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      Using built environment characteristics to predict walking for exercise

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          Abstract

          Background

          Environments conducive to walking may help people avoid sedentary lifestyles and associated diseases. Recent studies developed walkability models combining several built environment characteristics to optimally predict walking. Developing and testing such models with the same data could lead to overestimating one's ability to predict walking in an independent sample of the population. More accurate estimates of model fit can be obtained by splitting a single study population into training and validation sets (holdout approach) or through developing and evaluating models in different populations. We used these two approaches to test whether built environment characteristics near the home predict walking for exercise. Study participants lived in western Washington State and were adult members of a health maintenance organization. The physical activity data used in this study were collected by telephone interview and were selected for their relevance to cardiovascular disease. In order to limit confounding by prior health conditions, the sample was restricted to participants in good self-reported health and without a documented history of cardiovascular disease.

          Results

          For 1,608 participants meeting the inclusion criteria, the mean age was 64 years, 90 percent were white, 37 percent had a college degree, and 62 percent of participants reported that they walked for exercise. Single built environment characteristics, such as residential density or connectivity, did not significantly predict walking for exercise. Regression models using multiple built environment characteristics to predict walking were not successful at predicting walking for exercise in an independent population sample. In the validation set, none of the logistic models had a C-statistic confidence interval excluding the null value of 0.5, and none of the linear models explained more than one percent of the variance in time spent walking for exercise. We did not detect significant differences in walking for exercise among census areas or postal codes, which were used as proxies for neighborhoods.

          Conclusion

          None of the built environment characteristics significantly predicted walking for exercise, nor did combinations of these characteristics predict walking for exercise when tested using a holdout approach. These results reflect a lack of neighborhood-level variation in walking for exercise for the population studied.

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          Most cited references76

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          Travel demand and the 3Ds: Density, diversity, and design

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            Environmental factors associated with adults' participation in physical activity: a review.

            N Humpel (2002)
            Promoting physical activity is a public health priority, and changes in the environmental contexts of adults' activity choices are believed to be crucial. However, of the factors associated with physical activity, environmental influences are among the least understood. Using journal scans and computerized literature database searches, we identified 19 quantitative studies that assessed the relationships with physical activity behavior of perceived and objectively determined physical environment attributes. Findings were categorized into those examining five categories: accessibility of facilities, opportunities for activity, weather, safety, and aesthetic attributes. Accessibility, opportunities, and aesthetic attributes had significant associations with physical activity. Weather and safety showed less-strong relationships. Where studies pooled different categories to create composite variables, the associations were less likely to be statistically significant. Physical environment factors have consistent associations with physical activity behavior. Further development of ecologic and environmental models, together with behavior-specific and context-specific measurement strategies, should help in further understanding of these associations. Prospective studies are required to identify possible causal relationships.
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              Obesity relationships with community design, physical activity, and time spent in cars.

              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. 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. 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. 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. 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.
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                Author and article information

                Journal
                Int J Health Geogr
                International Journal of Health Geographics
                BioMed Central
                1476-072X
                2008
                29 February 2008
                : 7
                : 10
                Affiliations
                [1 ]Institute for Social and Economic Research and Policy, Columbia University, New York, NY, USA
                [2 ]Urban Design and Planning, University of Washington, Seattle, WA, USA
                [3 ]Architecture, Landscape Architecture, University of Washington, Seattle, WA, USA
                [4 ]Department of Geography, University of Washington, Seattle, WA, USA
                [5 ]Center for Health Studies, Group Health Cooperative, Seattle, WA, USA
                [6 ]Department of Epidemiology, University of Washington, Seattle, WA, USA
                [7 ]Department of Medicine, University of Washington, Seattle, WA, USA
                [8 ]Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA
                [9 ]Department of Biostatistics, University of Washington, Seattle, WA, USA
                [10 ]Department of Health Services, University of Washington, Seattle, WA, USA
                Article
                1476-072X-7-10
                10.1186/1476-072X-7-10
                2279119
                18312660
                49a89a79-1d40-48d1-9c42-bb1510b53121
                Copyright © 2008 Lovasi et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 November 2007
                : 29 February 2008
                Categories
                Research

                Public health
                Public health

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