Population density is beneficially associated with 12-year diabetes risk marker change among residents of lower socio-economic neighborhoods.

We examined associations of neighborhood population density with 12-year changes in diabetes risk (post-challenge plasma glucose), and potential moderation by neighborhood socio-economic status (SES) among 4,816 Australians. In lower SES neighborhoods, post-challenge plasma glucose increased by 6% in low-density, remained stable in medium-density and decreased by 3% in high-density neighborhoods. In medium SES neighborhoods, glucose remained stable in high-density, but increased by 2% and 3% in medium- and low-density neighborhoods, respectively. In higher SES neighborhoods, no significant interaction effect between time and density was observed. Densification may make protective contributions for diabetes risk in lower and medium SES neighborhoods.

Differences in park characteristic preferences for visitation and physical activity among adolescents: A latent class analysis.

In order to optimize environmental interventions, the current study aimed to investigate whether there are subgroups with different preferences regarding park characteristics for park visitation and park-based PA among adolescents (12-16 years). Furthermore, we examined whether the identified subgroups differed in socio-demographics, PA behavior, and park use characteristics (e.g. accompaniment to park, usual activities during park visitation, usual transportation to parks). Adolescents (12-16 years) were recruited via randomly selected secondary schools, located in Flanders (Belgium). Class visits were conducted between September and November 2016 and adolescents were asked to complete an online questionnaire. Latent class analyses using Sawtooth Software were used to identify possible subgroups. A final sample of 972 adolescents (mean age 13.3 ± 1.3 years) remained for analyses. Three subgroups of adolescents with similar preferences for park characteristics could be distinguished for both park visitation and park-based PA. Overall, current results indicate that park upkeep was the most important park characteristic for park visitation as well as park-based PA among at risk subgroups (i.e. adolescents with lower overall PA levels, girls, older adolescents,…) followed by the presence of a playground or outdoor fitness equipment. Among the more active adolescents, especially boys visiting the parks together with friends, the presence of a sport field (soccer and basketball) seems to be the best strategy to increase park visitation as well as park-based PA. Current results provide a starting point to advise policy makers and urban planners when designing or renovating parks that investing in good upkeep and maintenance of parks, and the provision of a playground or outdoor fitness equipment might be the best strategy to increase both park visitation and park-based PA among at risk adolescent subgroups.

Individual, social, and physical environmental factors related to changes in walking and cycling for transport among older adults: A longitudinal study.

To date, no longitudinal studies examined the change in walking and cycling for transport as distinct outcomes over time and investigated the predictors of those changes. Therefore, this present study examined the change in odds of engagement in walking and cycling for transport as distinct outcomes among Belgian older adults over a three-year follow-up period, and examined factors (i.e. socio-demographics, psychosocial, perceived social and physical environmental characteristics) related to these changes in engaging in walking and cycling for transport. Against our expectations, we found significantly higher odds of engaging in cycling for transport among older adults at follow-up compared to baseline and no significant differences in the odds of engaging in walking for transport. Interventions should assist older adults to increase their self-efficacy towards PA, their perceived benefits of PA, and their perception of land use mix diversity in their neighborhood in order to increase the engagement in walking/cycling for transport over time, or help to decrease their perceived barriers towards PA or their perception to have a lot of physical barriers to walk/cycle in their neighborhood. Future longitudinal studies with larger samples are warranted investigating interaction effects between different predictors at various levels to find out which factors can be further integrated into active transport interventions in older adults.

Changes in children's television and computer time according to parental education, parental income and ethnicity: A 6-year longitudinal EYHS study.

