail out panel survey was conducted over a 3-month period in the United States.
SUBJECTS: There were 1867 normal weight (ie body mass index (BMI)=20-24.99 kg/m2), 2145
overweight (ie BMI=25-29.99 kg/m2), and 1902 obese (ie BMI>30 kg/m2) adults. MEASURES:
Various demographic measurements were taken in addition to social support (SS), self-efficacy
(SE), access to facilities, and PA. RESULTS: Normal weight individuals engaged in significantly
more PA than overweight individuals, who in turn engaged in significantly more PA than obese
individuals F(2,5991)=55.51, P<0.01. Further regression analyses showed that higher SE, SS,
the access to facilities in a neighborhood, and various interactions among these constructs were
significantly and positively associated with PA. Interestingly, the strength of these relationships
varied depending on weight status. CONCLUSION: Weight status needs to be taken into
consideration when examining social ecological correlates of PA.
Boarnet, M. G., C. L. Anderson, et al. (2005). "Evaluation of the California Safe Routes to School
legislation: urban form changes and children's active transportation to school." American Journal
of Preventive Medicine 28(2 Suppl 2): 134-40.
BACKGROUND: Walking or bicycling to school could contribute to children's daily
physical activity, but physical environment changes are often needed to improve the safety and
convenience of walking and cycling routes. The California Safe Routes to School (SR2S)
legislation provided competitive funds for construction projects such as sidewalks, traffic lights,
pedestrian crossing improvements, and bicycle paths. METHODS: A cross-sectional evaluation
examined the relationship between urban form changes and walking and bicycle travel to school.
Surveys were distributed to parents of third- through fifth-grade children at ten schools that had a
completed SR2S project nearby. Two groups were created based on whether parents stated that
their children would pass the SR2S project on the way to school or not. RESULTS: Children who
passed completed SR2S projects were more likely to show increases in walking or bicycle travel
than were children who would not pass by projects (15% vs 4%), based on parents' responses.
CONCLUSIONS: Results support the effectiveness of SR2S construction projects in increasing
walking or bicycling to school for children who would pass these projects on their way to school.
Boarnet, M. G., K. Day, et al. (2005). "California's safe routes to school program - Impacts on
walking, bicycling, and pedestrian safety." Journal Of The American Planning Association 71(3):
301-317.
This article evaluates California's pioneering Safe Routes to School (SR2S) program,
which funds traffic improvement projects designed to improve safety for children's walking and
bicycling to school and to increase the number of children who do so. Through surveys of parents
and observations of vehicle and pedestrian traffic before and after project construction, we
examined the impacts of io traffic improvement projects funded through the SR2S program. We
measured changes in perceived safety and in safety-related behaviors associated with children's
trips to school, and examined changes in the number of children walking and bicycling following
these improvements. Five of the to traffic improvement projects we evaluated showed evidence of
a successful impact. The findings have implications for California's SR2S program and for similar
initiatives throughout the country.
Booth, K. M., M. M. Pinkston, et al. (2005). "Obesity and the built environment." Journal of the
American Dietetic Association 105(5 Suppl 1): S110-7.
Biological, psychological, behavioral, and social factors are unable to fully explain or
curtail the obesity epidemic. In this article we review research on the influence of the built
environment on obesity. Studies were evaluated with regard to their methods of assessing the
environment and obesity, as well as to their effects. Methods used to investigate the relationships
between the built environment and obesity were found to be dissimilar across studies and varied
from indirect to direct. Levels of assessment between and within studies varied from entire
counties down to the individual level. Despite this, obesity was linked with area of residence,
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Active Living Research Literature Summary 2004 & 2005
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resources, television, walkability, land use, sprawl, and level of deprivation, showing promise for
research utilizing more consistent assessment methods. Recommendations were made to use
more direct methods of assessing the environment, which would include specific targeting of
institutions thought to vary widely in relation to area characteristics and have a more influential
effect on obesity-related behaviors. Interventions should be developed from the individual to the
neighborhood level, specifically focusing on the effects of eliminating barriers and making
neighborhood level improvements that would facilitate the elimination of obesogenic
environments.
Bourdeaudhuij, I. d., P. J. Teixeira, et al. (2005). "Environmental and psychosocial correlates of
physical activity in Portuguese and Belgian adults." Public Health Nutrition 8(7): 886-895.
Objectives: To investigate differences in reported physical activity levels and in perceived
environmental and psychosocial correlates of activity between Portuguese and Belgian adults;
and to analyse the relative contribution of environmental and psychosocial variables in explaining
physical activity within different contexts in Portugal and Belgium. Design: Cross-sectional study.
Setting: One city in Portugal (Oeiras) and one in Belgium (Ghent). Subjects: In total 526
participants, 247 from Portugal and 279 from Belgium, completed the long International Physical
Activity Questionnaire and a validated questionnaire on environmental and psychosocial
correlates. Results: For the sum of all activities of at least moderate intensity, a significantly
higher mean level of activity was found in Belgian adults (<i>P</i><0.001). However, comparable
percentages of the Belgian (38%) and Portuguese (42%) samples did not meet the
recommendation of 30 min per day. The variance explained by environmental factors was lower
(1% to 8%) than by psychosocial factors (maximum 42%). Regression analyses showed activityspecific relations with environmental variables which were analogous in both countries.
Walking/cycling for transportation and walking for recreation were related to social support from
family and/or friends and to walkability and walking facilities in the neighbourhood. Recreational
physical activity was mainly determined by social support, self-efficacy, and perceived benefits
and barriers. Conclusions: Activity campaigns addressing psychosocial determinants are needed
to encourage leisure-time activity, while a combination of neighbourhood design changes and
encouragement of social support in walking is warranted to increase walking in different contexts.
Brisbon, N., J. Plumb, et al. (2005). "The asthma and obesity epidemics: the role played by the
built environment--a public health perspective." Journal of Allergy and Clinical Immunology
115(5): 1024-8.
Obesity and asthma have reached epidemic proportions in the United States. The
reasons for these epidemics are complex, and the solutions to address them are many. This
article explores the epidemics, their causes and consequences, associations and relationships,
an expansion of the definition of the environment, and current national initiatives that address the
components of the built and social environments that promote obesity and precipitate asthma.
Brodersen, N. H., A. Steptoe, et al. (2005). "Sociodemographic, developmental, environmental,
and psychological correlates of physical activity and sedentary behavior at age 11 to 12." Annals
of Behavioral Medicine 29(1): 2-11.
BACKGROUND: Low levels of physical activity and high levels of sedentary behavior
during adolescence are a cause for concern. Sociodemographic, developmental, environmental,
and psychological factors may be relevant, but the correlates of these behaviors may differ.
PURPOSE: To investigate the multidimensional correlates of physical activity and sedentary
behavior in a large sample of 11- to 12-year-old boys and girls. METHODS: Cross-sectional
survey of 2,578 boys and 1,742 girls from 36 schools stratified by socioeconomic background and
gender mix of students (84% response rate). Questionnaire assessments and objective
measurements of height and weight were obtained. RESULTS: Days of vigorous physical activity
and hours of sedentary behaviors over the past week were uncorrelated. Ethnicity,
socioeconomic factors, developmental stage, environmental factors, and psychological variables
were associated with physical activity and sedentary behavior in univariate analyses. In multiple
regression, sedentary behavior was greater in ethnic minority groups, in students from more
deprived backgrounds, and in those with conduct problems. Girls who were more advanced
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developmentally and who reported emotional symptoms also engaged in more sedentary
behaviors. Vigorous physical activity was associated with good self-rated health, prosocial
psychological characteristics, and (in boys) with low emotional symptoms. CONCLUSIONS: A
multidimensional approach to understanding the context of physical activity in early adolescence
is needed because factors in several domains are relevant. The correlates of physical activity and
sedentary behaviors are distinct in this age group, and there are also important gender
differences.
Brownson, R. C., T. K. Boehmer, et al. (2005). "Declining rates of physical activity in the United
States: what are the contributors?" Annul Review of Public Health 26: 421-43.
This review describes current patterns and long-term trends (up to 50 years when
possible) related to (a) physical activity, (b) employment and occupation, (c) travel behavior, (d)
land use, and (e) related behaviors (e.g., television watching). On the basis of available data, the
following trends were observed according to type of physical activity: relatively stable or slightly
increasing levels of leisure-time physical activity, declining work-related activity, declining
transportation activity, declining activity in the home, and increasing sedentary activity. These
result in an overall trend of declining total physical activity. Large differences were noted in the
rates of walking for transportation across metropolitan statistical areas. A strong linear increase
existed in vehicle miles traveled per person over the past half century, coupled with a strong and
consistent trend toward Americans living in suburbs. Although it is difficult to precisely quantify
owing to the lack of long-term data, it is apparent that a combination of changes to the built
environment and increases in the proportion of the population engaging in sedentary activities put
the majority of the American population at high risk of physical inactivity.
Burdette, H. L. and R. C. Whitaker (2005). "A national study of neighborhood safety, outdoor play,
television viewing, and obesity in preschool children." Pediatrics 116(3): 657-62.
OBJECTIVE: To test the hypothesis that preschool children have a higher prevalence of
obesity, spend less time playing outdoors, and spend more time watching television (TV) when
they live in neighborhoods that their mothers perceive as unsafe. METHODS: In a cross-sectional
survey in 20 large US cities, mothers reported the average daily time of outdoor play and TV
viewing for their 3-year-old children, and the children's BMI was measured. Maternal perception
of neighborhood safety was assessed with the Neighborhood Environment for Children Rating
Scales; the scale score was used to divide children into tertiles of neighborhood safety.
RESULTS: Of the 3141 children studied, 35% lived in households with incomes below the US
poverty threshold. After adjustment for sociodemographic factors (household income and
mothers' education, race/ethnicity, age, and marital status), obesity prevalence (BMI > or =95th
percentile) did not differ in children from the least safe to the safest neighborhood safety tertile
(18% vs 17% vs 20%) or in weekday (160 vs 151 vs 156 minutes/day) or weekend (233 vs 222 vs
222 minutes/day) outdoor play time. Children who lived in neighborhoods that were perceived by
their mothers as the least safe watched more TV (201 vs 182 vs 185 minutes/day) and were more
likely to watch >2 hours/day (66% vs 60% vs 62%). TV viewing and outdoor play minutes were
not significantly correlated to each other or to BMI. CONCLUSIONS: In a national sample of
preschool children, mothers' perception of neighborhood safety was related to their children's TV
viewing time but not to their outdoor play time or risk for obesity.
Burton, N. W., G. Turrell, et al. (2005). "The Relative Contributions of Psychological, Social, and
Environmental Variables to Explain Participation in Walking, Moderate-, and Vigorous-Intensity
Leisure-Time Physical Activity." Journal of Physical Activity and Health 2(2): 181-196.
Introduction: This study assessed the relative contributions of psychological, social, and
environmental variables to walking, moderate- and vigorous-intensity physical activity. Methods:
A questionnaire was mailed to a random sample (57% response rate). Analyses used a
backwards elimination logistic regression model, removing and replacing individual variables, and
adjusting for age, gender, household composition, and education (N = 1827). Results: The
sociodemographic and correlate variables collectively accounted for 43% of the variation in total
activity, 26% of walking, 22% of moderate-intensity activity and 45% of vigorous-intensity activity
(Nagelkerke R2). Individually, the correlates accounted for 0.0 to 4.0% of unique variation, with
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habit, efficacy, and support having higher values. Physical health, discouragement, competi-tion,
and time management contributed more to vigorous-intensity activity. Anticipated benefits of
social interactions and weight management contributed more to moderate-intensity activity.
Neighborhood aesthetics contributed more to walking. Conclusion: Walking, moderate- and
vigorous-intensity activity might be associated with different correlates.
Carver, A., J. Salmon, et al. (2005). "How do perceptions of local neighborhood relate to
adolescents' walking and cycling?" American Journal Of Health Promotion 20(2): 139-147.
Purpose. To examine how perceptions of the local to neighborhood adolescents' walking
and cycling. Design. Exploratory cross-sectional study. Setting. Birth cohort from the Nepean
Hospital, Sydney, Australia. Subjects. Three hundred forty-seven adolescents (79.1% response
rate; 49.6% boys, mean age = 13.0 +/- 0.2 years) and their parents. Measures. Self-report and
parental-report questionnaires. Results. Multiple linear regressions, adjusted for level of maternal
education, revealed that boys who reported having many Peers to hang out with locally, cycled
for recreation. (P = 0.242, p =.006) or for transport (beta = 0.141, p =.046) more often, and
walked for transport for longer (beta = 0.129, p =.024) on weekdays. for girls this variable was
related to cycling for recreation on weekends (beta = 0.164, p =.006) and walking to school (beta
= 0.118, p =.002). Adolescents who waved/talked to neighbors walked for transport more often
(boys, beta = 0.149, p =.037; girls, beta = 0.119, p =.012). Girls who perceived local roads to be
safe spent more time walking for transport on weekdays (beta = 0.183, p =.007) and for exercise
on weekends (beta = 0.184, p =.034). Parents' perception, of heavy traffic was negatively
associated with boys' walking for transport (beta = -0.138, p =.037) and many aspects of girls'
walking and cycling. cents' walking and cycling in their neighborhood. Limitations are the use of
self-report and cross-sectional data. Longitudinal studies may clarify these relations.
Chad, K. E., B. A. Reeder, et al. (2005). "Profile of physical activity levels in community-dwelling
older adults." Medicine and Science in Sports and Exercise 37(10): 1774-84.
PURPOSE: To examine relationships between selected sociodemographic, healthrelated and environmental factors and levels of physical activity in older adults across three age
groups. METHODS: Seven hundred sixty-four older adults (mean age = 77.4 +/- 8.6 yr) from a
midsize Canadian city completed a self-administered questionnaire under researcher supervision.
Level of physical activity was determined using the Physical Activity Scale for the Elderly (PASE).
Correlates of physical activity were examined using previously validated questionnaires. The
findings pertaining to personal and environmental factors are presented. RESULTS: Overall,
significantly higher mean PASE scores were seen in those individuals in the following categories:
male (P < 0.001), married or common-law (P < 0.001), not living alone (P < 0.001), not living in
senior's housing (P < 0.001), higher levels of education (P < 0.001) and higher incomes (P <
0.001). Better physical health showed significant positive associations (P < 0.001) with PASE
score. Individuals reporting at least four or more chronic health conditions had significantly lower
PASE scores than those reporting no chronic conditions (P < 0.001). Significantly lower PASE
scores were also reported in those using domestic services (P < 0.001). Higher PASE scores
were related to the presence of hills, biking and walking trails, street lights, various recreation
facilities, seeing others active and unattended dogs (P < 0.001 to P < 0.05). CONCLUSION: An
understanding of the factors that influence physical activity behavior in older adults is critical to
developing effective intervention strategies that will address the problem of physical inactivity in
this population, and in doing so, improve the health status and quality of life of the older adult,
while having a significant impact on healthcare expenditures.
Chen, A. and W. Zhu (2005). "Young children’s intuitive interest in physical activity: personal,
school, and home factors." Journal of Physical Activity and Health 2(1): 1-15.
Background: A physically active or inactive lifestyle begins with intuitive interest at a very
young age. This study examined the impact of selected personal, school, and home variables on
young children’s intuitive interests in physical and sedentary activities. Methods: National data
from the Early Childhood Longitudinal Study (US Department of Education) were examined using
Cohen’s d, hierarchical log-linear analyses, and logistic regression. Results: Children’s interest in
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Active Living Research Literature Summary 2004 & 2005
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physical activity is accounted for fractionally by personal variables, but substantially by school
and home variables including number of physical education classes per week, teacher
experiences of teaching PE, and neighborhood safety. Conclusion: School and home
environment variables have stronger impact than personal variables on children’s intuitive interest
in physical activity. Future interventions should focus on strengthening school physical education
and providing a safe home environment to help nurture young children’s intuitive interest in
physical activity.
Chung, S. J., Y. S. Han, et al. (2005). "Urban and rural differences in the prevalence of gender
and age specific obesity and related health behaviors in Korea." Journal of Korean Medical
Science 20(5): 713-20.
The objective of this study was to discuss the residential difference in gender and age
specific prevalence of obesity by body mass index (BMI) and obesity related health behaviors in
the Republic of Korea. A total of nationally representative 2,583 men and 3,087 women (age: 2064 yr) was used as subjects from 1998 National Health and Nutrition Survey. All statistics were
calculated using SUDAAN to consider a stratified multistage probability sampling design. The
prevalence of obesity (BMI> or =25) was significantly different by age, gender and residential
areas. Although younger men aged 20-49 yr did not show a residential difference in the
prevalence of obesity, men aged 50-64 yr showed differences, highest in big cities and lowest in
rural areas. However, in women, a higher prevalence was observed in rural areas compared to
urban areas in the younger age group (20-49 yr), but not in the older age group. Residential
differences of obesity related health behaviors existed mostly in the older population, but not in
the younger population. The urban-rural differences demonstrate the various stages of behavioral
transition that Korea is currently undergoing. Therefore, different strategies considering those
factors are needed to manage obesity problems in Korea.
Clarke, P. and L. K. George (2005). "The role of the built environment in the disablement
process." American Journal of Public Health 95(11): 1933-9.
The Disablement Process model explicates the transition from health conditions to
disability and specifically emphasizes the role of intervening factors that speed up or slow down
the pathway between pathology and disability. We used hierarchical Poisson regression analyses
with data on older adults from central North Carolina to examine the role of the built environment
as a modifying factor in the pathway between lower extremity functional limitations and activities
of daily living. We found that, despite declining physical function, older adults report greater
independence in instrumental activities when they live in environments with more land-use
diversity. Independence in self-care activities is modified by housing density, in part through the
effect of substandard and inadequate housing.
Collins, D. C. and R. A. Kearns (2005). "Geographies of inequality: child pedestrian injury and
walking school buses in Auckland, New Zealand." Social Science & Medicine 60(1): 61-9.
In the face of mounting concern at traffic congestion in the vicinity of schools and the
associated risks of child pedestrian injury, the 'walking school bus' (WSB) idea has been rapidly
adopted within metropolitan Auckland. WSBs involve volunteers guiding children to and from
school in an orderly manner following established walking routes. This paper reports on a survey
of the 34 Auckland primary schools which had adopted the scheme by November 2002. Despite
rates of child pedestrian injury being highest in areas of socio-economic deprivation, our survey
found WSB developments highly concentrated in low deprivation neighbourhoods. The
inequitable socio-spatial distribution of WSBs in Auckland suggests that the ability to respond to
road safety issues is closely correlated with socio-economic privilege. While our respondents
identified a number of individual and community health benefits accruing from WSBs, we
conclude that the initiative has a limited ability to address public health challenges originating
within an inequitable and car-dominated urban political system.
Cooper, A. R., L. B. Andersen, et al. (2005). "Physical activity levels of children who walk, cycle,
or are driven to school." American Journal of Preventive Medicine 29(3): 179-84.
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Active Living Research Literature Summary 2004 & 2005
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BACKGROUND: Active commuting to school by walking or bicycle is widely promoted to
increase children's physical activity. However, there is little data to describe the impact that travel
mode, and in particular cycling, may have on activity levels. METHODS: Primary school children
wore an accelerometer recording minute-by-minute physical activity, and completed questions
describing travel habits. Total volume of physical activity and hourly physical activity patterns
were estimated and groups of children compared by mode of travel to school. Data were
collected as part of the European Youth Heart Study. RESULTS: A total of 332 children (average
age 9.7 years, standard deviation [SD] = 0.4 years) completed all measurements. Children who
walked to school were significantly more physically active than those who traveled by car
(accelerometer counts per minute [cpm]: 667.7, SD = 233.7 vs 557.3, SD = 191.4; p = 0.01).
Those who cycled to school recorded higher accelerometer counts than those who traveled by
car, but differences were not significant. Boys who walked or cycled to school were significantly
more physically active than those traveling by car (walk: 732.2 cpm, SD = 253.1 vs 592.8 cpm,
SD = 193.9; p=0.007; cycle: 712.6 cpm, SD = 249.1 vs 592.8 cpm, SD = 193.9; p = 0.013). In
girls, walking but not cycling to school was significantly associated with higher daily physical
activity levels (606.3 cpm, SD = 197.7, vs 523.4 cpm, SD = 185.0 cpm; p = 0.05).
CONCLUSIONS: In primary school-aged children, walking to school is associated with higher
levels of overall physical activity compared with those who travel to school by motorized
transport. Cycling is associated with higher overall physical activity only in boys.
Cradock, A. L., I. Kawachi, et al. (2005). "Playground safety and access in Boston
neighborhoods." American Journal of Preventive Medicine 28(4): 357-63.
BACKGROUND: Youth physical activity is partly influenced by access to playgrounds
and recreational opportunities. Playgrounds in disadvantaged areas may be less safe.
METHODS: Investigators assessed safety at 154 playgrounds in Boston between July 2000 and
July 2001. Playgrounds were geocoded and safety scores assigned to census block groups
(CBGs). For each of Boston's 591 CBGs, investigators calculated the total number youth and
proportions of black residents, adults without a high school degree, and youth living in poverty.
