Activelivingresearch.org



Introduction to the

Active Living Research Reference List 2011

The following pages are citations of studies of the relationships between the environment, physical activity, and obesity published in 2011.  We have organized the publications into 8 categories to make them easier to review. The categories are:

1. Built Environment – Child Physical Activity/Obesity,

2. Built Environment – Adult Physical Activity/Obesity,

3. Policy – Physical Activity/Obesity,

4. Social, Cultural & Family Environments – Child Physical Activity/Obesity,

5. Social, Cultural & Family Environments – Adult Physical Activity/Obesity,

6. Measurement,

7. Community Based Interventions – Physical Activity and Obesity,

8. Childhood Obesity & Miscellaneous

The searches were conducted using several databases and were designed to represent the multiple disciplines in the active living research field. The number of citations continues to grow, especially as there is an extraordinary amount of literature on built environment and policy related to physical activity and obesity. Some citations do not include a journal issue or page numbers; these are articles that are available online ahead of print publication.

We have improved upon our search terms and hope that this list is inclusive. Please send us relevant citations we have missed. Studies that focus on food environments will be covered by the RWJF Healthy Eating Research program.

We will continue to publish yearly literature updates as the literature is expanding so rapidly. Papers that specifically report environmental correlates of physical activity behavior or obesity will be included in the online ALR literature database ().

If you have questions or comments please contact Chad Spoon at scspoon@ucsd.edu.

We would like acknowledgement the hard work of the Active Living Research staff for searching several databases and compiling the 2011 reference list.

2011 Search terms

|Physical Activity/Obesity terms (title or abstract) |Environment terms (title or abstract) |

|Obese OR overweight OR obesity OR “weight gain” OR BMI OR “Body |“Physical environment” OR neighborhood OR “built environment” OR |

|mass index” OR “body fat” OR “body composition” OR Accelerom* OR |“urban form” OR “urban design” OR "urban sprawl" OR "walkability" |

|pedomet* OR “step count” OR “heart rate monitor” OR fitness OR |OR "land use mix" OR "residential density" OR sidewalks OR "green |

|exercise OR “activity monitor” OR “Total energy expenditure” OR |space" OR "recreational facilities" OR “public transit” OR “public|

|“metabolic equivalent” OR “physical activity” |transportation” OR “block size” OR “street connectivity” OR “food |

| |environment” OR “food store” OR supermarket OR grocer* OR |

| |“farmer’s market” OR “fast food” OR restaurant OR bodega OR |

| |“convenience store” |

Databases used in the literature searches included Pub Med, ISI Web of Knowledge, SPORTDiscus, Leisure and Recreation Journals and other non-indexed journals.

For more specific information please contact Chad Spoon at scspoon@ucsd.edu.

Journal Counts:

These may indicate journals more interested in built environment research where you could send your manuscripts. Note that only journals with more than one count were included.

American Journal of Health Promotion - 5

American Journal of Preventive Medicine - 10

American Journal of Public health -6

BMC Public Health – 10

British Journal of Sports Medicine - 2

Health and Place - 15

Health Psychology - 2

International Journal of Behavioral Nutrition and Physical Activity- 17

International Journal of Environment and Public Health - 4

International Journal of Pediatric Obesity- 3

The Journal of Physical Activity and Health - 18

Journal of Adolescent Health - 2

Journal of Aging and Health - 4

Journal of Community Health - 3

Journal of Epidemiology and Community Health - 2

Journal of School Health- 3

Journal of Urban Health - 5

Pediatrics - 2

Preventive Medicine- 9

Public Health Nutrition- 3

Social Science and Medicine- 5

Transportation Research and Record -2

BUILT ENVIROMENT AND PHYSICAL ACTIVITY/ OBESITY AMONG YOUTH

Ajibade, P. B. (2011). "Physical Activity Patterns by Campus Housing Status Among African American Female College Students." Journal of Black Studies 42(4): 548-560.

Physical activity protects against heart disease, diabetes, high blood pressure, obesity, and cancer. Fewer than 40% of African American women obtain recommended amounts of physical activity. Healthy Campus 2010 identifies physical activity as a top priority for improving the health of college students. However, during college, women tend to reduce their levels of physical activity. This study examines the relationship between campus housing and physical activity behaviors in a sample of African American female college students (N = 138). Participants who lived on campus were significantly more likely to meet the recommended amounts of both moderate and vigorous physical activity than students who lived off campus (44% vs. 19%). The results demonstrate the importance of campus fitness resources in explaining the role that the built environment can play in increased physical activity among this population. Recommendations for the use of the campus's built environment and fitness resources are provided.

Almanza, E., M. Jerrett, et al. (2011). "A study of community design, greenness, and physical activity in children using satellite, GPS and accelerometer data." Health Place 18(1): 46-54.

This study examined relationships between greenness exposure and free-living physical activity behavior of children in smart growth and conventionally designed communities. Normalized Difference Vegetation Index (NDVI) was used to quantify children's (n=208) greenness exposure at 30-s epoch accelerometer and GPS data points. A generalized linear mixed model with a kernel density smoothing term for addressing spatial autocorrelation was fit to analyze residential neighborhood activity data. Excluding activity at home and during school-hours, an epoch-level analysis found momentary greenness exposure was positively associated with the likelihood of contemporaneous moderate-to-vigorous physical activity (MVPA). This association was stronger for smart growth residents who experienced a 39% increase in odds of MVPA for a 10th to 90th percentile increase in exposure to greenness (OR=1.39, 95% CI 1.36-1.44). An individual-level analysis found children who experienced >20 min of daily exposure to greener spaces (>90th percentile) engaged in nearly 5 times the daily rate of MVPA of children with nearly zero daily exposure to greener spaces (95% CI 3.09-7.20).

Anthamatten, P., L. Brink, et al. (2011). "An assessment of schoolyard renovation strategies to encourage children's physical activity." International Journal of Behavioral Nutrition and Physical Activity 8.

Background: Children in poor and minority neighborhoods often lack adequate environmental support for healthy physical development and community interventions designed to improve physical activity resources serve as an important approach to addressing obesity. In Denver, the Learning Landscapes LL) program has constructed over 98 culturally-tailored schoolyard play spaces at elementary schools with the goal to encourage utilization of play spaces and physical activity. In spite of enthusiasm about such projects to improve urban environments, little work has evaluated their impact or success in achieving their stated objectives. This study evaluates the impacts of LL construction and recency of renovation on schoolyard utilization and the physical activity rates of children, both during and outside of school, using an observational study design. Methods: This study employs a quantitative method for evaluating levels of physical activity of individuals and associated environmental characteristics in play and leisure environments. Schools were selected on the basis of their participation in the LL program, the recency of schoolyard renovation, the size of the school, and the social and demographic characteristics of the school population. Activity in the schoolyards was measured using the System for Observing Play and Leisure Activity (SOPLAY), a validated quantitative method for evaluating levels of physical activity of individuals in play and leisure environments. Trained observers collected measurements before school, during school recess, after school, and on weekends. Overall utilization the total number of children observed on the grounds) and the rate of activity the percentage of children observed who were physically active) were analyzed. Observations were compared using t-tests and the data were stratified by gender for further analysis. In order to assess the impacts of LL renovation, recently-constructed LL schoolyards were compared to LL schoolyards with older construction, as well as un-renovated schoolyards. Results: Overall utilization was significantly higher at LL schools than at un-renovated schools for most observation periods. Notably, LL renovation had no impact on girl's utilization on the weekends, although differences were observed for all other periods. There were no differences in rates of activity for any comparison. With the exception of the number of boys observed, there was no statistically significant difference in activity when recently-constructed LL schools are compared to LL schools with older construction dates and there was no difference observed in comparisons of older LL with unrenovated sites. Conclusions: While we observed greater utilization and physical activity in schools with LL, the impact of specific features of LL renovation is not clear. However, schoolyard renovation and programs to encourage schoolyard use before and after school may offer a means to encourage greater physical activity among children, and girls in particular. Additional study of schoolyard renovation may shed light on the specific reasons for these findings or suggest effective policies to improve the physical activity resources of poor and minority neighborhoods.

Buck, C., H. Pohlabeln, et al. (2011). "Development and application of a moveability index to quantify possibilities for physical activity in the built environment of children." Health Place 17(6): 1191-201.

Several studies show that urban forms are environmental correlates of physical activity. Most of these studies used data based on questionnaires while only a few used geographic information systems (GIS) to objectively assess urban forms. Based on GIS data, we applied a kernel density method to measure urban forms and combined these measures to a moveability index to assess the opportunities for physical activity in the German intervention region of the IDEFICS study. In this proof-of-principal analysis, we linked the moveability index with physical activity data obtained from the baseline survey of the IDEFICS study. Regression analyses revealed a modest but significant impact of the built environment on the physical activity of 596 school children in the study region, supporting the potential application of the moveability index.

Buliung, R., G. Faulkner, et al. (2011). "School travel planning: mobilizing school and community resources to encourage active school transportation." J Sch Health 81(11): 704-12.

BACKGROUND: Active school transport (AST), school travel using an active mode like walking, may be important to children's overall physical activity. A "school travel plan" (STP) documents a school's transport characteristics and provides an action plan to address school and neighborhood barriers to AST. METHODS: We conducted a pilot STP intervention at 12 schools in 4 Canadian provinces. Facilitators and school personnel created and implemented AST action plans. Parent's self-reports (N = 1489) were the basis for evaluating the intervention. A content analysis identified type, frequency, and perceived success of initiatives. RESULTS: School travel plans emphasized education and promotion, and AST activities and events. Capital improvement projects were more common at schools in older suburban neighborhoods, whereas enforcement was more common at schools in newer suburban neighborhoods. Rates of active transportation increased from 43.8% to 45.9%. At follow-up, 13.3% of households reported less driving. Parents/caregivers cited weather, convenience, and trip chaining as primary reasons for continued driving. CONCLUSION: The STP process may facilitate changes to patterns of school travel. An STP can expand a school's capacity to address transportation issues through mobilization of diverse community resources. Future STP initiatives may benefit from addressing convenience, safety through enforcement, and by examining how schools can be supported in implementing infrastructure improvements.

Burns, J. J., S. Goff, et al. (2011). "THE RELATIONSHIP BETWEEN LOCAL FOOD SOURCES AND OPEN SPACE TO BODY MASS INDEX IN URBAN CHILDREN." Public Health Reports 126(6): 890-900.

