Road Traffic Injuries and the Built Environment in Bogotá, Colombia, 2015-2019: A Cross-Sectional Analysis.

Nine in 10 road traffic deaths occur in low- and middle-income countries (LMICs). Despite this disproportionate burden, few studies have examined built environment correlates of road traffic injury in these settings, including in Latin America. We examined road traffic collisions in Bogotá, Colombia, occurring between 2015 and 2019, and assessed the association between neighborhood-level built environment features and pedestrian injury and death. We used descriptive statistics to characterize all police-reported road traffic collisions that occurred in Bogotá between 2015 and 2019. Cluster detection was used to identify spatial clustering of pedestrian collisions. Adjusted multivariate Poisson regression models were fit to examine associations between several neighborhood-built environment features and rate of pedestrian road traffic injury and death. A total of 173,443 police-reported traffic collisions occurred in Bogotá between 2015 and 2019. Pedestrians made up about 25% of road traffic injuries and 50% of road traffic deaths in Bogotá between 2015 and 2019. Pedestrian collisions were spatially clustered in the southwestern region of Bogotá. Neighborhoods with more street trees (RR, 0.90; 95% CI, 0.82-0.98), traffic signals (0.89, 0.81-0.99), and bus stops (0.89, 0.82-0.97) were associated with lower pedestrian road traffic deaths. Neighborhoods with greater density of large roads were associated with higher pedestrian injury. Our findings highlight the potential for pedestrian-friendly infrastructure to promote safer interactions between pedestrians and motorists in Bogotá and in similar urban contexts globally.

Effectiveness and adherence to closed face shields in the prevention of COVID-19 transmission: a non-inferiority randomized controlled trial in a middle-income setting (COVPROSHIELD).

BACKGROUND: The use of respiratory devices can mitigate the spread of diseases such as COVID-19 in community settings. We aimed to determine the effectiveness of closed face shields with surgical face masks to prevent SARS-CoV-2 transmission in working adults during the COVID-19 pandemic in Bogotá, Colombia. METHODS: An open-label non-inferiority randomized controlled trial that randomly assigned participants to one of two groups: the intervention group was instructed to wear closed face shields with surgical face masks, and the active control group was instructed to wear only surgical face masks. The primary outcome was a positive reverse transcription polymerase chain reaction test, IgG/IgM antibody test for SARS-CoV-2 detection, or both during and at the end of the follow-up period of 21 days. The non-inferiority limit was established at - 5%. RESULTS: A total of 316 participants were randomized, 160 participants were assigned to the intervention group and 156 to the active control group. In total, 141 (88.1%) participants in the intervention group and 142 (91.0%) in the active control group completed the follow-up. PRIMARY OUTCOME: a positive SARS-CoV-2 test result was identified in one (0.71%) participant in the intervention group and three (2.1%) in the active control group. In the intention-to-treat analysis, the absolute risk difference was - 1.40% (95% CI [- 4.14%, 1.33%]), and in the per-protocol analysis, the risk difference was - 1.40% (95% CI [- 4.20, 1.40]), indicating non-inferiority of the closed face shield plus face mask (did not cross the non-inferiority limit). CONCLUSIONS: The use of closed face shields and surgical face masks was non-inferior to the surgical face mask alone in the prevention of SARS-CoV-2 infection in highly exposed groups. Settings with highly active viral transmission and conditions such as poor ventilation, crowding, and high mobility due to occupation may benefit from the combined use of masks and closed face shields to mitigate SARS-CoV-2 transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT04647305 . Registered on November 30, 2020.

Consumo de alcohol en entornos urbanos alrededor de una universidad en Bogotá. Resultados de un estudio piloto / Consume of Alcohol in Urban Settings around a University in Bogotá. Results of a Pilot Study

Introducción: El objetivo de este estudio piloto fue caracterizar las percepciones de estudiantes universitarios sobre el consumo de alcohol y la disponibilidad de establecimientos que expenden licor en el perímetro urbano de una universidad de Bogotá. Métodos: Se llevó a cabo un estudio transversal y mixto en 201 estudiantes seleccionados por una muestra no probabilística. Se usó una encuesta autodiligenciada para evaluar percepciones respecto al consumo de alcohol alrededor de la universidad y sistemas de información geográfica para identificar los establecimientos que vendían alcohol. Resultados: El 66% de los participantes informó haber consumido alcohol alrededor del campus universitario. El 26% se mostraba de acuerdo o muy de acuerdo con la implementación de medidas estrictas para restringir el consumo, siendo mayor en personas que no consumieron (41,2%). El análisis geográfico encontró un patrón de concentración de oferta y consumo de alcohol en las inmediaciones de la universidad. Conclusión: Este estudio muestra la potencial relevancia que tiene la oferta y consumo de alcohol alrededor de un campus universitario para la salud pública. Se deben llevar a cabo estudios complementarios para entender, de mejor manera, posibles vínculos entre contextos urbanos universitarios y consumo de alcohol.

