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      Effectiveness and implementation of interventions to increase commuter cycling to school: a quasi-experimental study

      research-article
      , ,
      BMC Public Health
      BioMed Central
      Fitness, Adiposity, Bicycling, Children, Injury

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          Abstract

          Background

          Active transportation to school has been positively associated with various health parameters whereas only sparse evidence exists on risk of injury while commuting to school. This study investigated the overall effectiveness of cycling promotion combined with structural changes on cycling to school.

          Methods

          Interventions at public schools in three different regions in Denmark were based on planned infrastructural changes near schools (e.g. road surface and traffic regulation) and school-motivation for promoting commuter cycling. Participants were pupils from control schools ( n = 12) or intervention schools ( n = 13). All children ( n = 2415) from the 4 th and 5 th grade were measured at baseline during spring 2010 and at follow-up one year later.

          Results

          No significant differences in commuter cycling were detected in the adjusted analyses comparing the intervention with the control group neither when assessed as changes in short term (beta: 0.15 trips/week, p = 0.463) nor when assessed as changes in long term school cycling (beta: −0.02 units, p = 0.485). No differences were observed neither in the incidence of traffic injuries nor in the characteristics of injuries when comparing the control group and the intervention group. Approximately 50 % of all traffic injuries occurred during school transport with most injuries categorized as solo injuries. The only significant predictor of future traffic injuries was previous school transport injuries.

          Conclusion

          This multifaceted school cycling promotion programme did not affect school cycling behaviour or the health parameters assessed. Implementation issues relevant in the planning of future school cycling interventions are discussed in the article. The one year incidence of being involved in a traffic injury was approximately 25 % with almost 50 % of all traffic injuries occurred during school transport. Previous school transport injury predicted future school traffic injuries.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-015-2536-1) contains supplementary material, which is available to authorized users.

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          Most cited references18

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          Health benefits of cycling: a systematic review.

          The purpose of this study was to update the evidence on the health benefits of cycling. A systematic review of the literature resulted in 16 cycling-specific studies. Cross-sectional and longitudinal studies showed a clear positive relationship between cycling and cardiorespiratory fitness in youths. Prospective observational studies demonstrated a strong inverse relationship between commuter cycling and all-cause mortality, cancer mortality, and cancer morbidity among middle-aged to elderly subjects. Intervention studies among working-age adults indicated consistent improvements in cardiovascular fitness and some improvements in cardiovascular risk factors due to commuting cycling. Six studies showed a consistent positive dose-response gradient between the amount of cycling and the health benefits. Systematic assessment of the quality of the studies showed most of them to be of moderate to high quality. According to standard criteria used primarily for the assessment of clinical studies, the strength of this evidence was strong for fitness benefits, moderate for benefits in cardiovascular risk factors, and inconclusive for all-cause mortality, coronary heart disease morbidity and mortality, cancer risk, and overweight and obesity. While more intervention research is needed to build a solid knowledge base of the health benefits of cycling, the existing evidence reinforces the current efforts to promote cycling as an important contributor for better population health. © 2011 John Wiley & Sons A/S.
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            Personal, family, social, and environmental correlates of active commuting to school.

            Active commuting to school may be an important opportunity for children to accumulate adequate physical activity for improved cardiovascular risk factors, enhanced bone health, and psychosocial well-being. The purpose of this study was to examine personal, family, social, and environmental correlates of active commuting to school among children. Cross-sectional study of 235 children aged 5 to 6 years and 677 children aged 10 to 12 years from 19 elementary schools in Melbourne, Australia. Self-administered questionnaires were completed by parents, and the older children. The shortest possible routes to school were examined using a geographic information system. Among both age groups, negative correlates of active commuting to school included parental perception of few other children in the neighborhood and no lights or crossings for their child to use, and an objectively assessed busy road barrier en route to school. In younger children, an objectively assessed steep incline en route to school was negatively associated with walking or cycling to school. Good connectivity en route to school was negatively associated with walking or cycling to school among older children. Among both age groups, children were more likely to actively commute to school if their route was <800 meters. There were no associations with perceived energy levels or enjoyment of physical activity, weight status, or family factors. For children, creating child-friendly communities and providing skills to safely negotiate the environment may be important. Environmental correlates of active transport in children and adults may differ and warrant further investigation.
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              The impact of transportation infrastructure on bicycling injuries and crashes: a review of the literature

              Background Bicycling has the potential to improve fitness, diminish obesity, and reduce noise, air pollution, and greenhouse gases associated with travel. However, bicyclists incur a higher risk of injuries requiring hospitalization than motor vehicle occupants. Therefore, understanding ways of making bicycling safer and increasing rates of bicycling are important to improving population health. There is a growing body of research examining transportation infrastructure and the risk of injury to bicyclists. Methods We reviewed studies of the impact of transportation infrastructure on bicyclist safety. The results were tabulated within two categories of infrastructure, namely that at intersections (e.g. roundabouts, traffic lights) or between intersections on "straightaways" (e.g. bike lanes or paths). To assess safety, studies examining the following outcomes were included: injuries; injury severity; and crashes (collisions and/or falls). Results The literature to date on transportation infrastructure and cyclist safety is limited by the incomplete range of facilities studied and difficulties in controlling for exposure to risk. However, evidence from the 23 papers reviewed (eight that examined intersections and 15 that examined straightaways) suggests that infrastructure influences injury and crash risk. Intersection studies focused mainly on roundabouts. They found that multi-lane roundabouts can significantly increase risk to bicyclists unless a separated cycle track is included in the design. Studies of straightaways grouped facilities into few categories, such that facilities with potentially different risks may have been classified within a single category. Results to date suggest that sidewalks and multi-use trails pose the highest risk, major roads are more hazardous than minor roads, and the presence of bicycle facilities (e.g. on-road bike routes, on-road marked bike lanes, and off-road bike paths) was associated with the lowest risk. Conclusion Evidence is beginning to accumulate that purpose-built bicycle-specific facilities reduce crashes and injuries among cyclists, providing the basis for initial transportation engineering guidelines for cyclist safety. Street lighting, paved surfaces, and low-angled grades are additional factors that appear to improve cyclist safety. Future research examining a greater variety of infrastructure would allow development of more detailed guidelines.
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                Author and article information

                Contributors
                lostergaard@health.sdu.dk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                30 November 2015
                30 November 2015
                2015
                : 15
                : 1199
                Affiliations
                Center for Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej, 555230 Odense, Denmark
                Article
                2536
                10.1186/s12889-015-2536-1
                4665862
                26619996
                4d6aa393-8833-4f02-ab07-bc825ed9d4b2
                © Østergaard et al. 2015

                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.

                History
                : 13 March 2015
                : 22 November 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                fitness,adiposity,bicycling,children,injury
                Public health
                fitness, adiposity, bicycling, children, injury

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