Chiang, P. H., M. L. Wahlqvist, et al. (2011). "Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study." Public Health Nutr 14(9): 1601-9.

OBJECTIVE: There is increasing evidence that the school food environment contributes to childhood obesity and health in various locations. We investigated the influence of fast-food stores and convenience food stores (FS and CS, respectively) on growth and body composition in a range of residential densities for North-east Asian food culture. DESIGN: Anthropometrics and birth weight of schoolchildren were obtained. Geocoded mapping of schools and food outlets was conducted. Multivariable linear regression models, adjusted for father's ethnicity and education, as well as for household income, pocket money, birth weight, physical activity, television watching, food quality and region, were used to predict body composition from school food environments. SETTING: Elementary schools and school neighbourhoods in 359 townships/districts of Taiwan. SUBJECTS: A total of 2283 schoolchildren aged 6-13 years from the Elementary School Children's Nutrition and Health Survey in Taiwan conducted in 2001-2002. RESULTS: Remote and socially disadvantaged locations had the highest prevalence of lower weight, BMI, waist circumference and triceps skinfold thickness. Food store densities, FS and CS, were highest in urban Taiwan and lowest in remote Taiwan. In the fully adjusted models, FS densities predicted weight and BMI in boys; there was a similar association for waist circumference, except when adjusted for region. FS densities also predicted height for girls. Except for weight and BMI in boys, CS did not have effects evident with FS for either boys or girls. CONCLUSIONS: A high FS density, more than CS density, in Taiwan increased the risk of general (BMI) and abdominal (waist circumference) obesity in boys and stature in girls. These findings have long-term implications for chronic disease in adulthood.

Chomitz, V. R., D. B. Aske, et al. (2011). "The Role of Recreational Spaces in Meeting Physical Activity Recommendations Among Middle School Students." Journal of Physical Activity & Health 8: S8-S16.

Background: There is growing recognition of the importance of recreational space utilization for promoting physical activity (PA) among youth. Methods: An cross-sectional study was conducted with a sample of 926 diverse 6th-8th grade students in Somerville, MA. Participants completed the 2007 Youth Risk Surveillance Survey (YRBS). Chi-square testing and logistical regression modeling were performed to predict meeting national PA recommendations for moderate, vigorous, and 60 minutes or more (60+) PA. Results: The participants reported meeting recommended PA levels for moderate (27%), vigorous (70%) and 60+ (21%) PA. In multivariate analysis, being male and speaking English were significantly associated with meeting all 3 PA recommendations. Recreational spaces significantly associated with meeting PA recommendations included neighborhood parks and walk/bike paths, playing fields and courts, and recreational centers. Recreational space utilization varied by gender, race/ethnicity, and language. Conclusions: Recreational space utilization was an important predictor of meeting PA recommendations among middle school students. Our results showed that PA attainment and recreational space utilization varied by demographic characteristics. The role of each recreational space in predicting PA varied depending on the outcome used. This study demonstrates the potential use of YRBS data to inform resource allocation for PA promotion in diverse communities.

Colabianchi, N., A. L. Maslow, et al. (2011). "Features and amenities of school playgrounds: A direct observation study of utilization and physical activity levels outside of school time." International Journal of Behavioral Nutrition and Physical Activity 8.

Background: A significant amount of research has examined whether park or playground availability is associated with physical activity. However, little research has examined whether specific features or amenities of parks or playgrounds, such as the number of unique types of playground equipment or the safety of the equipment is associated with utilization of the facility or physical activity levels while at the facility. There are no studies that use direct observation and a detailed park assessment to examine these associations. Methods: Twenty urban schoolyards in the Midwest, ten of which were renovated, were included in this study. Using a detailed environmental assessment tool (i.e., Environmental Assessment of Public Recreation Spaces), information on a variety of playground attributes was collected. Using direct observation (i.e., System for Observing Play and Leisure Activity in Youth), the number of adults, girls and boys attending each schoolyard and their physical activity levels were recorded. Each schoolyard was observed ten times for 90 minutes each time outside of school hours. Clustered multivariable negative binomial regressions and linear regressions were completed to examine the association between playground attributes and utilization of the schoolyard and the proportion active on the playground, respectively. Effect modification by renovation status was also examined. Results: At renovated schoolyards, the total number of play features was significantly associated with greater utilization in adults and girls; overall cleanliness was significantly associated with less utilization in girls and boys; and coverage/shade for resting features was significantly associated with greater utilization in adults and boys. At unrenovated schoolyards, overall safety was significantly associated with greater utilization in boys. No playground attribute was associated with the proportion active on the playground after adjusting for all other significant playground attributes. Conclusions: Having a large quantity of play features and shade at renovated playgrounds were positively associated with utilization of the schoolyard. Modifying playgrounds to have these features may increase the utilization of these facilities outside of school time. Additional research should explore what features and amenities are associated with increased physical activity levels of children and adults who utilize the facilities.

Corder, K., J. F. Sallis, et al. (2011). "Active children use more locations for physical activity." Health Place 17(4): 911-9.

We examined frequency of use of 11 physical activity (PA) locations among 539 San Diego children (45.0% males, 41.2% Latinos; mean +/- SD age: 6.6 +/- 0.7 years) and explored associations between location use, PA and potential correlates. Parents reported child's use (visits/week) of 11 locations. Child PA was assessed by accelerometry (subsample n = 178). The most frequently used locations (mean +/- SD times/week) were homes (3.2 +/- 2.3) and parks/playground (1.6 +/- 1.3). Children used 4.0 +/- 2.0 locations in a typical week, and made a total of 12.5 +/- 6.8 visits/week to all locations. Latinos used fewer locations regularly (3.6 +/- 2.1 vs. 4.3 +/- 1.9 locations; p < 0.001) and had fewer visits to all locations (11.4 +/- 7.4 vs. 13.2 +/- 6.4 visits/week; p = 0.003) than non-Latinos. Accelerometry-assessed vigorous PA (VPA) was positively associated with the number of locations regularly used (ss = 0.04, p = 0.03) and total visits to all locations among Latinos (ss = 0.09, p = 0.005). Parental PA support was positively associated with locations used (ss = 0.64, p < 0.001) and visits to all locations (ss = 2.56, p < 0.001). Children using a greater variety of locations did more VPA. Latinos making more total visits to all locations had higher VPA.

D'Haese, S., F. De Meester, et al. (2011). "Criterion distances and environmental correlates of active commuting to school in children." Int J Behav Nutr Phys Act 8: 88.

BACKGROUND: Active commuting to school can contribute to daily physical activity levels in children. Insight into the determinants of active commuting is needed, to promote such behavior in children living within a feasible commuting distance from school. This study determined feasible distances for walking and cycling to school (criterion distances) in 11- to 12-year-old Belgian children. For children living within these criterion distances from school, the correlation between parental perceptions of the environment, the number of motorized vehicles per family and the commuting mode (active/passive) to school was investigated. METHODS: Parents (n = 696) were contacted through 44 randomly selected classes of the final year (sixth grade) in elementary schools in East- and West-Flanders. Parental environmental perceptions were obtained using the parent version of Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Information about active commuting to school was obtained using a self-reported questionnaire for parents. Distances from the children's home to school were objectively measured with Routenet online route planner. Criterion distances were set at the distance in which at least 85% of the active commuters lived. After the determination of these criterion distances, multilevel analyses were conducted to determine correlates of active commuting to school within these distances. RESULTS: Almost sixty percent (59.3%) of the total sample commuted actively to school. Criterion distances were set at 1.5 kilometers for walking and 3.0 kilometers for cycling. In the range of 2.01 - 2.50 kilometers household distance from school, the number of passive commuters exceeded the number of active commuters. For children who were living less than 3.0 kilometers away from school, only perceived accessibility by the parents was positively associated with active commuting to school. Within the group of active commuters, a longer distance to school was associated with more cycling to school compared to walking to school. CONCLUSIONS: Household distance from school is an important correlate of transport mode to school in children. Interventions to promote active commuting in 11-12 year olds should be focusing on children who are living within the criterion distance of 3.0 kilometers from school by improving the accessibility en route from children's home to school.

Eisenmann, J. C., K. Alaimo, et al. (2011). "Project FIT: Rationale, design and baseline characteristics of a school- and community-based intervention to address physical activity and healthy eating among low-income elementary school children." Bmc Public Health 11.

Background: This paper describes Project FIT, a collaboration between the public school system, local health systems, physicians, neighborhood associations, businesses, faith-based leaders, community agencies and university researchers to develop a multi-faceted approach to promote physical activity and healthy eating toward the general goal of preventing and reducing childhood obesity among children in Grand Rapids, MI, USA. Methods/design: There are four overall components to Project FIT: school, community, social marketing, and school staff wellness -all that focus on: 1) increasing access to safe and affordable physical activity and nutrition education opportunities in the schools and surrounding neighborhoods; 2) improving the affordability and availability of nutritious food in the neighborhoods surrounding the schools; 3) improving the knowledge, selfefficacy, attitudes and behaviors regarding nutrition and physical activity among school staff, parents and students; 4) impacting the 'culture' of the schools and neighborhoods to incorporate healthful values; and 5) encouraging dialogue among all community partners to leverage existing programs and introduce new ones. Discussion: At baseline, there was generally low physical activity (70% do not meet recommendation of 60 minutes per day), excessive screen time (75% do not meet recommendation of < 2 hours per day), and low intake of vegetables and whole grains and high intake of sugar-sweetened beverages, French fries and chips and desserts as well as a high prevalence of overweight and obesity (48.5% including 6% with severe obesity) among low income, primarily Hispanic and African American 3rd-5th grade children (n = 403).

Floyd, M. F., J. N. Bocarro, et al. (2011). "Park-Based Physical Activity Among Children and Adolescents." American Journal of Preventive Medicine 41(3): 258-265.

