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      The proportion of youths’ physical inactivity attributable to neighbourhood built environment features

      research-article
      1 , 1 ,
      International Journal of Health Geographics
      BioMed Central

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          Abstract

          Objective

          We investigated the independent association between several neighbourhood built environment features and physical inactivity within a national sample of Canadian youth, and estimated the proportion of inactivity within the population that was attributable to these built environment features.

          Methods

          This was a cross-sectional study of 6626 youth aged 11–15 years from 272 schools across Canada. Participants resided within 1 km of their school. Walkability, outdoor play areas (parks, wooded areas, yards at home, cul-de-sacs on roads), recreation facilities, and aesthetics were measured objectively within each school neighbourhood using geographic information systems. Physical inactivity (<5 days/week of 60 minutes of moderate-to-vigorous physical activity) was assessed by questionnaire. Multilevel logistic regression analyses, which controlled for several covariates, examined relationships between built environment features and physical inactivity.

          Results

          The final regression model indicated that, by comparison to youth living in the least walkable neighbourhoods, the risks for physical inactivity were 28-44% higher for youth living in neighbourhoods in the remaining three walkability quartiles. By comparison to youth living in neighbourhoods with the highest density of cul-de-sacs, risks for physical inactivity were 28-32% higher for youth living in neighbourhoods in the lowest two quartiles. By comparison to youth living in neighbourhoods with the least amount of park space, risks for physical inactivity were 28-37% higher for youth living in the neighbourhoods with a moderate to high (quartiles 2 and 3) park space. Population attributable risk estimates suggested that 23% of physical inactivity within the population was attributable to living in walkable neighbourhoods, 16% was attributable to living in neighbourhoods with a low density of cul-de-sacs, and 15% was attributable to living in neighbourhoods with a moderate to high amount of park space.

          Conclusions

          Of the neighbourhood built environment exposure variables measured in this study, the three that were the most highly associated with inactivity were walkability, the density of cul-de-sacs, and park space. The association between some of these features and youths’ activity levels were in the opposite direction to what has previously been reported in adults and younger children.

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          Most cited references46

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          Physical activity from childhood to adulthood: a 21-year tracking study.

          The aim of this study was to investigate stability of physical activity from childhood and adolescence to adulthood in multiple age cohorts, and analyze how well adult physical activity can be predicted by various physical activity variables measured in childhood and adolescence. The data were drawn from the Cardiovascular Risk in Young Finns Study. The study was started in 1980, when cohorts of randomly sampled boys and girls aged 3, 6, 9, 12, 15, and 18 years (total of 2309 subjects) were examined for the first time. The measurements were repeated in 1983, 1986, 1989, 1992, and 2001. In 2001, the subjects (n =1563, 68%) were aged 24, 27, 30, 33, 36, and 39 years, respectively. Physical activity was measured by means of a short self-report questionnaire that was administered individually in connection with a medical examination. On the basis of a questionnaire, a physical activity index (PAI) was calculated. There were no significant differences in the 1980 PAI between participants and dropouts in 2001. Spearmans rank order correlation coefficients for the 21-year tracking period varied from 0.33 to 0.44 in males, and from 0.14 to 0.26 in females. At shorter time intervals the correlation was higher. On average, the tracking correlation was lower in females than in males. Persistent physical activity, defined as a score in the most active third of the PAI in two or three consecutive measurements, increased the odds that an individual would be active in adulthood. Odds ratios for 3-year continuous activity versus continuous inactivity varied from 4.30 to 7.10 in males and 2.90 to 5.60 in females. The corresponding odds ratios for 6-year persistence were 8.70 to 10.80 and 5.90 to 9.40. It was concluded that a high level of physical activity at ages 9 to 18, especially when continuous, significantly predicted a high level of adult physical activity. Although the correlations were low or moderate, we consider it important that school-age physical activity appears to influence adult physical activity, and through it, the public health of the general population.
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            A physical activity screening measure for use with adolescents in primary care.

            To develop a reliable and valid physical activity screening measure for use with adolescents in primary care settings. We conducted 2 studies to evaluate the test-retest reliability and concurrent validity of 6 single-item and 3 composite measures of physical activity. Modifications were based on the findings of the 2 studies, and a best measure was evaluated in study 3. Accelerometer data served as the criterion standard for tests of validity. In study 1 (N = 250; mean age, 15 years; 56% female; 36% white), reports on the composite measures were most reliable. In study 2 (N = 57; mean age, 14 years; 65% female; 37% white), 6 of the 9 screening measures correlated significantly with accelerometer data. Subjects, however, had great difficulty reporting bouts of activity and distinguishing between intensity levels. Instead, we developed a single measure assessing accumulation of 60 minutes of moderate to vigorous physical activity. Evaluated in study 3 (N = 148; mean age, 12 years; 65% female; 27% white), the measure was reliable (intraclass correlation, 0.77) and correlated significantly (r = 0.40, P<.001) with accelerometer data. Correct classification (63%), sensitivity (71%), and false-positive rates (40%) were reasonable. The "moderate to vigorous physical activity" screening measure is recommended for clinical practice with adolescents.
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              Association of park size, distance, and features with physical activity in neighborhood parks.

              We studied whether park size, number of features in the park, and distance to a park from participants' homes were related to a park being used for physical activity. We collected observational data on 28 specific features from 33 parks. Adult residents in surrounding areas (n=380) completed 7-day physical activity logs that included the location of their activities. We used logistic regression to examine the relative importance of park size, features, and distance to participants' homes in predicting whether a park was used for physical activity, with control for perceived neighborhood safety and aesthetics. Parks with more features were more likely to be used for physical activity; size and distance were not significant predictors. Park facilities were more important than were park amenities. Of the park facilities, trails had the strongest relationship with park use for physical activity. Specific park features may have significant implications for park-based physical activity. Future research should explore these factors in diverse neighborhoods and diverse parks among both younger and older populations.
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                Author and article information

                Journal
                Int J Health Geogr
                Int J Health Geogr
                International Journal of Health Geographics
                BioMed Central
                1476-072X
                2013
                18 June 2013
                : 12
                : 31
                Affiliations
                [1 ]School of Kinesiology and Health Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
                Article
                1476-072X-12-31
                10.1186/1476-072X-12-31
                3689048
                23777593
                f2d75474-958d-483a-bb56-de1f28fb47aa
                Copyright ©2013 Laxer and Janssen; 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
                : 4 March 2013
                : 12 June 2013
                Categories
                Research

                Public health
                Public health

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