Investigators assigned each CBG a safety score, and calculated distance from the CBG centroid
to the nearest playground and nearest "safe" playground (top safety quartile). Statistical analyses
were completed using SAS PROC GENMOD by October 2002. RESULTS: In bivariate analysis,
playground safety was inversely associated with total CBG youth population (p =0.001) and
proportions of black residents (p <0.001), youth in poverty (p =0.003) and residents with no high
school degree (p <0.002). The proportion of black residents in the CBG was inversely associated
with safety (p =0.013), independent of CBG educational attainment and numbers of youth. The
average distance was 417 meters to the nearest playground and 1133 meters to the nearest
"safe" playground. Distance to the nearest playground was inversely associated with the
proportion of residents with no high school degree (p <0.0001) after controlling for numbers of
youth and proportion of black residents. CBGs with more youth had greater distances to the
safest playgrounds (p =0.04). CONCLUSIONS: In Boston, playground safety and access to
playgrounds varied according to indicators of small-area socioeconomic and racial/ethnic
composition.
Cummins, S., S. Macintyre, et al. (2005). "Measuring neighbourhood social and material context:
generation and interpretation of ecological data from routine and non-routine sources." Health &
Place 11(3): 249-60.
Investigating the role of the social and material environment in determining mortality,
morbidity and health behaviour has become increasingly popular in epidemiological research.
However, despite calls to use more innovative data about areas, there is still a tendency to use
'off the shelf' data derived from pre-existing routine surveys and censuses. Many researchers
argue that innovative ecological data about areas is difficult to collect and use effectively, difficult
to compare and hard to interpret and analyse. This paper considers an approach to obtaining and
interpreting innovative ecological data, and is based on a case study of empirical data collection
in the UK. The paper focuses on issues of scale, quality, generation, use and interpretation of
data. While it is important to start with a priori theories about the way specific domains of the local
environment might influence health, we report that finding robust measures of these domains at
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Active Living Research Literature Summary 2004 & 2005
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the correct spatial scale is difficult and time consuming. However we argue that the attempt to
measure specific chains of causation is important enough for public health for this approach to
followed and improved upon.
Cummins, S., M. Stafford, et al. (2005). "Neighbourhood environment and its association with self
rated health: evidence from Scotland and England." Journal of Epidemiology & Community
Health 59(3): 207-13.
OBJECTIVES: To investigate associations between measures of neighbourhood social
and material environment and self rated health. DESIGN: New contextual measures added to
cross sectional study of a sample of people from the Health Survey for England and the Scottish
Health Survey to provide multilevel data. PARTICIPANTS: 13,899 men and women aged 16 or
over for whom data on self rated health were available from the Health Survey for England (years
1994-99) and the Scottish Health Survey (years 1995 and 1998). RESULTS: Fair to very bad self
rated health was significantly associated with six neighbourhood attributes: poor physical quality
residential environment, left wing political climate, low political engagement, high unemployment,
lower access to private transport, and lower transport wealth. Associations were independent of
sex, age, social class, and economic activity. Odds ratios were larger for non-employed residents
than for employed residents. Self rated health was not significantly associated with five other
neighbourhood measures: public recreation facilities, crime, health service provision, access to
food shops, or access to banks and buildings societies. CONCLUSIONS: Some, but not all,
features of the neighbourhood environment are associated with self rated health and may be
indicators of important causal pathways that could provide a focus for public health intervention
strategies. Associations were more pronounced for non-employed residents, perhaps because of
greater exposure to the local environment compared with employed people. Operationalizing
specific measures of the characteristics of local areas hypothesised to be important for living a
healthy life provides a more focused approach than general measures of deprivation in the
search for area effects.
Cunningham, G. O., Y. L. Michael, et al. (2005). "Developing a reliable Senior Walking
Environmental Assessment Tool." American Journal Of Preventive Medicine 29(3): 215-217.
Background: Research of the effects of the built environment on physical activity often
excludes certain segments of the population. The senior population, one segment perhaps most
influenced by the physical features of an environment, has been understudied. Developing
reliable measures of the environment is important to increase our understanding of the
environmental effects on physical activity among seniors. Methods: A review of urban planning
and health literature helped identify important concepts and theories that were used to inform the
development of the Senior Walking Environmental Assessment Tool (SWEAT). Urban planning
and health research professionals were consulted and provided feedback on the tool. A total of
355 neighborhood segments were assessed using SWEAT. Thirty-six neighborhood segments
were assessed for inter-rater reliability. Results: Overall, raters exhibited good-to-excellent
agreement on most items included in SWEAT. Items assessing buildings and destinations were
less reliable than other categories. Conclusions: The development of a reliable senior-specific
environmental measurement of detailed street level environmental features that may influence
walking among seniors is important to advance this research and engage communities to
consider simple environmental changes that encourage walking among seniors.
Dannenberg, A. L., T. W. Cramer, et al. (2005). "Assessing the walkability of the workplace: a
new audit tool." American Journal of Health Promotion 20(1): 39-44.
PURPOSE: Walking can be incorporated into most people's daily routines if the process
is made convenient by a well-designed built environment. Walkability rarely is assessed in the
workplace, where adults spend much of their time. METHODS: From existing tools, we developed
an instrument to audit walkability at a single government agency's facilities, which were located in
multiple states. We used a five-point scale to evaluate nine elements of walkability: pedestrian
facilities, pedestrian-vehicle conflicts, crosswalks, route maintenance, walkway width, roadway
buffer, universal accessibility, aesthetics, and shade. Weighted scores ranged from 20 to 39
(poor), to 40 to 69 (fair), to 70 to 100 (good). RESULTS: Of 79 walking route segments surveyed
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Active Living Research Literature Summary 2004 & 2005
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on 10 agency campuses, 34% were rated poor, 32% fair, and 34% good. Repeat assessment of
20 walking route segments by three independent observers yielded similar scores.
CONCLUSION: Facility planners may find this walkability instrument useful in identifying and
eliminating barriers to convenient walking opportunities in workplaces such as office parks and
university campuses.
De Bourdeaudhuij, I., P. J. Teixeira, et al. (2005). "Environmental and psychosocial correlates of
physical activity in Portuguese and Belgian adults." Public Health Nutrition 8(7): 886-895.
Objectives: To investigate differences in reported physical activity levels and in perceived
environmental and psychosocial correlates of activity between Portuguese and Belgian adults;
and to analyse the relative contribution of environmental and psychosocial variables in explaining
physical activity within different contexts in Portugal and Belgium. Design: Cross-sectional study.
Setting: One city in Portugal (Oeiras) and one in Belgium (Ghent). Subjects: In total 526
participants, 247 from Portugal and 279 from Belgium, completed the long International Physical
Activity Questionnaire and a validated questionnaire on environmental and psychosocial
correlates. Results: For the sum of all activities of at least moderate intensity, a significantly
higher mean level of activity was found in Belgian adults (P < 0.001). However, comparable
percentages of the Belgian (38%) and Portuguese (42%) samples did not meet the
recommendation of 30 min per day. The variance explained by environmental factors was lower
(1% to 8%) than by psychosocial factors (maximum 42%). Regression analyses showed activityspecific relations with environmental variables which were analogous in both countries.
Walking/cycling for transportation and walking for recreation were related to social support from
family and/or friends and to walkability and walking facilities in the neighbourhood. Recreational
physical activity was mainly determined by social support, self-efficacy, and perceived benefits
and barriers. Conclusions: Activity campaigns addressing psychosocial determinants are needed
to encourage leisure-time activity, while a combination of neighbourhood design changes and
encouragement of social support in walking is warranted to increase walking in different contexts.
de Bruijn, G. J., S. P. Kremers, et al. (2005). "Determinants of adolescent bicycle use for
transportation and snacking behavior." Preventive Medicine 40(6): 658-67.
BACKGROUND: The prevalence of obesity has reached epidemic proportions in many
countries and is largely due to behavioral factors that disrupt the energy balance. The purpose of
the study was to test how well our conceptual model, combining features from the Theory of
Planned Behavior and the Theory of Triadic Influence, explained two behaviors related to the
energy balance, namely bicycle use for transportation and snacking behavior in a Dutch
adolescent sample. METHODS: Data was gathered in an 1997 cross-sectional sample of
adolescents (n = 3,859; mean age 14.8 years SD = 1.6) on snacking behavior, bicycle use,
demographics, and potential environmental, cognitive and psychological determinants. Data was
analyzed using bivariate correlations, multiple linear and binary logistic regression analyses.
RESULTS: Less snacking behavior was associated with female gender and a more positive
intention, a more positive attitude, and stronger perceived behavioral control towards restricting
snacking. Students who used their bicycle for transportation were more likely to attend secondary
education, to be native Dutch, to go to school in a less-urbanized city, to be younger, had a more
positive intention and perceived stronger behavioral control and subjective norm towards bicycle
use. CONCLUSIONS: The inclusion of environmental factors increased our understanding of
bicycle use for transportation and snacking behavior in adolescents. The environmental factors
are suggested to be taken into account in interventions aimed at changing these behaviors in
more healthy directions.
de Jong, J., K. A. Lemmink, et al. (2005). "Six-month effects of the Groningen active living model
(GALM) on physical activity, health and fitness outcomes in sedentary and underactive older
adults aged 55-65." Patient Education and Counseling.
OBJECTIVE: To determine the effects on energy expenditure, health and fitness
outcomes in sedentary older adults aged 55-65 after 6-month participation in the GALM program.
METHODS: In three Dutch communities, subjects from matched neighbourhoods were assigned
to an intervention (n=79) or a waiting-list control group (n=102). The GALM program consisted of
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fifteen 60min sessions once a week emphasising moderate-intensity recreational sports activities.
RESULTS: The intervention group showed significant increases in energy expenditure for
recreational sports activities, other leisure-time physical activity, health indicators, and perceived
and performance-based fitness. Contrary to our expectations, the same increases were found for
the control group. Consequently, only significant between-group differences, favouring the
intervention group, were obtained for sleep, diastolic blood pressure, perceived fitness score and
grip strength. CONCLUSION: The increases in energy expenditure for physical activity from the
GALM program, especially for the more intensive recreational sports activities, look promising
and are in line with the expected amounts necessary to improve health. Further research is
needed to evaluate long-term effects of participation in the GALM program. PRACTICE
IMPLICATIONS: These results underline that GALM can be considered successful in stimulating
leisure-time physical activity and improving health and fitness in older adults.
Deshpande, A. D., E. A. Baker, et al. (2005). "Environmental correlates of physical activity among
individuals with diabetes in the rural midwest." Diabetes Care 28(5): 1012-8.
OBJECTIVE: To determine the relationship between physical and social environment
attributes and levels of physical activity in a population-based sample of diabetic individuals living
in rural areas. RESEARCH DESIGN AND METHODS: Cross-sectional telephone survey data
from rural communities of southeastern Missouri, Tennessee, and Arkansas were used. Logistic
regression was used to calculate crude and adjusted prevalence odds ratios (PORs) and 95%
CIs. RESULTS: A total of 278 (11%) individuals with diabetes were identified. Almost 37% of this
group reported no leisure-time physical activity. Individuals with diabetes who reported regular
physical activity were more likely to report better general health status, normal BMI, and no
physical impairment. After adjustment, regular activity was positively associated with use of three
or more facilities (POR 14.3, 95% CI 3.0-67.3) in the past 30 days, the availability of many nearby
places to walk (2.3, 1.1-4.8), the availability of shoulders on streets (2.4, 1.3-4.5), often walking to
nearby places (4.1, 2.0-8.3), and rating the community for physical activity as generally pleasant
(2.3, 1.1-4.8). Additionally, the regular activity group was more likely to report their physician had
helped make a plan to increase physical activity (2.8, 1.3-5.8) and followed up on their plan (2.2,
1.1-4.4). Social environment variables were not associated with physical activity after adjustment.
CONCLUSIONS: Physical inactivity is a significant problem in rural diabetic populations. We have
identified aspects of the social and physical environment that are positively associated with
physical activity. Understanding the role of the environment may result in increased physical
activity for individuals with diabetes.
Dollman, J., K. Norton, et al. (2005). "Evidence for secular trends in children's physical activity
behaviour." British Journal of Sports Medicine 39(12): 892-7; discussion 897.
It is not clear whether the global increase in weight problems in children is the result of
excessive energy intake or decreasing energy expenditure. Methodological limitations have made
it difficult to analyse. There is evidence that at least part of the problem may lie with increasing
energy consumption, but it is important to examine the other side of the energy equation also.
However, it is not possible to conclusively describe physical activity trends because of the
absence of suitable baseline data. One solution is to summate all available evidence in as many
areas of daily activities as possible and then draw tentative conclusions. This review summarises
available trend data on direct representations of physical activity in a range of contexts, together
with indirect measures such as sedentariness, fitness, and attitudes. The conclusions drawn are:
physical activity in clearly defined contexts such as active transport, school physical education,
and organised sports is declining in many countries; young people would like to be active but are
often constrained by external factors such as school policy or curricula, parental rules in relation
to safety and convenience, and physical environmental factors.
Dollman, J. and A. Pilgrim (2005). "Changes in body composition between 1997 and 2002 among
South Australian children: influences of socio-economic status and location of residence."
Australia and New Zealand of Journal Public Health 29(2): 166-70.
OBJECTIVE: To compare rates of change in South Australian children's body
composition between 1997 and 2002 in subsamples based on location of residence and
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Active Living Research Literature Summary 2004 & 2005
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socioeconomic status. METHODS: Year 6 children from randomly selected South Australian
schools in 1997 (32 schools, n=1,423) and 2002 (29 schools, n=992) were compared on: body
mass index (BMI), sum of triceps and abdominal skinfolds (skinfold sum) and waist girth.
Samples were partitioned into urban (population >20,000) and rural (<10,000) subsamples, and
low, medium and high SES. ANCOVA, controlling for boys' decimal age and girls' predicted
menarcheal age, was conducted for the whole sample, and where interactions were significant,
separately in socio-demographic strata. RESULTS: Between surveys, there were significant
increases in boys' waist girth (p=0.004) and skinfold sum (p=0.007), and girls' BMI (p=0.0005)
and skinfold sum (p<0.0001). There were significant interactions of survey year and
sociodemographic variables among girls only. While there were no significant changes in
anthropometric variables among rural and high SES girls, urban girls increased in skinfold sum
(p<0.0001), waist girth (p=0.033) and BMI (p=0.0007). Low (p<0.0001) and medium (p=0.001)
SES girls' skinfold sum increased between surveys. CONCLUSIONS: Secular trends in
Australian children's body fatness are continuing. Further, the rates of change in girls are affected
by the socio-demographic milieu. Implications: The development of targeted interventions to
combat child obesity will depend on a clearer understanding of how environmental influences on
weight status are distributed across the sociodemographic landscape.
Duncan, M. and K. Mummery (2005). "Psychosocial and environmental factors associated with
physical activity among city dwellers in regional Queensland." Preventive Medicine 40(4): 363-72.
BACKGROUND: Research has recently adopted the use of social-ecological models in
the study of physical activity. Few studies, however, have addressed the influence of the
environment on activity using Geographic Information System (GIS)-derived measures of
environmental attributes and self-report ratings of other environmental attributes. Even fewer
have examined walking behaviors. METHODS: Self-report measures of physical activity, social
support, self-efficacy, and perceived neighborhood environment were obtained by means of a
Computer-Assisted-Telephone-Interview (CATI) survey of 1,281 residents of Rockhampton,
Queensland. Over 94% (1,215) of respondents' residential locations were successfully geocoded
into the existing city council GIS database. The self-report data, along with GIS-derived
measures, were used to determine the relationships among selected variables of the
neighborhood environment for each geocoded location. RESULTS: GIS-derived measures of
street connectivity and proximity to parkland, the number of active people in a 1-km radius, and
self-reported perceptions of neighborhood cleanliness showed associations with the likelihood of
achieving sufficient levels of physical activity when adjusting for selected psychosocial variables.
GIS-derived Euclidian distance to footpath networks, number of dogs in 0.8-km radius, network
distance to newsagents, and perceptions of footpath condition were significantly associated with
the likelihood of participating in any recreational walking. CONCLUSION: Environmental
characteristics were found to have differential influences on the two selected measures of
physical activity. Aesthetics and safety appear to be important influences of physical activity,
whereas proximal footpaths showed increased likelihood of participation in recreational walking. It
is proposed that the strength of association between the environmental and physical activity may
be improved if future research utilizes a Geographic Information System approach to the study of
restricted geographical areas.
Duncan, M. J., J. C. Spence, et al. (2005). "Perceived environment and physical activity: a metaanalysis of selected environmental characteristics." International Journal Behavioral Nutrition and
Physical Activity 2: 11.
BACKGROUND: Several narrative reviews have been conducted on the literature
examining environmental correlates of physical activity (PA). To date these reviews have been
unable to provide definitive summaries of observed associations. This study utilizes metaanalytical techniques to calculate summaries of associations between selected environmental
characteristics and PA. METHODS: Published studies were identified from electronic databases
and searches of personal files. Studies were examined to determine the environmental constructs
most frequently studied. Included studies (N = 16) examined at least one identified construct and
determined associations between perceived environmental constructs and PA using logistic
regression. Data were analyzed separately for crude and adjusted ORs using general-variance
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Active Living Research Literature Summary 2004 & 2005
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based fixed effect models. RESULTS: No significant associations emerged between
environmental characteristics and PA using crude OR. The perceived presence of PA facilities
(OR 1.20, 95% 1.06-1.34), sidewalks (OR 1.23, 95% 1.13-1.32), shops and services (OR 1.30,
95% 1.14-1.46) and perceiving traffic not to be a problem (OR 1.22, 95% 1.08-1.37) were
positively associated with activity using adjusted ORs. Variance in PA accounted for by significant
associations ranged from 4% (heavy traffic not a problem) to 7% (presence of shops and
services). CONCLUSION: Results of the meta-analysis support the relevance of perceived
environmental characteristics for understanding population PA. These results should encourage
the use of comprehensive ecological models that incorporate variables beyond basic
demographic information.
Engbers, L. H., M. N. van Poppel, et al. (2005). "Worksite health promotion programs with
environmental changes: a systematic review." American Journal of Preventive Medicine 29(1):
61-70.
BACKGROUND: It is now widely believed that health promotion strategies should go
beyond education or communication to achieve significant behavioral changes among the target
population. Environmental modifications are thought to be an important addition to a worksite
health promotion program (WHPP). This review aimed to systematically assess the effectiveness
of WHPPs with environmental modifications, on physical activity, dietary intake, and health risk
indicators. METHODS: Online searches were performed for articles published up to January 2004
using the following inclusion criteria: (1) (randomized) controlled trial (RCT/CT); (2) intervention
should include environmental modifications; (3) main outcome must include physical activity,
dietary intake, and health risk indicators; and (4) healthy working population. Methodologic quality
was assessed using a checklist derived from the methodologic guidelines for systematic reviews
(Cochrane Back Review Group), and conclusions on the effectiveness were based on a rating
system of five levels of evidence. RESULTS: Thirteen relevant, mostly multicenter, trials were
included. All studies aimed to stimulate healthy dietary intake, and three trials focused on physical
activity. Follow-up measurements of most studies took place after an average 1-year period.
Methodologic quality of most included trials was rated as poor. However, strong evidence was
found for an effect on dietary intake, inconclusive evidence for an effect on physical activity, and
no evidence for an effect on health risk indicators. CONCLUSIONS: It is difficult to draw general
conclusions based on the small number of studies included in this review. However, evidence
exists that WHPPs that include environmental modifications can influence dietary intake. More
controlled studies of high methodologic quality need to be initiated that investigate the effects of
environmental interventions on dietary intake and especially on physical activity in an
occupational setting.
Ersoy, C., S. Imamoglu, et al. (2005). "Comparison of the factors that influence obesity
prevalence in three district municipalities of the same city with different socioeconomical status: a
survey analysis in an urban Turkish population." Preventive Medicine 40(2): 181-8.
BACKGROUND: To evaluate the obesity status, factors and comorbidities related to it in
three district municipalities (DM) that compose city center of Bursa with inhabitants of different
socioeconomic status. METHODS: A total of 1632 inhabitants >/=18 years of age were
interviewed. The number of sample in each DM was obtained proportional to their populations by
stratified sampling method. Among 1632, a total of 1543 subjects were included by random
sampling and a questionnaire was filled in including demographic, social and behavioral features.
RESULTS: The participants living in DM with the highest socioeconomical status (SES) score and
level of education had the lowest body mass index (BMI) and body fat percentage (%BF)
compared to other DMs. The lowest obesity prevalence (30.8% vs. 36.4% and 39.3%) in that DM
was possibly due to younger age, lower female ratio, more active professional, higher percentage
of smoking, more consumption of vegetables, olive or corn oil, and less carbohydrate. For the
evaluation of the factors that may influence obesity risk, we investigated the effects of these
factors in men and women separately with logistic regression model. Sedentary life style and
dyslipidemia (DL) in men, being unemployed, having lower level of education and having
hypertension (HT) in women and familial obesity in both gender were found to be related to
increased obesity risk. CONCLUSIONS: The prevalence of obesity in Bursa is increasing
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Active Living Research Literature Summary 2004 & 2005
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although inhabitants are taking some precautions parallel to their socioeconomical and
educational levels. Obesity is becoming a more alarming public health problem in Bursa and
Turkey like in most other parts of the world, which forces us to invent new prevention policies.
Besides, the results of our study highlight the fact that especially female education requires more
attention for decreasing obesity prevalence in coming generations.
Evenson, K. R., A. H. Herring, et al. (2005). "Evaluating change in physical activity with the
building of a multi-use trail." American Journal of Preventive Medicine 28(2 Suppl 2): 177-85.