OBJECTIVES: To investigate changes in children's television and computer time according to three socio-economic status (SES) indicators. DESIGN: Prospective cohort study. METHODS: Data were drawn from the European Youth Heart Study and included longitudinal data collected in 1997 and 2003 in Denmark. Television and computer time were self-reported by children. Parental education, income and ethnicity were parent-reported. Baseline data were available for 549 children (47.0% boys, 9.6 years). Generalized linear mixed models analyzed whether changes in television and computer time from baseline to follow-up differed according to the SES-indicators. RESULT: TV viewing time increased with 25% over time (ExpB = 1.25, 95% CI = 1.04-1.50). At both time points, children with two higher educated parents viewed 25% less hours of television than children with no higher educated parents (ExpB = 0.75, 95% CI = 0.60-0.94) and one higher educated parent (ExpB = 0.75, 95%CI = 0.59-0.97). Among children with no higher educated parents the odds of being in a higher category of computer time increased with 80% over time (OR = 1.80, 95% CI = 1.24-2.60). Among children with two higher educated parents the odds of being in a higher category of computer time decreased with 45% over time (OR = 0.55, 95% CI = 0.32-0.94). The association with ethnicity showed that white children had 42% lower odds (OR = 0.58; 95% CI = 0.34-1.00) of being in a higher category of computer time than non-white children. No significant associations were found for parental income. CONCLUSIONS: The most important SES measure of screen-based behaviors in children was parental education. Ethnicity was only associated with computer time. Financial resources were less relevant for changes in television viewing and computer use.

Public open space characteristics influencing adolescents' use and physical activity: A systematic literature review of qualitative and quantitative studies.

The objective of this systematic review was to provide insight into the specific characteristics of public open spaces (POS) associated with adolescents' POS visitation and physical activity (PA). Qualitative research suggests many characteristics to be associated with POS visitation and PA. Quantitative evidence confirmed a positive association between presence of trails, playgrounds and specific types of sports fields (e.g. basketball) with POS visitation and PA, whereas safety and aesthetics seemed subordinate. Suggestions for future research, as well as some methodological recommendations are provided.

Cross-Sectional Associations between Home Environmental Factors and Domain-Specific Sedentary Behaviors in Adults: The Moderating Role of Socio-Demographic Variables and BMI.

Despite the negative health effects of too much sitting, the majority of adults are too sedentary. To develop effective interventions, insight is needed into home environmental correlates of adults' sedentary behaviors, and into the susceptibility of population subgroups to these home environmental cues. In total, 559 Flemish adults reported socio-demographics, weight and height, home environmental factors and domain-specific sedentary behaviors. Generalized linear modeling was conducted to examine main associations between home environmental factors and domain-specific sedentary behaviors, and to test the moderating role of socio-demographics and BMI on these associations. In case of significant interactions, stratified analyses were performed. Results showed that, among those who did use a computer/laptop during the last week, a one-unit increase in the number of computers or laptops was associated with 17% (OR = 1.17; 95% CI = 1.02, 1.34) and 24% (OR = 1.24; 95% CI = 1.08, 1.43) more minutes computer time per day, respectively. The proximity of the remote controller (p < 0.001) and the number of televisions (p = 0.03) were positively associated with television time, and the number of motorized vehicles (95% CI = 0.001, 0.12) was positively associated with the odds of participation in transport-related sitting time. The latter two associations were moderated by BMI, with significant positive associations limited to those not overweight. To conclude, home environmental factors were associated with domain-specific sedentary behaviors, especially in healthy weight adults. If confirmed by longitudinal studies, public health professionals should encourage adults to limit the number of indoor entertainment devices and motorized vehicles.

Insights into children's independent mobility for transportation cycling-Which socio-ecological factors matter?

