Neighborhood walkability and the walking behavior of Australian adults
TL;DR: The physical environment attributes that make up the walkability index are potentially important candidate factors for future environmental and policy initiatives designed to increase physical activity.
About: This article is published in American Journal of Preventive Medicine.The article was published on 2007-11-01. It has received 556 citations till now. The article focuses on the topics: Walkability & Poison control.
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TL;DR: The built environment was more likely to be associated with transportation walking compared with other types of physical activity including recreational walking, and three studies found an attenuation in associations between built environment characteristics and physical activity after accounting for neighborhood self-selection.
Abstract: Empirical evidence suggests that an association between the built environment and physical activity exists. This evidence is mostly derived from cross-sectional studies that do not account for other causal explanations such as neighborhood self-selection. Experimental and quasi-experimental designs can be used to isolate the effect of the built environment on physical activity, but in their absence, statistical techniques that adjust for neighborhood self-selection can be used with cross-sectional data. Previous reviews examining the built environment-physical activity relationship have not differentiated among findings based on study design. To deal with self-selection, we synthesized evidence regarding the relationship between objective measures of the built environment and physical activity by including in our review: 1) cross-sectional studies that adjust for neighborhood self-selection and 2) quasi-experiments. In September 2010, we searched for English-language studies on built environments and physical activity from all available years in health, leisure, transportation, social sciences, and geographical databases. Twenty cross-sectional and 13 quasi-experimental studies published between 1996 and 2010 were included in the review. Most associations between the built environment and physical activity were in the expected direction or null. Land use mix, connectivity and population density and overall neighborhood design were however, important determinants of physical activity. The built environment was more likely to be associated with transportation walking compared with other types of physical activity including recreational walking. Three studies found an attenuation in associations between built environment characteristics and physical activity after accounting for neighborhood self-selection. More quasi-experiments that examine a broader range of environmental attributes in relation to context-specific physical activity and that measure changes in the built environment, neighborhood preferences and their effect on physical activity are needed.
738 citations
Cites background or methods from "Neighborhood walkability and the wa..."
...Less than half of studies presented supporting evidence for the reliability or validity of their physical activity data collection method [29,33,34,36-42,45,54,55]....
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...The majority of studies were undertaken in the U.S. (n = 29), with one study being conducted each in Canada [28], Australia [29], U.K. [30], and Holland [31] (Additional file 1)....
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...[29] found that neighborhood walkability was associated with more frequent transportation walking among respondents who reported desire for nearby shops and services as important reasons for moving to their current neighborhood....
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...Western Australian Planning Commission: Livable Neighbourhoods....
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...A Western Australian Government Sustainable Cities Initiative....
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TL;DR: Perceived neighbourhood greenness was more strongly associated with mental health than it was with physical health, whereas the relationship between greenness and mental health was only partly accounted for by recreational walking and social coherence.
Abstract: Background: Studies have shown associations between health indices and access to “green” environments but the underlying mechanisms of this association are not clear. Objectives: To examine associations of perceived neighbourhood “greenness” with perceived physical and mental health and to investigate whether walking and social factors account for the relationships. Methods: A mailed survey collected the following data from adults (n = 1895) in Adelaide, Australia: physical and mental health scores (12-item short-form health survey); perceived neighbourhood greenness; walking for recreation and for transport; social coherence; local social interaction and sociodemographic variables. Results: After adjusting for sociodemographic variables, those who perceived their neighbourhood as highly green had 1.37 and 1.60 times higher odds of better physical and mental health, respectively, compared with those who perceived the lowest greenness. Perceived greenness was also correlated with recreational walking and social factors. When walking for recreation and social factors were added to the regression models, recreational walking was a significant predictor of physical health; however, the association between greenness and physical health became non-significant. Recreational walking and social coherence were associated with mental health and the relationship between greenness and mental health remained significant. Conclusions: Perceived neighbourhood greenness was more strongly associated with mental health than it was with physical health. Recreational walking seemed to explain the link between greenness and physical health, whereas the relationship between greenness and mental health was only partly accounted for by recreational walking and social coherence. The restorative effects of natural environments may be involved in the residual association of this latter relationship.
680 citations
Cites methods from "Neighborhood walkability and the wa..."
...Detailed methods of recruitment have been described elsewhere.(25) A spatially based sampling methodology using a household as a sampling unit (rather than individuals) was used to recruit study participants from neighbourhoods with a range of variation in their environmental attributes....
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TL;DR: It was concluded that living in walkable neighborhoods was associated with more physical activity and lower overweight/obesity but not with other benefits, and lower- and higher-income groups benefited similarly from living in high-walkability neighborhoods.