BACKGROUND: Cross-sectional studies suggest a positive association between the
presence of trails and physical activity participation. Prospective evaluations of the impact of
building a multi-use trail, in terms of change in physical activity levels among nearby residents,
are needed. DESIGN: The study was designed as a quasi-experimental noncontrol pre-post
design. SETTING/PARTICIPANTS: Participants included 366 adults aged > or =18 years living
within 2 miles of the evaluated trail. INTERVENTION: A railway of >23 miles was under
development for conversion to a multi-use trail in central North Carolina. A segment of the trail
was evaluated by randomly selecting and telephone interviewing adults living within 2 miles of the
planned trail before trail construction began and approximately 2 months after completion of
construction. MAIN OUTCOME MEASURES: Outcomes were time spent in leisure activity,
leisure activity near home, walking, bicycling, moderate activity, vigorous activity, and
transportation activity. RESULTS: At follow-up, of the 366 adults living within 2 miles of the trail,
11.0% had not heard of the trail, and 23.1% had heard of the trail and had used it at least once. In
multivariable logistic models, leisure activity, leisure activity near home, moderate activity,
vigorous activity, and walking for transportation did not significantly change for those who used
the trail compared to those not using the trail. CONCLUSIONS: This prospective study of the
building of a multi-use trail did not demonstrate an increase in physical activity among adults
living near the trail. Other prospective studies are encouraged, to take advantage of rigorously
evaluating different types of trails that are to be constructed in rural and urban settings.
Evenson, K. R. and A. P. McGinn (2005). "Test-retest reliability of a questionnaire to assess
physical environmental factors pertaining to physical activity." International Journal of Behavioral
Nutrition Physical Activity 2: 7.
BACKGROUND: Despite the documented benefits of physical activity, many adults do
not obtain the recommended amounts. Barriers to physical activity occur at multiple levels,
including at the individual, interpersonal, and environmental levels. Only until more recently has
there been a concerted focus on how the physical environment might affect physical activity
behavior. With this new area of study, self-report measures should be psychometrically tested
before use in research studies. Therefore the objective of this study was to document the testretest reliability of a questionnaire designed to assess physical environmental factors that might
be associated with physical activity in a diverse adult population. METHODS: Test and retest
surveys were conducted over the telephone with 106 African American and White women and
men living in either Forsyth County, North Carolina or Jackson, Mississippi. Reliability of selfreported environmental factors across four domains (e.g., access to facilities and destinations,
functionality and safety, aesthetics, natural environment) was determined using intraclass
correlation coefficients (ICC) overall and separately by gender and race. RESULTS: Generally
items displayed moderate and sometimes substantial reliability (ICC between 0.4 to 0.8), with a
few differences by gender or race, across each of the domains. CONCLUSION: This study
provides some psychometric evidence for the use of many of these questions in studies
examining the effect of self-reported physical environmental measures on physical activity
behaviors, among African American and White women and men.
Ewing, R. (2005). "Can the physical environment determine physical activity levels?" Exercise
Sport Science Review 33(2): 69-75.
Does your place of residence affect your level of physical activity and ultimately your
weight and health? There is relatively strong evidence of association between compact
development patterns and use of active travel modes such as walking and transit. There is
weaker evidence of linkage between compact development, overall physical activity, and
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Active Living Research Literature Summary 2004 & 2005
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downstream weight and health effects.
Frank, L. D. and P. Engelke (2005). "Multiple impacts of the built environment on public health:
Walkable places and the exposure to air pollution." International Regional Science Review 28(2):
193-216.
While considerable attention has been paid to the public-health-related impacts of air
pollution, relatively little research has been done to understand how other aspects of the built
environment impact health. Americans are increasingly sedentary; erstwhile the rate of increase
in obesity is alarming. New research suggests that increased auto dependence, and limited
opportunities to walk for utilitarian purposes, has contributed to this emerging obesity, epidemic.
Within socio-demographic strata, land use patterns and transportation investments collectively
shape the desire to walk, drive, or to travel via other means. Mixed use and more compact
community designs show significant promise for the promotion of physical activity and the
reduction of regional air pollution levels. Opportunities exist to increase physical activity and
improve regional air quality through more compact development. However, increased
compactness, or density, often exacerbates traffic congestion and can increase exposure of
harmful emissions within central areas. Therefore, strategies to reduce localized air pollution in
existing and developing centers are required to enable larger health benefits from smart growth to
be realized.
Frank, L. D., T. L. Schmid, et al. (2005). "Linking objectively measured physical activity with
objectively measured urban form: findings from SMARTRAQ." American Journal of Preventive
Medicine 28(2 Suppl 2): 117-25.
BACKGROUND: To date, nearly all research on physical activity and the built
environment is based on self-reported physical activity and perceived assessment of the built
environment. OBJECTIVE: To assess how objectively measured levels of physical activity are
related with objectively measured aspects of the physical environment around each participant's
home while controlling for sociodemographic covariates. METHODS: Objective measures of the
built environment unique to each household's physical location were developed within a
geographic information system to assess land-use mix, residential density, and street
connectivity. These measures were then combined into a walkability index. Accelerometers were
deployed over a 2-day period to capture objective levels of physical activity in 357 adults.
RESULTS: Measures of land-use mix, residential density, and intersection density were positively
related with number of minutes of moderate physical activity per day. A combined walkability
index of these urban form factors was significant (p =0.002) and explained additional variation in
the number of minutes of moderate activity per day over sociodemographic covariates. Thirtyseven percent of individuals in the highest walkability index quartile met the > or =30 minutes of
physical activity recommended, compared to only 18% of individuals in the lowest walkability
quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence
interval=1.18-4.88) than individuals in the lowest walkability quartile to meet the recommended >
or =30 minutes of moderate physical activity per day. CONCLUSIONS: This research supports
the hypothesis that community design is significantly associated with moderate levels of physical
activity. These results support the rationale for the development of policy that promotes increased
levels of land-use mix, street connectivity, and residential density as interventions that can have
lasting public health benefits.
Frenn, M., S. Malin, et al. (2005). "Determinants of physical activity and low-fat diet among low
income African American and Hispanic middle school students." Public Health Nursing 22(2): 8997.
African Americans, Hispanics, and those with low income experience disproportionate
health problems that can be prevented by physical activity and a lower fat diet. In this descriptive
cross-sectional study, antecedents of diet and exercise within the Health
Promotion/Transtheoretical Model were examined among low-income African American and
Hispanic seventh-grade students (n = 127). Total support was associated with higher physical
activity for girls. African Americans perceived greater social support for activity than Hispanics.
Family models and support for physical activity and low-fat diet were greater as family income
increased. However, higher family role models and lower dietary fat were found among the lowest
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income Hispanic students' residing ZIP code with a higher concentration of Hispanics and greater
availability of Hispanic foods and culture. A school-based approach may be useful to build peer
support for physical activity and lower dietary fat. Parish nurse or clinic settings may be most
appropriate for building family role models and support. Living in a neighborhood with traditional
Hispanic culture and foods appears to have ameliorated the harmful effects of lower income,
although further study with larger samples followed over time is needed.
Fujii, S. and A. Taniguchi (2005). "Reducing family car-use by providing travel advice or
requesting behavioral plans: An experimental analysis of travel feedback programs."
Transportation Research Part D-Transport And Environment 10(5): 385-393.
A field experiment was conducted to look at the effectiveness of a travel feedback
program aimed at reducing family car-use. The experiment focused on a travel feedback program
that urged participants to make behavioral plans, and compared it to a program that provided
individualized information. The results are used to discuss the psychological process of
behavioral modification, theoretically effective interventions, and policy implications for
implementing effective travel feedback programs. (c) 2005 Elsevier Ltd. All rights reserved.
Fulton, J. E., J. L. Shisler, et al. (2005). "Active transportation to school: Findings from a national
survey." Research Quarterly For Exercise And Sport 76(3): 352-357.
Garcia Bengoechea, E., J. C. Spence, et al. (2005). "Gender differences in perceived
environmental correlates of physical activity." International Journal of Behavioral Nutrition and
Physical Activity 2: 12.
BACKGROUND: Limited research has been conducted on gender differences in
perceived environmental correlates of physical activity (PA). The purpose of this study was to
explore the potential role of gender in the link between perceived environment and PA.
METHODS: Using a telephone-administered survey, data was collected on leisure time physical
activity (LTPA), perceptions of the neighbourhood environment, and self-efficacy in a
representative sample of 1209 adults from the province of Alberta, Canada. LTPA was regressed
on ten measures of perceived neighbourhood environment and self-efficacy in a series of logistic
regressions. RESULTS: Women were more likely than men to perceive their neighbourhood as
unsafe to go for walks at night (chi2 = 67.46, p < 0.001) and to report seeing people being active
in their neighbourhood (chi2 = 6.73, p < 0.01). Conversely, women were less likely to perceive
easy access to places for PA (chi2 = 11.50, p < 0.01) and availability of places to buy things
within easy walking distance from home (chi2 = 4.30, p < 0.05). Adjusting for age, education,
income, and place of residence, access to places for PA (OR = 2.49) and interesting things to
look at in the neighbourhood (OR = 1.94), were associated with higher levels of LTPA in men.
Access to places for PA (OR = 2.63) and reporting seeing people being active (OR = 1.50) were
associated with increased LTPA among women. After controlling for sociodemographic variables
and self-efficacy, the presence of shops and places to buy things within easy walking distance
from home (OR = 1.73), interesting things to look at in the neighbourhood (OR = 1.65), and
access to places for PA (OR = 1.82) were associated with higher levels of LTPA in men. Among
women, no significant relationships were observed between perceived environment and LTPA
after adjusting for self-efficacy. CONCLUSION: The results provide additional support for the use
of models in which gender is treated as a potential moderator of the link between the perceived
environment and PA. Further, the results suggest the possibility of differential interventions to
increase PA based on factors associated with gender.
Gauvin, L., L. Richard, et al. (2005). "From walkability to active living potential: an "ecometric"
validation study." American Journal of Preventive Medicine 28(2 Suppl 2): 126-33.
BACKGROUND: The purpose of this paper is to establish the reliability and validity of a
neighborhood-level measure of active living potential by applying principles of ecometrics.
METHODS: Following a 3-day training session, observers (n =8) were provided with a map of a
predetermined walking route constructed through the joining of ten randomly selected street
blocks. Then, using an 18-item observation grid, pairs of observers performed ratings of 112
neighborhoods. Resulting observations produced a hierarchically structured data set including
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4032 observations nested within observers, which in turn were nested within neighborhoods.
Data from the 2001 Canadian census were linked to the neighborhood data. RESULTS:
Application of ecometric multilevel modeling analyses showed that once interitem and
interobserver variability were statistically controlled, about one third of the variability in
observations were at the between-neighborhood level. Reliability estimates were 0.78 for items
measuring activity-friendliness, 0.76 for safety, and 0.83 for density of destinations. Assessment
of the convergent validity of the instrument identified that safety of the environment was positively
associated with neighborhood affluence. Density of destinations was negatively associated with
affluence and positively associated with higher proportions of persons in the neighborhood
walking to work. CONCLUSIONS: The three dimensions of the neighborhood active-living
potential measure have good reliability and convergent validity and are able to capture between
neighborhood differences. Measurement characteristics would have been difficult to ascertain
without the ecometrics methodology.
Giles-Corti, B., M. H. Broomhall, et al. (2005). "Increasing walking: how important is distance to,
attractiveness, and size of public open space?" American Journal of Preventive Medicine 28(2
Suppl 2): 169-76.
BACKGROUND: Well-designed public open space (POS) that encourages physical
activity is a community asset that could potentially contribute to the health of local residents.
METHODS: In 1995-1996, two studies were conducted-an environmental audit of POS over 2
acres (n =516) within a 408-km2 area of metropolitan Perth, Western Australia; and personal
interviews with 1803 adults (aged 18 to 59 years) (52.9% response rate). The association
between access to POS and physical activity was examined using three accessibility models that
progressively adjusted for distance to POS, and its attractiveness and size. In 2002, an
observational study examined the influence of attractiveness on the use of POS by observing
users of three pairs of high- and low-quality (based on attractiveness) POS matched for size and
location. RESULTS: Overall, 28.8% of respondents reported using POS for physical activity. The
likelihood of using POS increased with increasing levels of access, but the effect was greater in
the model that adjusted for distance, attractiveness, and size. After adjustment, those with very
good access to large, attractive POS were 50% more likely to achieve high levels of walking
(odds ratio, 1.50; 95% confidence level, 1.06-2.13). The observational study showed that after
matching POS for size and location, 70% of POS users observed visited attractive POS.
CONCLUSIONS: Access to attractive, large POS is associated with higher levels of walking. To
increase walking, thoughtful design (and redesign) of POS is required that creates large,
attractive POS with facilities that encourage active use by multiple users (e.g., walkers, sports
participants, picnickers).
Giles-Corti, B., A. Timperio, et al. (2005). "Understanding physical activity environmental
correlates: increased specificity for ecological models." Exercise Sport Science Review 33(4):
175-81.
Ecological models are now used to understand the complex array of factors that influence
physical activity, resulting in a greater emphasis on environmental correlates. This selective
review examines whether the predictive capacity of these models could be improved if behaviorspecific measures of the environment were used to predict context-specific behaviors.
Gobster, P. H. (2005). "Recreation and leisure research from an active living perspective: Taking
a second look at urban trail use data." Leisure Sciences 27(5): 367-383.
This paper examines recreation and leisure research within the context of active living,
and highlights an apparent gap between the current involvement of recreation and leisure
researchers and the potential they could offer to this important and expanding area of inquiry. To
illustrate this potential, I looked at two previous studies that focused on the recreational use of
urban trails and reanalyzed the data from an active living perspective. In Study 1, individual,
social and environmental factors helped distinguish between low, moderate, and high activity
level trail uses. In Study 2, use patterns helped distinguish between health-motivated trail users
and individuals using trails for recreation and other purposes, but perceptual and demographic
data were similar among groups. Findings from similar studies can help inform active living
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research, and recreation and leisure studies can provide leadership and contributions to a
transdisciplinary understanding of active living.
Godbey, G. C., L. L. Caldwell, et al. (2005). "Contributions of leisure studies and recreation and
park management research to the active living agenda." American Journal of Preventive Medicine
28(2 Suppl 2): 150-8.
Although the fields of leisure studies and recreation and parks were founded on
addressing health and wellness needs of people, only recently have these needs been addressed
by major, systematic research efforts. This paper examines the origins of leisure studies and the
study of recreation behavior and park use and their potential contribution to active living research.
Over the past 2 decades, leisure studies research has generated a body of literature pertinent to
understanding and increasing active living, including studies on time use, motivation for initiating
and maintaining activity, influence of user fees, and urban park use. Environmental,
transportation, and public recreation policy and management practices also are important
considerations in recreation and parks research. This article concludes with a list of
recommendations to integrate these and other considerations into transdisciplinary research on
active living. Opportunities for leisure studies/recreation and park research on active living include
studies of environmental, life span, and motivational influences; greater use of objective
measures of physical activity; and forming partnerships with allied industries to study physical
activity. Among suggestions for facilitating such studies are training seminars for leisure studies
and recreation researchers in active living research methods, changes in point allocation on grant
proposals, providing incentives for transdisciplinary collaboration, and special journal issues.
Gomez, L. F., O. L. Sarmiento, et al. (2005). "Prevalence and factors associated with walking and
bicycling for transport among young adults in two low-income localities of Bogotá, Colombia."
Journal of Physical Activity and Health 2(4): 445-459.
Background: Utilitarian physical activity confers health benefits, but little is known about
experiences in developing countries. The objective was to examine the prevalence and factors
associated with walking and bicycling for transport in adults from Bogotá. Methods: A crosssectional study including 1464 adults age 18 to 29 y during the year 2002. Results: 16.7%
reported bicycling for at least 10 min during the last week and 71.7% reported walking for at least
90 min during the last week. Bicycling was more likely among adults living in Tunjuelito (flat
terrain), who use the “ciclovía” (car-roads for recreational bicycling on holidays/Sundays) or
reporting physical activity during leisure-time and less likely among women, or adults with college
education. Walking was more likely among adults reporting physical activity during leisure time
and less likely among housewives/househusbands or those living in Tunjuelito. Conclusion:
Programs that promote walking or bicycling in Bogotá should consider differences in individual
and environmental factors.
Gordon-Larsen, P., M. C. Nelson, et al. (2005). "Associations among active transportation,
physical activity, and weight status in young adults." Obesity Research 13(5): 868-75.
OBJECTIVE: To describe prevalence of active, public, and car transit by overweight
status and amount of leisure-time physical activity in a nationally representative cohort of
ethnically diverse young adults. RESEARCH METHODS AND PROCEDURES: Questionnaire
data on patterns of transportation were collected from U.S. adolescents enrolled in Wave III
(2001) of the National Longitudinal Study of Adolescent Health (N = 10,771). Measured height
and weight data were used to calculate BMI and classify adults by overweight status (BMI > or =
25). Self-reported physical activity data were used to classify adults into those who achieved > or
= 5 bouts of weekly moderate-vigorous physical activity and those who did not. Results were
stratified by overweight and physical activity status. RESULTS: The vast majority of young adults
used car transit (work, 90.4%; school, 74.7%). A small proportion of young adults used active
means of transportation to work (8.1%) and school (26.7%), and fewer used public transportation
to work or school (<10%). The proportion of individuals using active transportation was higher
among the nonoverweight traveling to work (9.2%) and school (29.7%) and among the more
active traveling to work (15.2%) and school (37.0%) relative to the overweight and less active
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young adults. DISCUSSION: The vast majority of young adults of all racial/ethnic backgrounds,
particularly blacks and Hispanics, did not use active transportation to school and/or work. Active
transportation was more common among nonoverweight and more active young adults, of high
socioeconomic status, particularly full-time students. Population-level efforts (and environmental
supports) to increase non-leisure physical activity, particularly active transportation, are sorely
needed as a means of supporting and promoting overall physical activity.
Greenberg, M. R. and J. Renne (2005). "Where does walkability matter the most? An
environmental justice interpretation of New Jersey data." Journal Of Urban Health-Bulletin Of The
New York Academy Of Medicine 82(1): 90-100.
Physical inactivity contributes to a growing proportion of premature mortality and
morbidity in the United States, and the last decade has been the focus of calls for action. Analysis
of 340 residents of New Jersey found that 15%-20% reported multiple problems with using their
immediate neighborhoods for physical activity. These respondents were disproportionately
African Americans living in neighborhoods that they regard as only of fair or poor quality.
Neighborhood walkability is a second-wave environmental justice issue meriting carefully
designed research and ameliorative actions in concert with other neighborhood-level
redevelopment activities.
Handy, S., X. Y. Cao, et al. (2005). "Correlation or causality between the built environment and
travel behavior? Evidence from Northern California." Transportation Research Part D-Transport
And Environment 10(6): 427-444.
The sprawling patterns of land development common to metropolitan areas of the US
have been blamed for high levels of automobile travel, and thus for air quality problems. In
response, smart growth programs-designed to counter sprawl-have gained popularity in the US.
Studies show that, all else equal, residents of neighborhoods with higher levels of density, landuse mix, transit accessibility, and pedestrian friendliness drive less than residents of
neighborhoods with lower levels of these characteristics. These studies have shed little light,
however, on the underlying direction of causality-in particular, whether neighborhood design
influences travel behavior or whether travel preferences influence the choice of neighborhood.
The evidence thus leaves a key question largely unanswered: if cities use land use policies to
bring residents closer to destinations and provide viable alternatives to driving, will people drive
less and thereby reduce emissions? Here a quasi-longitudinal design is used to investigate the
relationship between neighborhood characteristics and travel behavior while taking into account
the role of travel preferences and neighborhood preferences in explaining this relationship. A
multivariate analysis of cross-sectional data shows that differences in travel behavior between
suburban and traditional neighborhoods are largely explained by attitudes. However, a quasilongitudinal analysis of changes in travel behavior and changes in the built environment shows
significant associations, even when attitudes have been accounted for, providing support for a
causal relationship. (c) 2005 Elsevier Ltd. All rights reserved.
Heelan, K. A., J. E. Donnelly, et al. (2005). "Active commuting to and from school and BMI in
elementary school children-preliminary data." Child Care Health Development 31(3): 341-9.
BACKGROUND: United States National Health Objectives include increasing the
proportion of trips made by walking to and from school for children who live within 1.6 km to 50%.
The purpose of this objective is to increase the level of physical activity among children. However,
the impact of walking, bicycling or skating (active commuting) to and from school on the
prevalence of overweight is unknown. METHODS: Body mass index (BMI) was measured for 320
children (age 10.2+/-0.7 years) in September. Over 5 months, an active commuting index (SI)
and daily physical activity were estimated via questionnaire. In April, BMI and body fat were
measured. RESULTS: A significant positive association was found between April BMI and SI
adjusting for September BMI (partial r=0.03, P<0.05). Positive associations were found between
SI and physical activity before school (r=0.17, P<0.05) and daily moderate intensity physical
activity (r=0.13, P<0.05). There were no significant association between SI and BF (P>0.05).
CONCLUSIONS: This preliminary data suggests that active commuting does not appear to
provide sufficient amounts of physical activity to attenuate BMI; however, it may contribute to the
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attainment of physical activity recommendations. Future research is needed to objectively
measure the impact of active commuting on the prevalence of overweight.
