Reliability of streetscape audits comparing on-street and online observations: MAPS-Global in 5 countries.

BACKGROUND: Microscale environmental features are usually evaluated using direct on-street observations. This study assessed inter-rater reliability of the Microscale Audit of Pedestrian Streetscapes, Global version (MAPS-Global), in an international context, comparing on-street with more efficient online observation methods in five countries with varying levels of walkability. METHODS: Data were collected along likely walking routes of study participants, from residential starting points toward commercial clusters in Melbourne (Australia), Ghent (Belgium), Curitiba (Brazil), Hong Kong (China), and Valencia (Spain). In-person on the street and online using Google Street View audits were carried out by two independent trained raters in each city. The final sample included 349 routes, 1228 street segments, 799 crossings, and 16 cul-de-sacs. Inter-rater reliability analyses were performed using Kappa statistics or Intraclass Correlation Coefficients (ICC). RESULTS: Overall mean assessment times were the same for on-street and online evaluations (22 ± 12 min). Only a few subscales had Kappa or ICC values < 0.70, with aesthetic and social environment variables having the lowest overall reliability values, though still in the "good to excellent" category. Overall scores for each section (route, segment, crossing) showed good to excellent reliability (ICCs: 0.813, 0.929 and 0.885, respectively), and the MAPS-Global grand score had excellent reliability (ICC: 0.861) between the two methods. CONCLUSIONS: MAPS-Global is a feasible and reliable instrument that can be used both on-street and online to analyze microscale environmental characteristics in diverse international urban settings.

Subgroups of adolescents differing in physical and social environmental preferences towards cycling for transport: A latent class analysis.

In order to be able to tailor environmental interventions to adolescents at risk for low levels of physical activity, the aim of the present study is to identify subgroups of adolescents with different physical and social environmental preferences towards cycling for transport and to determine differences in individual characteristics between these subgroups. In this experimental study, 882 adolescents (12-16 years) completed 15 choice tasks with manipulated photographs. Participants chose between two possible routes to cycle to a friend's house which differed in seven physical micro-environmental factors, cycling distance and co-participation in cycling (i.e. cycling alone or with a friend). Latent class analysis was performed. Data were collected from March till October 2016 across Flanders (Belgium). Three subgroups could be identified. Subgroup 1 attached most importance to separation of the cycle path and safety-related aspects. Subgroup 2 attached most importance to being able to cycle together with a friend and had the highest percentage of regular cyclists. In subgroup 3, the importance of cycling distance clearly stood out. This subgroup included the lowest percentage of regular cyclists. Results showed that in order to stimulate the least regular cyclists, and thus also the subgroup most at risk for low levels of active transport, cycling distances should be as short as possible. In general, results showed that providing well-separated cycle paths which enable adolescents to cycle side by side and introducing shortcuts for cyclists may encourage different subgroups of adolescents to cycle for transport without discouraging other subgroups.

Which physical and social environmental factors are most important for adolescents' cycling for transport? An experimental study using manipulated photographs.

BACKGROUND: Ecological models emphasize that cycling for transport is determined by an interplay between individual, physical and social environmental factors. The current study investigated (a) which physical and social environmental factors determine adolescents' preferences towards cycling for transport and (b) which individual, physical and social environmental factors are associated with their intention to actually cycle for transport. METHODS: An online questionnaire consisting of questions on individual and social environmental variables, and 15 choice-based conjoint tasks with manipulated photographs was completed by 882 adolescents (55.3% male; 13.9 ± 1.6 years). Within the choice tasks, participants were asked to indicate which of two situations they would prefer to cycle to a friend's house. The manipulated photographs were all modified versions of one semi-urban street which differed in the following physical micro-environmental attributes (separation of cycle path, evenness of cycle path, speed limit, speed bump, traffic density, amount of vegetation and maintenance). In addition, each photograph was accompanied by two sentences which described varying cycling distances and co-participation in cycling (i.e. cycling alone or with a friend). After each choice task participants were also asked if they would actually cycle in that situation in real life (i.e. intention). Hierarchical Bayes analyses were performed to calculate relative importances and part-worth utilities of environmental attributes. Logistic regression analyses were performed to investigate which individual, physical and social environmental factors were associated with adolescents' intention to actually cycle for transport. RESULTS: Adolescents' preference to cycle for transport was predominantly determined by separation of cycle path, followed by shorter cycling distance and co-participation in cycling. Higher preferences were observed for a separation between the cycle path and motorized traffic by means of a hedge versus a curb, versus a marked line. Similar findings were observed for intention to cycle. Furthermore, evenness of the cycle path and general maintenance of the street were also of considerable importance among adolescents, but to a lesser extent. CONCLUSIONS: Results of this experimental study justify investment by local governments in well-separated cycling infrastructure, which seemed to be more important than cycling distance and the social environment.

