A systematic review on the associations between the built environment and adult's physical activity in global tropical and subtropical climate regions.

BACKGROUND: Physical inactivity is a major public health concern, exacerbated in countries with a (sub)tropical climate. The built environment can facilitate physical activity; however, current evidence is mainly from North American and European countries with activity-friendly climate conditions. This study explored associations between built environment features and physical activity in global tropical or subtropical dry or desert climate regions. METHODS: A systematic review of four major databases (Web of Science, Scopus, PubMed, and SportDISCUS) was performed. To be included, studies had to investigate associations between perceived or objective built environment characteristics and adult's physical activity and had to be conducted in a location with (sub)tropical climate. Each investigated association was reported as one case and results were synthesized based upon perceived and objectively assessed environment characteristics as well as Western and non-Western countries. Study quality was evaluated using a tool designed for assessing studies on built environment and physical activity. RESULTS: Eighty-four articles from 50 studies in 13 countries with a total of 2546 built environment-physical activity associations were included. Design (connectivity, walking/cycling infrastructure), desirability (aesthetics, safety), and destination accessibility were the built environment characteristics most frequently associated with physical activity across the domains active transport, recreational physical activity, total walking and cycling, and moderate-to-vigorous physical activity, particularly if multiple attributes were present at the same time. Very few studies assessed built environment attributes specifically relevant to physical activity in (sub)tropical climates. Most studies were conducted in Western countries, with results being largely comparable with non-Western countries. Findings were largely generalizable across gender and age groups. Results from natural experiments indicated that relocating to an activity-friendly neighborhood impacted sub-groups differently. CONCLUSIONS: Built environment attributes, including destination accessibility, connectivity, walking and cycling infrastructure, safety, and aesthetics, are positively associated with physical activity in locations with (sub)tropical climate. However, few studies focus on built environment attributes specifically relevant in a hot climate, such as shade or indoor recreation options. Further, there is limited evidence from non-Western countries, where most of the urban population lives in (sub)tropical climates. Policy makers should focus on implementing activity-friendly environment attributes to create sustainable and climate-resilient cities.

Individual and day-to-day differences in domain-specific physical activity of 10- to 11-year-old children in Denmark-Measured using GPS and accelerometry.

OBJECTIVE: Physical activity (PA) and the achievement of 60 min of moderate-to-physical-activity daily is declining in school-aged-children, and effective strategies to increase PA is needed. We aimed to examine the individual and day-to-day distribution of PA on schooldays among children aged 10-11 in 4 domains-school, home, transport, and other. METHODS: Data were collected from August to September 2020 using accelerometer and GPS data to measure daily PA-levels and to locate in which domain PA occurs. Daily PA-levels were assessed in each domain, and analyses of the individual and day-to-day differences in PA-levels were calculated. RESULTS: The school domain contributed the most to children's daily MVPA with 47% of average MVPA, followed by the home domain with 26% of daily average MVPA, the other domain with 19% of daily average MVPA and the transport domain with 8% of daily average MVPA. Our results showed individual differences in where PA occurs, day-to-day differences in total MVPA and day-to-day differences in the MVPA-levels across domains. CONCLUSIONS: The school domain contributed the most to children's MVPA-levels followed by the domains of home, other, and transport. Our study indicated that PA-levels and the distribution of PA across domains differ from day-to-day. Future interventions should target more than one domain to accommodate these individual- and day-to-day differences in the goal of increasing PA-levels and to reduce the decline in PA seen from childhood to adolescence.

An ecosystem service perspective on urban nature, physical activity, and health.

Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants.

Adaptations to scale-up an early childhood education and care physical activity intervention for real-world availability - Play Active.