Background: The aim of this pilot study was to characterize the perceptions of university students in relation to alcohol consumption and the availability of alcohol outlets in the urban perimeter of a university in Bogotá. Methods: A mixed cross-sectional study was conducted among 201 undergraduate students ages 18 to 27 years using a non-probabilistic sampling design. The perceptions regarding alcohol consumption in the university's surroundings were assessed via a self-reported questionnaire. Geographic Information Systems were used to identify the outlets that sell alcohol. Results: 66% of participants reported alcohol consumption in in the university's surroundings. The proportion of students who agreed with implementing strict measures to control alcohol consumption was 26%, with higher percentages in those who didn't consume alcohol (41,2%). Geographic analysis showed that several urban attributes were correlated with alcohol consumption. Conclusión: The results of this study show the potential relevance that has the availability' of alcohol outlets near a university' campus as a public health issue. Further studies should be conducted in order to better understand the links between urban contexts around universities and alcohol consumption.

TransMilenio, a Scalable Bus Rapid Transit System for Promoting Physical Activity.

Transport systems can play an important role in increasing physical activity (PA). Bogotá has been recognized for its bus rapid transit (BRT) system, TransMilenio (TM). To date, BRTs have been implemented in over 160 cities worldwide. The aim of this study was to assess the association between PA and the use of TM among adults in Bogotá. The study consists of a cross-sectional study conducted from 2010 to 2011 with 1000 adults. PA was measured using the International Physical Activity Questionnaire. In a subsample of 250 adults, PA was objectively measured using ActiGraph accelerometers. Analyses were conducted using multilevel logistic regression models. The use of TM was associated with meeting moderate-to-vigorous PA (MVPA). TM users were more likely to complete an average of >22 min a day of MVPA (odds ratio [OR] = 3.1, confidence interval [CI] = 95 % 1.4-7.1) and to walk for transportation for ≥150 min per week (OR = 1.5; CI = 95 % 1.1-2.0). The use of TM was associated with 12 or more minutes of MVPA (95 % CI 4.5-19.4, p < 0.0001). Associations between meeting PA recommendations and use of TM did not differ by socioeconomic status (p value = 0.106) or sex (p value = 0.288). The use of TM is a promising strategy for enhancing public health efforts to reduce physical inactivity through walking for transport. Given the expansion of BRTs, these results could inform the development of transport PA programs in low- to high-income countries.

International variation in neighborhood walkability, transit, and recreation environments using geographic information systems: the IPEN adult study.

BACKGROUND: The World Health Organization recommends strategies to improve urban design, public transportation, and recreation facilities to facilitate physical activity for non-communicable disease prevention for an increasingly urbanized global population. Most evidence supporting environmental associations with physical activity comes from single countries or regions with limited variation in urban form. This paper documents variation in comparable built environment features across countries from diverse regions. METHODS: The International Physical Activity and the Environment Network (IPEN) study of adults aimed to measure the full range of variation in the built environment using geographic information systems (GIS) across 12 countries on 5 continents. Investigators in Australia, Belgium, Brazil, Colombia, the Czech Republic, Denmark, China, Mexico, New Zealand, Spain, the United Kingdom, and the United States followed a common research protocol to develop internationally comparable measures. Using detailed instructions, GIS-based measures included features such as walkability (i.e., residential density, street connectivity, mix of land uses), and access to public transit, parks, and private recreation facilities around each participant's residential address using 1-km and 500-m street network buffers. RESULTS: Eleven of 12 countries and 15 cities had objective GIS data on built environment features. We observed a 38-fold difference in median residential densities, a 5-fold difference in median intersection densities and an 18-fold difference in median park densities. Hong Kong had the highest and North Shore, New Zealand had the lowest median walkability index values, representing a difference of 9 standard deviations in GIS-measured walkability. CONCLUSIONS: Results show that comparable measures can be created across a range of cultural settings revealing profound global differences in urban form relevant to physical activity. These measures allow cities to be ranked more precisely than previously possible. The highly variable measures of urban form will be used to explain individuals' physical activity, sedentary behaviors, body mass index, and other health outcomes on an international basis. Present measures provide the ability to estimate dose-response relationships from projected changes to the built environment that would otherwise be impossible.