BackgroundThe World Health Organization recommends strategies to improve urban design, public transportation, and recreation facilities to facilitate physical activity for non-communicable disease prevention for an increasingly urbanized global population. Most evidence supporting environmental associations with physical activity comes from single countries or regions with limited variation in urban form. This paper documents variation in comparable built environment features across countries from diverse regions.MethodsThe International Physical Activity and the Environment Network (IPEN) study of adults aimed to measure the full range of variation in the built environment using geographic information systems (GIS) across 12 countries on 5 continents. Investigators in Australia, Belgium, Brazil, Colombia, the Czech Republic, Denmark, China, Mexico, New Zealand, Spain, the United Kingdom, and the United States followed a common research protocol to develop internationally comparable measures. Using detailed instructions, GIS-based measures included features such as walkability (i.e., residential density, street connectivity, mix of land uses), and access to public transit, parks, and private recreation facilities around each participant’s residential address using 1-km and 500-m street network buffers.ResultsEleven of 12 countries and 15 cities had objective GIS data on built environment features. We observed a 38-fold difference in median residential densities, a 5-fold difference in median intersection densities and an 18-fold difference in median park densities. Hong Kong had the highest and North Shore, New Zealand had the lowest median walkability index values, representing a difference of 9 standard deviations in GIS-measured walkability.ConclusionsResults show that comparable measures can be created across a range of cultural settings revealing profound global differences in urban form relevant to physical activity. These measures allow cities to be ranked more precisely than previously possible. The highly variable measures of urban form will be used to explain individuals’ physical activity, sedentary behaviors, body mass index, and other health outcomes on an international basis. Present measures provide the ability to estimate dose–response relationships from projected changes to the built environment that would otherwise be impossible.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-072X-13-43) contains supplementary material, which is available to authorized users.
Purpose Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multi-site evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively-measured PA outcomes; between-site differences in such associations; and, the extent to which perceived environmental attributes explain between-site differences in PA. Methods This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and USA. Participants were 6,968 adults residing in administrative units stratified by socio-economic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min/week of MVPA). Results Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix – access were significant predictors of both PA outcomes in the fully-adjusted models. Environmental attributes accounted for within-site variability in MVPA corresponding to a 3 min/d or 21 min/week standard deviation. Large between-site differences in PA outcomes were observed: 15.9% to 16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Conclusions Residents’ perceptions of neighborhood attributes that facilitate walking were positively associated with objectively-measured MVPA and meeting the guidelines for cancer/weight gain prevention at the within- and between-site levels. Associations were similar across study sites, lending support for international recommendations for designing PA-friendly built environments.
On the basis of systematic observation, ACP appears to be a useful strategy in promoting park use and physical activity among the population in Recife.
The aim of this study was to analyze the prevalence and association of barriers to physical activity among adolescents. This cross-sectional study evaluated a representative sample of public high school students in Curitiba-PR, Brazil. A total of 1,609 school adolescents (59.7% male) between 14 and 18 years of age answered a questionnaire on physical activity status and barriers to physical activity. Logistic regressions were conducted for each barrier investigated to verify the association between the prevalence of barriers and physical activity, adjusting for confounding variables (age and socioeconomic status). Analyses were done separately for boys and girls. Only 22% of boys and 9% of girls achieved the current physical activity recommendation. Among the 12 barriers investigated, only "there is nobody to take" did not differ between boys and girls. The perception of barriers was higher for girls than boys (p < 0.05) for all other barriers. "Lack of friends company" and "feel lazy" were the barriers most often reported by boys (30.4%) and girls (51.8%) respectively; however, the barrier most strongly associated with prevalence of physical inactivity was "prefer to do other things" for both boys (OR = 5.02 (2.69 - 9.37); p < 0.05) and girls (OR = 7.10 (3.71 - 13.60); p < 0.05). Perceived barriers for the practice of physical activity were more prevalent in girls and differed as to the extent of importance between genders.
Background:Open public spaces have been identified as important facilities to promote physical activity (PA) at the community level. The main goals of this study are to describe open public spaces user's characteristics and to explore to what extent these characteristics are associated with PA behavior.Methods:A system of direct observation was used to evaluate the PA levels on parks and squares (smaller parks) and users's characteristics (gender and age). The 4 parks and 4 squares observed were selected from neighborhoods with different socioeconomic status and environmental characteristics. The settings were observed 3 times a day, 6 days per week, during 2 weeks.Results:More men than women were observed in parks (63.1%) and squares (70.0%) as well as more adults and adolescents than older adults and children. Users were more physically active in parks (men = 34.1%, women = 36.1%) than in squares (men = 25.5%, women 22.8%).Conclusions:The characteristics of public open spaces may affect PA in the observed places. Initiatives to improve PA levels in community settings should consider users' characteristics and preferences to be more effective and reach a larger number of people.
The perceived stress scale (PSS-10) reliability and validity were evaluated in Brazilian adults. A two-stage translation procedure was employed to achieve a Portuguese version. Participants were 793 Brazilian university teachers. The exploratory factor analysis showed two factors with eigenvalues greater than 1.0 (56.8% of variance). The Cronbach's alpha coefficients were 0.83 (Factor 1), 0.77 (Factor 2) and 0.87 (Total Score). The test-retest reliability scores were 0.83 (Factor 1), 0.68 (Factor 2) and 0.86 (Total Score). PSS-10 and perceived health correlations ranged from -0.22 to -0.35. The PSS-10 showed an adequate reliability and validity supporting its use in this population.
The trajectory of aging is profoundly impacted by the physical and social environmental contexts in which we live. While “top–down” policy activities can have potentially wide impacts on such contexts, they often take time, resources, and political will, and therefore can be less accessible to underserved communities. This article describes a “bottom–up”, resident-engaged method to advance local environmental and policy change, called Our Voice, that can complement policy-level strategies for improving the health, function, and well-being of older adults. Using the World Health Organization’s age-friendly cities global strategy, we describe the Our Voice citizen science program of research that has specifically targeted older adults as environmental change agents to improve their own health and well-being as well as that of their communities. Results from 14 Our Voice studies that have occurred across five continents demonstrate that older adults can learn to use mobile technology to systematically capture and collectively analyze their own data. They can then successfully build consensus around high-priority issues that can be realistically changed and work effectively with local stakeholders to enact meaningful environmental and policy changes that can help to promote healthy aging. The article ends with recommended next steps for growing the resident-engaged citizen science field to advance the health and welfare of all older adults.
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