BACKGROUND: Adaptations for scale-up are ubiquitous but are rarely described in detail. Adaptations may be a key reason for the "scale-up penalty" which is when there is a reduction in intervention effect size following scale-up. The Play Active intervention consists of a physical activity policy for early childhood education and care (ECEC) services, with accompanying implementation support strategies. It was first implemented with 81 ECEC services in Perth, Western Australia, in 2021 - with significant positive changes in physical activity practice uptake. The aim of this paper is to describe the extent, type, fidelity consistency, goals, size, scope, and proposed impact of proposed adaptations to the implementation support strategies for scaling-up Play Active. METHODS: Proposed adaptations were defined as planned changes, made prior to making the intervention available. The authors created a list of adaptations from a comparison of the Play Active implementation support strategies, before and after adaptation for proposed statewide availability across Western Australia, Queensland and South Australia, Australia. We used the Framework for Reporting Adaptations and Modifications-Enhanced Implementation Strategies (FRAME-IS) to code adaptations to implementation support strategies. Three authors coded each adaptation and rated their size, scope and proposed impact. RESULTS: Fifty-three adaptations to Play Active were identified. Most (68%) were proposed for the 'content' of implementation strategies, including aspects of their delivery. In practice, this involved changing the delivery mode of implementation support strategies from phone call and email support, to website-based delivery. More than half (56%) of adaptations involved 'adding elements' for scale-up. Most adaptations were 'fidelity consistent' (95%). The main goals for adaptations were related to 'increasing the acceptability, appropriateness, or feasibility' (45%), 'decreasing the costs' (19%) and 'increasing adoption of the evidence-based practice' (19%). Adaptations were small to medium in size, with most proposed to have a positive (87%) or neutral (8%) effect on the effectiveness of the intervention, rather than negative (4%). CONCLUSIONS: A large number of small, fidelity-consistent, adaptations were proposed for Play Active scale-up. Overall, the process of reporting adaptations was found to be feasible. To understand the impact of these adaptations, it will be important to re-evaluate implementation, effectiveness and process outcomes, at-scale.

How to select interventions for promoting physical activity in schools? Combining preferences of stakeholders and scientists.

BACKGROUND: The failure to scale-up and implement physical activity (PA) interventions in real world contexts, which were previously successful under controlled conditions, may be attributed to the different criteria of stakeholders and scientists in the selection process of available interventions. Therefore, the aim of our study was to investigate and compare the criteria applied by local stakeholders and scientists for selecting amongst suitable school-based PA interventions for implementation. METHODS: We conducted a three-round repeated survey Delphi study with local stakeholders (n = 7; Bremen, Germany) and international scientific PA experts (n = 6). Independently for both panels, two rounds were utilized to develop a list of criteria and the definitions of criteria, followed by a prioritization of the criteria in the third round. For each panel, a narrative analysis was used to rank-order unique criteria, list the number of scorers for the unique criteria and synthesize criteria into overarching categories. RESULTS: The stakeholders developed a list of 53 unique criteria, synthesized into 11 categories with top-ranked criteria being 'free of costs', 'longevity' and 'integration into everyday school life'. The scientists listed 35 unique criteria, synthesized into 7 categories with the top-ranked criteria being 'efficacy', 'potential for reach' and 'feasibility'. The top ranked unique criteria in the stakeholder panel were distributed over many categories, whereas four out of the top six criteria in the scientist panel were related to 'evidence'. CONCLUSIONS: Although stakeholders and scientists identified similar criteria, major differences were disclosed in the prioritization of the criteria. We recommend an early collaboration of stakeholders and scientists in the design, implementation, and evaluation of PA interventions.

Play Active physical activity policy intervention and implementation support in early childhood education and care: results from a pragmatic cluster randomised trial.

BACKGROUND: Policy interventions to increase physical activity in early childhood education and care (ECEC) services are effective in increasing physical activity among young children. However, a large proportion of ECEC services do not have nor implement a physical activity policy. Play Active is an evidence-informed physical activity policy intervention with implementation support strategies to enable ECEC services to successfully implement their policy. This study examined the effectiveness, implementation, and process outcomes of Play Active. METHODS: A pragmatic cluster randomised trial in 81 ECEC services in Perth, Western Australia was conducted in 2021. Services implemented their physical activity policy over a minimum of three months. The effectiveness outcomes were changes in educator practices related to daily time provided for total physical activity and energetic play. Implementation outcomes included changes in director- and educator-reported uptake of policy practices and director-reported uptake of high impact and low effort policy practices. Process evaluation outcomes included awareness, fidelity, reach, and acceptability of the intervention and implementation strategies. Analysis involved descriptive statistics and generalised linear mixed effects models. RESULTS: There was a significant increase in the uptake of director-reported policy practices (p = 0.034), but no change in the uptake of the subset of high impact and low effort policy practices. Intervention group educators reported high awareness of the Play Active policy recommendations (90%). Play Active acceptability was high among educators (83%) and directors (78%). Fidelity and reach were high for most implementation support strategies (> 75%). There were no significant changes in the amount of physical activity or energetic play educators provided to children or in the proportion of educators providing the policy recommended ≥ 180 min of physical activity/day or ≥ 30 min of energetic play/day for intervention compared to wait-listed comparison services. CONCLUSIONS: Play Active resulted in significantly higher uptake of physical activity practices. However, there was no change in the amount of physical activity provided to children, which may be explained by the relatively short policy implementation period. Importantly, Play Active had high awareness, fidelity, reach, and acceptability. Future research should investigate the effectiveness of Play Active over longer implementation periods and its scalability potential. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (reference number 12620001206910, registered 13/11/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378304&isReview=true ).

Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users.

BACKGROUND: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.

Recreational walking and perceived environmental qualities: a national map-based survey in Denmark.

BACKGROUND: The aim of the study is to explore the diversity in recreational walking motives across groups with different sociodemographic characteristics, and to use a dynamic and person-centered approach to geographically assess recreational walking behavior, and preferences for place quality related to recreational walking. METHODS: A total of 1838 adult respondents (age 15-90 years), who engage in recreational walking, participated in the map-based survey. We used the online platform Maptionnaire to collect georeferenced information on the respondents' home location, other start locations for walking trips, and point of interest on their trips. Distance between home location and other start locations as well as point of interest were computed using a Geographic Information System (GIS). Additional information on recreational walking behavior and motives were collected using the traditional questionnaire function in Maptionnaire. RESULTS: The most prevalent motives for walking were mental well-being and physical health, together with enjoyment and experiences related to walking. Having a tertiary education was positively associated with mental well-being motive, experiences, and taking the dog and the children outside. Income was also positively associated with experiences and walking the dog together with enjoyment of walking and spending time with others. Using the map-based approach, we found that recreational walking often starts at a location away from home and is not limited to the nearest neighborhood. A total of 4598 points of interest were mapped, and the most frequently reported place qualities were greenery, water, wildlife, good views, and tranquility. CONCLUSION: We used a dynamic and person-centered approach and thereby giving the respondents the opportunity to point to relevant locations for their walking behavior independently of their residential neighborhood. Recreational walking often starts away from home or is not limit to the nearest neighborhod. The median distance from home to the mapped points of interests was between 1.0 and 1.6 km for home-based trips and between 9.4 and 30.6 km for trips with other start locations. The most popular place quality related to the mapped points were greenery, water, wildlife, good views, and tranquility.

Location-specific psychosocial and environmental correlates of physical activity and sedentary time in young adolescents: preliminary evidence for location-specific approaches from a cross-sectional observational study.

BACKGROUND: A better understanding of the extent to which psychosocial and environmental correlates of physical activity are specific to locations would inform intervention optimization. PURPOSE: To investigate cross-sectional associations of location-general and location-specific variables with physical activity and sedentary time in three common locations adolescents spend time. METHODS: Adolescents (N = 472,Mage = 14.1,SD = 1.5) wore an accelerometer and global positioning systems (GPS) tracker and self-reported on psychosocial (e.g., self-efficacy) and environmental (e.g., equipment) factors relevant to physical activity and sedentary time. We categorized each survey item based on whether it was specific to a location to generate psychosocial and environmental indices that were location-general or specific to either school, non-school, or home location. Physical activity (MVPA) and sedentary time were based on time/location match to home, school, or all "other" locations. Mixed-effects models investigated the relation of each index with location-specific activity. RESULTS: The location-general and non-school physical activity psychosocial indices were related to greater MVPA at school and "other" locations. The school physical activity environment index was related to greater MVPA and less sedentary time at school. The home activity environment index was related to greater MVPA at home. The non-school sedentary psychosocial index was related to less sedentary time at home. Interactions among indices revealed adolescents with low support on one index benefited (i.e., exhibited more optimal behavior) from high support on another index (e.g., higher scores on the location-general PA psychosocial index moderated lower scores on the home PA environment index). Concurrent high support on two indices did not provide additional benefit. CONCLUSIONS: No psychosocial or environment indices, including location-general indices, were related to activity in all locations. Most of the location-specific indices were associated with activity in the matching location(s). These findings provide preliminary evidence that psychosocial and environmental correlates of activity are location specific. Future studies should further develop location-specific measures and evaluate these constructs and whether interventions may be optimized by targeting location-specific psychosocial and environmental variables across multiple locations.