Pyschosocial factors associated with children's cycling for transport: A cross-sectional moderation study.

Promoting children's cycling for transport is a useful strategy to increase their physical activity levels. No studies have examined to which extent children's psychosocial characteristics play a role in their transportation cycling. Furthermore, insights into the association between children's independent mobility (IM) and transportation cycling is lacking in Europe. This study examined (1) the association of children's psychosocial characteristics with transportation cycling and its moderating effect of child's gender, parents' educational attainment and IM, and (2) the association between children's IM and transportation cycling. Children (n=1232, aged 10-12yrs) completed an online questionnaire at school assessing their psychosocial characteristics related with transportation cycling. Parents reported child's usual transportation cycling and the distance their child is allowed to cycle unsupervised (IM). Hurdle models were used to estimate associations between independent variables and odds of being a cyclist and with minutes of transportation cycling among those cycling. Data were collected during November-December 2014 across Flanders, Belgium. Children's perceived parental modeling, parental norm, peers' co-participation, self-efficacy and IM were positively related to the odds of being a cyclist, perceived benefits were negatively associated. Parental modeling, siblings' modeling, self-efficacy and parental norm were more strongly related to the odds of being a cyclist among children with a low IM. Friends' modeling was significantly related with odds of being a cyclist among boys. IM and parental norm (only among boys) were positively related to the time spent cycling. Targeting children, their friends and parents seems therefore most appropriate when aiming to increase children's transportation cycling.

Using an audit tool (MAPS Global) to assess the characteristics of the physical environment related to walking for transport in youth: reliability of Belgian data.

BACKGROUND: The aim was to examine inter-rater and alternate-form reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS) Global tool to assess the physical environment along likely walking routes in Belgium. METHODS: For 65 children participating in the BEPAS-children study, routes between their individual homes and the nearest pre-defined destination were defined. Using MAPS Global, physical environmental characteristics of the routes were audited by 4 trained auditors (2 on-site, 2 online using Google Street View). Inter-rater reliability was studied for on-site and online ratings separately. Alternate-form reliability was examined by comparing on-site with online ratings. RESULTS: Inter-rater reliability for on-site ratings was acceptable for 68% of items (kappa range 0.03-1.00) and for online ratings for 60% of items (kappa range -0.03 to 1.00). Acceptable alternate-form reliability was reported for 60% of items (kappa range -0.01 to 1.00/r range 0.31-1.00). CONCLUSIONS: MAPS Global can be used to assess the physical environment of potential walking routes. For areas where Google Street View imagery is widely covered and often updated, MAPS Global can be completed online.

Which environmental factors most strongly influence a street's appeal for bicycle transport among adults? A conjoint study using manipulated photographs.

BACKGROUND: Micro-environmental factors (specific features within a streetscape), instead of macro-environmental factors (urban planning features), are more feasible to modify in existing neighborhoods and thus more practical to target for environmental interventions. Because it is often not possible to change the whole micro-environment at once, the current study aims to determine which micro-environmental factors should get the priority to target in physical environmental interventions increasing bicycle transport. Additionally, interaction effects among micro-environmental factors on the street's appeal for bicycle transport will be determined. METHODS: In total, 1950 middle-aged adults completed a web-based questionnaire consisting of a set of 12 randomly assigned choice tasks with manipulated photographs. Seven micro-environmental factors (type of cycle path, speed limit, speed bump, vegetation, evenness of the cycle path surface, general upkeep and traffic density) were manipulated in each photograph. Conjoint analysis was used to analyze the data. RESULTS: Providing streets with a cycle path separated from motorized traffic seems to be the best strategy to increase the street's appeal for adults' bicycle transport. If this adjustment is not practically feasible, micro-environmental factors related to safety (i.e. speed limit, traffic density) may be more effective in promoting bicycle transport than micro-environmental factors related to comfort (i.e. evenness of the cycle path surface) or aesthetic (i.e. vegetation, general upkeep). On the other hand, when a more separated cycle path is already provided, micro-environmental factors related to comfort or aesthetic appeared to become more prominent. CONCLUSIONS: Findings obtained from this research could provide advice to physical environmental interventions about which environmental factors should get priority to modify in different environmental situations. TRIAL REGISTRATION: The study was approved by the Ethics Committee of the Ghent University Hospital. TRIAL REGISTRATION: B670201318588. Registered at 04/10/2013. http://www.ugent.be/ge/nl/faculteit/raden/ec.