Background: Availability of parks is associated with higher levels of physical activity among children and adolescents. Few studies examine actual park use and park-based physical activity in these populations. Purpose: This study examined associations among individual, park, and neighborhood environmental characteristics and children's and adolescent's park-based physical activity. Methods: Data were collected in 2007 on 2712 children in 20 randomly selected parks in Durham NC. The System for Observing Play and Recreation in Communities (SOPARC) provided measures of physical activity. Hierarchic regression analysis assessed associations among individual, park, and neighborhood environmental characteristics and children's park-based physical activity. Data were analyzed in 2010. Results: Of the 2712 children observed, 34.2% and 13.2% were engaged in walking or vigorous physical activity. Environmental features of parks were associated with activity levels whereas neighborhood characteristics were not. Physical activity was negatively associated with gender (girls) (p = 0.003); presence of a parent (p < 0.0001); presence of nonparental adult (p = 0.006); and an interaction involving the 0-5 years age group and style of play (p = 0.017). Higher level of physical activity was associated with presence of other active children (p < 0.0001); courts (e. g., basketball); and an interaction between number of recreation facilities and formal activities (p = 0.004). Conclusions: These social factors and design features should be considered in order to stimulate higher levels of park-based physical activity among children and adolescents. (Am J Prev Med 2011; 41(3): 258-265) (C) 2011 American Journal of Preventive Medicine

Gay, J. L., M. Dowda, et al. (2011). "Environmental determinants of children's physical activity in residential children's homes." J Phys Act Health 8(5): 636-44.

BACKGROUND: Children in residential children's homes (RCH) may be at increased risk for physical inactivity due to decreased access to opportunities for activity. Little is known about environmental determinants of physical activity for children in RCH. METHODS: Thirty-minute blocks of MVPA and Total METs were measured using the 3-Day Physical Activity Recall (3DPAR). A staff interview, based on the Structural Ecologic Model of Health Behavior, assessed physical activity opportunities, structures, characteristics, policies, and social environment. Wilcoxon 2-sample tests were used to examine differences in environment by location and presence of a recreation director. Mixed model ANOVAs assessed the differences in child level activity by environmental variables. RESULTS: There were significant correlations between opportunities and characteristics of physical activity, facilities, and equipment with total METS for children. Children in homes with a recreation director and homes in rural locations reported more physical activity. Only rural location had a significant effect on physical activity. Presence of a recreation director was significant in several models. CONCLUSIONS: Rural location may be conducive for increased physical activity in children at RCH. Employing a recreation director or other trained personnel may be an important policy determinant of physical activity for children.

Grigsby-Toussaint, D. S., S. H. Chi, et al. (2011). "Where they live, how they play: neighborhood greenness and outdoor physical activity among preschoolers." Int J Health Geogr 10: 66.

BACKGROUND: Emerging empirical evidence suggests exposure to "green" environments may encourage higher levels of physical activity among children. Few studies, however, have explored this association exclusively in pre-school aged children in the United States. We examined whether residing in neighborhoods with higher levels of greenness was associated with higher levels of outdoor physical activity among preschoolers. In addition, we also explored whether outdoor playing behaviors (e.g., active vs. quiet) were influenced by levels of neighborhood greenness independent of demographic and parental support factors. RESULTS: Higher levels of neighborhood greenness as measured by the Normalized Difference Vegetation Index (NDVI) was associated with higher levels of outdoor playing time among preschool-aged children in our sample. Specifically, a one unit increase in neighborhood greenness increased a child's outdoor playing time by approximately 3 minutes. A dose-response relationship was observed between increasing levels of parental support for physical activity (e.g., time spent playing with children) and child outdoor physical activity (p < 0.01). CONCLUSIONS: Consistent with previous studies, neighborhood greenness influences physical activity behavior. However, for preschoolers, parental involvement may be more critical for improving physical activity levels.

Howard, P. H., M. Fitzpatrick, et al. (2011). "Proximity of food retailers to schools and rates of overweight ninth grade students: an ecological study in California." Bmc Public Health 11.

Background: The prevalence of obesity and overweight in youth has increased dramatically since the 1980s, and some researchers hypothesize that increased consumption of low-nutrient, energy-dense foods is a key contributor. The potential importance of food retailers near schools has received increasing attention, but public health research and policy has focused primarily on fast food restaurants. Less is known about the relationship between overweight/obesity and other types of retailers. This study aims to investigate the potential associations between nearby 1) fast food restaurants, 2) convenience stores, and 3) supermarkets, and rates of overweight students in California schools. Methods: We examined the rate of overweight ninth grade students in public schools in 2007 using linear regression. The percentage of overweight students per school was determined by a state required physical fitness test, with three different options for measuring individual body composition. Our key independent variables were the presence of three different types of retailers within 800 m network buffers of the schools. Additional independent variables included school ethnic, gender and socioeconomic composition, as well as urban/non-urban location. We obtained the data from the California Department of Education and ESRI, Inc. Results: The presence of a convenience store within a 10-minute walking distance of a school was associated with a higher rate of overweight students than schools without nearby convenience stores, after controlling for all school-level variables in the regression (1.2%, 95% confidence interval 0.03, 2.36). Nearby fast food restaurants and supermarkets, however, were not associated with school rates of overweight students. Conclusions: Public health researchers and policy-makers interested in the food environments outside schools should expand their recent focus on nearby fast food restaurants to include convenience stores, which may also be important sources of low-nutrient, energy-dense foods for students.

Isgor, Z. and L. M. Powell (2011). "Availability of Commercial Physical Activity Facilities and Physical Activity Outside of School Among High School Students." Journal of Physical Activity & Health 8(5): 707-715.

Background: Environmental factors may play an important role in the determination of physical activity behaviors. Methods: This study used the Child Development Supplement of the Panel Study of Income Dynamics to examine the association between the availability of objectively measured commercial physical activity-related instruction facilities and weekly physical activity participation among high school students outside of school physical education classes. A Negative Binomial count model was used to examine the number of days of vigorous physical activity (at least 30 minutes/day) per week and a Probit model was used to examine the probability of frequent (4 or more days/week) vigorous physical activity participation. Results: The results indicated that an additional instruction school per 10,000 capita per 10 square miles was associated with an 8-percent increase in the weekly number of days of vigorous physical activity participation and a 4 percentage point increase in the likelihood of frequent physical activity participation for female adolescents only. By income, associations were larger for low- versus high-income female youths. Conclusion: Increased availability of local area physical activity-related instruction facilities may help to increase female high school students' physical activity levels, particularly among low-income female students.

Jilcott, S. B., S. Wade, et al. (2011). "The association between the food environment and weight status among eastern North Carolina youth." Public Health Nutr 14(9): 1610-7.

OBJECTIVE: To examine associations between various measures of the food environment and BMI percentile among youth. DESIGN: Cross-sectional, observational. SETTING: Pitt County, eastern North Carolina. SUBJECTS: We extracted the electronic medical records for youth receiving well child check-ups from January 2007 to June 2008. We obtained addresses for food venues from two secondary sources and ground-truthing. A geographic information systems database was constructed by geocoding home addresses of 744 youth and food venues. We quantified participants' accessibility to food venues by calculating 'coverage', number of food venues in buffers of 0.25, 0.5, 1 and 5 miles (0.4, 0.8, 1.6 and 8.0 km) and by calculating 'proximity' or distance to the closest food venue. We examined associations between BMI percentile and food venue accessibility using correlation and regression analyses. RESULTS: There were negative associations between BMI percentile and coverage of farmers' markets/produce markets in 0.25 and 0.5 mile Euclidean and 0.25, 0.5 and 1 mile road network buffers. There were positive associations between BMI percentile and coverage of fast-food and pizza places in the 0.25 mile Euclidean and network buffers. In multivariate analyses adjusted for race, insurance status and rural/urban residence, proximity (network distance) to convenience stores was negatively associated with BMI percentile and proximity to farmers' markets was positively associated with BMI percentile. CONCLUSIONS: Accessibility to various types of food venues is associated with BMI percentile in eastern North Carolina youth. Future longitudinal work should examine correlations between accessibility to and use of traditional and non-traditional food venues.

Kemperman, A. D. A. M. and H. J. P. Timmermans (2011). "Children's Recreational Physical Activity." Leisure Sciences 33(3): 183-204.

This study explored children's participation in recreational (physical) activities and the extent to which this participation was influenced by individual and household socio-demographics and characteristics of the social and physical environment. Travel and activity diaries were used to collect data on out-of-home recreational activities for a random sample of 4,293 children in primary schools in the Netherlands. These data were investigated in relation to measures describing the social and physical living environment. Specifically, a Bayesian belief network was proposed because it derives and represents simultaneously all direct and indirect relationships between the selected variables. Results indicated that participation in various types of recreational activities was directly related to the socio-economic status of the household, the perceived safety of the neighborhood, the size of agricultural area in the neighborhood, travel distance, and day of the week. Planners and designers are recommended to find a good land use mix, and specifically make sure that they focus their attention on safety issues, as these factors stimulate children's participation in recreational physical activities.

Lange, D., M. Wahrendorf, et al. (2011). "Associations between neighbourhood characteristics, body mass index and health-related behaviours of adolescents in the Kiel Obesity Prevention Study: a multilevel analysis." European Journal of Clinical Nutrition 65(6): 711-719.

Background/Objectives: To understand determinants of overweight, several studies addressed the association between neighbourhood characteristics and adult obesity. However, little is known about the association of such characteristics with adolescents' overweight. This study aims at the influence of neighbourhood characteristics on adolescent body mass index (BMI) and lifestyle and to what extent BMI and lifestyle variation between neighbourhoods can be explained by neighbourhood characteristics. Subjects/Methods: We used cross-sectional data from the Kiel Obesity Prevention Study collected between 2004 and 2008 in 28 different residential districts of the city of Kiel (North Germany). Anthropometric data were available for 1675 boys and 1765 girls (n = 3440) aged 13-15 years, and individual lifestyle factors and sociodemographic data were included in the analysis. At the macro level, six different neighbourhood characteristics were used: unemployment rate, population density, traffic density, prevalence of energy-dense food supply, number of sports fields and parks, and crime rate. To test our main hypothesis, linear and logistic multilevel regression analyses were performed to predict BMI and lifestyle factors in individuals nested in neighbourhoods. Results: Findings of multilevel analysis show little between-neighbourhood variations in BMI and health-related behaviours. In all, 2% of BMI variation, 4% of media time variation and 3% of variation in snacking behaviour could be attributed to differences in neighbourhoods. Conclusions: Environmental factors are significantly associated with adolescent BMI and health-related behaviour; however, their total effect is small. Owing to these results, recommendations for structural policy measures as part of prevention of overweight in adolescents must be made cautiously. European Journal of Clinical Nutrition (2011) 65, 711-719; doi:10.1038/ejcn.2011.21; published online 30 March 2011

Leatherdale, S. T., T. Pouliou, et al. (2011). "The association between overweight and opportunity structures in the built environment: a multi-level analysis among elementary school youth in the PLAY-ON study." International Journal of Public Health 56(3): 237-246.