Is vegetation cover in key behaviour settings important for early childhood socioemotional function? A preregistered, cross-sectional study.

The environmental influences on early childhood development are understudied. The association between vegetation cover (i.e., trees, shrubs, grassed areas) in four key behaviour settings and socioemotional functioning was investigated in 1196 young children (2-5 years). Emotional difficulties were inversely associated with vegetation cover in the home yard (OR: 0.81 [0.69-0.96]) and neighbourhood (OR: 0.79 [0.67-0.94]), but not in early childhood education and care (ECEC) centre outdoor areas or the ECEC neighbourhood. The higher odds of emotional difficulties associated with lower levels of maternal education was reduced with higher percentages of home yard vegetation cover. There was no evidence of mediation of the relationship between emotional difficulties and vegetation cover by time spent playing outside the home, day or nighttime sleep duration, or physical activity. We found no associations between vegetation cover and conduct, hyperactivity and inattention, peer difficulties, or prosocial behaviours. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=J3HeEiIjVZc.

The geospatial and conceptual configuration of the natural environment impacts the association with health outcomes and behavior in children and adolescents.

BACKGROUND: Studies investigating associations between natural environments and health outcomes or health behaviors in children and adolescents yielded heterogenous results to date. This may be the result of different geospatial configurations of the natural environment and confounding characteristics of the study population. Thus, we investigated how the relationship between the natural environment and mental health, muscular fitness, and physical activity varies depending on the geospatial configuration of nature and children's and adolescents' characteristics. METHODS: Data were derived from the German Motorik-Modul (MoMo) cohort study (2018-2020) that investigates physical activity, muscular fitness, and health parameters in a national sample of children and adolescents (N = 2843) between four and 17 years (Mage = 10.46 ± 3.49 years; 48.3% girls). Mental health was assessed via questionnaire, muscular fitness via standing long jump, and physical activity with 7-day accelerometer measurement. Using geographic information systems, land cover, and land use data, three different nature definitions were applied. Both circular buffers (100-1000 m) and street-network buffers (1000-5000 m) were created for each of the nature definitions. Associations were explored with linear regression models, and interaction analysis was used to investigate how those relationships vary by gender, age, and socio-economic status. RESULTS: The relationship between the three outcomes and the natural environment varied considerably depending on the nature definition, buffer size, and buffer type, as well as socio-demographic characteristics. Specifically, when comparing youth with a high socio-economic status to those with a medium socio-economic status, smaller circular buffer distances were related to less physical activity, but larger street-network buffer distances were related to greater mental health problems. Distinct relationships also occurred for youth with low socio-economic status in those relationships, with the pattern being less clear. CONCLUSIONS: For future health research studies that investigate the role of the natural environment, we argue for the development of an a-priori model that integrates both geospatial considerations (nature definition, buffer type, and buffer size) and conceptual considerations (health outcome/behavior, sample characteristics) based on potentially underlying mechanisms that link the natural environment and the health outcome or behavior under investigation to theoretically underpin the geospatial configuration of the natural environment.

From motorised to active travel: using GPS data to explore potential physical activity gains among adolescents.

BACKGROUND: A high proportion of adolescents worldwide are not doing enough physical activity for health benefits. Replacing short motorised trips with walking or cycling has the potential to increase physical activity at the population level. This study aimed to estimate the proportion of short distance motorised trips that could be replaced with walking or cycling, and the potential physical activity gains by sociodemographic and trip characteristics. METHODS: Data were from a subsample of the NEighbourhood Activity in Youth (NEArbY) study conducted among adolescents in Melbourne. A total of 217 adolescents with at least one motorised trip completed a survey and wore a Global Positioning Systems (GPS) device for eight consecutive days. Classification of travel modes were based on speed. GPS data points were geocoded in ArcGIS. Motorised trips within walkable (1.3 km) and cyclable (4.2 km) distances were identified (threshold based on 80th percentile of walking and cycling trip distances among Victorian adolescents), and the additional physical activity minutes that could be accrued by replacing walkable or cyclable motorised trip to active trips were quantified. Multilevel linear regression was used to assess differences in physical activity minutes gain by sociodemographic and trip characteristics. RESULTS: A total of 4,116 motorised trips were made. Of these, 17% were walkable and 61% were cyclable. Replacing motorised trips by walking and cycling resulted in estimated gains of six minutes and 15 min of physical activity per day, respectively. CONCLUSION: The sizable proportion of replaceable trips and potential physical activity gains from this shift calls for attention to improve safe and connected infrastructure to support active travel.

