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      The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis

      1 , 2 , 3 , , 1 , 4 , 1 , 1 , on behalf of the Council on Environment and Physical Activity (CEPA) – Older Adults working group
      The International Journal of Behavioral Nutrition and Physical Activity
      BioMed Central
      Older adults, Active travel, Cycling, Walking, Neighbourhood, Built environment, Meta-analysis, Systematic review, Moderators

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          Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations.


          Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic).


          Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified.


          Results support strong links between the neighbourhood physical environment and older adults’ AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12966-017-0471-5) contains supplementary material, which is available to authorized users.

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          Most cited references76

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          Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport.

          We used Comparative Risk Assessment methods to estimate the health effects of alternative urban land transport scenarios for two settings-London, UK, and Delhi, India. For each setting, we compared a business-as-usual 2030 projection (without policies for reduction of greenhouse gases) with alternative scenarios-lower-carbon-emission motor vehicles, increased active travel, and a combination of the two. We developed separate models that linked transport scenarios with physical activity, air pollution, and risk of road traffic injury. In both cities, we noted that reduction in carbon dioxide emissions through an increase in active travel and less use of motor vehicles had larger health benefits per million population (7332 disability-adjusted life-years [DALYs] in London, and 12 516 in Delhi in 1 year) than from the increased use of lower-emission motor vehicles (160 DALYs in London, and 1696 in Delhi). However, combination of active travel and lower-emission motor vehicles would give the largest benefits (7439 DALYs in London, 12 995 in Delhi), notably from a reduction in the number of years of life lost from ischaemic heart disease (10-19% in London, 11-25% in Delhi). Although uncertainties remain, climate change mitigation in transport should benefit public health substantially. Policies to increase the acceptability, appeal, and safety of active urban travel, and discourage travel in private motor vehicles would provide larger health benefits than would policies that focus solely on lower-emission motor vehicles.
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            Measuring accessibility: an exploration of issues and alternatives

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              Is Open Access

              Do attributes in the physical environment influence children's physical activity? A review of the literature

              Background Many youth today are physically inactive. Recent attention linking the physical or built environment to physical activity in adults suggests an investigation into the relationship between the built environment and physical activity in children could guide appropriate intervention strategies. Method Thirty three quantitative studies that assessed associations between the physical environment (perceived or objectively measured) and physical activity among children (ages 3 to 18-years) and fulfilled selection criteria were reviewed. Findings were categorized and discussed according to three dimensions of the physical environment including recreational infrastructure, transport infrastructure, and local conditions. Results Results across the various studies showed that children's participation in physical activity is positively associated with publicly provided recreational infrastructure (access to recreational facilities and schools) and transport infrastructure (presence of sidewalks and controlled intersections, access to destinations and public transportation). At the same time, transport infrastructure (number of roads to cross and traffic density/speed) and local conditions (crime, area deprivation) are negatively associated with children's participation in physical activity. Conclusion Results highlight links between the physical environment and children's physical activity. Additional research using a transdisciplinary approach and assessing moderating and mediating variables is necessary to appropriately inform policy efforts.

                Author and article information

                +61 3 92308260 , ecerin@hku.hk , Ester.Cerin@acu.edu.au
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                6 February 2017
                6 February 2017
                : 14
                [1 ]ISNI 0000 0001 2194 1270, GRID grid.411958.0, Institute for Health and Ageing, , Australian Catholic University, ; Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
                [2 ]ISNI 0000000121742757, GRID grid.194645.b, School of Public Health, , The University of Hong Kong, ; Hong Kong, China
                [3 ]ISNI 0000 0000 9760 5620, GRID grid.1051.5, , Baker IDI Heart and Diabetes Institute, ; Melbourne, Australia
                [4 ]ISNI 0000 0001 2069 7798, GRID grid.5342.0, Department of Public Health, , Ghent University, ; Ghent, Belgium
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                : 10 December 2016
                : 31 January 2017
                Custom metadata
                © The Author(s) 2017

                Nutrition & Dietetics
                older adults,active travel,cycling,walking,neighbourhood,built environment,meta-analysis,systematic review,moderators


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