To examine school-level opportunity structures of the built environment and student characteristics associated with being overweight. Multi-level logistic regression analysis were used to examine the school- and student-level characteristics associated with the odds of a student being overweight among grade 5-8 students attending 30 elementary schools in Ontario, Canada, as part of the Play-Ontario (PLAY-ON) study. Significant between school random variation in overweight was identified [sigma (mu 0) (2) = 0.187 (0.084), P < 0.001]; school-level differences accounted for 5.4% of the variability in the odds of a student being overweight. The more fast-food retailers there were surrounding a school, the more likely a student was to be overweight; students in grade 5 were at increased risk relative to students in grades 6-8. The more grocery stores there were surrounding a school, the more likely a student was to be overweight; students in grade 5 were at increased risk relative to students in grades 6-8. Developing a better understanding of the school- and student-level characteristics associated with overweight among youth is critical for informing intervention programs and policies.

Leung, C. W., B. A. Laraia, et al. (2011). "The Influence of Neighborhood Food Stores on Change in Young Girls' Body Mass Index." American Journal of Preventive Medicine 41(1): 43-51.

Background: As the prevalence of childhood obesity has risen in past decades, more attention has been given to how the neighborhood food environment affects children's health outcomes. Purpose: This exploratory study examined the relationship between the presence of neighborhood food stores within a girl's neighborhood and 3-year risk of overweight/obesity and change in BMI, in girls aged 6 or 7 years at baseline. Methods: A longitudinal analysis of participants in the Cohort Study of Young Girls' Nutrition, Environment and Transitions (CYGNET) was conducted from 2005 to 2008. Neighborhood food stores were identified from a commercial database and classified according to industry codes in 2006. Generalized linear and logistic models were used to examine how availability of food stores within 0.25-mile and 1.0-mile network buffers of a girl's residence were associated with BMI z-score change and risk of overweight or obesity, adjusting for baseline BMI/weight and family sociodemographic characteristics. Data were analyzed in 2010. Results: Availability of convenience stores within a 0.25-mile network buffer of a girl's residence was associated with greater risk of overweight/obesity (OR=3.38, 95% CI=1.07, 10.68) and an increase in BMI z-score (beta=0.13, 95% CI=0.00, 0.25). Availability of produce vendors/farmer's markets within a 1.0-mile network buffer of a girl's residence was inversely associated with overweight/obesity (OR=0.22, 95% CI=0.05, 1.06). A significant trend was observed between availability of produce vendors/farmer's markets and lower risk of overweight/obesity after 3 years. Conclusions: Although food store inventories were not assessed and food store indices were not created, the availability of neighborhood food stores may affect a young girl's weight trajectory over time. (Am J Prev Med 2011; 41(1): 43-51) (C) 2011 American Journal of Preventive Medicine

Li, M., M. J. Dibley, et al. (2011). "School environment factors were associated with BMI among adolescents in Xi'an City, China." Bmc Public Health 11.

Background: School environment influences students' behaviours. The purpose of this research was to identify school environment factors associated with BMI. Methods: A cross-sectional study was conducted among 1792 school-aged adolescents from 30 schools in six districts in Xi'an City in 2004. Height and weight were taken from students by trained field staff. School environment characteristics such as physical factors (school facilities, school shops and fast food outlets in school area), school curricula and policies were collected from school doctors using school environment questionnaire. School environment factors were identified in linear mixed effect models with BMI as outcome and adjusted for socio-demographic factors. Results: After adjusted for socio-demographic factors, BMI was associated with the availability of soft drinks at school shops, the availability and the number of western food outlet in the school vicinity. School curricula such as sports-meeting and health education session were also associated with BMI. Conclusions: Urgent actions are needed to address the obesogenic elements of school environments. Community and school policy makers should make efforts for students to avoid exposure to fast food outlet in school area and soft drinks at school shops, and to improve school curricula to promote healthy behaviours.

Lightfoot, K. and C. Blanchard (2011). "Does Race or Sex Moderate the Perceived Built Environment/Physical Activity Relationship in College Students?" Behavioral Medicine 37(2): 54-59.

The purpose of this research was to explore the relationship between the perceived built environment and physical activity (PA) among college students, and to determine whether race and/or sex moderate this relationship. Participants were 785 college students (435 students in Study 1 and 350 in Study 2). Students completed questionnaires assessing characteristics of their neighborhood, and were followed up 1 (Study 1) or 2 (Study 2) weeks later to measure PA levels. Seeing others in one's neighbourhood being active was found to be significantly related (p .01) to higher levels of PA for students in both studies. In Study 2, race was found to moderate the relationship between having many places within walking distance and PA, affecting African Americans more strongly than Caucasians. Sex was not found to moderate the perceived built environment/PA relationship. It appears that certain aspects of the perceived built environment may have an effect on the level of PA in college students, with race moderating this relationship.

Lovasi, G. S., J. S. Jacobson, et al. (2011). "Is the Environment Near Home and School Associated with Physical Activity and Adiposity of Urban Preschool Children?" Journal of Urban Health-Bulletin of the New York Academy of Medicine 88(6): 1143-1157.

Preventing sedentary behavior and adiposity in childhood has become a public health priority. We examined urban social and built environment characteristics as correlates of physical activity and anthropometry among 428 preschool children from low-income families in New York City. We measured the children's height, weight, skinfold thicknesses, physical activity by accelerometer, and covariates. We geocoded home and Head Start center addresses and estimated the following for an area within 0.5 km of those two locations using a detailed geographic database: neighborhood composition, walkability, crime and traffic safety, and aesthetic characteristics. Generalized estimating equations were used to examine the associations of area characteristics with physical activity or adiposity, adjusted for characteristics of the child, mother, and home. Participants were 2-5 years old, 53% female, 83% Hispanic, and 43% either overweight or obese. Of the walkability indicators, land use mix was associated with physical activity (26 more activity counts/minute per standard deviation increase in mixed land use, p = 0.015) and subway stop density was associated with adiposity (1.2 mm smaller sums of skinfold thicknesses sum per standard deviation increase in subway stop density, p = 0.001). The pedestrian-auto injury rate, an indicator of traffic safety problems, was associated with physical activity and adiposity (16 fewer activity counts/minute, p = 0.033, and 1.0 mm greater skinfold thickness per standard deviation increase in pedestrian-auto injuries, p = 0.018). Children living in areas with more street trees were more physically active and those living in areas with more park access had smaller skinfolds. However, many of the tested associations were not statistically significant and some trends were not in the hypothesized direction. Efforts to enhance walkability, safety, and green spaces in the local environment may be relevant to physical activity and adiposity, and therefore to the health of preschool-aged children from low-income families.

Maslow, A. L. and N. Colabianchi (2011). "Youth Physical Activity Resource Use and Activity Measured by Accelerometry." American Journal of Health Behavior 35(2): 219-227.

Objectives: To examine whether use of physical activity resources (eg, parks) was associated with daily physical activity measured by accelerometry. Methods: One hundred eleven adolescents completed a travel diary with concurrent accelerometry. The main exposure was self-reported use of a physical activity resource (none/1+ resources). The main outcomes were total minutes spent in daily (1) moderate-vigorous physical activity and (2) vigorous physical activity. Results: Using a physical activity resource was significantly associated with total minutes in moderate-vigorous physical activity. African Americans and males had significantly greater moderate-vigorous physical activity. Conclusions: Results from this study support the development and use of physical activity resources.

McCormack, G. R., B. Giles-Corti, et al. (2011). "A cross-sectional study of the individual, social, and built environmental correlates of pedometer-based physical activity among elementary school children." International Journal of Behavioral Nutrition and Physical Activity 8.

Background: Children who participate in regular physical activity obtain health benefits. Preliminary pedometer-based cut-points representing sufficient levels of physical activity among youth have been established; however limited evidence regarding correlates of achieving these cut-points exists. The purpose of this study was to identify correlates of pedometer-based cut-points among elementary school-aged children. Method: A cross-section of children in grades 5-7 (10-12 years of age) were randomly selected from the most (n = 13) and least (n = 12) 'walkable' public elementary schools (Perth, Western Australia), stratified by socioeconomic status. Children (n = 1480; response rate = 56.6%) and parents (n = 1332; response rate = 88.8%) completed a survey, and steps were collected from children using pedometers. Pedometer data were categorized to reflect the sex-specific pedometer-based cut-points of >= 15000 steps/day for boys and >= 12000 steps/day for girls. Associations between socio-demographic characteristics, sedentary and active leisure-time behavior, independent mobility, active transportation and built environmental variables - collected from the child and parent surveys - and meeting pedometer-based cut-points were estimated (odds ratios: OR) using generalized estimating equations. Results: Overall 927 children participated in all components of the study and provided complete data. On average, children took 11407 +/- 3136 steps/day (boys: 12270 +/- 3350 vs. girls: 10681 +/- 2745 steps/day; p < 0.001) and 25.9% (boys: 19.1 vs. girls: 31.6%; p < 0.001) achieved the pedometer-based cut-points. After adjusting for all other variables and school clustering, meeting the pedometer-based cut-points was negatively associated (p < 0.05) with being male (OR = 0.42), parent self-reported number of different destinations in the neighborhood (OR 0.93), and a friend's (OR 0.62) or relative's (OR 0.44, boys only) house being at least a 10-minute walk from home. Achieving the pedometer-based cut-points was positively associated with participating in screen-time < 2 hours/day (OR 1.88), not being driven to school (OR 1.48), attending a school located in a high SES neighborhood (OR 1.33), the average number of steps among children within the respondent's grade (for each 500 step/day increase: OR 1.29), and living further than a 10-minute walk from a relative's house (OR 1.69, girls only). Conclusions: Comprehensive multi-level interventions that reduce screen-time, encourage active travel to/from school and foster a physically active classroom culture might encourage more physical activity among children.

Mecredy, G., W. Pickett, et al. (2011). "Street Connectivity is Negatively Associated with Physical Activity in Canadian Youth." International Journal of Environmental Research and Public Health 8(8): 3333-3350.