Evaluating the effectiveness of the Play Active policy intervention and implementation support in early childhood education and care: a pragmatic cluster randomised trial protocol.

BACKGROUND: Daily physical activity is critical during the early years of life for facilitating children's health and development. A large proportion of preschool children do not achieve the recommended 3 h of daily physical activity. Early childhood education and care (ECEC) services are a key setting to intervene to increase physical activity. There is a significant need for ECEC specific physical activity policy, including clearer guidelines on the amount of physical activity children should do during care, and strategies for implementation of these guidelines. METHODS: This study is a pragmatic cluster randomised trial to evaluate the effectiveness of the Play Active physical activity policy intervention to improve early childhood education and care educator's physical activity-related practices. The central component of Play Active is an evidence-informed physical activity policy template which includes 25 practices to support nine age-specific recommendations on the amount of physical activity and sedentary time, including screen time, young children should do while in care. There are six implementation support strategies to facilitate physical activity policy implementation: (i) personalise policy (services select at least five of the 25 practices to focus on initially); (ii) policy review and approval; (iii) a resource guide; (iv) a brief assessment tool for monitoring children's energetic play; (v) professional development; and (vi) Project Officer implementation support (phone calls). A total of 60 early childhood education and care services will be recruited from metropolitan Perth, Western Australia. After baseline assessment, services will be randomly allocated to either intervention or wait-listed comparison conditions. Primary (educator-reported frequency and amount of daily time provided for children's physical activity, sedentary and screen time) and secondary (educator physical activity-related practices, self-efficacy, motivation, attitudes and beliefs, social support, and supportive physical environment) outcomes will be assessed at baseline and post-intervention, after intervention services have had a minimum 3 months of policy implementation within their service. DISCUSSION: The Play Active trial will rigorously evaluate a novel physical activity policy intervention with implementation support that promotes positive physical activity behaviours in educators and children attending ECEC. If effective, the program could be adapted, scaled-up and delivered in ECEC services nationally. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620001206910 (date of registration 13/11/2020).

Tunneling a crosstown highway: a natural experiment testing the longitudinal effect on physical activity and active transport.

BACKGROUND: In the city of Maastricht in the Netherlands, a highway crossing several deprived neighborhoods was tunneled in 2016. The vacant space on top of this tunnel was redesigned and prioritized for pedestrians and cyclists. The aim of this study was to evaluate the effect of this major infrastructural change, named the Green Carpet, on total and transport-based physical activity (PA) levels. METHODS: Participants (≥18 years) were part of one of three area-based exposure groups. The maximal exposure group lived in neighborhoods directly bordering the Green Carpet. The minimal exposure group consisted of individuals living at the other side of the city, and the no exposure group consisted of individuals living in a nearby city. Actual use of the new infrastructure was incorporated as a second measure of exposure. Data were collected before and 3-15 months after the opening of the Green Carpet. Device-based measurements were conducted to obtain PA levels and collect location data. Changes in PA over time and intervention effects were determined using linear mixed models. RESULTS: PA levels in the Green Carpet area increased for the maximal and minimal exposure groups, but did not lead to an increase in total or transport-based PA. For the no exposure group, transport-based MVPA decreased and transport-based SB increased. The significant interaction (time x exposure) for transport-based SB, indicated differences in trends between the no exposure and maximal exposure group (B=-3.59, 95% CI - 7.15; -0.02) and minimal exposure group (B= -4.02, 95% CI -7.85, -0.19). Trends in the results based on analyses focusing on actual use and non-use of the new infrastructure were similar to those of the area-based analyses. CONCLUSIONS: Results suggest that the Green Carpet led to more PA in this specific area, but did not increase the total volume of PA. The area-based differences might reflect the differences between users and non-users, but we should be careful when interpreting these results, due to possible interference of selective mobility bias. This paper reflects that the relationship between infrastructure and PA is not unambiguous. TRIAL REGISTRATION: This research was retrospectively registered at the Netherlands Trial Register ( NL8108 ).