OBJECTIVES: To assess the associations of socio-ecological factors with independent mobility for transportation cycling among 10-to-12-year-old boys and girls. Additionally, we examined whether associations differed across family socio-economic status (SES) and urbanization level. DESIGN: Cross-sectional survey. METHODS: Parents (n=1286) were recruited via 45 primary schools across Flanders, Belgium. They completed an online questionnaire assessing demographic and psychosocial factors, neighborhood environmental perceptions, as well as some characteristics of their child. Independent mobility was assessed as the distance children were allowed to cycle for transport without adult supervision. Multilevel gamma regression analyses stratified by gender were performed to examine the associations between the independent variables and children's independent mobility and the moderating effects of family SES and urbanization level. RESULTS: Independent mobility was higher among boys compared to girls. Perception of children's cycling and traffic skills and children's grade were positively associated with independent mobility among boys and girls. Perceptions of neighborhood traffic safety were positively associated with independent mobility among girls, but not among boys. Perceptions of cycling skills were positively associated with independent mobility among boys living in high urbanized areas, but not in low urbanized areas. Parental cycling for transport was negatively associated with independent mobility among girls with a low family SES, but not among girls with a high family SES. CONCLUSIONS: Our findings suggest that interventions targeting increases in children's cycling and traffic skills may be effective to increase independent mobility. Few differences in associations were found according to children's gender, family SES or urbanization level.

Socio-Ecological Variables Associated with Context-Specific Sitting Time in Belgian Older Adults: A One-Year Follow-Up Study.

INTRODUCTION: Knowledge about variables associated with context-specific sitting time in older adults is limited. Therefore, this study explored cross-sectional and longitudinal associations of socio-demographic, social-cognitive, physical-environmental and health-related variables with sitting during TV viewing, computer use and motorized transport in older adults. METHODS: A sample of Belgian older adults completed structured interviews on context-specific sitting time and associated variables using a longitudinal study design. Objective measurements of grip strength and physical performance were also completed. Complete baseline data were available of 258 participants (73.98±6.16 years) of which 229 participants remained in the study at one year follow-up (retention rate: 91.60%). Cross-sectional correlates (baseline data) and longitudinal predictors (change-scores in relation with change in sitting time) were explored through multiple linear regression analyses. RESULTS: Per context-specific sitting time, most of the cross-sectional correlates differed from the longitudinal predictors. Increases over time in enjoyment of watching TV (+one unit), encouragement of partner to watch less TV (+one unit) and TV time of partner (+30.0 min/day) were associated with respectively 9.1 min/day (p<0.001), 16.0 min/day (p<0.001) and 12.0 min/day (p<0.001) more sitting during TV viewing at follow-up. Increases over time in enjoyment of using a computer (+one unit), the number of smartphones and tablets (+1) and computer use of the partner (+30.0 min/day) were associated with respectively 5.5 min/day (p < .01), 10.4 min/day (p < .05) and 3.0 min/day (p < .05) more sitting during computer use at follow-up. An increase over time in self-efficacy regarding taking a bicycle or walking was associated with 2.9 min/day (p < .05) less sitting during motorized transport at follow-up. CONCLUSIONS: The results stressed the importance of looking at separate contexts of sitting. Further, the results highlighted the importance of longitudinal research in order to reveal which changes in particular variables predicted changes in context-specific sitting time. Variables at the social-cognitive level were most frequently related to context-specific sitting.

Socio-Demographic, Social-Cognitive, Health-Related and Physical Environmental Variables Associated with Context-Specific Sitting Time in Belgian Adolescents: A One-Year Follow-Up Study.