Street connectivity, defined as how well streets connect to one and other and the density of intersections, is positively associated with active transportation in adults. Our objective was to study the relation between street connectivity and physical activity in youth. Study participants consisted of 8,535 students in grades 6-10 from 180 schools across Canada who completed the 2006 Health Behaviour in School-aged Children (HBSC) survey. Street connectivity was measured in a 5 km circular buffer around these schools using established geographic information system measures. Physical activity performed outside of school hours was assessed by questionnaire, and multi-level regression analyses were used to estimate associations with street connectivity after controlling for several covariates. Compared to students living in the highest street connectivity quartile, those in the second (relative risk = 1.22, 95% confidence interval = 1.10-1.35), third (1.25, 1.13-1.37), and fourth (1.21, 1.09-1.34) quartiles were more likely to be physically active outside of school. In conclusion, youth in neighbourhoods with the most highly connected streets reported less physical activity outside of school than youth from neighbourhoods with less connected streets. Relationships between street connectivity and physical activity reported in this national study are in the opposite direction to those previously observed for active transportation in adult populations.

Mendoza, J. A., K. Watson, et al. (2011). "The Walking School Bus and Children's Physical Activity: A Pilot Cluster Randomized Controlled Trial." Pediatrics 128(3): E537-E544.

OBJECTIVE: To evaluate the impact of a "walking school bus" program on children's rates of active commuting to school and physical activity. METHODS: We conducted a pilot cluster randomized controlled trial among 4th-graders from 8 schools in Houston, Texas (N = 149). Random allocation to treatment or control conditions was at the school level. Study staff walked with children to and from school up to 5 days/week. Outcomes were measured the week before (time 1) and during weeks 4 and 5 of the intervention (time 2). The main outcome was the weekly rate of active commuting, and a secondary outcome was moderate-to-vigorous physical activity. Covariates included sociodemographics, distance from home to school, neighborhood safety, child BMI z score, parent self-efficacy/outcome expectations, and child self-efficacy for active commuting. A mixed-model repeated measures regression accounted for clustering by school, and stepwise procedures with backward elimination of nonsignificant covariates were used to identify significant predictors. RESULTS: Intervention children increased active commuting (mean +/- SD) from 23.8% +/- 9.2% (time 1) to 54% +/- 9.2% (time 2), whereas control subjects decreased from 40.2% +/- 8.9% (time 1) to 32.6% +/- 8.9% (time 2) (P < .0001). Intervention children increased their minutes of daily moderate-to-vigorous physical activity from 46.6 +/- 4.5 (time 1) to 48.8 +/- 4.5 (time 2), whereas control children decreased from 46.1 +/- 4.3 (time 1) to 41.3 +/- 4.3 (time 2) (P = .029). CONCLUSIONS: The program improved children's active commuting to school and daily moderate-to-vigorous physical activity. Pediatrics 2011; 128: e537-e544

Mota, J., R. Santos, et al. (2011). "Perceived neighbourhood environmental characteristics and physical activity according to socioeconomic status in adolescent girls." Annals of Human Biology 38(1): 1-6.

Objective: The purpose of this study was to analyse the associations between physical activity (PA) and several characteristics of the built environment with socioeconomic status (SES) in adolescent girls. Methods: The sample comprised 599 girls (mean age 14.7, SD = 1.6 years) living in the Aveiro Region of Portugal. Questionnaires were used to describe physical activity level and perceived neighbourhood environments. SES was established by maternal education level. Girls were grouped into low, middle or high SES group. Results: Logistic regression analysis showed that girls assigned to the higher SES group were more likely (OR = 2.4; 95%CI = 1.3-4.5) to belong to the active group than their low SES peers. Girls in high (OR = 2.4; 95%CC = 1.3-4.4) and medium (OR = 1.6; 95%CC = 1.14-2.3) SES groups were more likely to have a higher perception of better aesthetics in their neighbourhoods than their low SES peers and higher SES was also associated with better perception of a street connectivity (OR = 2.9; 95%CI = 1.7-5.4). Conclusion: The study showed that girls of higher SES are more active than those of lower SES and that social background might be associated with differences in neighbourhood environmental perceptions.

Oliver, M., K. Witten, et al. (2011). "Kids in the city study: research design and methodology." Bmc Public Health 11: 587.

BACKGROUND: Physical activity is essential for optimal physical and psychological health but substantial declines in children's activity levels have occurred in New Zealand and internationally. Children's independent mobility (i.e., outdoor play and traveling to destinations unsupervised), an integral component of physical activity in childhood, has also declined radically in recent decades. Safety-conscious parenting practices, car reliance and auto-centric urban design have converged to produce children living increasingly sedentary lives. This research investigates how urban neighborhood environments can support or enable or restrict children's independent mobility, thereby influencing physical activity accumulation and participation in daily life. METHODS/DESIGN: The study is located in six Auckland, New Zealand neighborhoods, diverse in terms of urban design attributes, particularly residential density. Participants comprise 160 children aged 9-11 years and their parents/caregivers. Objective measures (global positioning systems, accelerometers, geographical information systems, observational audits) assessed children's independent mobility and physical activity, neighborhood infrastructure, and streetscape attributes. Parent and child neighborhood perceptions and experiences were assessed using qualitative research methods. DISCUSSION: This study is one of the first internationally to examine the association of specific urban design attributes with child independent mobility. Using robust, appropriate, and best practice objective measures, this study provides robust epidemiological information regarding the relationships between the built environment and health outcomes for this population.

O'Loghlen, S., J. W. Pickett, et al. (2011). "Active transportation environments surrounding Canadian schools." Can J Public Health 102(5): 364-8.

OBJECTIVES: Walking or cycling to school represents an opportunity for children to engage in physical activity. The study objectives were to: 1) describe active transportation policies, programs, and built environments of Canadian schools and their surrounding neighbourhoods, and 2) document variations based on urban-rural location and school type (primary vs. secondary vs. mixed primary/secondary schools). METHODS: 397 schools from across Canada were studied. A school administrator completed a questionnaire and responses were used to assess schools' policies and programs related to active transportation and the safety and aesthetics of their respective neighbourhoods. Built environment features in a 1 km-radius circular buffer around each school were measured using geographic information systems. RESULTS: Greater than 70% of schools had passive policies (e.g., skateboards permitted on school grounds) and facilities (e.g., bicycle racks in secure area to avoid theft) to encourage bicycle and small-wheeled vehicle use. Less than 40% of schools had active programs designed to encourage active transportation, such as organized 'walk to school' days. Garbage in the streets, crime and substance abuse were barriers in most school neighbourhoods. Approximately 42% of schools were located on high-speed roads not amenable to active transportation and 14% did not have a sidewalk leading to the school. Secondary schools had less favourable active transportation policies/programs and neighbourhood safety/aesthetics compared to primary schools. Rural schools had less favourable built environments than urban schools. CONCLUSION: Canadian children, particularly those from rural areas, face a number of impediments to active transportation as a method of travelling to school.

Price, A. E., D. M. Pluto, et al. (2011). "School administrators' perceptions of factors that influence children's active travel to school." J Sch Health 81(12): 741-8.

BACKGROUND: Increasing children's active travel to school may be 1 strategy for addressing the growing prevalence of obesity among school age children. Using the School Travel Survey, we examined South Carolina school district leaders' perceptions of factors that influence elementary and middle school students walking to school. METHODS: Frequency distributions and chi-square tests were used to analyze the survey responses; open-ended questions were reviewed qualitatively for recurring topics and themes. RESULTS: School and district leaders (N = 314) most often reported street crossing safety (54.0%) and number of sidewalks (54.0%) as priority factors that should be addressed to increase students' active travel to school, followed by distance to school (46.0%), traffic volume (42.4%), parental attitudes (27.0%), traffic speed (26.7%), neighborhood condition (24.4%), and student attitudes (10.0%). Several respondents expressed concerns about liability issues related to students' active travel to school while others reported that schools are not responsible for students' safety once students leave school grounds. Independent of their comments about liability, respondents were concerned about the safety of students while walking to school. CONCLUSIONS: Those promoting active travel to school may benefit from addressing those factors perceived as most important by school and district leaders, including street crossing safety, number of sidewalks, and by educating school and district leaders about liability and safety issues related to students walking to school.

Prins, R. G., K. Ball, et al. (2011). "Associations between availability of facilities within three different neighbourhood buffer sizes and objectively assessed physical activity in adolescents." Health & Place 17(6): 1228-1234.

This study aims to explore whether objectively measured availability of parks and sports facilities within three different buffer sizes are associated with moderate-to-vigorous physical activity (MVPA) among adolescents, and to identify potential cognitive mediators of this association. Data were obtained from adolescents (N=209, mean age: 14.5 (SD: 0.6) years) at the follow-up measurement of the Children Living in Active Neighbourhoods study in 2004. MVPA was measured using accelerometers. Availability of parks and sport facilities were measured within 400, 800 and 2000 m buffers around participants' residential homes. Potential mediators (self-efficacy, attitude and the perceived availability of parks and sports grounds) were measured by self-administered questionnaires. No direct association was found between the objectively measured availability of facilities and objective assessments of MVPA and no evidence for mediation by cognitions was found in any of the buffer sizes. More specific and sensitive measures may be needed to understand environmental correlates of MVPA. (C) 2011 Elsevier Ltd. All rights reserved.

Rodriguez, D. A., G. H. Cho, et al. (2011). "Out and about: association of the built environment with physical activity behaviors of adolescent females." Health Place 18(1): 55-62.

Locational data, logged on portable GPS units and matched with accelerometer data, was used to examine associations of the built environment with physical activity and sedentary behaviors of adolescent females. In a sample of 293 adolescent females aged 15 to 18 years old in Minneapolis and San Diego, the built environment around each GPS point and its corresponding sedentary, light, and moderate-to-vigorous intensity physical activity was examined using random intercept multinomial logistic regression models. The odds of higher physical activity intensity (3-level outcome: sedentary, light, MVPA) were higher in places with parks, schools, and high population density, during weekdays, and lower in places with more roads and food outlets. Understanding the places where physical activity and sedentary behaviors occur appears to be a promising strategy to clarify relationships and inform policy aimed at increasing physical activity and reducing sedentary behaviors.

Stevens, R. B. and B. B. Brown (2011). "Walkable new urban LEED_Neighborhood-Development (LEED-ND) community design and children's physical activity: selection, environmental, or catalyst effects?" International Journal of Behavioral Nutrition and Physical Activity 8.

