Neighbourhood built environment associations with body size in adults: mediating effects of activity and sedentariness in a cross-sectional study of New Zealand adults.

BACKGROUND: The aim of this study was to determine the associations between body size and built environment walkability variables, as well as the mediating role of physical activity and sedentary behaviours with body size. METHODS: Objective environment, body size (body mass index (BMI), waist circumference (WC)), and sedentary time and physical activity data were collected from a random selection of 2033 adults aged 20-65 years living in 48 neighbourhoods across four New Zealand cities. Multilevel regression models were calculated for each comparison between body size outcome and built environment exposure. RESULTS AND DISCUSSION: Street connectivity and neighborhood destination accessibility were significant predictors of body size (1 SDchange predicted a 1.27 to 1.41 % reduction in BMI and a 1.76 to 2.29 % reduction in WC). Significantrelationships were also observed for streetscape (1 SD change predicted a 1.33 % reduction in BMI) anddwelling density (1 SD change predicted a 1.97 % reduction in BMI). Mediation analyses revealed asignificant mediating effect of physical activity on the relationships between body size and street connectivity and neighbourhood destination accessibility (explaining between 10.4 and 14.6 % of the total effect). No significant mediating effect of sedentary behaviour was found. Findings from this cross-sectional study of a random selection of New Zealand adults are consistent with international research. Findings are limited to individual environment features only; conclusions cannot be drawn about the cumulative and combined effect of individual features on outcomes. CONCLUSIONS: Built environment features were associated with body size in the expected directions. Objectively-assessed physical activity mediated observed built environment-body size relationships.

Environmental and socio-demographic associates of children's active transport to school: a cross-sectional investigation from the URBAN Study.

BACKGROUND: Active transport (e.g., walking, cycling) to school (ATS) can contribute to children's physical activity and health. The built environment is acknowledged as an important factor in understanding children's ATS, alongside parental factors and seasonality. Inconsistencies in methodological approaches exist, and a clear understanding of factors related to ATS remains equivocal. The purpose of this study was to gain a better understanding of associates of children's ATS, by considering the effects of daily weather patterns and neighbourhood walk ability and neighbourhood preferences (i.e., for living in a high or low walkable neighbourhood) on this behaviour. METHODS: Data were drawn from the Understanding Relationships between Activity and Neighbourhoods study, a cross-sectional study of physical activity and the built environment in adults and children in four New Zealand cities. Parents of participating children completed an interview and daily trip diary that assessed their child's mode of travel to school, household and individual demographic information, and parental neighbourhood preference. Daily weather data were downloaded from New Zealand's national climate database. Geographic information systems-derived variables were calculated for distance to school and neighbourhood walkability. Bivariate analyses were conducted with ATS and potential associates; factors related to ATS at p < 0.20 were considered simultaneously in generalized estimation equation models, and backwards elimination of non-significant factors was conducted; city was treated as a fixed effect in all models. RESULTS: A total of 217 children aged 6.5-15 years participated in this study. Female sex, age, city, household income, limited/no car access, residing in zone of school, shorter distance to school, neighbourhood self selection, rainfall, and sunlight hours were simultaneously considered in multivariate generalised estimation equation modelling (all p < 0.20 in bivariate analyses). After elimination of non-significant factors, age (p = 0.005), shorter distance to school (p < 0.001), city (p = 0.03), and neighbourhood self selection (p = 0.04) remained significantly associated with ATS in the multivariate analysis. CONCLUSION: Distance to school is the prevailing environmental influencing factor on children's ATS. This study, in conjunction with previous research, suggests that school siting is likely an important associate of children's ATS.

Associations between children's independent mobility and physical activity.

BACKGROUND: Independent mobility describes the freedom of children to travel and play in public spaces without adult supervision. The potential benefits for children are significant such as social interactions with peers, spatial and traffic safety skills and increased physical activity. Yet, the health benefits of independent mobility, particularly on physical activity accumulation, are largely unexplored. This study aimed to investigate associations of children's independent mobility with light, moderate-to-vigorous, and total physical activity accumulation. METHODS: In 2011-2012, 375 Australian children aged 8-13 years (62% girls) were recruited into a cross-sectional study. Children's independent mobility (i.e. independent travel to school and non-school destinations, independent outdoor play) and socio-demographics were assessed through child and parent surveys. Physical activity intensity was measured objectively through an Actiheart monitor worn on four consecutive days. Associations between independent mobility and physical activity variables were analysed using generalized linear models, accounting for clustered sampling, Actiheart wear time, socio-demographics, and assessing interactions by sex. RESULTS: Independent travel (walking, cycling, public transport) to school and non-school destinations were not associated with light, moderate-to-vigorous and total physical activity. However, sub-analyses revealed a positive association between independent walking and cycling (excluding public transport) to school and total physical but only in boys (b = 36.03, p < 0.05). Frequent independent outdoor play (three or more days per week) was positively associated with light and total physical activity (b = 29.76, p < 0.01 and b = 32.43, p = 0.03, respectively). No significant associations were found between independent outdoor play and moderate-to-vigorous physical activity. When assessing differences by sex, the observed significant associations of independent outdoor play with light and total physical activity remained in girls but not in boys. All other associations showed no significant differences by sex. CONCLUSIONS: Independent outdoor play may boost children's daily physical activity levels, predominantly at light intensity. Hence, facilitating independent outdoor play could be a viable intervention strategy to enhance physical activity in children, particularly in girls. Associations between independent travel and physical activity are inconsistent overall and require further investigation.