Differences in environmental preferences towards cycling for transport among adults: a latent class analysis.

BACKGROUND: Increasing cycling for transport can contribute to improve public health among adults. Micro-environmental factors (i.e. small-scaled street-setting features) may play an important role in affecting the street's appeal to cycle for transport. Understanding about the interplay between individuals and their physical environment is important to establish tailored environmental interventions. Therefore, the current study aimed to examine whether specific subgroups exist based on similarities in micro-environmental preferences to cycle for transport. METHODS: Responses of 1950 middle-aged adults (45-65 years) on a series of choice tasks depicting potential cycling routes with manipulated photographs yielded three subgroups with different micro-environmental preferences using latent class analysis. RESULTS: Although latent class analysis revealed three different subgroups in the middle-aged adult population based on their environmental preferences, results indicated that cycle path type (i.e. a good separated cycle path) is the most important environmental factor for all participants and certainly for individuals who did not cycle for transport. Furthermore, only negligible differences were found between the importances of the other micro-environmental factors (i.e. traffic density, evenness of the cycle path, maintenance, vegetation and speed limits) regarding the two at risk subgroups and that providing a speed bump obviously has the least impact on the street's appeal to cycle for transport. CONCLUSIONS: Results from the current study indicate that only negligible differences were found between the three subgroups. Therefore, it might be suggested that tailored environmental interventions are not required in this research context.

Assessing cycling-friendly environments for children: are micro-environmental factors equally important across different street settings?

BACKGROUND: As physical activity levels decrease as children age, sustainable and accessible forms of physical activity are needed from a young age. Transportation cycling is one such physical activity and has been associated with many benefits. The aims of the study were to identify whether manipulating micro-environmental factors (e.g. speed limits, evenness of cycle path) within a photographed street influences the perceived supportiveness for transportation cycling; and whether changing these micro-environmental factors has the same effect across different street settings. METHODS: We recruited 305 fifth and sixth grade children and their parents from twelve randomly selected primary schools in Flanders, Belgium. They completed a web-based questionnaire including 12 choice-based conjoint tasks, in which they had to choose between two possible routes depicted on manipulated photographs, which the child would cycle along. The routes differed in four attributes: general street setting (enclosed, half open, open), evenness of cycle path (very uneven, moderately uneven, even), speed limit (70 km/h, 50 km/h, 30 km/h) and degree of separation between a cycle path and motorised traffic (no separation, curb, hedge). Hierarchical Bayes analyses revealed the relative importance of each micro-environmental attribute across the three street settings. RESULTS: For each attribute, children and their parents chose routes that had the best alternative (i.e. open street setting, even cycle path, 30 km/h, a hedge separating the cycle path from motorised traffic). The evenness of the cycle path and lower speed limit had the largest effect for the children, while the degree of separation and lower speed limit had the largest effect for their parents. Interactions between micro-scale and macro-scale factors revealed differences in the magnitude but not direction of their effects on route choice. The results held across the different kinds of street settings tested. CONCLUSIONS: Improving micro-scale attributes may increase the supportiveness of a street for children's transportation cycling. We call for on-site research to test effects of changes in micro-environmental attributes on transportation cycling among children.

Does Sleep Mediate the Association between School Pressure, Physical Activity, Screen Time, and Psychological Symptoms in Early Adolescents? A 12-Country Study.

