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      Physical Activity through Sustainable Transport Approaches (PASTA): a study protocol for a multicentre project

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          Abstract

          Introduction

          Only one-third of the European population meets the minimum recommended levels of physical activity (PA). Physical inactivity is a major risk factor for non-communicable diseases. Walking and cycling for transport (active mobility, AM) are well suited to provide regular PA. The European research project Physical Activity through Sustainable Transport Approaches (PASTA) pursues the following aims: (1) to investigate correlates and interrelations of AM, PA, air pollution and crash risk; (2) to evaluate the effectiveness of selected interventions to promote AM; (3) to improve health impact assessment (HIA) of AM; (4) to foster the exchange between the disciplines of public health and transport planning, and between research and practice.

          Methods and analysis

          PASTA pursues a mixed-method and multilevel approach that is consistently applied in seven case study cities. Determinants of AM and the evaluation of measures to increase AM are investigated through a large scale longitudinal survey, with overall 14 000 respondents participating in Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zurich. Contextual factors are systematically gathered in each city. PASTA generates empirical findings to improve HIA for AM, for example, with estimates of crash risks, factors on AM-PA substitution and carbon emissions savings from mode shifts. Findings from PASTA will inform WHO's online Health Economic Assessment Tool on the health benefits from cycling and/or walking. The study's wide scope, the combination of qualitative and quantitative methods and health and transport methods, the innovative survey design, the general and city-specific analyses, and the transdisciplinary composition of the consortium and the wider network of partners promise highly relevant insights for research and practice.

          Ethics and dissemination

          Ethics approval has been obtained by the local ethics committees in the countries where the work is being conducted, and sent to the European Commission before the start of the survey. The PASTA website ( http://www.pastaproject.eu) is at the core of all communication and dissemination activities.

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          Most cited references34

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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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            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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              Transdisciplinarity: Between mainstreaming and marginalization

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2016
                7 January 2016
                : 6
                : 1
                : e009924
                Affiliations
                [1 ]University of Natural Resources and Life Sciences Vienna, Institute for Transport Studies , Vienna, Austria
                [2 ]Dresden University of Technology, Chair of Integrated Transport Planning and Traffic Engineering , Dresden, Germany
                [3 ]Centre for Environmental Policy, Imperial College London , London, UK
                [4 ]Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
                [5 ]Universitat Pompeu Fabra (UPF) , Barcelona, Spain
                [6 ]CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid, Spain
                [7 ]Flemish Institute for Technological Research (VITO) , Mol, Belgium
                [8 ]Transportation Research Institute (IMOB), Hasselt University , Diepenbeek, Belgium
                [9 ]Polis , Brussels, Belgium
                [10 ]Transport Studies Unit, University of Oxford (UOXF) , Oxford, UK
                [11 ]Centre for Environmental Sciences, Hasselt University , Diepenbeek, Belgium
                [12 ]Trivector Traffic AB , Stockholm, Sweden
                [13 ]Physical Activity and Health Unit, Epidemiology, Biostatistics and Prevention Institute , University of Zurich , Zurich, Switzerland
                [14 ]World Health Organization (WHO) Regional Office for Europe , Copenhagen, Denmark
                Author notes
                [Correspondence to ] Professor Regine Gerike; regine.gerike@ 123456tu-dresden.de
                Author information
                http://orcid.org/0000-0002-8063-6636
                Article
                bmjopen-2015-009924
                10.1136/bmjopen-2015-009924
                4716182
                26743706
                f10e4056-ce7d-4b03-b2a3-ceea367debbd
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an open access article distributed under the terms of the Creative Commons Attribution IGO License ( https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

                History
                : 6 September 2015
                : 28 September 2015
                : 5 October 2015
                Categories
                Public Health
                Protocol
                1506
                1724
                1703
                1735

                Medicine
                public health,sports medicine,statistics & research methods
                Medicine
                public health, sports medicine, statistics & research methods

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