Henderson, K. (2005). "Research Update: Parks and Physical Activity." Parks and Recreation
40(8): 20-26.
Although a proven relationship exists between parks and recreation and physical activity,
additional measurements are needed.
Henderson, K. A. and M. D. Bialeschki (2005). "Leisure and active lifestyles: research
reflections." Leisure Sciences 27(5): 355-365.
Leisure researchers have been studying active living for many years. The research,
however, has focused more on individual factors than social and environmental determinants that
enable physical activity and health. The focus of this introduction to this special issue on "leisure
and active lifestyles" is to highlight the leisure literature that can be directly tied to active living.
These dimensions include outdoor recreation, community recreation areas and facilities, time
usage, barriers and constraints, and social interdependence. An overview is provided of the
significance of the papers in this special issue and some reflections are offered regarding future
research related to active living, physical activity, health, and leisure. The paper underlines the
value of the holistic approach evident in leisure research and calls for broader methods and more
collaborative transdisciplinary research.
Higgins, J. W. and T. Rickert (2005). "A Taste of Healthy Living: A recreational opportunity for
people at risk of developing type 2 diabetes." Leisure Sciences 27(5): 439-458.
Hoehner, C. M., L. K. Brennan Ramirez, et al. (2005). "Perceived and objective environmental
measures and physical activity among urban adults." American Journal of Preventive Medicine
28(2 Suppl 2): 105-16.
BACKGROUND: Enhancing community environments to support walking and bicycling
serves as a promising approach to increase population levels of physical activity. However, few
studies have simultaneously assessed perceptions and objectively measured environmental
factors and their relative association with transportation or recreational physical activity.
METHODS: For this cross-sectional study, high- and low-income study areas were selected
among census tracts in St. Louis MO ("low-walkable" city) and Savannah GA ("high-walkable"
city). Between February and June 2002, a telephone survey of 1068 adults provided measures of
the perceived environment and physical activity behavior. In this timeframe, objective measures
were collected through environmental audits of all street segments (n =1158). These measures
were summarized using 400-m buffers surrounding each respondent. Neighborhood
characteristics included the land use environment, transportation environment, recreational
facilities, aesthetics, and social environment. Associations were examined between neighborhood
features and transportation- and recreation-based activity. RESULTS: After adjusting for age,
gender, and education, transportation activity was negatively associated with objective measures
of sidewalk levelness and perceived and objective neighborhood aesthetics. It was positively
associated with perceived and objectively measured number of destinations and public transit,
perceived access to bike lanes, and objective counts of active people in the neighborhood.
Recreational activity was positively associated with perceived access to recreational facilities and
objective measures of attractive features. CONCLUSIONS: These findings indicate that physical
activities for transportation or recreational are associated with different perceived and objective
environmental characteristics. Modifications to these features may change the physical activity
behavior of residents exposed to them.
Hooker, S. P., D. K. Wilson, et al. (2005). "Perceptions of environmental supports for physical
activity in African American and white adults in a rural county in South Carolina." Preventing
Chronic Disease 2(4): A11.
INTRODUCTION: This study examined the association between perceptions of social
and safety-related environmental attributes and physical activity (PA) and walking in African
American and white adults. METHODS: In a random-digit-dial telephone survey, 1165 adults in a
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rural county in South Carolina answered questions about their perceptions of social and safetyrelated environmental supports for PA and their overall PA and walking behavior. Social
perceptions included whether neighbors could be trusted or were perceived to be physically
active. Safety-related perceptions included neighborhood safety, the safety of public recreation
facilities, problems with unattended dogs, traffic volume, and streetlight quality. Logistic
regression models were used to examine the associations between environmental supports and
PA and walking stratified by race. RESULTS: No association between perceived neighborhood
environmental supports and PA or walking was observed in African Americans. Among whites,
individuals who perceived their neighbors as active were twice (95% confidence interval [CI],
1.19-3.25) as likely to report meeting the recommendation for PA compared with individuals who
did not report their neighbors as active. Whites who perceived their neighbors as active were 2.5
times (95% CI, 1.54-4.08) as likely to report meeting the recommendations for walking than
whites who did not, and whites who perceived their neighborhoods as safe were 1.8 times (95%
CI, 1.03-3.12) as likely to report meeting the recommendations for walking than whites who did
not. CONCLUSION: These data indicate that perceptions of certain social and safety-related
environmental supports were strongly associated with meeting the recommendations for PA and
walking among white but not African American adults.
Hume, C., J. Salmon, et al. (2005). "Children's perceptions of their home and neighborhood
environments, and their association with objectively measured physical activity: a qualitative and
quantitative study." Health Education Research 20(1): 1-13.
Environmental factors may have an important influence on children's physical activity, yet
children's perspectives of their home and neighborhood environments have not been widely
assessed. The aim of this study was to investigate children's perceptions of their environments,
and to examine associations between these perceptions and objectively measured physical
activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their
home and neighborhood environments. A subsample of children photographed places and things
in these environments that were important to them. The maps were analyzed for themes, and for
the frequency with which particular objects and locations appeared. Physical activity was
objectively measured using accelerometers. Six themes emerged from the qualitative analysis of
the maps and photographs: the family home; opportunities for physical activity and sedentary
pursuits; food items and locations; green space and outside areas; the school and opportunities
for social interaction. Of the 11 variables established from these themes, one home and two
neighborhood factors were associated with children's physical activity. These findings contribute
to a broader understanding of children's perceptions of their environment, and highlight the
potential importance of the home and neighborhood environments for promoting physical activity
behavior.
Jackson, J. E., M. P. Doescher, et al. (2005). "A national study of obesity prevalence and trends
by type of rural county." Journal of Rural Health 21(2): 140-8.
CONTEXT: Obesity is epidemic in the United States, but information on this trend by type
of rural locale is limited. PURPOSE: To estimate the prevalence of and recent trends in obesity
among US adults residing in rural locations. METHODS: Analysis of data from the Behavioral
Risk Factor Surveillance System (BRFSS) for the years 1994-1996 (n = 342,055) and 2000-2001
(n = 385,384). The main outcome measure was obesity (body mass index [BMI] > or = 30), as
determined by calculating BMI from respondents' self-reported height and weight. RESULTS: In
2000-2001, the prevalence of obesity was 23.0% (95% confidence interval [CI] 22.6%-23.4%) for
rural adults and 20.5% (95% CI 20.2%-20.7%) for their urban counterparts, representing
increases of 4.8% (95% CI 4.2%-5.3%) and 5.5% (95% CI 5.1%-5.9%), respectively, since 19941996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and
Texas; obesity prevalence increased for rural residents in all states but Florida over the study
period. African Americans had the highest obesity prevalence of any group, up to 31.4% (95% CI
29.1%-33.6) in rural counties adjacent to urban counties. The largest difference in obesity
prevalence between those with a college education compared with those without a high school
diploma occurred in urban areas (18.4% [95% CI 17.9%-18.9%] vs 23.5% [95% CI 22.5%24.5%], respectively); the smallest difference occurred in small, remote rural counties (20.3%
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Active Living Research Literature Summary 2004 & 2005
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[95% CI 18.7%-21.9%] versus 22.3% [95% CI 20.7%-24.0%], respectively). CONCLUSIONS: The
prevalence of obesity is higher in rural counties than in urban counties; obesity affects some
residents of rural counties disproportionately.
Jackson, R. J. (2005). "Commentary on active living research." American Journal of Preventive
Medicine 28(2 Suppl 2): 218-9.
Jago, R., C. B. Anderson, et al. (2005). "Adolescent patterns of physical activity differences by
gender, day, and time of day." American Journal of Preventive Medicine 28(5): 447-52.
BACKGROUND: More information about the physical activity of adolescents is needed.
This study used objective measurement to investigate differences in activity patterns related to
gender, body mass index (BMI), day, and time of day. METHODS: Eighth-grade adolescents (37
boys, 44 girls) wore the Manufacturing Technologies Inc. (MTI) accelerometer for 4 days and kept
a previous-day physical activity recall diary in the fall of 2002. Minutes per hour in sedentary,
light, and moderate/vigorous activity, as recorded by the MTI, and in nine activity categories, as
recorded by the diary, were calculated for three time periods (6:00 am to 2:59 pm, 3:00 pm to
6:59 pm, 7:00 pm to midnight) on each day (Thursday through Sunday). RESULTS: Doubly
multivariate analysis of variance revealed significant gender by day by time differences in
sedentary (p =0.005) and moderate/vigorous (p <0.001) activity, but no significant BMI
interactions. Except on Sunday, boys were less sedentary and more active than girls during the
late afternoon period. Significant gender by category (p <0.001) and day by category (p <0.001)
interactions were also found in the log data. Boys spent more time engaged in TV/electronics and
sports, while girls spent more time in personal care. Three activity categories (sports, social
interaction, active transportation) stayed at consistent levels across days, while others varied
widely by day of the week. CONCLUSIONS: Except on Sunday, consistent gender differences
were found in activity levels, especially for the late afternoon period. Significant increases in
sitting, TV/electronic games, and chores were seen for weekend days. Results support strategies
to reduce sitting and electronic recreation, which may increase physical activity.
Jago, R., T. Baranowski, et al. (2005). "Observed environmental features and the physical activity
of adolescent males." American Journal of Preventive Medicine 29(2): 98-104.
BACKGROUND: It has recently been reported that adult physical activity was associated
with environmental features. The aim of this study was to determine whether environmental
features were associated with physical activity among male adolescents. METHODS: Physical
activity levels of 210 Boy Scouts were assessed for 3 days by accelerometry during 2003 and
2004. Mean minutes of sedentary, light, and moderate-to-vigorous intensity activity were
calculated. Environmental features within a 400-meter radius of each participant's home address
were assessed by direct observation using the Systematic Pedestrian and Cycling Environmental
Scan (SPACES) instrument. Principal component factor analysis reduced the 35 SPACES items
to four factors. Hierarchical and spatial regressions were conducted with physical activity as the
dependent variable and environmental factors, age, body mass index, and ethnicity as
independent variables. RESULTS: Four factors were obtained: walking/cycling ease, tidiness,
sidewalk characteristics, and street access and condition. Sidewalk characteristics were
negatively associated with minutes of sedentary behavior while age was positively associated.
Sidewalk characteristics were positively associated with minutes of light-intensity physical activity
and age negatively associated. No environmental factor correlated with moderate-to-vigorous
physical activity. CONCLUSIONS: A sidewalk characteristics factor, composed of sidewalk
location, sidewalk material, presence of streetlights, and number and height of trees, was
positively associated with light-intensity physical activity among male adolescents.
Kahan, D. (2005). "Jewish day-schooled adolescents' perceptions of parental and environmental
support of physical activity." Research Quarterly For Exercise And Sport 76(3): 243-250.
Few studies of religiosity and physical activity (PA) correlates have been conducted; thus,
a cross-sectional survey of 367 more and less religious Jewish adolescents'(M age = 12.8 years,
SD = 0.9) perceptions of parental and environmental support of PA was conducted at religious
day schools in two large American cities. Maternal Support, Environmental Support, and Paternal
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Non-Support factors were verified through confirmatory factor analysis. Factor scores were
analyzed through a 2 x 2 (gender x religiosity level) multivariate analysis of variance. A significant
main effect for religiosity was obtained (F = 6 93, p <. 001); however, a main effect for gender and
an interaction effect were not. Post hoc discriminant analysis revealed Paternal Non-Support and
Environmental Support factors as differentiating more and less religious adolescents.
Kavanagh, A. M., J. L. Goller, et al. (2005). "Urban area disadvantage and physical activity: a
multilevel study in Melbourne, Australia." Journal of Epidemiology & Community Health 59(11):
934-40.
OBJECTIVE: To estimate variation between small areas in the levels of walking, cycling,
jogging, and swimming and overall physical activity and the importance of area level
socioeconomic disadvantage in predicting physical activity participation. METHODS: All census
collector districts (CCDs) in the 20 innermost local government areas in metropolitan Melbourne,
Australia, were identified and ranked by the percentage of low income households (<400
dollars/week) living in the CCD. Fifty CCDs were randomly selected from the least, middle, and
most disadvantaged septiles of the ranked CCDs and 2349 residents (58.7% participation rate)
participated in a cross sectional postal survey about physical activity. Multilevel logistic regression
(adjusted for extrabinomial variation) was used to estimate area level variation in walking, cycling,
jogging, and swimming and in overall physical activity participation, and the importance of area
level socioeconomic disadvantage in predicting physical activity participation. RESULTS: There
were significant variations between CCDs in all activities and in overall physical participation in
age and sex adjusted models; however, after adjustment for individual SES (income, occupation,
education) and area level socioeconomic disadvantage, significant differences remained only for
walking (p = 0.004), cycling (p = 0.003), and swimming (p = 0.024). Living in the most
socioeconomically disadvantaged areas was associated with a decreased likelihood of jogging
and of having overall physical activity levels that were sufficiently active for health; these effects
remained after adjustment for individual socioeconomic status (sufficiently active: OR 0.70, 95%
CI 0.55 to 0.90 and jogging: OR = 0.69, 95% CI 0.51 to 0.94). CONCLUSION: These research
findings support the need to focus on improving local environments to increase physical activity
participation.
Khattak, A. J. and D. Rodriguez (2005). "Travel behavior in neo-traditional neighborhood
developments: A case study in USA." Transportation Research Part A-Policy And Practice 39(6):
481-500.
Although previous research has supported the view that neo-traditional or new urbanist
designs result in more walking activity, several questions remain: Do residents of these
neighborhoods substitute walking for driving trips., or do they make more trips overall? What is
the role of self-selection of residents in these developments? This paper aims to address these
questions by examining differences in travel behavior in a matched pair of neighborhoods (one
conventional and one neo-traditional) in Chapel Hill and Carrboro, North Carolina. A detailed
behavioral survey of 453 households and two-stage regression models suggest that single-family
households in the neo-traditional development make a similar number of total trips, but
significantly fewer automobile trips and fewer external trips, and they travel fewer miles, than
households in the conventional neighborhood, even after controlling for demographic
characteristics of the households and for resident self-selection. The findings suggest that
households in the neo-traditional development substitute driving trips with walking trips. (c) 2005
Elsevier Ltd. All rights reserved.
King, W. C., S. H. Belle, et al. (2005). "Objective measures of neighborhood environment and
physical activity in older women." American Journal of Preventive Medicine 28(5): 461-9.
BACKGROUND: Regular physical activity is known to help prevent chronic disease and
promote healthy aging. Yet, most older women are not regularly active. This study attempts to
identify objectively measured attributes of the neighborhood environment that may be associated
with physical activity levels in older women. METHODS: Sociodemographics and physical activity
level, as measured by pedometer, were assessed in 158 overweight Caucasian and AfricanAmerican postmenopausal women from southwestern Pennsylvania at the baseline evaluation of
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Active Living Research Literature Summary 2004 & 2005
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a randomized clinical trial in 2002-2003. Geographic information systems technology was used to
obtain neighborhood-level data, including neighborhood socioeconomic status (SES) indicators,
the median year that homes were built (as a proxy measure for urban form), and proximity to
businesses and facilities. Multiple linear regression was used to test associations between
individuals' physical activity level and neighborhood characteristics. RESULTS: After controlling
for individual age, race/ethnicity, education, smoking status, and body mass index, indicators of
low neighborhood SES, living in a neighborhood with homes built between 1950 and 1969
(representing an urban form that is more pedestrian-friendly than after 1969), and living within
walking distance (1500 m) of specific types of businesses and facilities were positively associated
with individuals' physical activity level measured by pedometer (p <0.05). CONCLUSIONS:
Results suggest that certain aspects of the neighborhood environment may have an important
influence on the physical activity levels of postmenopausal women. Results warrant future
research to clarify the role of these environmental attributes in other populations.
Kravets, N. and W. C. Hadden (2005). "The accuracy of address coding and the effects of coding
errors." Health & Place.
Studies that estimate the influence of characteristics of place on health often use
geocoded addresses to identify location of study subjects. This study uses housing built before
1990 selected for the 1995-2001 National Health Interview Survey (N=252,421) to develop a
standard against which geocodes obtained from an address-coding program are compared. The
results show that geocoding is generally accurate and is more successful in urban areas.
Blockgroups with missing codes are more rural and somewhat poorer than blockgroups with
correct codes. The effect of incorrect codes on statistical analyses depends on the proportion
rural in a study population.
Krenichyn, K. (2005). "'The only place to go and be in the city': women talk about exercise, being
outdoors, and the meanings of a large urban park." Health & Place.
This article explores women's physical activities in an urban park in Brooklyn, NY, USA.
Physical inactivity is a growing health concern, and research has begun to address the physical
environment, a subset of which looks particularly at the role of the environment for women. These
qualitative interviews cited physical features, such as hills, a continuous loop, and trails, but
safety was a concern due to traffic or wooded areas. The park provided support for bodily needs,
such as rest rooms and freedom to wear comfortable clothes. Nature was described as
stimulating the senses and restoring mental capacities, and the park was an important nearby
outdoor resource. Results are discussed in the context of current research, in relation to women
but also more broadly in relation to research on physical activity and the outdoor environment.
LaPage, W. (2005). "Pursuing happiness through parks - the obesity argument for continued
investment in public parks." Parks & Recreation 40(4): 8-13.
In light of the obesity pandemic in the USA, this paper argues that parks can demonstrate
many alternatives to food as an antidote to unhappiness. Public parks not only offer the pursuit of
happiness but also the discovery of self and a healthy lifestyle.
Lee, R. E., K. M. Booth, et al. (2005). "The Physical Activity Resource Assessment (PARA)
instrument: evaluating features, amenities and incivilities of physical activity resources in urban
neighborhoods." International Journal of Behavioral Nutrition and Physical Activity 2: 13.
BACKGROUND: Neighborhood environment factors may influence physical activity (PA).
The purpose of this study was to develop and test a brief instrument to systematically document
and describe the type, features, amenities, quality and incivilities of a variety of PA resources.
METHOD: The one-page Physical Activity Resource Assessment (PARA) instrument was
developed to assess all publicly available PA resources in thirteen urban lower income, high
ethnic minority concentration neighborhoods that surrounded public housing developments (HDs)
and four higher income, low ethnic minority concentration comparison neighborhoods.
Neighborhoods had similar population density and connectivity. Trained field coders rated 97 PA
resources (including parks, churches, schools, sports facilities, fitness centers, community
centers, and trails) on location, type, cost, features, amenities, quality and incivilities.
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Assessments typically took about 10 minutes to complete. RESULTS: HD neighborhoods had a
mean of 4.9 PA resources (n = 73) with considerable variability in the type of resources available
for each neighborhood. Comparison neighborhoods had a mean of 6 resources (n = 24). Most
resources were accessible at no cost (82%). Resources in both types of neighborhoods typically
had about 2 to 3 PA features and amenities, and the quality was usually mediocre to good in both
types of neighborhoods. Incivilities at PA resources in HD neighborhoods were significantly more
common than in comparison neighborhoods. CONCLUSION: Although PA resources were similar
in number, features and amenities, the overall appearance of the resources in HD neighborhoods
was much worse as indicated by substantially worse incivilities ratings in HD neighborhoods. The
more comprehensive assessment, including features, amenities and incivilities, provided by the
PARA may be important to distinguish between PA resources in lower and higher deprivation
areas.
Lee, S. M. (2005). "Physical activity among minority populations: what health promotion
practitioners should know - a commentary." Health Promotion Practice 6(4): 447-452.
Leisure time and moderate-level physical activity participation in the United States is low
among the majority of the population. Minority populations are especially inactive and report
having fewer opportunities and access to be physically active. Physical activity programs utilizing
a strong health promotion framework (including needs assessment, program plan and design,
program implementation, and evaluation) are limited, particularly among minority populations.
The purpose of this article is to discuss the importance of physical activity, briefly review and
describe current literature, identify the need for physical activity programs among minority
populations, and relate the concepts of a health promotion framework to physical activity
programs that are usable among practitioners. The article also provides health promotion
practitioners with various resources for improving physical activity programs.
Lee, Y. S. (2005). "Gender differences in physical activity and walking among older adults."
Journal of Women & Aging 17(1-2): 55-70.
Older women are generally more sedentary and less active than older men, but little is
known about the specific factors underlying the differences between the genders in physical
activity (PA). The purpose of this study was to compare men and women regarding their
household leisure time PA, walking activity, and personal and environmental factors related to
physical activity. Self-administered questionnaires were completed by 276 older adults recruited
from senior centers. Findings revealed that women were less active overall but more involved in
household activities. The women's personal and environmental factors represented poor
conditions for PA, and as a result they engaged in lower levels of PA than men.
Leslie, E., N. Coffee, et al. (2005). "Walkability of local communities: Using geographic
information systems to objectively assess relevant environmental attributes." Health & Place.
Geographic Information Systems (GIS) can be used to objectively measure features of
the built environment that may influence adults' physical activity, which is an important
determinant of chronic disease. We describe how a previously developed index of walkability was
operationalised in an Australian context, using available spatial data. The index was used to
generate a stratified sampling frame for the selection of households from 32 communities for the
PLACE (Physical Activity in Localities and Community Environments) study. GIS data have the
potential to be used to construct measures of environmental attributes and to develop indices of
walkability for cities, regions or local communities.