INTRODUCTION: More knowledge is warranted about multilevel ecological variables associated with context-specific sitting time among adolescents. The present study explored cross-sectional and longitudinal associations of ecological domains of sedentary behaviour, including socio-demographic, social-cognitive, health-related and physical-environmental variables with sitting during TV viewing, computer use, electronic gaming and motorized transport among adolescents. METHODS: For this longitudinal study, a sample of Belgian adolescents completed questionnaires at school on context-specific sitting time and associated ecological variables. At baseline, complete data were gathered from 513 adolescents (15.0±1.7 years). At one-year follow-up, complete data of 340 participants were available (retention rate: 66.3%). Multilevel linear regression analyses were conducted to explore cross-sectional correlates (baseline variables) and longitudinal predictors (change scores variables) of context-specific sitting time. RESULTS: Social-cognitive correlates/predictors were most frequently associated with context-specific sitting time. Longitudinal analyses revealed that increases over time in considering it pleasant to watch TV (p < .001), in perceiving TV watching as a way to relax (p < .05), in TV time of parents/care givers (p < .01) and in TV time of siblings (p < .001) were associated with more sitting during TV viewing at follow-up. Increases over time in considering it pleasant to use a computer in leisure time (p < .01) and in the computer time of siblings (p < .001) were associated with more sitting during computer use at follow-up. None of the changes in potential predictors were significantly related to changes in sitting during motorized transport or during electronic gaming. CONCLUSIONS: Future intervention studies aiming to decrease TV viewing and computer use should acknowledge the importance of the behaviour of siblings and the pleasure adolescents experience during these screen-related behaviours. In addition, more time parents or care givers spent sitting may lead to more sitting during TV viewing of the adolescents, so that a family-based approach may be preferable for interventions. Experimental study designs are warranted to confirm the present findings.

Interactions between Neighborhood Social Environment and Walkability to Explain Belgian Older Adults' Physical Activity and Sedentary Time.

This study examined associations between neighborhood social factors and physical activity (PA) and sedentary behavior (SB) in older adults. Furthermore, possible moderating effects of neighborhood walkability were explored. Data from 431 community-dwelling Belgian older adults (≥65 years) were analyzed. Neighborhood social factors included measures of neighboring, social trust and cohesion and social diversity. Neighborhood walkability was measured objectively. Outcome measures were self-reported weekly minutes of domain-specific walking and TV viewing, and accelerometer-assessed weekly minutes of moderate-to-vigorous physical activity (MVPA) and overall SB. A higher frequency of talking to neighbors was associated with higher levels of self-reported walking for transport and for recreation. Moderation analyses showed that only in highly-walkable neighborhoods, higher social diversity of the neighborhood environment was associated with more transport walking; and talking to neighbors and social interactions among neighbors were negatively associated with overall SB and television viewing, respectively. Findings suggest that a combination of a favorable neighborhood social and physical environment are important to promote older adults' PA and limit SB.

Social and Physical Environmental Factors Influencing Adolescents' Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews.

Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents' visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12-16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents' behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents' home or school may stimulate physical activity, if adolescents also experience a safe and familiar social environment.

Psychosocial and Environmental Correlates of Walking, Cycling, Public Transport and Passive Transport to Various Destinations in Flemish Older Adolescents.

BACKGROUND: Active transport is a convenient way to incorporate physical activity in adolescents' daily life. The present study aimed to investigate which psychosocial and environmental factors are associated with walking, cycling, public transport (train, tram, bus, metro) and passive transport (car, motorcycle, moped) over short distances (maximum eight kilometres) among older adolescents (17-18 years), to school and to other destinations. METHODS: 562 older adolescents completed an online questionnaire assessing socio-demographic variables, psychosocial variables, environmental variables and transport to school/other destinations. Zero-inflated negative binomial regression models were performed. RESULTS: More social modelling and a higher residential density were positively associated with walking to school and walking to other destinations, respectively. Regarding cycling, higher self-efficacy and a higher social norm were positively associated with cycling to school and to other destinations. Regarding public transport, a higher social norm, more social modelling of siblings and/or friends, more social support and a higher land use mix access were positively related to public transport to school and to other destinations, whereas a greater distance to school only related positively to public transport to school. Regarding passive transport, more social support and more perceived benefits were positively associated with passive transport to school and to other destinations. Perceiving less walking and cycling facilities at school was positively related to passive transport to school only, and more social modelling was positively related to passive transport to other destinations. CONCLUSIONS: Overall, psychosocial variables seemed to be more important than environmental variables across the four transport modes. Social norm, social modelling and social support were the most consistent psychosocial factors which indicates that it is important to target both older adolescents and their social environment in interventions promoting active transport. Walking or cycling together with siblings or friends has the potential to increase social norm, social modelling and social support towards active transport.