626 citations
Additional excerpts
..., 2008; Frank, Kerr, & Sallis, 2007; Frank, Saelens, Powell, & Chapman, 2007), including studies in Australia (Cerin, Leslie, DuToit, Owen, & Frank, 2007; Leslie et al., 2007; Owen et al., 2007) and studies of youth (Kerr et al....
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...More importantly, use of the walkability index is supported by at least 12 published papers showing the same or similar indexes have been significant positive correlates of walking and physical activity (Frank, Andresen, & Schmid, 2004; Frank, Schmid, Sallis, Chapman, & Saelens, 2005; Frank et al., 2006; Frank et al., 2008; Frank, Kerr, & Sallis, 2007; Frank, Saelens, Powell, & Chapman, 2007), including studies in Australia (Cerin, Leslie, DuToit, Owen, & Frank, 2007; Leslie et al., 2007; Owen et al., 2007) and studies of youth (Kerr et al., 2006; Kerr, Frank, Sallis, & Chapman, 2007; Kligerman, Sallis, Ryan, Frank, & Nader, 2007)....
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...…Sallis, 2007; Frank, Saelens, Powell, & Chapman, 2007), including studies in Australia (Cerin, Leslie, DuToit, Owen, & Frank, 2007; Leslie et al., 2007; Owen et al., 2007) and studies of youth (Kerr et al., 2006; Kerr, Frank, Sallis, & Chapman, 2007; Kligerman, Sallis, Ryan, Frank, & Nader, 2007)....
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TL;DR: Physical activity is beneficial to health with or without weight loss, but adults who find it difficult to maintain a normal weight should probably be encouraged to reduce energy intake and minimize time spent in sedentary behaviours to prevent further weight gain.
Abstract: Our understanding of the relationship between physical activity and health is constantly evolving. Therefore, the British Association of Sport and Exercise Sciences convened a panel of experts to review the literature and produce guidelines that health professionals might use. In the ABC of Physical Activity for Health, A is for All healthy adults, B is for Beginners, and C is for Conditioned individuals. All healthy adults aged 18-65 years should aim to take part in at least 150 min of moderate-intensity aerobic activity each week, or at least 75 min of vigorous-intensity aerobic activity per week, or equivalent combinations of moderate- and vigorous-intensity activities. Moderate-intensity activities are those in which heart rate and breathing are raised, but it is possible to speak comfortably. Vigorous-intensity activities are those in which heart rate is higher, breathing is heavier, and conversation is harder. Aerobic activities should be undertaken in bouts of at least 10 min and, ideally, should be performed on five or more days a week. All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence. Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults. Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends. Conditioned individuals who have met the physical activity levels recommended for all healthy adults for at least 6 months may obtain additional health benefits by engaging in 300 min or more of moderate-intensity aerobic activity per week, or 150 min or more of vigorous-intensity aerobic activity each week, or equivalent combinations of moderate- and vigorous-intensity aerobic activities. Adults who find it difficult to maintain a normal weight and adults with increased risk of cardiovascular disease or type 2 diabetes may in particular benefit from going beyond the levels of activity recommended for all healthy adults and gradually progressing towards meeting the recommendations for conditioned individuals. Physical activity is beneficial to health with or without weight loss, but adults who find it difficult to maintain a normal weight should probably be encouraged to reduce energy intake and minimize time spent in sedentary behaviours to prevent further weight gain. Children and young people aged 5-16 years should accumulate at least 60 min of moderate-to-vigorous-intensity aerobic activity per day, including vigorous-intensity aerobic activities that improve bone density and muscle strength.
613 citations
Cites background from "Neighborhood walkability and the wa..."
...…walking, which appear to be related to a neighbourhood’s aesthetics (Owen et al., 2004) rather than its ‘‘walkability’’ (that is, neighbourhoods characterized by higher connectivity of street networks, the presence of mixed-use planning, and higher population density) (Owen et al., 2007)....
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..., 2004) rather than its ‘‘walkability’’ (that is, neighbourhoods characterized by higher connectivity of street networks, the presence of mixed-use planning, and higher population density) (Owen et al., 2007)....
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TL;DR: A systematic review of the literature concerning the relationship between the physical environment and PA in older adults found results were inconsistent but most of the studied environmental characteristics were reported not to be related to PA.
447 citations
References
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TL;DR: Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings.