Leslie, E., B. Saelens, et al. (2005). "Residents' perceptions of walkability attributes in objectively
different neighbourhoods: a pilot study." Health & Place 11(3): 227-236.
Physical attributes of local environments may influence walking. We used a modified
version of the Neighbourhood Environment Walkability Scale to compare residents' perceptions
of the attributes of two neighbourhoods that differed on measures derived from Geographic
Information System databases. Residents of the high-walkable neighbourhood rated relevant
attributes of residential density, land-use mix (access and diversity) and street connectivity,
consistently higher than did residents of the low-walkable neighbourhood. Traffic safety and
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safety from crime attributes did not differ. Perceived neighbourhood environment characteristics
had moderate to high test retest reliabilities. Neighbourhood environment attribute ratings may be
used in population surveys and other studies. (c) 2004 Elsevier Ltd. All rights reserved.
Li, F., J. Fisher, et al. (2005). "A multilevel analysis of change in neighborhood walking activity in
older adults." Journal of Aging and Physical Activity 13(2): 145-59.
The article reports on a multilevel analysis conducted to examine change in
neighborhood walking activity over a 12-month period in a community-based sample of 28
neighborhoods of 303 older adults age 65 and over. The study employed a multilevel (residents
nested within neighborhoods) and longitudinal (4 repeated measures over 1 year) design and a
multilevel analysis of change and predictors of change in neighborhood walking activity. Results
indicated a significant neighborhood effect, with neighborhood-level walking characterized by a
downward trajectory over time. Inclusion of baseline variables using selected perceived
neighborhood-level social- and physical-environment measures indicated that neighborhoods with
safe walking environments and access to physical activity facilities had lower rates of decline in
walking activity. The findings provide preliminary evidence of neighborhood-level change and
predictors of change in walking activity in older adults. They also suggest the importance of
analyzing change in physical activity in older adults from a multilevel or macrolevel framework.
Li, F., K. J. Fisher, et al. (2005). "Neighborhood influences on physical activity in middle-aged and
older adults: a multilevel perspective." Journal of Aging and Physical Activity 13(1): 87-114.
Over the past few years, attention has been drawn to the importance of neighborhood
influences on physical activity behavior and the need to consider a multilevel analysis involving
not only individual-level variables but also social- and physical-environment variables at the
neighborhood level in explaining individual differences in physical activity outcomes. This new
paradigm raises a series of issues concerning systems of influence observed at different
hierarchical levels (e.g., individuals, neighborhoods) and variables that can be defined at each
level. This article reviews research literature and discusses substantive, operational, and
statistical issues in studies involving multilevel influences on middle-aged and older adults'
physical activity. To encourage multilevel research, the authors propose a model that focuses
attention on multiple levels of influence and the interaction among variables characterizing
individuals, among variables characterizing neighborhoods, and across both levels. They
conclude that a multilevel perspective is needed to increase understanding of the multiple
influences on physical activity.
Li, F., K. J. Fisher, et al. (2005). "Multilevel modelling of built environment characteristics related
to neighbourhood walking activity in older adults." Journal of Epidemiological Community Health
59(7): 558-64.
OBJECTIVE: To examine the relation between built environment factors (representing
several dimensions of urban form of neighbourhoods) and walking activity at both the
neighbourhood level and the resident level, in an older adult sample. DESIGN, SETTING,
PARTICIPANTS: A cross sectional, multilevel design with neighbourhoods as the primary
sampling unit and senior residents as the secondary unit. Five hundred and seventy seven
residents (mean age = 74 years, SD = 6.3 years) participated in the survey, which was conducted
among 56 city defined neighbourhoods in Portland, Oregon, USA. Neighbourhood level variables
were constructed using geographical information systems. Resident level variables consisted of a
mix of self reports and geocoded data on the built environment. MAIN OUTCOME MEASURE:
Self reported neighbourhood walking. MAIN RESULTS: A positive relation was found between
built environment factors (density of places of employment, household density, green and open
spaces for recreation, number of street intersections) and walking activity at the neighbourhood
level. At the resident level, perceptions of safety for walking and number of nearby recreational
facilities were positively related to high levels of walking activity. A significant interaction was
observed between number of street intersections and perceptions of safety from traffic.
CONCLUSIONS: Certain neighbourhood built environment characteristics related to urban form
were positively associated with walking activity in the neighbourhoods of senior residents. Public
health promotion of walking activity/urban mobility and the design of interventions need to
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consider the contribution of neighbourhood level built environment influences.
Lim, K. and L. Taylor (2005). "Factors associated with physical activity among older people--a
population-based study." Preventive Medicine 40(1): 33-40.
BACKGROUND: Regular physical activity improves survival and functional ability, and
can improve quality of life. Few studies have examined factors associated with physical activity in
older adults at a population level. This study examines factors associated with physical activity in
the New South Wales (NSW) older population. METHODS: Data from a random survey of 8881
community-dwelling people aged 65+ years were examined. We used Cox's regression to
analyze the influence of demographic, health, and social factors on physical activity. 'Adequate'
physical activity was defined as at least 30 min of walking, moderate or vigorous activity on at
least 5 days in the last week. Reported barriers to physical activity were also examined.
RESULTS: Adequate physical activity was independently associated with sex (male), younger
age, ability to travel independently, better physical functioning, lower psychological distress, rural
residence, not having diabetes, adequate fruit and vegetable intake, and speaking a language
other than English at home. No independent associations were found for good long distance
eyesight, being a caregiver, living alone, age left school, employment status, fear of falling, or
perception of neighborhood safety. Health problems were frequently reported barriers to physical
activity. CONCLUSIONS: About half of older adults report adequate physical activity. These
results will inform strategies to promote physical activity among older people.
Lockett, D., A. Willis, et al. (2005). "Through seniors' eyes: an exploratory qualitative study to
identify environmental barriers to and facilitators of walking." Canadian Journal of Nursing
Research 37(3): 48-65.
This qualitative exploratory study examined environmental factors influencing the walking
choices of elderly people using the photovoice approach. A total of 13 seniors in Ottawa, Canada,
took photographs of barriers to and facilitators of walking in their neighbourhoods. These photos
were displayed during 3 focus-group sessions and served as touchstones for discussion. A total
of 22 seniors, including 8 of the 13 photographers, participated in the focus-group sessions. The
findings show that environmental hazards related to traffic and falls risks can be significant
barriers to walking for seniors, and that connectivity can truly exist for the elderly only if
convenience, hazard-free routes are available. They also indicate that simple amenities such as
benches and washrooms might facilitate walking for seniors. A neighbourhood that is activityfriendly for seniors will also be a good place for everyone else to live, work, and play. The use of
photovoice as a method was well received by the participants and provided rich information that
may not have been captured through other means.
Lopez-Zetina, J., H. Lee, et al. (2005). "The link between obesity and the built environment.
Evidence from an ecological analysis of obesity and vehicle miles of travel in California." Health &
Place.
Aims: Obesity and physical inactivity are known to be risk factors for many chronic
diseases including hypertension, coronary artery disease, diabetes, and cancer. We sought to
explore the association between an indicator of transportation data (Vehicle Miles of Travel, VMT)
at the county level as it relates to obesity and physical inactivity in California. Methods: Data from
the California Health Interview Survey 2001 (CHIS 2001), the US 2000 Census, and the
California Department of Transportation were merged to examine ecological correlations between
vehicle miles of travel, population density, commute time, and county indicators of obesity and
physical inactivity. Obesity was measured by body mass index (BMI). Physical inactivity was
based on self-reported behaviors including walking, bicycling, and moderate to vigorous activity.
The unit of analysis was the county. Thirty-three counties in California with population size
greater than 100,000 persons per county were retained in the analyses. Results: CHIS 2001
statewide obesity prevalence ranged from 11.2% to 28.5% by county. Physical inactivity ranged
from 13.4% to 35.7%. Daily vehicle miles of travel ranged from 3.3 million to 183.8 million per
county. By rank bivariate correlation, obesity and physical inactivity were significantly associated
(p<0.01). Furthermore, by rank analysis of variance, the highest mean rank obesity was
associated with the highest rank of VMT (p<0.01). Similar rank patterns were observed between
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obesity and physical inactivity and commute time. Associations between VMT and physical
inactivity were examined but failed to reach statistical significance. Conclusion: This analysis
adds to the growing evidence supporting the association between VMT (a measure of automobile
transportation) and obesity. An urban design characterized by over dependence on motorized
transportation may be related to adverse health effects.
Martin, S. L., G. J. Kirkner, et al. (2005). "Urban, rural, and regional variations in physical activity."
Journal of Rural Health 21(3): 239-44.
PURPOSE: There is some speculation about geographic differences in physical activity
(PA) levels. We examined the prevalence of physical inactivity (PIA) and whether U.S. citizens
met the recommended levels of PA across the United States. In addition, the association between
PIA/PA and degree of urbanization in the 4 main U.S. regions (Northeast, Midwest, South, and
West) was determined. METHODS: Participants were 178,161 respondents to the 2000
Behavioral Risk Factor Surveillance System (BRFSS). Data from 49 states and the District of
Columbia were included (excluding Alaska). States were categorized by urban status according
to the U.S. Department of Agriculture. Physical activity variables were those commonly used in
national surveillance systems (PIA = no leisure-time PA; and PA = meeting a PA
recommendation). RESULTS: Nationally, PA levels were higher in urban areas than in rural
areas; correspondingly, PIA levels were higher in rural areas than in urban areas. Regionally, the
urban-rural differences were most striking in the South and were, in fact, often absent in other
regions. Demographic factors appeared to modify the association. CONCLUSION: The
association between PA and degree of urbanization is evident and robust in the South but cannot
be generalized to all regions of the United States. For the most part, the Midwest and the
Northeast do not experience any relationship between PA and urbanization, whereas, in the
West, the trend appears to be opposite of that observed in the South.
Matson-Koffman, D. M., J. N. Brownstein, et al. (2005). "A site-specific literature review of policy
and environmental interventions that promote physical activity and nutrition for cardiovascular
health: what works?" American Journal of Health Promotion 19(3): 167-93.
OBJECTIVE: To review the literature to determine whether policy and environmental
interventions can increase people's physical activity or improve their nutrition. DATA SOURCES:
The following databases were searched for relevant intervention studies: Medline, Chronic
Disease Prevention File, PsychInfo, Health Star, Web of Science, ERIC, the U.S. Department of
Transportation, and the U.S. Department of Agriculture. STUDY SELECTION: To be included in
the review, studies must have (1) addressed policy or environmental interventions to promote
physical activity and/or good nutrition; (2) been published from 1970 to October 2003; (3)
provided a description of the intervention; and (4) reported behavioral, physiological, or
organizational change outcomes. Studies that had inadequate intervention descriptions or that
focused on determinants research, individual-level interventions only, the built environment, or
media-only campaigns were excluded. DATA EXTRACTION: We extracted and summarized
studies conducted before 1990 (n = 65) and during 1990-2003 (n = 64). DATA SYNTHESIS: Data
were synthesized by topic (i.e., physical activity or nutrition), by type of intervention (i.e., point-ofpurchase), and by setting (i.e., community, health care facility, school, worksite). Current studies
published during 1990-2003 are described in more detail, including setting and location, sample
size and characteristics, intervention, evaluation period, findings, and research design. Findings
are also categorized by type of intervention to show the strength of the study designs and the
associations of policy and environmental interventions with physical activity and nutrition.
CONCLUSIONS: The results of our review suggest that policy and environmental strategies may
promote physical activity and good nutrition. Based on the experimental and quasi-experimental
studies in this review, the following interventions provide the strongest evidence for influencing
these behaviors: prompts to increase stair use (N = 5); access to places and opportunities for
physical activity (N = 6); school-based physical education (PE) with better-trained PE teachers,
and increased length of time students are physically active (N = 7); comprehensive work-site
approaches, including education, employee and peer support for physical activity, incentives, and
access to exercise facilities (N = 5); the availability of nutritious foods (N = 33), point-of-purchase
strategies (N = 29); and systematic officer reminders and training of health care providers to
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provide nutritional counseling (N = 4). Further research is needed to determine the long-term
effectiveness of different policy and environmental interventions with various populations and to
identify the steps necessary to successfully implement these types of interventions.
McMillan, T. E. (2005). "Urban form and a child's trip to school: The current literature and a
framework for future research." Journal Of Planning Literature 19(4): 440-456.
Meister, J. S. and J. Guernsey de Zapien (2005). "Bringing health policy issues front and center
in the community: expanding the role of community health coalitions." Preventing Chronic
Disease 2(1): A16.
Merom, D., Y. Miller, et al. (2005). "Effect of Australia's Walk to Work Day campaign on adults'
active commuting and physical activity behavior." American Journal of Health Promotion 19(3):
159-62.
PURPOSE: To determine whether Australia's Walk to Work Day media campaign
resulted in behavioral change among targeted groups. METHODS: Pre- and postcampaign
telephone surveys of a cohort of adults aged 18 to 65 years (n = 1100, 55% response rate) were
randomly sampled from Australian major metropolitan areas. Tests for dependent samples were
applied (McNemar chi2 or paired t-test). RESULTS: Among participants who did not usually
actively commute to work was a significant decrease in "car only" use and an increase in walking
combined with public transport. Among those who were employed was a significant increase in
total time walking (+ 16 min/wk; t [780] = 2.04, p <.05) and in other moderate physical activity
(+120 min/wk; t [1087] = 4.76, p <.005), resulting in a significant decrease in the proportion who
were "inactive" (chi2 (1) = 6.1, p <.05). CONCLUSION: Although nonexperimental, the Walk to
Work Day initiative elicited shortterm changes in targeted behaviors among target groups.
Reinforcement by integrating worksite health promotion strategies may be required for sustained
effects.
Merom, D., C. Tudor-Locke, et al. (2005). "Active commuting to school among NSW primary
school children: implications for public health." Health & Place.
Regular active commuting by walking/cycling can help maintain an active lifestyle. The
frequency, duration and correlates of school active commuting were examined for primary school
children in NSW, Australia. Walking/cycling -only and in combination with bus/car were of short
duration (median 7 or 4min, respectively) and their frequency dropped within a short distance
(>0.75km) from school. Apart from distance, child's age, school affiliation and perceived safety,
regular walking/cycling (10 trips, 22%) was associated with parents' travel mode to work and with
father taking the child to school. Frequent walking/cycling (5 trips, 37%) was associated with
child's level of independence and the perceived benefits of active commuting. Behaviour change
in this setting requires multi-level strategies.
Merrill, R. M., E. C. Shields, et al. (2005). "Climate conditions and physical activity in the United
States." American Journal of Health Behavior 29(4): 371-381.
This study identified the influence season and climate have on physical activity among
US adults. Seven weather classifications from 255 weather stations were linked with 355 counties
covered by the 2003 Behaviour Risk Factor Surveillance System. The percentage meeting the
recommendations for physical activity ranged from 30.9% in Puerto Rico to 60.9% in Montana
and significantly varied across seasons: 44.6% in winter, 46.2% in spring, 48.4% in summer, and
45.8% in fall. Counties in the top 25% meeting the recommendations for physical activity had the
highest percentage of days with dry moderate conditions. Counties in the bottom 25% had the
highest percentage of days with moist tropical conditions. It is concluded that season and climate
significantly influence physical activity in the USA.
Meyer, K., L. Rezny, et al. (2005). "Physical activity of adults aged 50 years and older in
Switzerland." Sozial- und Praventivmedizin 50(4): 218-29.
OBJECTIVE: This study explores the prevalence of guideline-compliant physical activity
(PA) behavior based on socio-demographic, health-related and environmental variables.
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METHODS: Cross-sectional data of the Swiss Health Survey 2002 were used in a Swiss
population segment aged 50+. Four categories of PA were created with respect to Swiss and US
guidelines: "moderate sports/exercise", "vigorous sports/exercise", "habitual PA", and "optimal
PA" (i.e. combined variable used when both "vigorous sports/exercise" and "habitual PA" apply).
Sedentary lifestyle was a fifth category. RESULTS: In the total sample considered for analysis (N
= 8405) the prevalence of guideline-compliant PA was: 9.1% moderate sports/exercise; 18.2%
vigorous sports/exercise; 45% habitual PA; 8.7% optimal PA. Almost 50% of the age groups 6579 and 80+ were involved in habitual PA. Higher socio-economic status was associated with
involvement in moderate sports/exercise, vigorous sports/exercise, or optimal PA. In contrast,
lower socioeconomic status was associated with habitual PA. While living in an urban or rural
environment had no differentiating effect on sports/exercise, living in rural areas was associated
with a sedentary lifestyle and little involvement in habitual PA and/or optimal PA. Self-reported
good health and/or health orientation were associated with vigorous sports/exercise, habitual PA
and optimal PA, regardless of whether the person had chronic health problems or not.
CONCLUSION: Habitual PA seems to have the greatest potential for increasing overall guidelinecompliant activity levels. A behavioral/cognitive and political/environmental approach to improving
PA is suggested.
Michael, Y. L., M. K. Green, et al. (2005). "Neighborhood design and active aging." Health &
Place.
This qualitative analysis of focus groups describes how neighborhood design encourages
active aging. Nine focus groups were conducted in 2002 and 2003 with residents (N=60) aged 55
and over living in Portland, OR, USA. Content analysis revealed that local shopping and services,
traffic and pedestrian infrastructure, neighborhood attractiveness, and public transportation
influence activity among older adults. This information will be useful for making policy
recommendations relating to land use planning and transportation, to assist in senior-friendly
developments and neighborhood improvements, and to design effective senior health
interventions with an emphasis on neighborhood design influences.
Miller, Y. D. and W. J. Brown (2005). "Determinants of active leisure for women with young
children - an " ethic of care" prevails." Leisure Sciences 27(5): 405-420.
Monden, C. W., F. J. van Lenthe, et al. (2005). "A simultaneous analysis of neighbourhood and
childhood socio-economic environment with self-assessed health and health-related behaviours."
Health & Place.
Childhood socio-economic environment and neighbourhood socio-economic environment
later in life are closely related. However, few studies have considered their effects
simultaneously. Using cross-sectional data of approximately 8000 respondents in 86
neighbourhoods in the city of Eindhoven, the Netherlands, we study associations of both
determinants with self-assessed health, smoking, alcohol consumption and overweight. Growing
up in a low socio-economic environment increased the probability to live a more deprived
neighbourhood in adulthood. Controlling for individual socio-economic characteristics, both
childhood and neighbourhood socio-economic environment were related to smoking and
overweight, but not with excessive alcohol consumption. Associations between childhood socioeconomic environment and smoking and overweight are still substantial after controlling for
neighbourhood socio-economic environment. Similarly, neighbourhood inequalities in smoking
and overweight remain substantial after controlling for childhood socio-economic environment.
Mota, J., M. Almeida, et al. (2005). "Perceived Neighborhood Environments and physical activity
in adolescents." Preventive Medicine 41(5-6): 834-6.
BACKGROUND: There is a reason to believe that physical environments variables play
an especially important role in the level of physical activity. Few studies have examined the
association between environmental variables and level of physical activity in adolescents.
OBJECTIVES: This study aims were: (1) to evaluate differences in perceived neighborhood
environment according to physical activity level and (2) to determine which, if any, perceived
neighborhood environmental variables were associated with reported physical activity levels in an
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adolescent population. METHODS: The sample comprised of 1123 adolescents, which were
classified according to physical activity levels into actives (n = 589) and non-active (n = 534). A
questionnaire assessed Perceived Neighborhood Environments. Physical activity was assessed
by questionnaire and used as the dependent variable. RESULTS: More active children were
reported to more significantly (P < 0.05) agree with the importance of the accessibility of shops,
the social environment, neighbors with recreational facilities, and aesthetics. Logistic regression
analysis showed that aesthetic (OR = 1.302; P = 0.05) and recreational facilities (OR = 1.297; P =
0.05) domains were related to being physically active. CONCLUSIONS: Some perceived
neighborhood environmental attributes were found to be associated with level of physical activity
in adolescents.
Motl, R. W., R. K. Dishman, et al. (2005). "Perceived physical environment and physical activity
across one year among adolescent girls: self-efficacy as a possible mediator?" Journal Of
Adolescent Health 37(5): 403-408.
Purpose: This study involved an examination of the direct and mediated effects of
perceived equipment accessibility and neighborhood safety on physical activity across a one-year
period among adolescent girls. Methods: Adolescent girls (N = 1,038) completed self-report
measures of perceived environment, barriers self-efficacy, and physical activity in the Spring
semesters of 1999 (baseline) and 2000 (follow-up) when students were in the 8(th) and 9(th)
grades. Results: An initial analysis demonstrated that neighborhood safety did not exhibit crosssectional or longitudinal direct effects on physical activity, whereas equipment accessibility
exhibited a statistically significant cross-sectional, but not longitudinal, direct effect on physical
activity. The secondary analysis demonstrated that self-efficacy for overcoming barriers mediated
the cross-sectional effect of equiment accessibility on physical activity. Conclusions: We conclude
that the cross-sectional effect of perceived equipment accessibility on physical activity is
mediated by self-efficacy for overcoming barriers among adolescent girls. This is consistent with
the reciprocal relationships among the environment, person, and behavior described by socialcognitive theory. (c) 2005 Society for Adolescent Medicine. All rights reserved.
Moudon, A. V., C. Lee, et al. (2005). "Cycling and the built environment, a US perspective."
Transportation Research Part D-Transport And Environment 10(3): 245-261.