This study examines the mediating role of sleep duration and sleep onset difficulties in the association of school pressure, physical activity, and screen time with psychological symptoms in early adolescents. Data were retrieved from 49,403 children (13.7 ± 1.6 years old, 48.1% boys) from 12 countries participating in the World Health Organization (WHO) "Health Behaviour in School-aged Children" 2013/2014 study. A validated self-report questionnaire assessed psychological symptoms (feeling low, irritability or bad temper, feeling nervous), school pressure, physical activity (number of days/week 60 min moderate-to-vigorous), screen time, sleep duration on week- and weekend days, and perceived difficulties in getting asleep. Multilevel mediation analyses were conducted. School pressure and screen time were positively associated with psychological symptoms, whereas physical activity was negatively associated. With the exception of sleep duration in the association between physical activity and psychological symptoms, all associations were significantly mediated by sleep duration on week- and weekend days and sleep onset difficulties. Percentages mediated ranged from 0.66% to 34.13%. This study partly explains how school pressure, physical activity, and screen time are related to adolescents' psychological symptoms. Future interventions improving adolescents' mental well-being could target schoolwork, physical activity, and screen time, as these behaviours are directly and indirectly (through sleep) related to psychological symptoms.

Trends in sleeping difficulties among European adolescents: Are these associated with physical inactivity and excessive screen time?

OBJECTIVES: We examined changes in sleep-onset difficulties over time and associations with physical activity and screen time behavior among adolescents. METHODS: We used data from last four survey waves of the Health Behavior in School-Aged Children (HBSC) study (2002-2006-2010-2014). Multilevel logistic regression analyses were conducted to explore associations between regular sleeping difficulties, excessive screen time exposure and being insufficiently physically active (i.e., < 60 min daily) among 33 European and non-European countries. RESULTS: Findings indicate an increase in the prevalence of sleep-onset difficulties and in excessive screen time exposure and a small but significant increase in physical activity levels. Additionally, adolescents exceeding 2-h daily screen time had 20% higher odds of reporting sleep-onset difficulties, while no association was found for physical activity. The strength of the association between screen time and sleep-onset difficulties increased over time, which may reflect a change in type of screen time use (e.g., the increased use of easy accessible screens such as smartphones and tablets). CONCLUSIONS: Effective strategies to reduce screen time are key to reverse the detrimental trend in sleep-onset difficulties among adolescents.

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.

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.

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.

Does parental accompaniment when walking or cycling moderate the association between physical neighbourhood environment and active transport among 10-12 year olds?

OBJECTIVES: To assess whether associations between neighbourhood environmental features and frequency of children's active trips per week are moderated by frequency of parental accompaniment when walking/cycling. DESIGN: Cross-sectional survey METHODS: Children aged 10-12 years (n=677) were recruited from 19 schools in Melbourne, Australia. Parents reported the number of walking/cycling trips/week usually made by their child to eight local destinations. Environmental variables (i.e. number of cul-de-sacs, intersections, public open spaces (POS) defined as reserves or parks, sport and recreation POS, sport options, population density, length of busy roads and length of walking/cycling tracks) within an 800m buffer around participants' homes were objectively assessed with a Geographic Information System. Associations between neighbourhood features and frequency of active trips were assessed using multilevel linear regressions. Moderating effects of regular parental accompaniment when walking/cycling were examined. RESULTS: Parental co-participation in walking and cycling was positively associated with frequency of overall walking/cycling trips. Number of intersections, sport and recreation POS, sport options and population density were positively associated with walking/cycling trips. Only one significant interaction was found; a positive association was found between intersection density and walking/cycling trips among children whose parents did not cycle with them while it was not associated among others. CONCLUSIONS: Building supporting and safe neighbourhood environments is needed to support children's active travel behaviours to improve real and perceived safety concerns and provide relevant infrastructure and destinations, regardless of whether or not parents accompany children during walking and cycling. Although little evidence of moderation was found, future research should include co-participation in a broader range of walking behaviours.

Creating Cycling-Friendly Environments for Children: Which Micro-Scale Factors Are Most Important? An Experimental Study Using Manipulated Photographs.