Street characteristics preferred for transportation walking among older adults: a choice-based conjoint analysis with manipulated photographs.

BACKGROUND: Knowledge about the relationships between micro-scale environmental factors and older adults' walking for transport is limited and inconsistent. This is probably due to methodological limitations, such as absence of an accurate neighborhood definition, lack of environmental heterogeneity, environmental co-variation, and recall bias. Furthermore, most previous studies are observational in nature. We aimed to address these limitations by investigating the effects of manipulating photographs on micro-scale environmental factors on the appeal of a street for older adults' transportation walking. Secondly, we used latent class analysis to examine whether subgroups could be identified that have different environmental preferences for transportation walking. Thirdly, we investigated whether these subgroups differed in socio-demographic, functional and psychosocial characteristics, current level of walking and environmental perceptions of their own street. METHODS: Data were collected among 1131 Flemish older adults through an online (n = 940) or an interview version of the questionnaire (n = 191). This questionnaire included a choice-based conjoint exercise with manipulated photographs of a street. These manipulated photographs originated from one panoramic photograph of an existing street that was manipulated on nine environmental attributes. Participants chose which of two presented streets they would prefer to walk for transport. RESULTS: In the total sample, sidewalk evenness had by far the greatest appeal for transportation walking. The other environmental attributes were less important. Four subgroups that differed in their environmental preferences for transportation walking were identified. In the two largest subgroups (representing 86% of the sample) sidewalk evenness was the most important environmental attribute. In the two smaller subgroups (each comprising 7% of the sample), traffic volume and speed limit were the most important environmental attributes for one, and the presence of vegetation and a bench were the most important environmental attributes for the other. This latter subgroup included a higher percentage of service flat residents than the other subgroups. CONCLUSIONS: Our results suggest that the provision of even sidewalks should be considered a priority when developing environmental interventions aiming to stimulate older adults' transportation walking. Natural experiments are needed to confirm whether our findings can be translated to real environments and actual transportation walking behavior.

Diurnal Patterns and Correlates of Older Adults' Sedentary Behavior.

INTRODUCTION: Insights into the diurnal patterns of sedentary behavior and the identification of subgroups that are at increased risk for engaging in high levels of sedentary behavior are needed to inform potential interventions for reducing older adults' sedentary time. Therefore, we examined the diurnal patterns and sociodemographic correlates of older adults' sedentary behavior(s). METHODS: Stratified cluster sampling was used to recruit 508 non-institutionalized Belgian older adults (≥ 65 years). Morning, afternoon, evening and total sedentary time was assessed objectively using accelerometers. Specific sedentary behaviors, total sitting time and sociodemographic attributes were assessed using an interviewer-administered questionnaire. RESULTS: Participants self-reported a median of 475 (Q1-Q3 = 383-599) minutes/day of total sitting time and they accumulated a mean of 580 ± 98 minutes/day of accelerometer-derived sedentary time. Sedentary time was lowest during the morning and highest during the evening. Older participants were as sedentary as younger participants during the evening, but they were more sedentary during daytime. Compared to married participants, widowers were more sedentary during daytime. Younger participants (< 75 years), men and the higher educated were more likely to engage in (high levels of) sitting while driving a car and using the computer. Those with tertiary education viewed 29% and 22% minutes/day less television compared to those with primary or secondary education, respectively. Older participants accumulated 35 sedentary minutes/day more than did younger participants and men accumulated 32 sedentary minutes/day more than did women. CONCLUSION: These findings highlight diurnal variations and potential opportunities to tailor approaches to reducing sedentary time for subgroups of the older adult population.

Assessment of physical activity in older Belgian adults: validity and reliability of an adapted interview version of the long International Physical Activity Questionnaire (IPAQ-L).