This disaggregate cross-sectional study uses primary data on the cycling behavior of 608
randomly sampled respondents in urbanized King County, Washington, and objective parcel-level
GIS measures of land use and infrastructure conditions. Binary logit model findings provide new
insights on who bicycles, and on perceived and actual built environmental conditions associated
with the likelihood of cycling in neighborhoods, controlling for socio-demographic variables. A
high 21% of the respondents report cycling at least once a week in their neighborhood, more
often for recreation or exercise than for transportation. Cycling is more popular among male,
younger adults, transit users, and those who are physically active and in good health. Both
perceived and objective environmental conditions contribute to the likelihood of cycling. Proximity
to trails and the presence of agglomerations of offices, clinics/hospitals, and fast food restaurants,
measured objectively, are significant environmental variables. Previously researched correlates of
cycling, such as the presence of bicycle lanes, traffic speed and volume, slope, block size, and
the presence of parks, are found insignificant when objectively measured. A non-linear
relationship is found between the odds of cycling and the perception of traffic problems and
automobile-oriented facilities. Overall, cycling is only moderately associated with the
neighborhood environment. It appears to be an individual choice that is independent from
environmental support. This finding likely reflects the limited bicycle infrastructure in the sample
frame-an unfortunate condition found in most US metropolitan regions. Policy and intervention
programs could increase cycling by improving both actual and perceived environmental
conditions. (c) 2005 Elsevier Ltd. All rights reserved.
Muniz, I. and A. Galindo (2005). "Urban form and the ecological footprint of commuting. The case
of Barcelona." Ecological Economics 55(4): 499-514.
One of the most controversial ideas in the debate on urban sustainability is that urban
sprawl causes problems of ecological stress. This widespread assumption has been tested by
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measuring the ecological footprint left by commuters in the 163 municipalities of the Barcelona
Metropolitan Region (BMR). This paper explores the determinants of the ecological footprint of
commuting municipal variability by using the following regressors: population density,
accessibility, average household income, and job ratio. The results confirm that urban form
appears as the main determinant of ecological footprint variation among the municipalities of
BMR. (c) 2005 Elsevier B.V. All rights reserved.
Neville, L., S. Furber, et al. (2005). "A health impact assessment of an environmental
management plan: the impacts on physical activity and social cohesion." Health Promotion
Journal of Austria 16(3): 194-200.
ISSUE ADDRESSED: This article describes a prospective health impact assessment
(HIA) on a local government environmental management plan, the Shellharbour Foreshore
Management Plan (SFM Plan). The health outcomes of interest were physical activity and social
cohesion. METHODS: The procedures undertaken include: screening; scoping; assessment of
potential health impacts; negotiation; and decision-making. The potential positive and negative
health impacts of the SFM Plan were assessed and opportunities to enhance the positive and
mitigate the negative were identified. RESULTS: Implementation of the SFM Plan was supported
as the HIA showed a potential to benefit the health of local residents and visitors to the
Shellharbour Foreshore area by increasing physical activity and social cohesion. CONCLUSION:
The HIA provided a useful framework for establishing a collaborative relationship between the
local government and health sector. It improved the local government's understanding of the
inter-relationship between the environment and physical activity and social cohesion and enabled
health authorities to have an impact on a capital works program to maximise health gain.
Norman, G. J., B. A. Schmid, et al. (2005). "Psychosocial and environmental correlates of
adolescent sedentary behaviors." Pediatrics 116(4): 908-916.
Objective. To determine correlates of sedentary behaviors in adolescents through the
examination of psychosocial and environmental variables. Method. The study used a crosssectional design to evaluate an ethnically diverse clinic-based sample of 878 adolescents who
were 11 to 15 years old. Bivariate and multivariate analyses were stratified by gender to assess
correlates of sedentary behaviors occurring on the most recent nonschool day (television viewing,
computer video games, sitting listening to music, and talking on the phone). Results. For girls,
age, family support, television/video rules, and hills in the neighborhood were associated with
sedentary behaviors. Furthermore, psychological constructs such as self-efficacy, enjoyment,
change strategies, and pros and cons of change emerged as correlates of sedentary behaviors. A
moderator effect revealed that the proportion of girls in the low-BMI group decreased with
increased self-efficacy, whereas the proportion of girls in the high-BMI group did not vary
significantly by self-efficacy. For boys, age, ethnicity, BMI, cons of change, and self-efficacy were
associated with sedentary behaviors. Conclusions. This study provides evidence of factors
associated and not associated with adolescent sedentary behaviors. Similar to physical activity,
measures of specific psychosocial constructs of sedentary behavior demonstrated important
associations. The results highlight the need for additional examination of the correlates of
sedentary behavior to determine which correlates are mechanisms of behavior change.
Özdirenc, M., A. Özcan, et al. (2005). "Physical fitness in rural children compared with urban
children in Turkey." Pediatrics International 47(1): 26-31.
Background: In a crowded modern world, it is vital that the promotion of sport and
exercise should be compatible with environmental and public health outcomes. This study aims to
investigate the effects of environmental factors, lifestyle and leisure time activities on physical
fitness in rural and urban children. Methods: A cross-sectional observational study of 98 rural and
74 urban healthy children aged 9-11 years was conducted in Turkey [date not given]. A
questionnaire was used in collecting information about the children's physical activity habits and
their school's facilities. The physical fitness of children was evaluated with EUROFIT test battery.
Results: The rural children preferred to play football and volleyball, while the urban children had a
tendency to prefer indoor sports. The percentage of urban children not involved in any sports
activity was 35%, while this rate was 30.6% for rural children. It was also observed that the urban
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children watched TV more often than the rural children (13.4 plus or minus 2.7 h/week vs. 10.9
plus or minus 2.7 h/week, respectively). Body mass index and skinfolds thickness were higher in
the urban children (<i>P</i><0.05). There were no significant differences in the hip-waist ratio or
the hip and waist circumference between the two groups. In cardiopulmonary and motor fitness,
no difference was found between the two groups. In contrast, flexibility and muscle endurance
were significantly higher in the rural children. Conclusion: The children living in the urban areas
were more inactive and obese, which resulted in a decrease in their flexibility and muscle
endurance fitness.
Pate, R. R., D. S. Ward, et al. (2005). "Promotion of physical activity among high-school girls: a
randomized controlled trial." American Journal of Public Health 95(9): 1582-7.
OBJECTIVES: Many adolescent girls fail to meet national guidelines for physical activity,
and the prevalence of obesity is increasing among this group. Our study examined the effects of
a comprehensive school-based intervention on physical activity among high-school girls.
METHODS: A group-randomized controlled field trial was conducted at 24 high schools. A
school-based sample of 2744 girls (48.7% African American, 46.7% White) participated in a
measurement protocol when they were in eighth and then ninth grade. A comprehensive physical
activity intervention was designed to change the instructional program and the school
environment to increase support for physical activity among girls. RESULTS: At follow-up, 45% of
girls in the intervention schools and 36% of girls in the control schools reported vigorous physical
activity during an average of 1 or more 30-minute time blocks per day over a 3-day period.
CONCLUSIONS: A comprehensive school-based intervention can increase regular participation
in vigorous physical activity among high-school girls.
Paxton, R. J., P. A. Sharpe, et al. (2005). "Associations of sociodemographic and community
environmental variables to use of public parks and trails for physical activity." International
Journal of Health Promotion and Education 43(4): 108-116.
Health practitioners suggest that building walking trails and parks that are available and
accessible to the public are useful interventions to promote physical activity; however few studies
exist on factors that promote public park or trail use. The purpose of this exploratory study was to
investigate determinants of and correlates to public park and trail use. A random-digit-dialled,
cross-sectional telephone survey was administered to 2117 residents in South Carolina, USA,
two adjacent counties. Participants more likely to use trails were employed (p<0.001), African
American (p<0.001), younger (aged 18-34, p<0.001), perceived the community safe for physical
activity (p<0.05), knew one or more mapped out routes for walking/jogging and bicycle routes
(p<0.001), and reported one or more available trails or parks they might use (p<0.001). Similar to
participants reporting trial use, park users were more likely to be employed (p<.001), male
(p<0.05), African American (p<.001), aged 18-34 (p<0.001), knew of two or more walking/jogging
or bicycle routes (p<0.001), perceived the community was safe (p<0.05) and perceived that
physical activity was important to citizens in the county (p<0.05). Convenient and accessible trails
and parks may be of particular importance/benefit for promoting physical activity among persons
of ethnic minority groups.
Payne, L., S. E. Orsega, et al. (2005). "Local Park Use and Personal Health Among Older Adults:
An Exploratory Study." Journal of park and recreation administration (Champaign, Ill.) 23(2): 1.
Regular park use is common among older adults. However, this use has only recently
(i.e., last 15 years) been recognized as related to health and health policy. Although visits to
parks are thought of as recreation, increasing evidence indicates such behavior has significant
health consequences. Given the huge and growing expenditures for health in the United States,
the aging of the population, and the consequences of the Baby Boom cohort reaching old age,
new ways of conceptualizing and delivering health care will occur rapidly. Recreation and park
professionals need to better understand the ways in which low cost, readily available resources
such as local parks may contribute to personal health and the potential for such a contribution to
be increased. This study was undertaken to examine the relationship between use of local parks
and self-reported individual health among adults 50 years of age and older. Specific aims were to
examine: (1) sociodemographic differencesbetween park users and non-park users, (2)
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differences in perceived health between park users and non-park users, (3) the logistics (e.g.,
frequency, travel mode) of park use, (4) benefits attributed to park use, and 5) the relationship
between park access and perceived health. A questionnaire was developed and distributed in
cooperation with Cleveland Metroparks and a grant from the National Recreation Foundation. The
questionnaire was distributed in parks, supermarkets, shopping malls, and senior centers to
achieve a diverse sample of both park and non-park users. The survey included questions about
personal health (i.e., physical, mental), social support, health behaviors, park and leisure
behavior, and demographics. The results of this exploratory study indicated support for the
contention that local parks should be thought of as a part of a viable strategy for health promotion
and disease prevention. Park use was fairly extensive among older Cleveland residents, with 33
% whovisited a local park frequently and 53 % who visited occasionally. Regarding use of
Cleveland Metroparks, the mean number of annual visits was 30 and 12 % of respondents visited
a Cleveland Metropark at least once per week. The majority of older park users were physically
active during their visit, with over 69 % obtaining moderate or high levels of physical activity. An
average visit lasted about 2 hours and users spent about half of their time walking. The benefits
that older local park users ascribed to their visits were mostly health related. In addition, people
who lived within walking distance of a park used parks significantly more than individuals without
a park within walking distance. Moreover, individuals with a park within walking distance were in
better health than those without a park nearby. Results suggested that parks are a viable context
for health promotion activities such as physical activity. [ABSTRACT FROM AUTHOR]
Peterson, J. J., J. B. Lowe, et al. (2005). "The relationship between active living and healthrelated quality of life: income as a moderator." Health Education Research.
This study used a moderator model to examine the relationship between active living and
the physical components of health-related quality of life [i.e. overall physical component of quality
of life (PQOL), physical functioning and ability to fulfill physical role] among a randomly selected
sample of rural residents (n = 407) from the Midwestern US. Results showed that active living
was associated with greater increases in health-related quality of life for those reporting lower
income. The effect size of the relationship between active living and the PQOL for the low-income
group was over 2 times the effect size for the high-income group. For physical functioning, the
effect size of active living for the low-income group was greater than 3 times the effect size for the
high-income group. Although active living behaviors have been demonstrated to be less prevalent
among those of low socioeconomic status, this group may have the most to gain from these
activities. Findings highlight the need for increased and specifically targeted promotion of active
living interventions.
Pitsavos, C., D. B. Panagiotakos, et al. (2005). "Epidemiology of leisure-time physical activity in
socio-demographic, lifestyle and psychological characteristics of men and women in Greece: the
ATTICA Study." BMC Public Health 5(1): 37.
BACKGROUND: We aimed to evaluate the prevalence, frequency and type of leisuretime physical activity (LTPA) among adults in Greece, as well as its relationship with sociodemographic, lifestyle and clinical characteristics of these people. METHODS: From May 2001 to
December 2002 we randomly enrolled 1514 men and 1528 women, without any evidence of
cardiovascular or any other chronic disease. The sampling was stratified by the age-gender
distribution of (census 2001) of the greater area of Athens. Weekly energy expenditure assessed
by considering frequency, duration (in minutes) and intensity of sports related physical activity
during a usual week. RESULTS: 53% of men and 48% of women were classified as physically
active. Men were more likely to be active as compared to women (p < 0.05), while the lowest
activity rates were observed in 40 to 49 years old participants (p < 0.01). Physically active people
had higher occupation skills, were more likely to live in rural areas, to be unmarried, non smokers
and they were devoted to a healthier dietary pattern, as compared to sedentary, irrespective of
age and sex (all p < 0.05). In addition, the cumulative risk factors score of obesity, hypertension,
hypercholesterolemia and diabetes, was inversely associated with activity status (p < 0.001).
Finally, physically active men and women were less likely to report depressive symptoms (p <
0.01), after various adjustments were made. CONCLUSION: Half of the studied population
reported physically inactive, indicating that sedentary lifestyle becomes a serious epidemic in
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Active Living Research Literature Summary 2004 & 2005
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Greece. High occupation skills, non-smoking, devotion to a healthier dietary pattern and a better
cardiovascular risk factors profile were some of the determinants of physically active people.
Plaut, P. O. (2005). "Non-motorized commuting in the US." Transportation Research Part DTransport And Environment 10(5): 347-356.
Non-motorized forms of commuting include bicycling, walking to work and working at
home and have the potential for reducing environmental damage. These non-motorized modes
are analyzed empirically using US journey to work data. Higher salary income and more
expensive housing are associated with greater propensity to work at home, but lower propensity
to walk or bicycle. College education is in several cases associated with greater propensity to use
non-motorized modes. There are sharp differences in the likelihood of using non-motorized
modes across the sub-regions within the metropolitan area. Car ownership, race, gender, and
various locational and neighborhood features are shown to affect modal choices regarding nonmotorized alternatives, in comparison with car commuting. (c) 2005 Elsevier Ltd. All rights
reserved.
Plotnikoff, R. C., T. R. Prodaniuk, et al. (2005). "Development of an ecological assessment tool
for a workplace physical activity program standard." Health Promotion Practice 6(4): 453-63.
This project was undertaken to develop a Workplace Physical Activity Assessment Tool
to evaluate workplace physical activity programs based on a standard of best practices indicated
in the literature and by key stakeholders. The development of the Assessment Tool was
structured on an ecological model for health and physical activity promotion and an occupational
health and safety audit instrument. The project included a review and synthesis of pertinent
literature, expert and stakeholder reviews, interrater reliability appraisals, and workplace
consultations over three distinct study phases. The Assessment Tool was received positively by
the expert reviewers (i.e., academics, policy makers, and practitioners) and revealed generally
high interrater reliability. The Workplace Physical Activity Assessment Tool can be used to plan,
implement, and evaluate physical activity programs in the workplace. Recommendations for
future research are identified.
Popkin, B. M., K. Duffey, et al. (2005). "Environmental influences on food choice, physical activity
and energy balance." Physiology and Behavior 86(5): 603-13.
In this paper, the environment is defined as the macro- and community-level factors,
including physical, legal and policy factors, that influence household and individual decisions.
Thus, environment is conceived as the external context in which household and individual
decisions are made. This paper reviews the literature on the ways the environment affects diet,
physical activity, and obesity. Other key environmental factors discussed include economic, legal,
and policy factors. Behind the major changes in diet and physical activity in the US and globally
lie large shifts in food production, processing, and distribution systems as well as food shopping
and eating options, resulting in the increase in availability of energy-dense foods. Similarly, the
ways we move at home, work, leisure, and travel have shifted markedly, resulting in substantial
reductions in energy expenditure. Many small area studies have linked environmental shifts with
diet and activity changes. This paper begins with a review of environmental influences on diet and
physical activity, and includes the discussion of two case studies on environmental influences on
physical activity in a nationally representative sample of US adolescents. The case studies
illustrate the important role of physical activity resources and the inequitable distribution of such
activity-related facilities and resources, with high minority, low educated populations at strong
disadvantage. Further, the research shows a significant association of such facilities with
individual-level health behavior. The inequity in environmental supports for physical activity may
underlie health disparities in the US population.
Poskitt, E. M. (2005). "Tackling childhood obesity: diet, physical activity or lifestyle change?" Acta
Paediatr 94(4): 396-8.
The present day, almost worldwide, fattening of children is widely attributed to both
excessive energy intake and reduced physical activity. However, treatments which only focus on
reducing energy intakes and increasing energy expenditures rarely show long-term success. The
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Active Living Research Literature Summary 2004 & 2005
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family attitudes and environments which contribute to energy imbalance and the development of
obesity are virtually unchanged by many treatment programmes. We need to learn more about
the nurture of those children who retain normal fatness although enveloped by obesity-promoting
environments. Conclusion: Better understanding of these children's lifestyles could lead to
significant community-directed initiatives to promote normal childhood nutrition and growth even
within affluent modem society.
Powell, E. C., E. J. Ambardekar, et al. (2005). "Poor neighborhoods: safe playgrounds." Journal
of Urban Health 82(3): 403-10.
Although unstructured physical play is helpful to child development and physical activity
is important to obesity prevention, up-to-date information about playgrounds and playground
hazards in urban areas is limited. Local data are needed to identify problems and target
interventions. The aim of this study was to describe the hazards in playgrounds located in lowincome (median dollars 28,728-38,915) and very low-income (median dollars 18,266-18,955)
Chicago neighborhoods. Using a standardized on-site survey (National Program for Playground
Safety), two investigators reviewed seventy-eight public playgrounds for hazards related to
playground design, safe surfaces, supervision, and equipment design and maintenance. The
design of 56 playgrounds (72%) posed no hazards. One playground lacked protection from motor
vehicles, and 21 had minor flaws. One playground had an asphalt surface; all others had
protective surfaces, usually wood chips. The chips were too thin in many places, and in 15
playgrounds (19%), at least one concrete footing was exposed. Trash was a common surface
hazard (68%). Although most equipment was safe (swings of soft materials and appropriate
platform barriers), many pieces needed repairs. Equipment maintenance hazards included gaps
(44%) and missing (38%) or broken parts (35%). In 13 of 39 playgrounds (33%) where children
were observed playing, one or more were unsupervised. Playgrounds in very low-income
neighborhoods more often had trash in the fall zone and exposed footings (P<.01 for each); there
were no differences between low and very low-income neighborhoods in playground design or
equipment maintenance. We conclude that playgrounds in low-income Chicago neighborhoods
are of good design and have appropriate surfaces. Needed improvements include attention to
wood chip depth, the removal of trash from the fall zone, and equipment repairs. Greater adult
supervision is warranted.
Powell, K. E. (2005). "Land use, the built environment, and physical activity: a public health
mixture; a public health solution." American Journal of Preventive Medicine 28(2 Suppl 2): 216-7.
Pretty, J., J. Peacock, et al. (2005). "The mental and physical health outcomes of green
exercise." International Journal of Environmental Health Research 15(5): 319-337.
Both physical activity and exposure to nature are known separately to have positive
effects on physical and mental health. We have investigated whether there is a synergistic benefit
in adopting physical activities whilst being directly exposed to nature ('green exercise'). Five
groups of 20 subjects were exposed to a sequence of 30 scenes projected on a wall whilst
exercising on a treadmill. Four categories of scenes were tested: rural pleasant, rural unpleasant,
urban pleasant and urban unpleasant. The control was running without exposure to images.
Blood pressure and two psychological measures (self-esteem and mood) were measured before
and after the intervention. There was a clear effect of both exercise and different scenes on blood
pressure, self-esteem and mood. Exercise alone significantly reduced blood pressure, increased
self-esteem, and had a positive significant effect on 4 of 6 mood measures. Both rural and urban
pleasant scenes produced a significantly greater positive effect on self-esteem than the exerciseonly control. This shows the synergistic effect of green exercise in both rural and urban
environments. By contrast, both rural and urban unpleasant scenes reduced the positive effects
of exercise on self-esteem. The rural unpleasant scenes had the most dramatic effect, depressing
the beneficial effects of exercise on three different measures of mood. It appears that threats to
the countryside depicted in rural unpleasant scenes have a greater negative effect on mood than
already urban unpleasant scenes. We conclude that green exercise has important public and
environmental health consequences.
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Active Living Research Literature Summary 2004 & 2005
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Rasinaho, M., R. Leinonen, et al. (2005). "Neighborhood characteristics, desire to increase
physical activity and mobility limitation among older people." Gerontologist 45: 360-360.
Reed, J. A. and D. A. Phillips (2005). "Relationships between physical activity and the proximity
of exercise facilities and home exercise equipment used by undergraduate university students."
Journal of American College Health 53(6): 285-90.
The authors used stratified random sampling procedures to investigate the relationships
among physical activity (PA), the proximity of exercise facilities, and the quantity of home
exercise equipment in a sample of 411 undergraduates. To examine the data they collected from
the modified Godin Leisure-Time Exercise Questionnaire and the Home Environment
Questionnaire, the authors used correlational analyses and analysis of variance. Intensity and
duration of PA showed a significant relationship to the proximity of exercise facilities. Intensity,
frequency, and duration of PA were significantly related to the quantity of students' home exercise
equipment. Freshmen and sophomores engaged in PA closer to their residences and participated
in 3 more exercise bouts per week than juniors and seniors. These findings suggest that proximity
of the activity episode may have an effect on PA behavior of college students.