Recruitment and retention of children in behavioral health risk factor studies: REACH strategies.

BACKGROUND: Children are a common target group in behavioral health research. Yet their recruitment into community setting studies poses challenges to researchers and little guidance exists on recruitment and retention methods. PURPOSE: This study aims to present successful strategies for the recruitment and retention of children into behavioral health risk factor studies. METHOD: Firstly, a literature search in various databases was undertaken for papers published 1990-2012, focusing on recruitment and retention methods used in community-based studies with children aged 3-18 years. Secondly, a Delphi study was conducted in 2012 with 27 international experts in the fields of child-related behavioral health risk factors to gather expertise and consensus on successful recruitment and retention strategies applicable in children. RESULTS: The literature review and Delphi study yielded a set of successful child recruitment and retention strategies, and examples for implementation. These are presented as strategies to Recruit, Engage and retAin Children in behavioral Health risk factor studies (REACH). Recognized strategies for successful recruitment and retention included building trustful relationships between researchers and study partners, parents, and children; having project champions; optimizing consent and follow-up procedures; offering incentives to study partners, children, and parents; minimizing participant burden; and designing feasible studies with cohesive research teams. CONCLUSION: Using multiple REACH strategies is most promising for maximizing response rates and minimizing attrition of children in cross-sectional, longitudinal, and behavioral intervention studies in community settings such as schools, child care centers, and other youth-related organizations. Researchers can select the most suitable strategies based on their specific study design and requirements.

Using wearable cameras to categorise type and context of accelerometer-identified episodes of physical activity.

BACKGROUND: Accelerometers can identify certain physical activity behaviours, but not the context in which they take place. This study investigates the feasibility of wearable cameras to objectively categorise the behaviour type and context of participants' accelerometer-identified episodes of activity. METHODS: Adults were given an Actical hip-mounted accelerometer and a SenseCam wearable camera (worn via lanyard). The onboard clocks on both devices were time-synchronised. Participants engaged in free-living activities for 3 days. Actical data were cleaned and episodes of sedentary, lifestyle-light, lifestyle-moderate, and moderate-to-vigorous physical activity (MVPA) were identified. Actical episodes were categorised according to their social and environmental context and Physical Activity (PA) compendium category as identified from time-matched SenseCam images. RESULTS: There were 212 days considered from 49 participants from whom SenseCam images and associated Actical data were captured. Using SenseCam images, behaviour type and context attributes were annotated for 386 (out of 3017) randomly selected episodes (such as walking/transportation, social/not-social, domestic/leisure). Across the episodes, 12 categories that aligned with the PA Compendium were identified, and 114 subcategory types were identified. Nineteen percent of episodes could not have their behaviour type and context categorized; 59% were outdoors versus 39% indoors; 33% of episodes were recorded as leisure time activities, with 33% transport, 18% domestic, and 15% occupational. 33% of the randomly selected episodes contained direct social interaction and 22% were in social situations where the participant wasn't involved in direct engagement. CONCLUSION: Wearable camera images offer an objective method to capture a spectrum of activity behaviour types and context across 81% of accelerometer-identified episodes of activity. Wearable cameras represent the best objective method currently available to categorise the social and environmental context of accelerometer-defined episodes of activity in free-living conditions.

Accelerometer data reduction in adolescents: effects on sample retention and bias.

BACKGROUND: Accelerometry is increasingly being recognized as an accurate and reliable method to assess free-living physical activity (PA) in children and adolescents. However, accelerometer data reduction criteria remain inconsistent, and the consequences of excluding participants in for example intervention studies are not well described. In this study, we investigated how different data reduction criteria changed the composition of the adolescent population retained in accelerometer data analysis. METHODS: Accelerometer data (Actigraph GT3X), anthropometric measures and survey data were obtained from 1348 adolescents aged 11-14 years enrolled in the Danish SPACE for physical activity study. Accelerometer data were analysed using different settings for each of the three key data reduction criteria: (1) number of valid days; (2) daily wear time; and (3) non-wear time. The effects of the selected setting on sample retention and PA counts were investigated and compared. Ordinal logistic regression and multilevel mixed-effect linear regression models were used to analyse the impact of differing non-wear time definitions in different subgroups defined by body mass index, age, sex, and self-reported PA and sedentary levels. RESULTS: Increasing the minimum requirements for daily wear time and the number of valid days and applying shorter non-wear definitions, resulted in fewer adolescents retained in the dataset. Moreover, the different settings for non-wear time significantly influenced which participants would be retained in the accelerometer data analyses. Adolescents with a higher BMI (OR:0.93, CI:0.87-0.98, p=0.015) and older adolescents (OR:0.68, CI:0.49-0.95, p=0.025) were more likely to be excluded from analysis using 10 minutes of non-wear compared to longer non-wear time periods. Overweight and older adolescents accumulated more daily non-wear time if the non-wear time setting was short, and the relative difference between groups changed depending on the non-wear setting. Overweight and older adolescents did also accumulate more sedentary time, but this was not significant correlated to the non-wear setting used. CONCLUSIONS: Even small differences in accelerometer data reduction criteria can have substantial impact on sample size and PA and sedentary outcomes. This study highlighted the risk of introducing bias with more overweight and older adolescents excluded from the analysis when using short non-wear time definitions.