Social network characteristics as correlates and moderators of older adults' quality of life-the SHARE study.

BACKGROUND: The quality of life (QoL) of older adults is a key aspect of healthy ageing, and older adults' socioeconomic status (SES), the neighbourhood they live in and their social networks (SN) are known to impact QoL. However, little is known about the interaction between these concepts. The aim was to examine how SN, SES and neighbourhood type are associated with QoL in older adults. METHODS: : Wave 4 (year 2011) and wave 6 (year 2015) data from the longitudinal Survey of Health, Ageing and Retirement in Europe were used for the analysis. Multilevel regression models estimated the associations including 34 792 participants from wave 4 and 67 334 participants from wave 6 from 16 countries (mean age = 66.45 years). The outcome variable was QoL, independent variables were SES (education and making end meet) and neighbourhood type (housing type and housing area), and SN variables (satisfaction and size) were the moderators. RESULTS: : SES and SN variables were positively associated with QoL. Living in a house or duplex was positively associated with QoL compared with living in a farmhouse. SN moderated the association between education and QoL. The effect of area type on QoL was moderated by SN size. SN satisfaction was an independent correlate of QoL. CONCLUSION: : Older adults' satisfaction with their SN may be more important than having a large SN. Low SES older adults may be more prone to having weak SN. Maintaining and creating supportive SN may attenuate the negative effects of low SES or less favourable neighbourhood characteristics.

Smart Watch Versus Classic Receivers: Static Validity of Three GPS Devices in Different Types of Built Environments.

In order to study the relationship between human physical activity and the design of the built environment, it is important to measure the location of human movement accurately. In this study, we compared an inexpensive GPS receiver (Holux RCV-3000) and a frequently used Garmin Forerunner 35 smart watch, with a device that has been validated and recommended for physical activity research (Qstarz BT-Q1000XT). These instruments were placed on six geodetic points, which represented a range of different environments (e.g., residential, open space, park). The coordinates recorded by each device were compared with the known coordinates of the geodetic points. There were no differences in accuracy among the three devices when averaged across the six sites. However, the Garmin was more accurate in the city center and the Holux was more accurate in the park and housing estate areas compared to the other devices. We consider the location accuracy of the Holux and the Garmin to be comparable to that of the Qstarz. Therefore, we consider these devices to be suitable instruments for locating physical activity. Researchers must also consider other differences among these devices (such as battery life) when determining if they are suitable for their research studies.

Built Environment, Physical Activity, and Obesity: Findings from the International Physical Activity and Environment Network (IPEN) Adult Study.

Creating more physical activity-supportive built environments is recommended by the World Health Organization for controlling noncommunicable diseases. The IPEN (International Physical Activity and Environment Network) Adult Study was undertaken to provide international evidence on associations of built environments with physical activity and weight status in 12 countries on 5 continents (n > 14,000). This article presents reanalyzed data from eight primary papers to identify patterns of findings across studies. Neighborhood environment attributes, whether measured objectively or by self-report, were strongly related to all physical activity outcomes (accelerometer-assessed total physical activity, reported walking for transport and leisure) and meaningfully related to overweight/obesity. Multivariable indexes of built environment variables were more strongly related to most outcomes than were single-environment variables. Designing activity-supportive built environments should be a higher international health priority. Results provide evidence in support of global initiatives to increase physical activity and control noncommunicable diseases while achieving sustainable development goals.

Development of physical activity policy and implementation strategies for early childhood education and care settings using the Delphi process.