Romero, A. J. (2005). "Low-income neighborhood barriers and resources for adolescents'
physical activity." Journal Of Adolescent Health 36(3): 253-259.
Purpose: To investigate factors of low-income neighborhoods and households on
physical activity with a sample of adolescents from low-income neighborhoods. Methods: Middleschool-aged youth (n = 74) from a low-income neighborhood completed self-report surveys.
Measures include vigorous exercise frequency, neighborhood hazards, after-school time
demands, availability of facilities, quality of facilities, and perceived safety. Hierarchical multiple
linear regression and Pearson product moment correlations were conducted to test hypotheses
that more frequent physical activity would be associated with more available locations, better
quality facilities, fewer time demands, more after-school programs, more perceived safety, and
more hazards. Results: Results indicate that more physical activity was associated with more
hours spent in after-school programs (r =.50, p <.001) and perception of higher quality of local
facilities (r =.28, p <.05). Perception of safe adults at local facilities accounted for more variance
than perception of neighborhood hazards in the association with physical activity even after
accounting for gender, age, and socioeconomic status. Conclusions: Future health promotion
programs should consider factors of after-school programs such as quality, cost, and presence of
safe adults when attempting to increase and maintain youth physical activity in lower income
areas. (c) 2005 Society for Adolescent Medicine. All rights reserved.
Rosenberger, R. S., Y. Sneh, et al. (2005). "A spatial analysis of linkages between health care
expenditures, physical inactivity, obesity and recreation supply." Journal Of Leisure Research
37(2): 216-235.
Rates of physical inactivity and obesity in the United States have reached epidemic
proportions. This study estimates the linkages between health care expenditures for treatments of
circulatory problems, physical inactivity, obesity, and the supply of recreation opportunities in
West Virginia. Estimation of a spatial econometric model shows that rates of physical inactivity for
counties are positively related to expenditures on health care treatments of diseases and
disorders Of the circulatory system. Results also show that quantities of variously measured
recreation opportunities are negatively related to rates of physical inactivity, but not to Obesity.
The recursive nature of our model demonstrates that physical inactivity explains spatial patterns
of obesity, but not vice versa. Therefore, increasing recreation opportunities have the potential to
decrease health care expenditures and rates of Obesity through increasing rates of physical
activity.
Rutt, C. D. and K. J. Coleman (2005). "Examining the relationships among built environment,
physical activity, and body mass index in El Paso, TX." Preventive Medicine 40(6): 831-41.
OBJECTIVE: The current study examined the relationships among built environment,
physical activity, and body mass index (BMI) in a primarily Hispanic border community in El Paso,
TX. METHODS: Data from a 2001 community-wide health survey were matched to environmental
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data using geocoding techniques in ARC VIEW software. A total of 996 adults were surveyed by
phone and 452 were successfully geocoded. RESULTS: The sample was 71% female, 79%
Hispanic, 42 +/- 17 years old, moderately acculturated, and had socioeconomic status (SES)
levels of semi-skilled workers. Increasing BMI was related to less moderate intensity physical
activity (P = 0.05), higher SES (P = 0.0003), worse overall health (P = 0.0004), and living in areas
with greater land-use mix (less residential; P = 0.03). The relationship between overall health and
BMI was in part mediated by higher numbers of barriers to physical activity in those with poor
health, which lead to a decrease in moderate physical activity. These variables explained 20% of
the variance in BMI. CONCLUSIONS: This is one of the first studies to find a positive relationship
between land-use mix and BMI in a predominantly Hispanic, low-income community. The positive
association between BMI and land-use mix may be due to the inclusion of individual SES as a
controlling variable in the analyses, suggesting that SES may have a differential effect on how the
built environment influences BMI in low- to moderate-income minority communities.
Rutt, C. D. and K. J. Coleman (2005). "The impact of the built environment on walking as a
leisure-time activity along the U.S./Mexico border." Journal of Physical Activity and Health 2(3):
257-271.
This study examined if the environmental variables related to transportation walking were
related to leisure-time walking. Methods: The sample (N = 452) was 71% female, 79% Hispanic,
age 42 ± 17 y, and moder-ately acculturated. The data was analyzed with multiple stepwise
regression. Results: For the entire sample, total time spent walking was related to higher
socioeconomic status (SES) (P = 0.02; R2 = 0.06), walking frequency was related to fewer
barriers (P = 0.03; R2 = 0.07), and walking duration was related to higher SES (P = 0.02), better
health (P = 0.40), fewer barriers (P = 0.02), and living in a residential area (P = 0.04; R2 = 0.08).
Among regular walkers, total time spent walking was related to older age (P = 0.03) and fewer
physi-cal activity facilities (P = 0.04; R2 = 0.11). Walking frequency was related to older age (P =
0.02), fewer facilities (P = 0.04), and living in a commercial neighborhood (P = 0.02; R2 = 0.11).
Conclusions: Most of the variables that influence transportation walking were not related to
leisure-time walking. Land use had differential impacts on walking depending on the sample
examined.
Sallis, J. F., R. Cervero, et al. (2005). "An Ecological Approach to Creating Active Living
Communities." Annual Review of Public Health.
The thesis of this article is that multilevel interventions based on ecological models and
targeting individuals, social environments, physical environments, and policies must be
implemented to achieve population change in physical activity. A model is proposed that identifies
potential environmental and policy influences on four domains of active living: recreation,
transport, occupation, and household. Multilevel research and interventions require multiple
disciplines to combine concepts and methods to create new transdisciplinary approaches. The
contributions being made by a broad range of disciplines are summarized. Research to date
supports a conclusion that there are multiple levels of influence on physical activity, and the
active living domains are associated with different environmental variables. Continued research is
needed to provide detailed findings that can inform improved designs of communities,
transportation systems, and recreation facilities. Collaborations with policy researchers may
improve the likelihood of translating research findings into changes in environments, policies, and
practices. Expected online publication date for the Annual Review of Public Health Volume 27 is
March 17, 2006. Please see http://www.annualreviews.org/catalog/pubdates.asp for revised
estimates.
Sallis, J. F., L. Linton, et al. (2005). "The first Active Living Research Conference: growth of a
transdisciplinary field." American Journal of Preventive Medicine 28(2 Suppl 2): 93-5.
Salmon, J., A. Timperio, et al. (2005). "Association of family environment with children's television
viewing and with low level of physical activity." Obesity Research 13(11): 1939-1951.
Objective: This study examined associations between the family environment and
children's television (TV) viewing and likelihood of being low-active. Research Methods and
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Active Living Research Literature Summary 2004 & 2005
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Procedures: In 2001, children were recruited from 19 primary schools in Melbourne, Australia.
Parents completed a questionnaire about their child's TV viewing and the family environment.
Children also completed a questionnaire and wore an accelerometer for 8 days. Movement
counts were used to identify low-active children (lowest quartile). Data were analyzed in May
2004. Results: The sample consisted of 878 children (mean age = 11.5 +/- 0.6 yrs). Multiple
logistic regression revealed that socioeconomic status [adjusted odds ratios (AOR) = 0.4 boys],
frequency families watched TV together (AOR = 2.0 boys), mothers' (AOR = 1.8 boys; AOR = 2.5
girls) and fathers' (AOR = 2.6 boys; AOR = 2.8 girls) TV viewing, and rules prohibiting TV during
mealtimes (AOR 0.6 boys; AOR = 0.6 girls) related to children watching TV >= 2 h/d. Variables
associated with low-level physical activity included self-reported enjoyment of Internet use (AOR
= 1.7 boys) and preference for watching TV (AOR = 2.3 Girls), perception that mother uses
computer a lot (AOR = 1.9 boys) and likes using the computer (AOR = 0.6 Girls), fathers' reported
computer/electronic games use (AOR = 1.7 girls), frequency families used computer together
(AOR = 0.4 girls), rules that TV viewing must be supervised (AOR = 1.9 boys; AOR = 0.6 girls),
and having pay TV (AOR 0.6 boys) and electronic games at home (AOR = 2.6 boys). Discussion:
These findings suggest that the relationships between the family environment and TV viewing
and low-level activity are complex and that these behaviors are distinct.
Schilling, J. and L. S. Linton (2005). "The public health roots of zoning: in search of active living's
legal genealogy." American Journal of Preventive Medicine 28(2 Suppl 2): 96-104.
BACKGROUND: Improvements in the built environment and changes in land-use policy
are promising approaches to increasing physical activity among a largely sedentary population.
Opportunities for walking and cycling as part of daily life are important to increasing physical
activity and improving health. Yet, local zoning codes and related land-use regulations have
made it difficult to create vibrant, mixed-use neighborhoods with well-connected streets and more
compact development-the infrastructure necessary to support healthier rates of walking and
cycling for transportation. METHODS: To better understand the dynamic nature of land-use law
and policy, and how policymakers might accomplish zoning reform to encourage more physically
active environments, this paper traces the public health roots of zoning through a family tree of
land-use legal doctrines. RESULTS: Zoning and public health laws evolved from the same legal
ancestors-the common law of public nuisance and the expansion of state police powers, both
premised on protection of the public's health. When the U.S. Supreme Court approved zoning in
the 1926 case of Ambler Realty v. Village of Euclid, it nominally recognized the health basis of
zoning. But it went on to craft a new legal rationale focused more on protection of property rights
and residential neighborhoods. Since Euclid, court decisions have given little consideration to the
public health roots of zoning. Given an emerging body of research demonstrating the importance
of walking-friendly environments and the deference shown by the courts to the passage of zoning
laws, the courts are likely to support policymakers as they move to change zoning systems
conceived long ago. CONCLUSIONS: Legal, historical, and policy rationales support the
modernization of zoning and land use policies that allow sensible mixes of land uses. Mixed land
uses make walking an attractive alternative to driving and support a more physically active and
healthy citizenry.
Schofield, G., L. Schofield, et al. (2005). "Active transportation - an important part of adolescent
physical activity." Youth Studies Australia 24(1): 43-47.
The results of a cross-sectional study examining physical activity in a sample of
adolescent students (n=1033) in central Queensland, Australia, highlight the potential of
promoting active transportation as a means of increasing physical activity levels of adolescent
school goers. Overall, the results of the study paint a worrying picture about the physical activity
patterns of New Zealand youth. Only half of the sample was classified as moderately active. In
addition, at a time of the year in central Queensland when the weather conditions can be
regarded as ideal, the majority did not engage in active transportation on the afternoon surveyed.
On average, television watching and passive transport activities accounted for two hours of
afternoon time. The hypothesis that those engaging in active transportation would be more likely
to be physically active than those who do not engage in such transportation was supported.
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Active Living Research Literature Summary 2004 & 2005
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Schwanen, T. and P. L. Mokhtarian (2005). "What if you live in the wrong neighborhood? The
impact of residential neighborhood type dissonance on distance traveled." Transportation
Research Part D-Transport And Environment 10(2): 127-151.
While urban form in general and density in particular are believed by many to significantly
influence travel behavior, various recent studies have argued that the true determinants of travel
patterns are attitudes rather than land use characteristics. This research builds on this notion and
investigates to what extent a lack of congruence between physical neighborhood structure and
preferences regarding land use near one's home location (termed 'residential neighborhood type
dissonance' or mismatch) affect distance traveled overall and by mode. A conceptual model is
described in which the relationship between neighborhood type dissonance and distance traveled
is embedded in a wider set of individual and household choices, and tobit models of the influence
of neighborhood type mismatch are presented. The results suggest that neighborhood type
mismatch should be taken into account in future research as well as in policies attempting to
modify travel behavior through land use regulations. (c) 2004 Elsevier Ltd. All rights reserved.
Sidhu, S., A. Kaur, et al. (2005). "Prevalence of overweight and obesity among urban and rural
adult females of Punjab." Anthropologischer Anzeiger 63(3): 341-5.
The prevalence of overweight and obesity was assessed during a community based
epidemiological survey on a randomized sample of 1700 (900 urban and 800 rural) adult Punjabi
females in the age group from 20-45 years. For the assessment of overweight and obesity, height
and weight measurements were taken on each subject. The prevalence rate of malnutrition was
calculated according to the critical limits of body mass index (BMI). The observations show that
the combined overall prevalence rate of overweight/obesity in the present study is 43.88% and
22.26%, respectively, for urban and rural females. The frequency of overweight and obesity is
more among urban females than in their rural female counterparts.
Sirard, J. R., B. E. Ainsworth, et al. (2005). "Prevalence of active commuting at urban and
suburban elementary schools in Columbia, SC." American Journal of Public Health 95(2): 236-7.
We directly observed the prevalence of walking and bicycling (active commuting) to 8
randomly selected urban and suburban elementary schools. When school was used as the unit of
analysis, only 5.0% of the students actively commuted to or from school across all observed trips.
Active commuting was not affected (P >/=; 18) by school urbanization level, school
socioeconomic status, time of day, day of week, weather conditions, or temperature. These
results indicate a need for school- and community-based interventions.
Spangler-Murphy, E., D. A. Krummel, et al. (2005). "Environmental perceptions related to
physical activity in high- and low-risk counties." Health Promotion Practice 6(1): 57-63.
To identify whether perceptions about the physical activity environment were related to
the prevalence of sedentary lifestyle, residents from high-risk (n = 153) or low-risk (n = 100)
counties were interviewed. County risk status was determined by the prevalence of
cardiovascular mortality, overweight, and sedentary lifestyle. Key public officials in the same
counties were also interviewed. Residents in the low-risk county were more likely to report having
sidewalks in their community and that these sidewalks were safe and well lit than residents living
in the high-risk counties. Low-risk county residents also reported more indoor recreation facilities
being available than the residents in the high-risk counties. Residents supported allocating tax
dollars toward improving sidewalks, lighting, and so on. Thus a more conducive environment for
physical activity was found in the low-risk county. Improving physical environments and individual
perceptions could help increase physical activity behavior.
Steele, R. and C. Caperchione (2005). "The role of local government in physical activity:
employee perceptions." Health Promotion Practice 6(2): 214-218.
A key component in the promotion of health-related physical activity at the community
level is the formation of key partnerships with traditional and nontraditional providers of physical
activity. Local government, in particular, has a significant investment in the health and well-being
of the community through their contribution to the development of infrastructure and the built
environment. However, local government perceptions of how this investment, commitment, and
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Active Living Research Literature Summary 2004 & 2005
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partnership translate to the promotion of physical activity is less known. To identify the role and
perceptions of local government in the promotion of physical activity, a series of focus groups
were conducted within six key departments of the Rockhampton City Council. The findings show
that although physical activity is not considered the core business of local government, there was
a clear understanding of the role that local government has in the provision of facilities and
infrastructure that support that community's ability to be active. The focus groups identified
emerging patterns concerning physical infrastructure, liability and safety, responsibility within the
organizational structure, and community partnerships. These results inform physical activity
community initiatives and enhance future collaboration between the community and local
government in Rockhampton.
Stokols, D., R. Harvey, et al. (2005). "In vivo studies of transdisciplinary scientific collaboration
Lessons learned and implications for active living research." American Journal of Preventive
Medicine 28(2 Suppl 2): 202-13.
The past 2 decades have witnessed a surge of interest and investment in
transdisciplinary research teams and centers. Only recently, however, have efforts been made to
evaluate the collaborative processes and scientific and public policy outcomes of these
endeavors. This paper offers a conceptual framework for understanding and evaluating
transdisciplinary research, and describes a large-scale national initiative, the National Institutes of
Health Transdisciplinary Tobacco Use Research Centers (TTURCs) program, undertaken to
promote cross-disciplinary scientific collaboration in the field of tobacco use science and
prevention. A 5-year evaluation of collaborative processes and outcomes observed across
multiple TTURC centers conducted during 1999 to 2004 is described. The findings highlight key
contextual circumstances faced by participating centers (i.e., the breadth of disciplines and
departments represented by each center, the extent to which members had worked together on
prior projects, spatial proximity among researchers' offices, and frequency of their face-to-face
interaction) that influenced their readiness for collaboration and prompted them to follow different
pathways toward transdisciplinary integration. Implications of these findings for developing and
evaluating future transdisciplinary research initiatives in the field of active living research are
discussed.
Sturm, R. (2005). "Economics and physical activity: a research agenda." American Journal of
Preventive Medicine 28(2 Suppl 2): 141-9.
Both economic and public health/medical perspectives play an important role in the policy
process, but often approach policy questions in an incompatible way. Economics and public
health perspectives can complement each other, although harnessing any synergy requires an
understanding of the other perspective. This article contrasts the two perspectives and reviews
existing economic research in physical activity. Much effort has gone into producing cost-ofillness numbers or cost-offset claims with limited value from an economic perspective, although
some simple steps could make them more informative. A more notable advance for active living
research would be the adoption of standardized cost-effectiveness analysis methods, even just
as an add-on to ongoing intervention trials. Probably the most challenging and exciting area,
however, is the emerging research on the interaction between environmental incentives and
physical activity. An economic perspective with its explicit focus on market failures is an important
complement to ongoing active living research as policymakers in the United States are more
likely to rely on the market to solve policy problems than on regulation. It is imperative to
understand how the market works in actuality, not in the abstract, an area wide open for empirical
research.
Sturm, R. and A. Datar (2005). "Body mass index in elementary school children, metropolitan
area food prices and food outlet density." Public & Health 119(12): 1059-1068.
Objective: The aim of this study was to examine the association between food prices and
food outlet density and changes in the body mass index (BMI) among elementary school children
in the USA. Methods: The Early Childhood Longitudinal Study followed a nationally representative
sample of kindergarten children over 4 years. We merged individual-level data to (a) metropolitan
data on food prices and (b) per capita number of restaurants, grocery stores and convenience
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stores in the child's home and school zip code. The dependent variables were BMI changes over
1 and 3 years. We analysed mean changes with least-squares regression, and median changes
and 85th percentile changes with quantile regression. We controlled for baseline BMI, age, real
family income and sociodemographic characteristics. Results: Lower real prices for vegetables
and fruits were found to predict a significantly lower gain in BMI between kindergarten and third
grade; half of that effect was found between kindergarten and first grade. Lower meat prices had
the opposite effect, although this effect was generally smaller in magnitude and was insignificant
for BMI gain over 3 years. Differences across subgroups were not statistically significant due to
smaller sample sizes in subgroup analyses, but the estimated effects were meaningfully larger for
children in poverty, children already at risk for overweight or overweight in kindergarten, and
Asian and Hispanic children. There were no significant effects for dairy or fast-food prices, nor for
outlet density, once we had controlled for individual characteristics and random intercepts to
adjust standard errors for the sampling design. Discussion: The geographic variation in fruit and
vegetable prices is large enough to explain a meaningful amount of the differential gain in BMI
among elementary school children across metropolitan areas. However, as consumption
information was not available, we cannot confirm that this is the actual pathway. We found no
effects of food outlet density at the neighbourhood level, possibly because availability is not an
issue in metropolitan areas. (c) 2005 The Royal Institute of Public Health. Published by Elsevier
Ltd. All rights reserved.
Suminski, R. R., W. S. Poston, et al. (2005). "Features of the neighborhood environment and
walking by U.S. adults." American Journal of Preventive Medicine 28(2): 149-55.
BACKGROUND: Manipulating the physical environment may be an efficacious way to
promote physical activity. This study examined the relationships between features of the
neighborhood environment and walking in the neighborhood by U.S. adults. METHODS: A
random sample of women (n =266) and men (n =208) aged >18 years participated. Door-to-door
interviews were conducted in 2003 to collect information about demographics, walking behavior,
and features of the neighborhood environment. RESULTS: The analyses conducted in 2004
revealed that women were more likely to walk for exercise (odds ratio [OR]=4.6, 95% confidence
interval [CI]=1.01-20.72) or walk a dog (OR=3.3, 95% CI=1.01-11.08) in the neighborhood if
neighborhood safety was average as opposed to below average (p <0.05). Women with an
average number of neighborhood destinations were more likely to walk for transportation in the
neighborhood (OR=5.7, 95% CI=1.63-19.73) than women with a below average number of
neighborhood destinations (p <0.01). In men, none of the neighborhood features were
significantly associated with walking for exercise or walking a dog. Men were less likely to walk
for transportation in the neighborhood if the functional (OR=0.22, 95% CI=0.06-0.89) or aesthetic
(OR=0.17, 95% CI=0.03-0.89) features of the neighborhood were average versus below average.
CONCLUSIONS: Prospective studies are needed to determine if changes in neighborhood safety
and awareness of neighborhood destinations promote increases in walking by women.
Evaluations of the relationships between other environmental features and walking behavior in
men are warranted.
Thompson, A. M., L. A. Rehman, et al. (2005). "Factors influencing the physically active leisure of
children and youth: a qualitative study." Leisure Sciences 27(5): 421-438.
A phenomenological framework guided data collection and analysis of the prevalent
influences on attitudes and behaviours of elementary, junior, and secondary school students
towards their physically active leisure. Twenty-two students living in a rural town and community
in Nova Scotia (Canada) participated in individual in-depth interviews. Parental influence and
outdoor play effected choice and level of physically active leisure for elementary students.
Opportunities for organized and non-structured physically active leisure and friends were
significant for junior students. Academic responsibilities and organized physically active leisure
were influential for secondary students. Common threads were parental influence and the belief
that the students were too old to start new activities. These findings highlight the importance of
providing opportunities in safe environments for children and youth to participate in a variety of
structured and non-structured forms of physically active leisure.