Background: Interest is growing in physical activity-friendly community designs, but few tests exist of communities explicitly designed to be walkable. We test whether students living in a new urbanist community that is also a pilot LEED_ND (Leadership in Energy and Environmental Design-Neighborhood Development) community have greater accelerometer-measured moderate-to-vigorous physical activity (MVPA) across particular time periods compared to students from other communities. We test various time/place periods to see if the data best conform to one of three explanations for MVPA. Environmental effects suggest that MVPA occurs when individuals are exposed to activity-friendly settings; selection effects suggest that walkable community residents prefer MVPA, which leads to both their choice of a walkable community and their high levels of MVPA; catalyst effects occur when walking to school creates more MVPA, beyond the school commute, on schooldays but not weekends. Methods: Fifth graders (n = 187) were sampled from two schools representing three communities: (1) a walkable community, Daybreak, designed with new urbanist and LEED-ND pilot design standards; (2) a mixed community (where students lived in a less walkable community but attended the walkable school so that part of the route to school was walkable), and (3) a less walkable community. Selection threats were addressed through controlling for parental preferences for their child to walk to school as well as comparing in-school MVPA for the walkable and mixed groups. Results: Minutes of MVPA were tested with 3 x 2 (Community by Gender) analyses of covariance (ANCOVAs). Community walkability related to more MVPA during the half hour before and after school and, among boys only, more MVPA after school. Boys were more active than girls, except during the half hour after school. Students from the mixed and walkable communities-who attended the same school-had similar in-school MVPA levels, and community groups did not differ in weekend MVPA, providing little evidence of selection effects. Conclusions: Even after our controls for selection effects, we find evidence of environmental effects on MVPA. These results suggest that walkable community design, according to new urbanist and LEED_ND pilot design standards, is related to higher MVPA among students at certain times.

Trapp, G. S., B. Giles-Corti, et al. (2011). "Increasing children's physical activity: individual, social, and environmental factors associated with walking to and from school." Health Educ Behav 39(2): 172-82.

BACKGROUND: Efforts to increase the prevalence of children's active school transport require evidence to inform the development of comprehensive interventions. This study used a multilevel ecological framework to investigate individual, social, and environmental factors associated with walking to and from school among elementary school-aged children, stratified by gender. METHOD: Boys aged 10 to 13 years (n = 617) and girls aged 9 to 13 years (n = 681) attending 25 Australian primary schools located in high or low walkable neighborhoods completed a 1-week travel diary and a parent/child questionnaire on travel habits and attitudes. RESULTS: Boys were more likely (odds ratio [OR] = 3.37; p < .05) to walk if their school neighborhood had high connectivity and low traffic and less likely to walk if they had to cross a busy road (OR = 0.49; p < .05). For girls, confidence in their ability to walk to or from school without an adult (OR = 2.03), school encouragement (OR = 2.43), scheduling commitments (OR = 0.41), and parent-perceived convenience of driving (OR = 0.24) were significantly associated (p < .05) with walking. Irrespective of gender and proximity to school, child-perceived convenience of walking (boys OR = 2.17 and girls OR = 1.84) and preference to walk to school (child perceived, boys OR = 5.57, girls OR = 1.84 and parent perceived, boys OR = 2.82, girls OR = 1.90) were consistently associated (p < .05) with walking to and from school. CONCLUSION: Although there are gender differences in factors influencing children walking to and from school, proximity to school, the safety of the route, and family time constraints are consistent correlates. These need to be addressed if more children are to be encouraged to walk to and from school.

Trapp, G. S., B. Giles-Corti, et al. (2011). "On your bike! a cross-sectional study of the individual, social and environmental correlates of cycling to school." Int J Behav Nutr Phys Act 8: 123.

BACKGROUND: Active school transport (AST) has declined rapidly in recent decades. While many studies have examined walking, cycling to school has received very little attention. Correlates of cycling are likely to differ to those from walking and cycling enables AST from further distances. This study examined individual, social and environmental factors associated with cycling to school among elementary school-aged children, stratified by gender. METHODS: Children (n = 1197) attending 25 Australian primary schools located in high or low walkable neighborhoods, completed a one-week travel diary and a parent/child questionnaire on travel habits and attitudes. RESULTS: Overall, 31.2% of boys and 14.6% of girls cycled >/= 1 trip/week, however 59.4% of boys and 36.7% of girls reported cycling as their preferred school transport mode. In boys (but not girls), school neighborhood design was significantly associated with cycling: i.e., boys attending schools in neighborhoods with high connectivity and low traffic were 5.58 times more likely to cycle (95% CI 1.11-27.96) and for each kilometer boys lived from school the odds of cycling reduced by 0.70 (95% CI 0.63-0.99). Irrespective of gender, cycling to school was associated with parental confidence in their child's cycling ability (boys: OR 10.39; 95% CI 3.79-28.48; girls: OR 4.03; 95% CI 2.02-8.05), parental perceived convenience of driving (boys: OR 0.42; 95% CI 0.23-0.74; girls: OR 0.40; 95% CI 0.20-0.82); and child's preference to cycle (boys: OR 5.68; 95% CI 3.23-9.98; girls: OR 3.73; 95% CI 2.26-6.17). CONCLUSION: School proximity, street network connectivity and traffic exposure in school neighborhoods was associated with boys (but not girls) cycling to school. Irrespective of gender, parents need to be confident in their child's cycling ability and must prioritize cycling over driving.

Voorhees, C. C., A. F. Yan, et al. (2011). "Neighborhood Environment, Self-efficacy, and Physical Activity in Urban Adolescents." American Journal of Health Behavior 35(6): 674-688.

Objectives: To test the pathways between perceptions of built environment factors and physical activity in urban youth. Methods: Three hundred fifty high school students' perceptions of neighborhood, and barrier self efficacy were measured by a Web survey. Physical activities were assessed using a one-week diary and accelerometers. Results: Land-use mix/accessibility and neighborhood satisfaction had direct pathways to walking. Barrier self-efficacy had a direct pathway to walking. In addition, land use, specifically neighborhood accessibility, influenced adolescents' walking behavior via self-efficacy. Similar pathways were found in MVPA models. Conclusions: Neighborhood factors appear to work together with self-efficacy to facilitate physical activity.

BUILT ENVIROMENT AND PHYSICAL ACTIVITY/ OBESITY AMONG ADULTS

Adams, M. A., J. F. Sallis, et al. (2011). "Neighborhood environment profiles related to physical activity and weight status: A latent profile analysis." Preventive Medicine 52(5): 326-331.

Background. Neighborhood built environments (BE) include combinations of co-existing stimuli influencing physical activity (PA). Dealing with numerous environmental variables and complexity presents a significant challenge. The current analysis explored whether a range of reported BE features associated with adults' physical activity produced distinct multivariate patterns, and tested whether adults' PA and body mass differed by BE profiles. Methods. Participants (20-65 years, 48.2% female, 26% ethnic minority) were recruited between 2002 and 2005 from 32 neighborhoods from Seattle-King County, WA (N = 1287) and Baltimore, MD-Washington, DC regions (N= 912). Independent Latent Profile Analyses were conducted in each region with 11 environmental variables from the Neighborhood Environment Walkability Scale. Validity of the neighborhood profiles was examined by their relationship to PA (accelerometer-derived moderate-to-vigorous minutes/day, self-reported minutes/week of walking for transportation and leisure) and self-reported BMI using ANCOVA models. Results. Neighborhood profiles for Seattle and Baltimore regions were visually similar, suggesting generalizability. High-walkable recreationally-dense neighborhoods differed significantly from other neighborhood types by as much as 13 MVPA minutes/day, almost 60 minutes/week of walking for transportation, and 75 min/week of leisure-time activity. Neighborhood profiles also differed significantly for BMI. Discussion. These findings could help identify optimal patterns of environmental attributes that facilitate physical activity and improve weight status. (C) 2011 Elsevier Inc. All rights reserved.

Block, J. P., N. A. Christakis, et al. (2011). "Proximity to Food Establishments and Body Mass Index in the Framingham Heart Study Offspring Cohort Over 30 Years." American Journal of Epidemiology 174(10): 1108-1114.

Existing evidence linking residential proximity to food establishments with body mass index (BMI; weight (kg)/height (m)(2)) has been inconclusive. In this study, the authors assessed the relation between BMI and proximity to food establishments over a 30-year period among 3,113 subjects in the Framingham Heart Study Offspring Cohort living in 4 Massachusetts towns during 1971-2001. The authors used novel data that included repeated measures of BMI and accounted for residential mobility and the appearance and disappearance of food establishments. They calculated proximity to food establishments as the driving distance between each subject's residence and nearby food establishments, divided into 6 categories. The authors used cross-classified linear mixed models to account for time-varying attributes of individuals and residential neighborhoods. Each 1-km increase in distance to the closest fast-food restaurant was associated with a 0.11-unit decrease in BMI (95% credible interval: -0.20, -0.04). In sex-stratified analyses, this association was present only for women. Other aspects of the food environment were either inconsistently associated or not at all associated with BMI. Contrary to much prior research, the authors did not find a consistent relation between access to fast-food restaurants and individual BMI, necessitating a reevaluation of policy discussions on the anticipated impact of the food environment on weight gain.

Boone-Heinonen, J. and P. Gordon-Larsen (2011). "Life stage and sex specificity in relationships between the built and socioeconomic environments and physical activity." Journal of Epidemiology and Community Health 65(10): 847-852.

Background In the largely cross-sectional literature, built environment characteristics such as walkability and recreation centres are variably related to physical activity. Subgroup-specific effects could help explain inconsistent findings, yet few studies have compared built environment associations by key characteristics such as sex or life stage. Methods Using data from the National Longitudinal Study of Adolescent Health (wave I 1994-5, wave III 2001-2; n=12 701) and a linked geographic information system, cross-sectional relationships between moderate to vigorous physical activity (MVPA) bouts and built and socioeconomic environment measures were estimated. Negative binomial generalised estimating equation regression modelled MVPA as a function of log-transformed environment measures, controlling for individual sociodemographics and testing for interactions with sex and life stage (waves I and III, when respondents were adolescents and young adults, respectively). Results Higher landscape diversity (coefficient 0.040; 95% CI 0.019 to 0.062) and lower crime (coefficient -0.047; 95% CI -0.071 to -0.022) were related to greater weekly MVPA regardless of sex or life stage. Higher street connectivity was marginally related to lower MVPA (coefficient -0.176; 95% CI -0.357 to 0.005) in females but not males. Pay facilities and public facilities per 10 000 population and median household income were unrelated to MVPA. Conclusions Similar relationships between higher MVPA and higher landscape diversity and lower crime rate across sex and life stage suggest that application of these environment features may benefit broad populations. Sex-specific associations for street connectivity may partly account for the variation in findings across studies and have implications for targeting physical activity promotion strategies.