BACKGROUND: The aim of this study was to gain consensus on an evidence informed physical activity policy template for early childhood education and care (ECEC) and determine best-practice dissemination and implementation strategies using the Delphi process. METHODS: Three-round modified Delphi methodology. During round one an expert working group developed an evidence informed ECEC specific physical activity policy template. Rounds two and three involved national online surveys to seek insight from a group of experts on the draft physical activity policy template. RESULTS: Ninety per cent of experts reported ECEC services are fully responsible for having a physical activity policy. There was consensus on the components of the policy and key physical activity and sedentary behaviour statements and recommendations. The most effective methods for disseminating a physical activity policy to ECEC providers included online (websites, social and electronic media), ECEC targeted launch events, direct mail outs and via professional associations. Twenty five key strategies related to management, supervisors and educators; the ECEC physical environment; communicating with families; and accreditation, monitoring and review, were identified as necessary for the successful implementation of physical activity policy in ECEC. Experts reached consensus on nine of these strategies indicating they were both easy to implement and likely to have a high level of influence. Key barriers and enablers to implementing ECEC-specific physical activity were also identified. CONCLUSIONS: This evidence informed physical activity policy template for ECEC provides recommendations on the amount of physical activity and sedentary time (including screen time) children should have whilst attending ECEC and aligns with national/international guidelines. A number of effective physical activity policy implementation strategies for ECEC were identified. An important next step is advocating for the introduction of legislative requirements for services to have and implement a physical activity policy.

Differences in adolescent activity and dietary behaviors across home, school, and other locations warrant location-specific intervention approaches.

BACKGROUND: Investigation of physical activity and dietary behaviors across locations can inform "setting-specific" health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents. METHODS: Participants were adolescents aged 12-16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h dietary recalls to assess dietary behaviors and eating locations. Spatial analyses were performed to classify daily physical activity, sedentary time patterns, and dietary behaviors by location, categorized as home, school, and "other" locations. RESULTS: Adolescents were least physically active at home (2.5 min/hour of wear time) and school (2.9 min/hour of wear time) compared to "other" locations (5.9 min/hour of wear time). Participants spent a slightly greater proportion of wear time in sedentary time when at school (41 min/hour of wear time) than at home (39 min/hour of wear time), and time in bouts lasting ≥30 min (10 min/hour of wear time) and mean sedentary bout duration (5 min) were highest at school. About 61% of daily energy intake occurred at home, 25% at school, and 14% at "other" locations. Proportionately to energy intake, daily added sugar intake (5 g/100 kcal), fruits and vegetables (0.16 servings/100 kcal), high calorie beverages (0.09 beverages/100 kcal), whole grains (0.04 servings/100 kcal), grams of fiber (0.65 g/100 kcal), and calories of fat (33 kcal/100 kcal) and saturated fat (12 kcal/100 kcal) consumed were nutritionally least favorable at "other" locations. Daily sweet and savory snacks consumed was highest at school (0.14 snacks/100 kcal). CONCLUSIONS: Adolescents' health behaviors differed based on the location/environment they were in. Although dietary behaviors were generally more favorable in the home and school locations, physical activity was generally low and sedentary time was higher in these locations. Health behavior interventions that address the multiple locations in which adolescents spend time and use location-specific behavior change strategies should be explored to optimize health behaviors in each location.

Physical activity benefits of attending a senior center depend largely on age and gender: a study using GPS and accelerometry data.

BACKGROUND: Senior centers offer important opportunities for physical activity and social interaction. Seniors who visit a senior center regularly can gain physical activity from transportation and from specific activities offered within the senior center. However, there is very little knowledge regarding the specific physical activity gains obtained from regular visits to senior centers, and no effort has been made to use device-based measures of physical activity to test the potential physical activity benefits of attending a senior center. METHODS: To fill this gap, the present study examined the physical activity patterns of 227 seniors living in the Barcelona Metropolitan Area in Spain. Using GPS and Accelerometer 7-day tracking data, and GIS measures we assessed the light physical activity and moderate-to-vigorous intensity physical activity (MVPA) benefits of attending the senior center on a weekly and daily basis. RESULTS: Seniors who attended a senior center at least once a week did not accumulate significantly more daily physical activity (211.6 min; 95% CI 196.6; 226.6) than seniors without any visit 215.9 min; 95% CI 202.7; 229). However, on a day-to-day basis, it was found that visiting a senior center had positive effects in physical activity and was associated with less sedentary time among younger participants in general (- 18.2 daily min 95% CI - 33.2;-3.3 p = 0.016) and among older female participants in particular (- 19.7 daily min 95% CI -21.06;-18.5 p = 0.011). CONCLUSIONS: The benefits of attending senior centers in terms of physical activity should not be viewed as universal, but rather as contingent to the demographics of the user, and the type of activity that the visit is replacing.