Abstract: CRAIG, C. L., A. L. MARSHALL, M. SJOSTROM, A. E. BAUMAN, M. L. BOOTH, B. E. AINSWORTH, M. PRATT, U. EKELUND, A. YNGVE, J. F. SALLIS, and P. OJA. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Med. Sci. Sports Exerc., Vol. 35, No. 8, pp. 1381-1395, 2003. Background: Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Methods: Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Results: Overall, the IPAQ questionnaires produced repeatable data (Spearman's clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. Conclusions: The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment. Key Words: MEASUREMENT, SURVEILLANCE, EPIDEMIOLOGY
15,345 citations
Book•
01 Jan 1999
TL;DR: In this paper, the authors proposed a multilevel regression model to estimate within-and between-group correlations using a combination of within-group correlation and cross-group evidence.
Abstract: Preface second edition Preface to first edition Introduction Multilevel analysis Probability models This book Prerequisites Notation Multilevel Theories, Multi-Stage Sampling and Multilevel Models Dependence as a nuisance Dependence as an interesting phenomenon Macro-level, micro-level, and cross-level relations Glommary Statistical Treatment of Clustered Data Aggregation Disaggregation The intraclass correlation Within-group and between group variance Testing for group differences Design effects in two-stage samples Reliability of aggregated variables Within-and between group relations Regressions Correlations Estimation of within-and between-group correlations Combination of within-group evidence Glommary The Random Intercept Model Terminology and notation A regression model: fixed effects only Variable intercepts: fixed or random parameters? When to use random coefficient models Definition of the random intercept model More explanatory variables Within-and between-group regressions Parameter estimation 'Estimating' random group effects: posterior means Posterior confidence intervals Three-level random intercept models Glommary The Hierarchical Linear Model Random slopes Heteroscedasticity Do not force ?01 to be 0! Interpretation of random slope variances Explanation of random intercepts and slopes Cross-level interaction effects A general formulation of fixed and random parts Specification of random slope models Centering variables with random slopes? Estimation Three or more levels Glommary Testing and Model Specification Tests for fixed parameters Multiparameter tests for fixed effects Deviance tests More powerful tests for variance parameters Other tests for parameters in the random part Confidence intervals for parameters in the random part Model specification Working upward from level one Joint consideration of level-one and level-two variables Concluding remarks on model specification Glommary How Much Does the Model Explain? Explained variance Negative values of R2? Definition of the proportion of explained variance in two-level models Explained variance in three-level models Explained variance in models with random slopes Components of variance Random intercept models Random slope models Glommary Heteroscedasticity Heteroscedasticity at level one Linear variance functions Quadratic variance functions Heteroscedasticity at level two Glommary Missing Data General issues for missing data Implications for design Missing values of the dependent variable Full maximum likelihood Imputation The imputation method Putting together the multiple results Multiple imputations by chained equations Choice of the imputation model Glommary Assumptions of the Hierarchical Linear Model Assumptions of the hierarchical linear model Following the logic of the hierarchical linear model Include contextual effects Check whether variables have random effects Explained variance Specification of the fixed part Specification of the random part Testing for heteroscedasticity What to do in case of heteroscedasticity Inspection of level-one residuals Residuals at level two Influence of level-two units More general distributional assumptions Glommary Designing Multilevel Studies Some introductory notes on power Estimating a population mean Measurement of subjects Estimating association between variables Cross-level interaction effects Allocating treatment to groups or individuals Exploring the variance structure The intraclass correlation Variance parameters Glommary Other Methods and Models Bayesian inference Sandwich estimators for standard errors Latent class models Glommary Imperfect Hierarchies A two-level model with a crossed random factor Crossed random effects in three-level models Multiple membership models Multiple membership multiple classification models Glommary Survey Weights Model-based and design-based inference Descriptive and analytic use of surveys Two kinds of weights Choosing between model-based and design-based analysis Inclusion probabilities and two-level weights Exploring the informativeness of the sampling design Example: Metacognitive strategies as measured in the PISA study Sampling design Model-based analysis of data divided into parts Inclusion of weights in the model How to assign weights in multilevel models Appendix. Matrix expressions for the single-level estimators Glommary Longitudinal Data Fixed occasions The compound symmetry models Random slopes The fully multivariate model Multivariate regression analysis Explained variance Variable occasion designs Populations of curves Random functions Explaining the functions 27415.2.4 Changing covariates Autocorrelated residuals Glommary Multivariate Multilevel Models Why analyze multiple dependent variables simultaneously? The multivariate random intercept model Multivariate random slope models Glommary Discrete Dependent Variables Hierarchical generalized linear models Introduction to multilevel logistic regression Heterogeneous proportions The logit function: Log-odds The empty model The random intercept model Estimation Aggregation Further topics on multilevel logistic regression Random slope model Representation as a threshold model Residual intraclass correlation coefficient Explained variance Consequences of adding effects to the model Ordered categorical variables Multilevel event history analysis Multilevel Poisson regression Glommary Software Special software for multilevel modeling HLM MLwiN The MIXOR suite and SuperMix Modules in general-purpose software packages SAS procedures VARCOMP, MIXED, GLIMMIX, and NLMIXED R Stata SPSS, commands VARCOMP and MIXED Other multilevel software PinT Optimal Design MLPowSim Mplus Latent Gold REALCOM WinBUGS References Index
9,578 citations
7,710 citations
01 Jan 2008
TL;DR: There are evidence-based clinical practice guidelines for most major behavioral health risks, including tobacco use, unhealthy diet, sedentary lifestyle, risky drinking, and diabetes management and there are parallel research-based guidelines for the health care system changes and policies needed to assure their delivery and use.