Carlson, J. A., J. F. Sallis, et al. (2011). "Interactions between psychosocial and built environment factors in explaining older adults' physical activity." Prev Med 54(1): 68-73.

OBJECTIVE: To evaluate ecological model predictions of cross-level interactions among psychosocial and environmental correlates of physical activity in 719 community-dwelling older adults in the Baltimore, Maryland and Seattle, Washington areas during 2005-2008. METHOD: Walkability, access to parks and recreation facilities and moderate-to-vigorous physical activity (MVPA) minutes per week (min/week) were measured objectively. Neighborhood aesthetics, walking facilities, social support, self-efficacy, barriers and transportation and leisure walking min/week were self-reported. RESULTS: Walkability interacted with social support in explaining total MVPA (B=13.71) and with social support (B=7.90), self-efficacy (B=7.66) and barriers (B=-8.26) in explaining walking for transportation. Aesthetics interacted with barriers in explaining total MVPA (B=-12.20) and walking facilities interacted with self-efficacy in explaining walking for leisure (B=-10.88; Ps= 2 gyms vs. none (41.7% vs. 26.0%, POR = 1.5; 95% CI = 1.11-2.1). Conclusion. The presence of some recreational facilities for PA was associated with recommended levels of PA during leisure time in Curitiba, Brazil. (C) 2011 Elsevier Inc. All rights reserved.

Hoehner, C. M., S. L. Handy, et al. (2011). "Association between neighborhood walkability, cardiorespiratory fitness and body-mass index." Social Science & Medicine 73(12): 1707-1716.

Many studies have found cross-sectional associations between characteristics of the neighborhood built environment and physical activity (PA) behavior. However, most are based on self-reported PA, which is known to result in overestimation of PA and differential misclassification by demographic and biological characteristics. Cardiorespiratory fitness (CRF) is an objective marker of PA because it is primarily determined by PA. Furthermore, it is causally related to long-term health outcomes. Therefore, analyses of the association between CRF and built environment could strengthen arguments for the importance of built environment influences on health. We examined the association between neighborhood walkability and CRF and body-mass index (BM!). This cross-sectional analysis included 16,543 adults (5017 women, 11,526 men) aged 18-90 years with home addresses in Texas who had a comprehensive clinical examination between 1987 and 2005. Outcomes included CRF from total duration on a maximal exercise treadmill test and measured BMI. Three neighborhood walkability factors emerged from principal components analyses of block-group measures derived from the U.S. Census. In multilevel adjusted analyses, the neighborhood walkability factors were significantly associated with CRF and BMI among men and women in the expected direction. An interaction between one of the neighborhood factors and age was also observed. The interaction suggested that living in neighborhoods with older homes and with residents traveling shorter distances to work was more strongly positively associated with CRF among younger adults and more strongly negatively associated with BMI among older adults. In conclusion, neighborhood characteristics hypothesized to support more PA and less driving were associated with higher levels of CRF and lower BMI. Demonstration of an association between built environment characteristics and CRF is a significant advance over past studies based on self-reported PA. Nevertheless, stronger causal evidence depends on more robust study designs and sophisticated measures of the environment, behavior, and their physiological consequences. (C) 2011 Elsevier Ltd. All rights reserved.

Hoerster, K. D., J. A. Mayer, et al. (2011). "Dog walking: Its association with physical activity guideline adherence and its correlates." Preventive Medicine 52(1): 33-38.

Objective. We examined the prevalence and correlates of dog walking among dog owners, and whether dog walking is associated with meeting the American College of Sports Medicine/American Heart Association physical activity guidelines. Methods. In March 2008, we mailed a survey to dog-owning clients from two San Diego County veterinary clinics. Useable data were obtained from 984 respondents, and 75 of these completed retest surveys. We assessed associations between potential correlates and dog walking (i.e., yes/no dog walking for at least 10 min in past week). Results. Test-retest reliability of measures was generally high. Approximately one-third of the sample (31.5%) were not dog walkers. Proportions of dog walkers versus non-dog walkers meeting United States guidelines were 64.3% and 55.0%, respectively. Dog walking was independently associated with meeting guidelines in a multivariate model (odds ratio = 1.59, p = 0.004). Three variables were independently associated with dog walking in a multivariate model: dog encouragement of dog walking, dog-walking obligation, and dog-walking self-efficacy. Conclusion. Dog walking was associated with meeting physical activity guidelines, making it a viable method for promoting physical activity. Dog-walking obligation and self-efficacy may be important mediators of dog walking and may need to be targeted if interventions are to be successful. Published by Elsevier Inc.

Inoue, S., Y. Ohya, et al. (2011). "Perceived neighborhood environment and walking for specific purposes among elderly Japanese." J Epidemiol 21(6): 481-90.

BACKGROUND: Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults. METHODS: This population-based, cross-sectional study enrolled 1921 participants (age: 65-74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders. RESULTS: Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00-1.51), 1.39 (1.14-1.71), and 1.48 (1.21-1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women. CONCLUSIONS: Specific environment-walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in promoting physical activity among elderly Japanese.

Jaime, P. C., A. C. Duran, et al. (2011). "Investigating Environmental Determinants of Diet, Physical Activity, and Overweight among Adults in Sao Paulo, Brazil." Journal of Urban Health-Bulletin of the New York Academy of Medicine 88(3): 567-581.

There is worldwide recognition that the burden of noncommunicable diseases (NCDs) and obesity-related health problems is rapidly increasing in low- and middle-income countries. Environmental determinants of obesity are likely to differ between countries, particularly in those undergoing rapid socioeconomic and nutrition transitions such as Brazil. This study aims to describe some built environment and local food environment variables and to explore their association with the overweight rate and diet and physical activity area-level aggregated indicators of adults living in the city of Sao Paulo, the largest city in Brazil. This formative study includes an ecological analysis of environmental factors associated with overweight across 31 submunicipalities of the city of Sao Paulo using statistical and spatial analyses. Average prevalence of overweight was 41.69% (95% confidence interval 38.74, 44.64), ranging from 27.14% to 60.75% across the submunicipalities. There was a wide geographical variation of both individual diet and physical activity, and indicators of food and built environments, favoring wealthier areas. After controlling for area socioeconomic status, there was a positive correlation between regular fruits and vegetables (FV) intake and density of FV specialized food markets (r = 0.497; p < 0.001), but no relationship between fast-food restaurant density and overweight prevalence was found. A negative association between overweight prevalence and density of parks and public sport facilities was seen (r = -0.527; p < 0.05). Understanding the relationship between local neighborhood environments and increasing rates of poor diet, physical activity, and obesity is essential in countries undergoing rapid economic and urban development, such as Brazil, in order to provide insights for policies to reduce increasing rates of NCDs and food access and health inequalities.

Kaczynski, A. T. and A. J. Mowen (2011). "Does self-selection influence the relationship between park availability and physical activity?" Preventive Medicine 52(1): 23-25.

Objective. Increased proximity to parkland is associated with physical activity (PA). This study explored the extent to which self-selection - the idea that active persons simply seek out neighborhoods more endowed with active resources - influences the relationship between park availability and PA. Method. In August 2007, measures of parkland availability within 1 km, importance placed on living near parks, and park-based PA participation were assessed for 585 adults in Waterloo, Ontario. Results. Logistic regression revealed that (i) participants who placed greater importance on neighborhood open space were not more likely to live near more parkland; (ii) both park importance and park space availability were associated with increased, and relatively equal, odds of engaging in at least some park-based PA; and (iii) participants who placed a low importance on living near parks but had a higher amount of park space nearby were significantly more likely to engage in park-based PA than participants who also placed a low importance on parks but had less nearby park space. Conclusion. The issue of self-selection does not solely account for the relationship frequently observed between park space availability and PA. Future prospective and intervention studies are needed to draw more definitive conclusions about causality. (c) 2010 Elsevier Inc. All rights reserved.

Kaczynski, A. T., S. A. W. Stanis, et al. (2011). "Variations in Observed Park Physical Activity Intensity Level by Gender, Race, and Age: Individual and Joint Effects." Journal of Physical Activity & Health 8: S151-S160.

Background: Parks are important settings for physical activity (PA), but few studies have documented the actual behaviors of park users. The purpose of this study was to examine the individual and joint effects of various park user demographic characteristics on observed PA intensity levels. Methods: Four parks were observed using the System for Observing Play and Recreation in Communities. Observers recorded the age group, gender, race, and intensity level of all park users in 83 activity areas over two weekends at each park. Logistic regression examined whether male/White, female/White, and male/non-White users were more likely than female/non-White users to be observed engaging in moderate-to-vigorous PA (MVPA) rather than sedentary activity across 4 age groups. Results: In total, 8612 users were observed during the study. In the child age group, male/White users were significantly more likely to be observed in MVPA than female/non-White users. For teens, female/White and male/White users were less likely to engage in MVPA. For both adults and seniors, female/White and male/White users were more likely to be observed in MVPA. Conclusion: Observations revealed significant differences in intensity levels across gender, age, and race groups. Future interventions should emphasize park design that promotes increased MVPA among diverse groups.

Kapinos, K. A. and O. Yakusheva (2011). "Environmental Influences on Young Adult Weight Gain: Evidence From a Natural Experiment." Journal of Adolescent Health 48(1): 52-58.