BACKGROUND: Adequate monitoring of older adults' physical activity (PA) is essential to develop effective health promotion programs. The present study examined criterion validity and test-retest reliability of the long International Physical Activity Questionnaire (IPAQ-L), adapted for Belgian, community-dwelling older adults (65 y and older). METHODS: Participants (n = 434) completed the last seven days version of IPAQ-L, modified for the Belgian population of community-dwelling older adults. This elderly-adapted version of IPAQ-L combined vigorous and moderate activities, and questions on gait speed and recreational cycling were added. Furthermore, participants wore an ActiGraph GT3X(+) accelerometer for at least five days. Criterion validity was determined by comparing self-reported weekly minutes of moderate-to-vigorous physical activity (MVPA) and weekly minutes of total PA with accelerometer data, defined by two different cut points (Freedson vs. Copeland). To examine test-retest reliability, a subsample of 29 participants completed IPAQ-L for a second time within a ten day interval. RESULTS: IPAQ-L showed moderate criterion validity for measuring weekly minutes of MVPA and total PA (Spearman's ρ range 0.33-0.40). However, plots on agreement between self-reported and accelerometer PA showed a systematic over-reporting of IPAQ-L for MVPA. In contrast, plots indicated that IPAQ-L under-estimated levels of total PA, however, this under-estimation of total PA was substantially lower than the observed over-reporting of MVPA. Test-retest reliability was moderate-to-good for work-related PA, domestic PA, MVPA and total PA (ICC range 0.52-0.81), but poorer for transportation and recreational PA (ICC 0.44 and 0.43, respectively). CONCLUSIONS: Criterion validity results suggest that IPAQ-L is more valid to measure older adults' weekly minutes of total PA than weekly MVPA minutes. Moreover, results might imply that content validity of IPAQ-L can be improved if specific light-intensity PA items are incorporated into IPAQ-L. Test-retest reliability of IPAQ-L was moderate to good, except for weekly minutes of transportation and recreational PA, probably due to week-to-week variability of these behaviors.

Park proximity, quality and recreational physical activity among mid-older aged adults: moderating effects of individual factors and area of residence.

BACKGROUND: The transition from active employment to retirement is a potentially critical period for promoting maintenance or development of recreational physical activity in older age. Park proximity and quality might be important correlates of recreational physical activity in this age group. However, research on park-physical activity relationships among mid-older aged adults is limited and inconclusive. Furthermore, while knowledge of individual moderators of park-physical activity relationships is crucial for tailoring interventions, this knowledge is also limited. We investigated relationships between perceived park proximity, park quality and recreational physical activity among mid-older aged adults. Additionally, we examined the potential moderating effects of gender, education level, retirement status, functional limitations and area of residence on these relationships. METHODS: Self-reported data on demographics, functional limitations, park proximity, park quality, recreational walking and other recreational moderate- to vigorous-intensity physical activity (MVPA) were collected among 2700 Australian adults (57-67 years) in 2012. Objective information on area of residence was collected. To examine associations of park-related variables with recreational walking and other recreational MVPA, zero-inflated negative binomial (ZINB) regression models were used. RESULTS: Park proximity significantly interacted with retirement status; non-retired participants who reported living near a park were more likely to participate in recreational walking, whereas no relationship was observed in retired participants. Among those who walked for recreation, higher park quality was related to more weekly minutes of recreational walking. No significant relationships with other recreational MVPA and no moderating effects of gender, education level, functional limitations and area of residence were observed. CONCLUSIONS: Parks may stimulate engagement in recreational walking among non-retirees and more walking among those who already walk. Future research should investigate which environmental factors relate to engagement in recreational walking among retirees and examine whether improvements in park quality actually lead to increases in mid-older aged adults' recreational walking.

The effect of changing micro-scale physical environmental factors on an environment's invitingness for transportation cycling in adults: an exploratory study using manipulated photographs.