BACKGROUND: Increasing participation in transportation cycling represents a useful strategy for increasing children's physical activity levels. Knowledge on how to design environments to encourage adoption and maintenance of transportation cycling is limited and relies mainly on observational studies. The current study experimentally investigates the relative importance of micro-scale environmental factors for children's transportation cycling, as these micro-scale factors are easier to change within an existing neighborhood compared to macro-scale environmental factors (i.e. connectivity, land-use mix, …). METHODS: Researchers recruited children and their parents (n = 1232) via 45 randomly selected schools across Flanders and completed an online questionnaire which consisted of 1) demographic questions; and 2) a choice-based conjoint (CBC) task. During this task, participants chose between two photographs which we had experimentally manipulated in seven micro-scale environmental factors: type of cycle path; evenness of cycle path; traffic speed; traffic density; presence of speed bumps; environmental maintenance; and vegetation. Participants indicated which route they preferred to (let their child) cycle along. To find the relative importance of these micro-scale environmental factors, we conducted Hierarchical Bayes analyses. RESULTS: Type of cycle path emerged as the most important factor by far among both children and their parents, followed by traffic density and maintenance, and evenness of the cycle path among children. Among parents, speed limits and maintenance emerged as second most important, followed by evenness of the cycle path, and traffic density. CONCLUSION: Findings indicate that improvements in micro-scale environmental factors might be effective for increasing children's transportation cycling, since they increase the perceived supportiveness of the physical environment for transportation cycling. Investments in creating a clearly designated space for the young cyclist, separated from motorized traffic, appears to be the most effective way to increase perceived supportiveness. Future research should confirm our laboratory findings with experimental on-site research.

Does the Effect of Micro-Environmental Factors on a Street's Appeal for Adults' Bicycle Transport Vary across Different Macro-Environments? An Experimental Study.

BACKGROUND: Characteristics of the physical environment can be classified into two broad categories: macro- ("raw" urban planning features influenced on a regional level) and micro- (features specifically within a streetscape influenced on a neighborhood level) environmental factors. In urban planning applications, it is more feasible to modify conditions at the neighborhood level than at the regional level. Yet for the promotion of bicycle transport we need to know whether relationships between micro-environmental factors and bicycle transport depend on different types of macro-environments. This study aimed to identify whether the effect of three micro-environmental factors (i.e., evenness of the cycle path surface, speed limits and type of separation between cycle path and motorized traffic) on the street's appeal for adults' bicycle transport varied across three different macro-environments (i.e., low, medium and high residential density street). METHODS: In total, 389 middle-aged adults completed a web-based questionnaire consisting of socio-demographic characteristics and a series of choice tasks with manipulated photographs, depicting two possible routes to cycle along. Conjoint analysis was used to analyze the data. RESULTS: Although the magnitude of the overall effects differed, in each macro-environment (i.e., low, medium and high residential density), middle-aged adults preferred a speed limit of 30 km/h, an even cycle path surface and a hedge as separation between motorized traffic and the cycle path compared to a speed limit of 50 or 70 km/h, a slightly uneven or uneven cycle path surface and a curb as separation or no separation between motorized traffic and the cycle path. CONCLUSIONS: Our results suggest that irrespective of the macro-environment, the same micro-environmental factors are preferred in middle-aged adults concerning the street's appeal for bicycle transport. The controlled environment simulations in the experimental choice task have the potential to inform real life environmental interventions and suggest that micro-environmental changes can have similar results in different macro-environments.

Critical environmental factors for transportation cycling in children: a qualitative study using bike-along interviews.

BACKGROUND: Environmental factors are found to influence transport-related physical activity, but have rarely been studied in relation with cycling for transport to various destinations in 10-12 yr old children. The current qualitative study used 'bike-along interviews' with children and parents to allow discussion of detailed environmental factors that may influence children's cycling for transport, while cycling in the participant's neighborhood. METHODS: Purposeful convenience sampling was used to recruit 35 children and one of their parents residing in (semi-) urban areas. Bike-along interviews were conducted to and from a randomly chosen destination (e.g. library) within a 15 minutes' cycle trip in the participant's neighborhood. Participants wore a GoPro camera to objectively assess environmental elements, which were subsequently discussed with participants. Content analysis and arising themes were derived using a grounded theory approach. RESULTS: The discussed environmental factors were categorized under traffic, urban design, cycling facilities, road design, facilities at destination, aesthetics, topography, weather, social control, stranger danger and familiar environment. Across these categories many environmental factors were (in)directly linked to road safety. This was illustrated by detailed discussions of the children's visibility, familiarity with specific traffic situations, and degree of separation, width and legibility of cycle facilities. CONCLUSION: Road safety is of major concern in this 10-12 yr old study population. Bike-along interviews were able to identify new, detailed and context-specific physical environmental factors which could inform policy makers to promote children's cycling for transport. However, future studies should investigate whether hypothetical changes to such micro environmental features influence perceptions of safety and if this in turn could lead to changes in children's cycling for transport.