Objectives: This study investigated the importance of environmental influences in explaining weight gain and related behaviors among freshman college students. Methods: We exploited a natural experiment that takes place on most college campuses in the United States - randomized dormitory assignments. We estimated the effects of living in dormitories with varying physical environment characteristics on weight gain and related behaviors (daily number of meals and snacks, weekly frequency of exercise) among randomly assigned freshman students. Results: We found strong evidence linking weight and related behaviors to individual dormitories, as well as to specific characteristics of the dormitories. On average, students assigned to dormitories with on-site dining halls gained more weight and exhibited more behaviors consistent with weight gain during the freshman year as compared with students not assigned to such dormitories. Females in such dormitories weighed .85 kg (p = .03) more and exercised 1.43 (p N(2) > N(4) > N(10) > N(9) > N(11) > N(7) > N(6) > N(5) > N(8) > N(1) > N(12) > N(13). From above, the urban center environment is most appropriate for physical activity, subcivil center ranks the second position and suburbs the last. The urban environment is most appropriate for physical activity, subcivil center ranks the second position and suburb the last. The logical result proved the gray correlation analysis is an effective method to study the relationship between physical activity and environment. Conclusion. These findings collectively suggest that public health, city planning and environment protecting need to consider how to create more livable and pedestrian-friendly community areas, especially in developing countries, as China.

POLICY

Coffield, J. E., J. M. Metos, et al. (2011). "A Multivariate Analysis of Federally Mandated School Wellness Policies on Adolescent Obesity." Journal of Adolescent Health 49(4): 363-370.

Purpose: To evaluate the effects of school wellness policies mandated by the 2004 Child Nutrition and WIC Reauthorization Act on the prevalence of overweight and obesity among adolescents. Methods: Multivariate logistic regressions, adjusted for clustering within school districts, were used to estimate the effects of district-level wellness policies on the odds of overweight and obesity among adolescents. The analyses were performed on a population-based sample obtained from the Utah Population Database, a compilation of vital characteristic, administrative, and genealogical records on all residents in Utah. Models controlled for individual, maternal, and familial characteristics, as well as characteristics of school district of residence. Self-reported body mass index was taken from drivers license data. Results: Each additional component included in a district's wellness policy was associated with as much as: 3.2% lower odds in the prevalence of adolescent overweight (OR = .968; 95% CI = .941-.997), 2.5% lower odds of obesity (OR = .975; CI = .952-.997), and 3.4% lower odds of severe obesity (OR = .966; CI = .938-.995). Wellness policy components related to diet were significantly associated with lower body mass indexes across all three thresholds, whereas those related to physical activity had significant associations for lower odds of severe obesity only. Conclusion: Results suggest that school wellness policies can significantly reduce the risk of adolescent obesity. Further research should address specific policy components that are most effective in various populations, as well as the level of commitment that is required at both the school-and district-levels for sustained effect. (C) 2011 Society for Adolescent Health and Medicine. All rights reserved.

Dill, J. and D. Howe (2011). "The Role of Health and Physical Activity in the Adoption of Innovative Land Use Policy: Findings From Surveys of Local Governments." Journal of Physical Activity & Health 8: S116-S124.

Background: Research has established that built environments, including street networks, bicycle and pedestrian infrastructure, and land uses, can positively affect the frequency and duration of daily physical activity. Attention is now being given to policy frameworks such as zoning codes that set the standards and expectations for this built environment. Methods: We examined the adoption and implementation of mixed-use and related zoning provisions with specific attention to the role that physical activity serves as a motivation for such policies and to what extent public health agencies influence the adoption process. A sample of planning directors from 53 communities with outstanding examples of mixed-use developments and 145 randomly selected midsized communities were surveyed. Results: Physical activity is not a dominant motivator in master plans and/or zoning codes and public health agencies played minor roles in policy adoption. However, physical activity as a motivation appears to be increasing in recent years and is associated with higher levels of policy innovation. Conclusions: Recommendations include framing the importance of physical activity in terms of other dominant concerns such as livability, dynamic centers, and economic development. Health agencies are encouraged to work in coalitions to focus arguments on behalf of physical activity.

Edwards, K. L., G. P. Clarke, et al. (2011). "The neighbourhood matters: studying exposures relevant to childhood obesity and the policy implications in Leeds, UK (vol 64, pg 194, 2010)." Journal of Epidemiology and Community Health 65(1): 77-77.

Background Reducing childhood obesity is a key UK government target. Obesogenic environments are one of the major explanations for the rising prevalence and thus a constructive focus for preventive strategies. Spatial analysis techniques are used to provide more information about obesity at the neighbourhood level in order to help to shape local obesity-prevention policies.

Methods Childhood obesity was defined by body mass index, using cross-sectional height and weight data for children aged 3–13 years (obesity>98th centile; British reference dataset). Relationships between childhood obesity and 12 simulated obesogenic variables were assessed using geographically weighted regression. These results were applied to three wards with different socio-economic backgrounds, tailoring local obesity-prevention policy.

Results The spatial distribution of childhood obesity varied, with high prevalence in deprived and affluent areas. Key local covariates strongly associated with childhood obesity differed: in the affluent ward, they were perceived neighbourhood safety and fruit and vegetable consumption; in the deprived ward, expenditure on food, purchasing school meals, multiple television ownership and internet access; in all wards, perceived access to supermarkets and leisure facilities. Accordingly, different interventions/strategies may be more appropriate/effective in different areas.

Conclusions These analyses identify the covariates with the strongest local relationships with obesity and suggest how policy can be tailored to the specific needs of each micro-area: solutions need to be tailored to the locality to be most effective. This paper demonstrates the importance of small-area analysis in order to provide health planners with detailed information that may help them to prioritise interventions for maximum benefit.

SOCIAL ENVIRONMENT AND PHYSICAL ACTIVITY/OBESITY AMONG YOUTH

Craggs, C., E. M. van Sluijs, et al. (2011). "Do children's individual correlates of physical activity differ by home setting?" Health Place 17(5): 1105-12.

We investigated whether physical activity (PA) correlates differed for 9-10 year-old British children living in urban, suburban and rural settings. We analysed cross-sectional data on 1653 children (SPEEDY study). Exposure variables were self-reported, whilst PA was measured using Actigraph accelerometers. Data were analysed using multilevel hierarchical regression models, stratified by home setting. PA levels did not differ by home setting. Boys, those of normal weight and those having a preference for PA had higher PA levels in all strata, but additional correlates were identified within each setting. These results highlight the potential importance of tailoring interventions to specific environmental and population strata.

Crawford, D. A., K. Ball, et al. (2011). "Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods." Br J Nutr 107(7): 1028-36.

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5-12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Children's height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = - 0.04, 95 % CI - 0.06, - 0.02), and children who had a television (TV) in their bedroom (B = 0.24, 95 % CI 0.04, 0.44) and whose mothers made greater use of food as a reward for good behaviour (B = 0.05, 95 % CI 0.01, 0.09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in children's bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities.

De Bourdeaudhuij, I., C. Simon, et al. (2011). "Are physical activity interventions equally effective in adolescents of low and high socio-economic status (SES): results from the European Teenage project." Health Education Research 26(1): 119-130.

The aim was to study whether physical activity (PA) interventions in European teenagers are equally effective in adolescents of low versus high socio-economic status (SES). Based on a systematic review (Project TEENAGE), three school-based studies for secondary analyses were selected. SES stratified analyses were run in: (i) a Belgian multi-component intervention, (ii) a French multi-component intervention and (iii) a Belgian computer-tailored education trial. Results of the secondary analyses showed that no overall significant differences between low and high SES groups were found, but some interesting specific effects were revealed. Results from the first study showed an increase in objective PA in the low SES group (P = 0.015) compared with no significant effects in the high SES group. In the second study, larger effects were found in adolescents of high SES (increase of 11 min day(-1) P < 0.001), compared with adolescents of lower SES (increase of 7 min day(-1), P = 0.02) at the longer term. The third study showed a positive effect on school-related PA in adolescents of high SES (P < 0.05) and on leisure time transportation in adolescents of low SES (P < 0.05). To conclude, we were not able to show a significant widening or narrowing of inequalities in European adolescents.

de Farias Junior, J. C., A. d. S. Lopes, et al. (2011). "Perception of the social and built environment and physical activity among Northeastern Brazil adolescents." Preventive Medicine 52(2): 114-119.

Objective. To evaluate the association between levels of physical activity and perception of the social and built environmental in adolescents from Northeastern Brazil. Methods. The sample comprised 2874 adolescents aged 14 to 19 years (57.8% females) enrolled in private or public secondary schools in the municipality of Joao Pessoa, Northeastern Brazil. Level of physical activity was measured by questionnaire. Perception of environmental characteristics was measured by means of fifteen questions rated on four-point Likert-type scales ranging from 1 ("strongly disagree") to 4 ("strongly agree"). The association between physical activity and perception of environmental characteristics was investigated using multivariate binary logistic regression. Results. Multivariate analysis showed that adolescents living in neighborhoods where other adolescents were physically active (68.7% vs. 60.1%, OR = 1.20; 95%CI: 1.05-1.56, among boys only) or who lived close to places they liked to frequent (71.8% vs. 53.4%, OR = 1.96; 95%CI: 1.40-2.78 among boys; and 42.0% vs. 32.3% OR= 1.33; 95%CI: 1.10-1.74 among girls) were more likely to be physically active. Conclusions. Adolescents with positive perceptions of certain environmental characteristics were more likely to be physically active. Environmental characteristics may relate differently to levels of physical activity among boys and girls. Published by Elsevier Inc.

de Jong, E., D. F. Schokker, et al. (2011). "Behavioural and socio-demographic characteristics of Dutch neighbourhoods with high prevalence of childhood obesity." International Journal of Pediatric Obesity 6(3-4): 298-305.

Objective. To identify neighbourhoods with increased prevalence of overweight children and to examine whether the association between neighbourhood and overweight can be explained by demographic characteristics and energy-related behaviours. Method. This cross-sectional study was carried out among 4,072 primary schoolchildren in the city of Zwolle, The Netherlands. Data collection consisted of measured height, weight and waist circumference, and a parental questionnaire on socio-demographic characteristics, dietary and (in) activity behaviour of their child. With Multivariate Logistic regressions, associations between unhealthy behaviours and neighbourhoods (defined by postal code) with high and low prevalence of childhood overweight were investigated. Results. In three neighbourhoods the prevalence of overweight was significantly higher (16.5% vs. 10.6%, p < 0.05). The odds of living in these neighbourhoods were higher among children watching >2 h television/day (OR: 1.57; 95% CI: 1.15-2.14), not eating breakfast daily (OR: 2.86; 95% CI: 1.93-4.23), drinking >3 glasses/day sugared drinks (OR: 1.23; 95% CI: 1.01-1.50) on weekdays and not participating in organized sports (OR: 1.32; 95% CI: 1.09-1.59). This odds was however lower among children eating ................
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