Academic journal article Environmental Health Perspectives

Perceived Neighborhood Environmental Attributes Associated with Walking and Cycling for Transport among Adult Residents of 17 Cities in 12 Countries: The IPEN Study

Academic journal article Environmental Health Perspectives

Perceived Neighborhood Environmental Attributes Associated with Walking and Cycling for Transport among Adult Residents of 17 Cities in 12 Countries: The IPEN Study

Article excerpt

Introduction

The 2011 United Nations High-level Meeting on Non-Communicable Diseases identified increasing physical activity as one of five priority intervention areas to reduce the impact of noncommunicable diseases, noting modification of the built environment to support habitual physical activity as a key focus area (Beaglehole et al. 2011). Engaging in active transport (AT) (i.e., walking and cycling for travel purposes) provides opportunities to habitually accumulate physical activity (Badland and Schofield 2008), and those who engage in AT tend to be more active in duration and frequency than those who do not (Berrigan et al. 2006).

People who walk and cycle for transport have been reported to be less likely to be overweight or obese than those who travel by private motor vehicle (Badland and Schofield 2008; Bassett et al. 2008). Additional benefits of AT reported by previous studies include greater social inclusion (Currie et al. 2007), improved air quality, and reduced traffic congestion, vehicle miles traveled, and road infrastructure expenditure (Haines et al. 2009). The prevalence of walking and bicycling for transport varies worldwide, with estimated bicycling rates ranging from 1-2% in North America and Australasia to 25% in The Netherlands (Bassett et al. 2008; Gonzalez et al. 2014; Merom et al. 2010; Reis et al. 2013). Because private motor vehicle journeys often cover distances (< 5 km) that are feasible for AT modes, there is great potential to replace automobile trips with AT that provides health benefits (Dekoster and Schollaert 1999; Keller 2004; Sugiyama et al. 2012).

The role of environmental and policy strategies to increase AT has recently received attention, with calls for further evidence on the most relevant and potentially modifiable environmental attributes (Fraser and Lock 2011). Several studies have explored associations between built-environment attributes and walking or cycling for transport (Badland et al. 2008; Pucher and Buehler 2008; Saelens and Handy 2008). Few of these studies, however, had sufficient power and variability to assess walking and cycling separately.

We hypothesize that identifying environmental attributes that benefit both modes of AT will be important to maximize health, social, and environmental gains in a fiscally constrained global environment. AT studies thus far have been primarily limited to Australasia, Europe, and North America (Bassett et al. 2008), and associations have been weak or inconsistent, possibly due to limited variability in the samples. Although objective measures of the built environment are important, perceptions of environments are also related to behavior and may provide complementary information. Some attributes, such as aesthetics, cannot be measured objectively; other attributes, such as sidewalks, are simply unavailable as objective data in most cities. International studies performed using comparable methods can identify the relevant differences and similarities between countries and inform evidence-based international and country-specific interventions to increase AT.

The purpose of the present study, conducted across diverse cities and countries, was to examine the strength and shape of the relationship of adults' perceptions of several built-environment attributes, selected for a priori theoretical and empirical reasons, with walking and cycling for transport. Analyses controlled for multiple potential confounding variables and interactions by city were explored to assess the international generalizability of the findings. Understanding these relationships is critical for guiding policy and practice to support walking and cycling for transport.

Methods

Study design and locations. The International Physical activity and Environment Network (IPEN) adult study is an observational epidemiologic multicountry cross-sectional study using a common design and comparable methods (Kerr et al. …

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