Abstract: Health behavior change is our greatest hope for reducing the burden of preventable disease and death around the world. Tobacco use, sedentary lifestyle, unhealthy diet, and alcohol use together account for almost one million deaths each year in the United States alone. Smoking prevalence in the United States has dropped by half since the first Surgeon General’s Report on Smoking and Health was published in 1964, but tobacco use still causes over 400,000 premature deaths each year. The World Health Organization has warned that the worldwide spread of the tobacco epidemic could claim one billion lives by the end of this century. The rising prevalence of childhood obesity could place the United States at risk of raising the first generation of children to live sicker and die younger than their parents, and the spreading epidemic of obesity among children and adults threatens staggering global health and economic tolls. The four leading behavioral risks factors and a great many others (for example, nonadherence to prescribed medical screening and prevention and disease management practices, risky sexual practices, drug use, family and gun violence, worksite and motor vehicle injuries) take disproportionate tolls in low-income and disadvantaged racial and ethnic populations, as well as in low-resource communities across the world. Addressing these behavioral risks and disparities, and the behaviors related to global health threats, such as flu pandemics, water shortages, increasingly harmful sun exposure, and the need to protect the health of the planet itself, will be critical to world health in the twenty-first century. In the past two decades since the publication of the first edition of Health Education and Health Behavior: Theory, Research, and Practice in 1990, there has been extraordinary growth in our knowledge about interventions needed to change health behaviors at both individual and population levels. This progress can be measured in the proliferation of science-based recommendations issued by authoritative evidence review panels, including the U.S. Clinical Preventive Services Task Force, the Centers for Disease Prevention and Control Task Force on Community Preventive Services, and the international Cochrane Collaboration. Today, there are evidence-based clinical practice guidelines for most major behavioral health risks, including tobacco use, unhealthy diet, sedentary lifestyle, risky drinking, and diabetes management. And there are parallel research-based guidelines for the health care system changes and policies needed to assure their delivery and use. New community practice guidelines offer additional evidence-based recommendations for a wide array of population-level school-, worksite-, and community-based programs and public policies to improve vaccination rates and physical activity levels for children and adults, improve diabetes self-management, reduce harmful sun exposure, reduce secondhand smoke exposure, prevent youth tobacco use and help adult smokers quit, reduce workplace and motor vehicle injuries, and curb drunk driving and family and gun violence.
7,073 citations
Book•
30 Aug 2004
TL;DR: This report is the first report of the Surgeon General on physical activity and health, and strong evidence is shown to indicate that regular physical activity will provide clear and substantial health gains.
Abstract: : This report is the first report of the Surgeon General on physical activity and health. For more than a century, the Surgeon General of the Public Health Service has focused the nation's attention on important public health issues. Reports from Surgeons General on the adverse health consequences of smoking triggered nationwide efforts to prevent tobacco use. Reports on nutrition, violence, and HIV/AlDS - to name but a few - have heightened America's awareness of important public health issues and have spawned major public health initiatives. This new report, which is a comprehensive review of the available scientific evidence about the relationship between physical activity and health status, follows in this notable tradition. Scientists and doctors have known for years that substantial benefits can be gained from regular physical activity. The expanding and strengthening evidence on the relationship between physical activity and health necessitates the focus this report brings to this important public health challenge. Although the science of physical activity is a complex and still-developing field, we have today strong evidence to indicate that regular physical activity will provide clear and substantial health gains. In this sense, the report is more than a summary of the science - it is a national call to action.
5,107 citations