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Titze, S., W. Stronegger, et al. (2005). "Prospective study of individual, social, and environmental
predictors of physical activity: women's leisure running." Psychology Of Sport And Exercise 6(3):
363-376.
Background: Understanding and influencing the determinants of physical activity is an
important public health challenge. We used prospective data to examine the influence of
individual, social, and environmental factors on physical activity behaviour, using regular running
as the behavioural model. Methods: Over 500 middle-aged women completed two consecutive
questionnaires in 2000 and 2002. Logistic regression analyses were used to examine factors
predicting adoption of and regression from regular leisure-time running during the follow-up.
Results: Women who frequently used behavioural change skills were more likely to adopt regular
running (OR=4.0, CI=1.7-9.5). There was an interaction between the enjoyment of running and
family support: those who rated enjoyment of running high and reported high family support were
less likely to adopt running (OR= 0.2, CI = 0.1-0.5). Women who reported infrequent use of
motives were more likely (OR = 3.3, CI = 1.6-6.9) to regress from regular running. There was an
interaction between perceived health and the neighbourhood environment: those who perceived
themselves to be in poor health and had an unattractive neighbourhood were more likely (OR =
2.7, CI = 0.9-8.3) to regress from regular running. Conclusions: Behavioural skills and enjoyment
may be of particular importance for the adoption of regular activity; social support and an
aesthetically attractive neighbourhood are likely to have a key role in encouraging maintenance.
(c) 2004 Elsevier Ltd. All rights reserved.
Treuth, M. S., N. Hou, et al. (2005). "Accelerometry-measured activity or sedentary time and
overweight in rural boys and girls." Obesity Research 13(9): 1606-14.
OBJECTIVE: The aim of this study was to examine the association between overweight
and physical activity or sedentary time measured by accelerometry in rural boys and girls 7 to 19
years old. RESEARCH METHODS AND PROCEDURES: A cross-sectional study was conducted
involving 130 girls and 99 boys in elementary, middle, and high school in rural Maryland. After
weight, height, and body composition were measured, children wore an Actiwatch accelerometer
for 6 days. Comparisons for activity counts were made between normal and overweight or at risk
for overweight (at-risk/overweight) participants (>or=85th percentile of BMI). The associations
between body composition and accelerometry-defined activity levels (sedentary, light, moderate,
and vigorous) were analyzed by age group for boys and girls. RESULTS: Differences in total
activity in counts per day or counts per minute were not observed between normal and atrisk/overweight boys or girls in all age groups. No associations between measures of body
composition and time spent in an activity level were seen in boys. Fat mass and percentage fat
were positively correlated to time spent in sedentary activity (range r = 0.42 to 0.54, all p < 0.01)
for girls. In contrast, fat mass and percentage fat were negatively related to time spent in light
activity (range, r = -0.40 to -0.51, p < 0.05) for girls. DISCUSSION: In girls, but not boys, greater
body fat is associated with greater time spent being inactive, and lower levels of body fat are
associated with more time spent in light activity. Physical activity interventions targeting inactive
children in rural communities are warranted.
Troped, P. J., R. P. Saunders, et al. (2005). "Comparisons between rail-trail users and nonusers
and men and women's patterns of use in a suburban community." Journal of Physical Activity and
Health 2(2): 169-180.
Background: Physical activity research on trails is limited. We compared rail-trail users
and nonusers on demographics, physical activity, and barriers/concerns about trail use; and
described use among men and women. Methods: Four hundred thirteen adults completed a
physical activity survey during fall 1998. Chi-square statistics and t-tests were used to compare
trail users to nonusers, and men and women on trail use. Results: More trail users (79%)
performed recreational physical activity ³ 3 d/wk, compared to nonusers (47%). Walking was the
most common activity for trail users and nonusers. Both groups shared concerns about safe
access to the trail and certain trail conditions. A higher percentage of female versus male users
traveled to the trail by walking, walked on the trail, used the trail with a friend, and perceived that
if the trail were not available their activity would decrease. Conclusions: Trail users perform more
recreational physical activity than nonusers. Gender differences in trail use patterns should be
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Active Living Research Literature Summary 2004 & 2005
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considered in the design and promotion of trails.
Tsai, E. H. L. (2005). "A cross-cultural study of the influence of perceived positive outcomes on
participation in regular active recreation: Hong Kong and Australian university students." Leisure
Sciences 27(5): 385-404.
This study examined the ways that perceptions of positive outcomes of engagement in
regular active recreation influence engagement interest, engagement intentions and subsequent
engagement in regular active recreation in the two contrasting cultures of Hong Kong and
Australia. A total of 927 Hong Kong and 1,018 Australian university students completed survey
questionnaires. Findings from the study indicated that having an interest in the activities was an
important condition that led to enduring engagement in active recreation. Beliefs about
physiological benefits of active recreation had no significant impact on young people's
engagement interest, intention, and actual engagement. Perception of affective outcomes was an
important motivator for Australian but not for Hong Kong students. Perceptions of psychological
outcomes was an important predictor only for Hong Kong students. The findings suggested that
cultural values and social, physical, and leisure environments could moderate the cognitive
processes that underlie engagement in regular active recreation.
Tsimeas, P. D., A. L. Tsiokanos, et al. (2005). "Does living in urban or rural settings affect
aspects of physical fitness in children? An allometric approach." British Journal Of Sports
Medicine 39(9): 671-674.
Objective: The aim of this study was to investigate physical fitness in relation to fatness in
urban and rural Greek children by means of allometric scaling. Methods: The sample consisted of
360 (189 urban and 171 rural; age 12.3 +/- 0.42 years) boys and 247 (125 urban and 122 rural;
age 12.3 +/- 0.43 years) girls. The sample was highly representative (32 - 64%) of all 12 year old
children registered in the prefecture of Trikala, Greece. All volunteers were assessed for BMI and
% body fat, as well as sit and reach, basketball throw (BT), vertical jump (VJ), handgrip strength
(HG), 40 m sprint, agility run, and 20 m shuttle run. To correct for possible associations between
fatness and fitness, a single cause allometric scaling was employed using the natural logarithms
(ln) of fitness parameters that were significantly correlated with the ln body fat. Results:
Independent-samples t tests revealed that VJ (p< 0.05) was significantly higher in boys living in
urban settings compared to their rural counterparts. Similarly, BT was found to be significantly
better (p< 0.05) in urban girls, whereas HG was significantly higher (p< 0.05) in rural girls.
Conclusion: Considering that (a) only three out of the 14 possible cases (seven fitness
parameters for boys and seven for girls) were significantly different between urban and rural
children, and (b) these differences were not uniformly distributed in children living in either urban
or rural environments, it is concluded that the place of residence has no clear impact on physical
fitness as studied herein.
Ulijaszek, S. J., S. Koziel, et al. (2005). "Village distance from urban centre as the prime
modernization variable in differences in blood pressure and body mass index of adults of the
Purari delta of the Gulf Province, Papua New Guinea." Annals of Human Biology 32(3): 326-38.
OBJECTIVE: The study examined the extent to which the geographical proximity of
villages to an urban centre and other modernization variables are associated with variation in
blood pressure and body mass index (BMI) of adults of the Purari delta of the Gulf Province,
Papua New Guinea (PNG). METHODS: Mean BMI, systolic blood pressure (SBP) and diastolic
blood pressure (DBP) of 292 adults surveyed in 1995-1997 in the Purari delta, PNG, are reported
by village of residence, and related to modernization variables, including village of residence,
urban life, urban connectedness, economic status and education. RESULTS: Mean BMI, SBP
and DBP differ according to village of residence, there being a gradient in mean blood pressure
from highest in the village closest to the urban centre, Baimuru, and lowest in the village most
distant from it. The gradients in these variables across the three villages are not due to
differences in age structures between the villages. Place of residence, which represents the
distance from town, has the greatest impact on the BMI of males, while among the females, the
number of relatives living in urban centres had a significant effect on BMI. For both males and
females, place of residence has the strongest effect on SBP. While for the males, place of
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residence is the only significant factor associated with SBP, for the females, SBP is also
associated with BMI, level of income and to a lesser extent with age. Very similar results were
obtained for DBP. CONCLUSIONS: Distance to urban centre appears to have a strong effect,
relative to other modernization variables, on BMI and blood pressure, this effect being far
stronger for males than for females. In large part, this effect operates by way of differences in
number of sources of income as well as number of close relatives of women who are resident in
an urban centre. Reasons for the male-female differences observed may include gender
differences in degree of mobility, and possibly greater physical sensitivity of males to the
environment than females. Traditionally, there have been clear divisions of labour between males
and females, the latter spending longer in subsistence activities than the former. It is speculated
that males have more free time to travel to town should they wish, while women may travel to
town to take produce to market, and be limited by how much time they spend in town when they
are there, by the need to return to carry out household and subsistence tasks. It may also be that
young adult males are more susceptible to modernization, in that they exhibit a greater degree of
non-conformity than young women, and may be more favourably disposed to adopt aspects of
western lifestyle.
van Lenthe, F. J., J. Brug, et al. (2005). "Neighbourhood inequalities in physical inactivity: the role
of neighbourhood attractiveness, proximity to local facilities and safety in the Netherlands." Social
Science & Medicine 60(4): 763-775.
We investigated the association between the neighbourhood socioeconomic environment
and physical inactivity. and explored the contribution of neighbourhood characteristics to this
association. Data were analysed of 20-69 year's old participants of the Dutch GLOBE study who
lived in 78 neighbourhoods of Eindhoven (n = 8.767). The neighbourhood socioeconomic
environment was assessed from aggregated self-reported information of participants' education
and occupation level, and employment status. Aspects of physical inactivity investigated were
based on the time spent on (a) walking and cycling to shops or work, (b) walking, cycling and
gardening in leisure time, and (c) participation in sports activities. Characteristics of
neighbourhoods included the proximity to food shops. general physical design of
neighbourhoods, quality of green facilities, noise pollution from traffic and required police
attention as evaluated by municipal services (professionals) responsible for these characteristics.
Compared to those living in the most advantaged neighbourhoods. residents living in the quartile
of economically most disadvantaged neighbourhoods were more likely to walk or cycle to shops
or work, but less likely to walk, cycle or garden in leisure time and less likely to participate in
sports activities (adjusted for age. sex and individual educational level). Neighbourhood
inequalities in walking or cycling to shops or work were not mediated by specific neighbourhood
characteristics included in our analyses. The increased probability of almost never walking,
cycling and gardening in leisure time in the most disadvantaged neighbourhoods was partly
mediated by a poorer general physical design in these neighbourhoods. Similarly, the increased
probability of almost never participating in sports activities in the most disadvantaged
neighbourhoods was partly mediated by larger amounts of required police attention. The direction
of neighbourhood inequalities differs for aspects of physical inactivity. Neighbourhood
characteristics are related to physical inactivity and contribute to neighbourhood socioeconomic
inequalities in physical inactivity. (C) 2004 Elsevier Ltd. All rights reserved.
Vernez Moudon, A. (2005). "Active living research and the urban design, planning, and
transportation disciplines." American Journal of Preventive Medicine 28(2 Suppl 2): 214-5.
Vest, J. and A. Valadez (2005). "Perceptions of neighborhood characteristics and leisure-time
physical inactivity - Austin/Travis County, Texas, 2004." Morbidity and Mortality Weekly Report
54(37): 926-928.
During 2004, to assess the association between perceived neighbourhood characteristics
and leisure-time physical inactivity in eastern Travis County, Texas, USA, the local health
department collected and analysed data by using the methodology of the Behavioral Risk Factor
Surveillance System. This report describes the results of that analysis, which indicated that
persons who perceived their neighbourhoods as less than extremely safe were more than twice
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Active Living Research Literature Summary 2004 & 2005
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as likely to have no leisure-time physical activity, and those who perceived their neighbourhoods
as not at all safe were nearly 3 times as likely to have no leisure-time physical activity. Public
health agencies promoting physical activity in neighbourhoods should consider how residents
perceive their safety and design programmes that specifically address those safety concerns.
Wang, G., C. A. Macera, et al. (2005). "A cost-benefit analysis of physical activity using
bike/pedestrian trails." Health Promotion Practice 6(2): 174-9.
From a public health perspective, a cost-benefit analysis of using bike/pedestrian trails in
Lincoln, Nebraska, to reduce health care costs associated with inactivity was conducted. Data
was obtained from the city's 1998 Recreational Trails Census Report and the literature. Per
capita annual cost of using the trails was 209.28 U.S. dollars (59.28 U.S. dollars construction and
maintenance, 150 U.S. dollars of equipment and travel). Per capita annual direct medical benefit
of using the trails was 564.41 U.S. dollars. The cost-benefit ratio was 2.94, which means that
every 1 U.S. dollar investment in trails for physical activity led to 2.94 U.S. dollars in direct
medical benefit. The sensitivity analyses indicated the ratios ranged from 1.65 to 13.40.
Therefore, building trails is cost beneficial from a public health perspective. The most sensitive
parameter affecting the cost-benefit ratios were equipment and travel costs; however, even for
the highest cost, every 1 U.S. dollar investment in trails resulted in a greater return in direct
medical benefit.
Wilcox, S., L. Oberrecht, et al. (2005). "A qualitative study of exercise in older African American
and white women in rural South Carolina: Perceptions, barriers, and motivations." Journal Of
Women & Aging 17(1-2): 37-53.
Six focus groups were conducted with underactive African American (n = 16) and white
(n = 23) women aged 50 years and older, residing in a nonmetropolitan county in South Carolina,
to examine perceptions, barriers, and motivators related to exercise. Transcripts were coded and
codes were entered into NUD*IST to assist with organizing and reporting themes. Participants
could not reach consensus on the frequency, intensity, and duration of exercise needed for older
women, and emphasized that PA recommendations should consider age, health, and physical
abilities. While benefits and barriers to exercise were similar to those found in other groups, the
risk of "overdoing it," being "too old," and environmental barriers specific to rurality were unique.
Exercise enablers were also similar to those found in other groups, but rural women discussed
the role that the church played in supporting exercise. Other enablers included transportation,
free facilities, and age-appropriate programs. Results indicate the need to tailor recommendations
and advice to older women, and to consider the rural context in which they live. (c) 2005 by The
Haworth Press, Inc. All rights reserved.
Williams, J. E., M. Evans, et al. (2005). "Development and use of a tool for assessing sidewalk
maintenance as an environmental support of physical activity." Health Promotion Practice 6(1):
81-8.
The importance of regular physical activity is well documented, yet according to
epidemiological surveillance data, physical inactivity among all age groups persists. Past
attempts to promote physical activity focused on individual-level changes; current approaches
focus on environmental changes that will provide opportunities for whole communities to be
active. The current ecological focus has led to an increase in funding and research regarding
environmental supports of physical activity. As this is a new area of research, much work needs
to be done to improve the ability to assess environmental features that support physical activity.
This article describes a partnership between researchers and community members to develop
and test an objective tool to measure sidewalk maintenance. Community members used data
collected with the tool to increase awareness about sidewalk maintenance issues among local
policy makers. Collaboration between researchers and community partners was critical for the
success of this study.
Xu, F., X. M. Yin, et al. (2005). "Family average income and body mass index above the healthy
weight range among urban and rural residents in regional Mainland China." Public Health
Nutrition 8(1): 47-51.
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Active Living Research Literature Summary 2004 & 2005
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OBJECTIVE: To explore the relationship between family average income (FAI; an index
of socio-economic status) and body mass index (BMI; a widely used, inexpensive indicator of
weight status) above the healthy weight range in a region of Mainland China. DESIGN:
Population-based cross-sectional study, conducted between October 1999 and March 2000 on a
sample of regular local residents aged 35 years or older who were selected by random cluster
sampling. SETTING: Forty-five administrative villages selected from three urban districts and two
rural counties of Nanjing municipality, Mainland China, with a regional population of 5.6 million.
SUBJECTS: In total, 29,340 subjects participated; 67.7% from urban and 32.3% from rural areas;
49.8% male and 50.2% female. The response rate among eligible participants was 90.1%.
RESULTS: The proportion of participants classified as overweight was 30.5%, while 7.8% were
identified as obese. After adjusting for possible confounding variables (age, gender, area of
residence, educational level, occupational and leisure-time physical activity, daily vegetable
consumption and frequency of red meat intake), urban participants were more likely to be
overweight or obese relative to their rural counterparts, more women than men were obese, and
participants in the lowest FAI tertile were the least likely to be above the healthy weight range.
CONCLUSIONS: The proportion of adults with BMI above the healthy weight range was positively
related to having a higher socio-economic status (indexed by FAI) in a regional Chinese
population.
Yamauchi, T. and M. Umezaki (2005). "Rural-urban migration and changing physical activity
among Papua New Guinea highlanders from the perspective of energy expenditure and time
use." Environmental Science 12(3): 155-66.
We examined the effects of rural-urban migration on nutritional status, daily activity
patterns and physical activity levels for a Papua New Guinea Highland population. A large sample
(n = 353) of adult males and females was selected for anthropometry and a smaller sample (n =
56) for behavioral observation in conjunction with heart rate monitoring. Urban migrants had
higher body mass index and more body fat than their rural counterparts, particularly the females.
The physical exertion index calculated for observed activities using heart rate values was much
higher in farming activities in the rural area than in sedentary work activities in the urban area. In
addition, walking time was notably shorter in the urban group than in the rural group (118 vs 52
min/day in males and 116 vs 29 min/day in females). Consequently, despite the urban group
spending a shorter time resting and a longer time working, their daily physical activity level did not
achieve the desirable level (1.75-1.80). It is thus necessary for urban residents to increase
walking time to about 2 h per day, the level observed in their rural counterparts.
Yin, Z., J. Hanes, Jr., et al. (2005). "An after-school physical activity program for obesity
prevention in children: the Medical College of Georgia FitKid Project." Evaluation and the Health
Professions 28(1): 67-89.
This article describes the process of setting up a 3-year, school-based after-school
physical activity intervention in elementary schools. The primary aim of the study is to determine
whether adiposity and fitness will improve in children who are exposed to a fitogenic versus an
obesogenic environment. Eighteen schools were randomized to the control (obesogenic) or
intervention (fitogenic) group. The study design, program components, and evaluation of the
intervention are described in detail. The intervention consists of (a) academic enrichment, (b) a
healthy snack, and (c) physical activity in a mastery-oriented environment. Successful
implementation would show the feasibility of schools' being able to provide a fitogenic
environment. Significant differences between the groups would provide evidence that a fitogenic
environment after school has positive health benefits. If feasibility and efficacy are demonstrated,
implementing an after-school program like this one in elementary schools could play a major role
in preventing and reducing childhood obesity.
Zhang, M. (2005). "Exploring the relationship between urban form and nonwork travel through
time use analysis." Landscape And Urban Planning 73(2-3): 244-261.
Zimring, C., A. Joseph, et al. (2005). "Influences of building design and site design on physical
activity: research and intervention opportunities." American Journal of Preventive Medicine 28(2
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Active Living Research Literature Summary 2004 & 2005
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Suppl 2): 186-93.
Americans spend much of their days in buildings, yet relatively little is known about how
the design of buildings or their site influences physical activity. Although some evidence suggests
that using specific features of buildings and their immediate surroundings such as stairs can have
a meaningful impact on health, the influences of the physical environment on physical activity at
the building and site scale are not yet clear. While there is some research suggesting that people
will be more active in buildings that have visible, accessible, pleasing, and supportive features,
such as motivational point-of-decision prompts and well-designed stairs, there is only limited
evidence to support that assertion. This paper reviews the available evidence linking design and
site decisions to physical activity, and suggests a framework for connecting research and
implementation strategies for creating activity-friendly buildings. In consideration of the kinds of
physical activities associated with buildings and their sites, it is proposed that the form of
buildings and sites affect physical activity at several spatial scales: the selection and design of
sites with respect to a building's location on its site and within its immediate community and the
provision and layout of site amenities; building design such as the programming, layout, and form
of the building; and building element design such as the design and layout of elements such as
stairs or exercise rooms. The paper concludes with an overview of opportunities for research and
intervention strategies within the building industry, focusing on public buildings, which provide
numerous high-leverage opportunities for linking research and implementation.
Zlot, A. I. and T. L. Schmid (2005). "Relationships among community characteristics and walking
and bicycling for transportation or recreation." American Journal Of Health Promotion 19(4): 314317.
Purpose. Compare walking and bicycling for transportation and recreation with the
percentage of the community devoted to parklands. Methods. Behavioral Risk Factor Surveillance
System (N = 206,992), Nationwide Personal Transportation Survey (N = 409,025), and Trust for
Public Land (N = 55) data were used to estimate recreational walking and bicycling, utilitarian
walking and bicycling, and parkland as a percentage of city acreage. Data were linked at the
metropolitan statistical area or city level (N = 34). Pearson correlation coefficients were used to
assess the associations among recreational and utilitarian walking and bicycling and parkland
acreage. Results. Utilitarian walking and bicycling and parkland acreage were significantly
correlated (r =.62, p <.0001). No significant relationships were observed for leisure time walking
or bicycling. Discussion. Communities with more parks had significantly higher levels of walking
and bicycling for transportation. Urban design features associated with leisure time physical
activity might differ from those associated with transportation-related physical activity. Further
studies are needed to articulate the relationships among community attributes and purposes of
physical activity.
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