Previous studies have shown convincing evidence for positive relationships between transportation cycling in adults and macro-scale physical environmental factors. In contrast, relationships are less consistent for more changeable, micro-scale environmental factors. The majority of existing studies used observational study designs, which cannot determine causality. The present mixed-methods study used manipulated photographs to determine causal relationships between micro-scale environmental factors and the environment's invitingness for transportation cycling. Further, interactions among environmental factors and moderating effects of gender, age and educational level were investigated. For this study, panoramic photograph of a street was manipulated on eight environmental factors: traffic, speed bump, general upkeep, evenness of the cycle path, vegetation, separation of motorized traffic, separation with sidewalk and cycle path width. Sixty-six middle-aged adults participated in the study and sorted the manipulated panoramic photographs from least to most inviting to cycle for transportation. Participants also provided qualitative data on how they sorted the streets. Multilevel cross-classified modelling was used to analyse the relationships between the environmental manipulations and the invitingness-scores. The qualitative data were deductively categorized according to the environmental factors. All environmental factors, except for separation with sidewalk, proved to have a significant main effect on the invitingness-score for transportation cycling. Cycle path evenness appeared to have the strongest effect on the invitingness. This effect was even stronger in an environment with good compared to poorly overall upkeep. Another significant interaction effect showed that the invitingness decreased when both separations along the cycle path were present compared to only a separation with traffic. No moderating effects of the demographic factors on these relationships were found. Qualitative data confirmed the observed quantitative relationships and added depth and understanding. Current study shows that the use of manipulated photographs can be an effective way to examine environment-physical activity relationships. Our findings indicate that evenness of the cycle path may be a crucial environmental factor when aiming to increase a street's invitingness for transportation cycling among middle-aged adults. The findings of our exploratory study could be used to develop an environmental intervention to determine if our findings are applicable to real changes in cycling behavior.

Relationship between neighborhood walkability and older adults' physical activity: results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors).

BACKGROUND: Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated. METHODS: The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (≥65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted. RESULTS: Findings showed a positive relationship between neighborhood walkability and weekly minutes of older adults' self-reported walking for transportation (B = 4.63 ± 1.05;p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = -1.38 ± 0.62;p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 ± 1.03;p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents. CONCLUSIONS: This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high neighborhood walkability relates to higher levels of older adults' transport-related walking. As transport-related walking is an accessible activity for older adults and easy to integrate in their daily routine, policy makers and health promoters are advised to provide sufficient destinations and pedestrian-friendly facilities in the close vicinity of older adults' residences, so short trips can be made by foot. Neighborhood income moderated the relationship between walkability and objectively-measured MVPA. Increasing total MVPA levels in older adults should be a key topic in development of promotion initiatives and special attention should be paid to low-income neighborhood residents.

Relationships between the perceived neighborhood social environment and walking for transportation among older adults.

Ecological models state that physical activity (PA) behaviors can be explained by the interplay between individuals and their surrounding physical and social environment. However, the majority of research on PA-environment relationships has focused upon the physical environment. The purpose of the current study was to investigate the relationship between the perceived social environment and older adults' walking for transportation, while adjusting for individual and perceived physical environmental factors. Questionnaires were used to collect data on walking for transportation, individual, perceived physical and social environmental factors in 50,986 Flemish older adults (≥65 years) in the period of 2004-2010. Multilevel logistic regression analyses were applied to examine the relationships between perceived social environmental factors and the odds of daily walking for transportation. The final models showed significant positive relationships for frequency of contacts with neighbors, neighbors' social support, too many immigrants residing in the neighborhood, neighborhood involvement, participation, and volunteering. These results emphasize the need for including social environmental factors in future studies examining correlates of older adults' physical activity. Current findings suggest that projects stimulating interpersonal relationships, place attachment, and formal community engagement might promote walking for transportation among older adults. Future research should try to further disentangle the complex (inter)relationships and causal mechanisms between older individuals, their environments, and their walking for transportation behavior.