Acceptability of standing workstations in elementary schools: a pilot study.

OBJECTIVE: To examine the acceptability of introducing standing workstations in elementary-school classrooms; and to quantify changes in children's time spent sitting, standing, and walking; step counts; sit-to-stand transitions; and musculoskeletal discomfort. METHODS: A controlled trial was conducted in two elementary schools in Auckland, New Zealand (March-May 2012). Participants were 30 third and fourth graders (n = 23 intervention, n = 7 control). Intervention classes received standing workstations; control class retained usual sitting desks. Children wore ActivPAL monitors over 7 days at baseline and during the fourth week of the intervention. RESULTS: Children spoke enthusiastically of the standing workstations. School staffs were supportive of the standing workstations because they offered "flexibility in learning". Overall, children in the intervention group sat less (intervention: 8.27 (1.45), mean (SD); control: 9.00 (0.80) h/day), stood longer (3.75 (0.88); 2.85 (0.30) h/day), and engaged in fewer transitions from sitting to standing (93 (17); 98 (26) counts) compared to the control group. Effect size ranged from small-large (-0.49; 95% confidence limits (0.64)%, 0.71; (0.48), -0.96; (0.54)% respectively). Results for time spent stepping and step counts were unclear. CONCLUSION: Standing workstations can be successfully integrated in classroom environments and appear to decrease overall sedentariness.

Utility of passive photography to objectively audit built environment features of active transport journeys: an observational study.

BACKGROUND: Active transport can contribute to physical activity accumulation and improved health in adults. The built environment is an established associate of active transport behaviours; however, assessment of environmental features encountered during journeys remains challenging. The purpose of this study was to examine the utility of wearable cameras to objectively audit and quantify environmental features along work-related walking and cycling routes. METHODS: A convenience sample of employed adults was recruited in New Zealand, in June 2011. Participants wore a SenseCam for all journeys over three weekdays and completed travel diaries and demographic questionnaires. SenseCam images for work-related active transport journeys were coded for presence of environmental features hypothesised to be related to active transport. Differences in presence of features by transport mode and in participant-reported and SenseCam-derived journey duration were determined using two-sample tests of proportion and an independent samples t-test, respectively. RESULTS: Fifteen adults participated in the study, yielding 1749 SenseCam images from 30 work-related active transport journeys for coding. Significant differences in presence of features were found between walking and cycling journeys. Almost a quarter of images were uncodeable due to being too dark to determine features. There was a non-significant tendency for respondents to under-report their journey duration. CONCLUSION: This study provides proof of concept for the use of the SenseCam to capture built environment data in real time that may be related to active transportation. Further work is required to test and refine coding methodologies across a range of settings, travel behaviours, and demographic groups.

Linking GPS and travel diary data using sequence alignment in a study of children's independent mobility.

BACKGROUND: Global positioning systems (GPS) are increasingly being used in health research to determine the location of study participants. Combining GPS data with data collected via travel/activity diaries allows researchers to assess where people travel in conjunction with data about trip purpose and accompaniment. However, linking GPS and diary data is problematic and to date the only method has been to match the two datasets manually, which is time consuming and unlikely to be practical for larger data sets. This paper assesses the feasibility of a new sequence alignment method of linking GPS and travel diary data in comparison with the manual matching method. METHODS: GPS and travel diary data obtained from a study of children's independent mobility were linked using sequence alignment algorithms to test the proof of concept. Travel diaries were assessed for quality by counting the number of errors and inconsistencies in each participant's set of diaries. The success of the sequence alignment method was compared for higher versus lower quality travel diaries, and for accompanied versus unaccompanied trips. Time taken and percentage of trips matched were compared for the sequence alignment method and the manual method. RESULTS: The sequence alignment method matched 61.9% of all trips. Higher quality travel diaries were associated with higher match rates in both the sequence alignment and manual matching methods. The sequence alignment method performed almost as well as the manual method and was an order of magnitude faster. However, the sequence alignment method was less successful at fully matching trips and at matching unaccompanied trips. CONCLUSIONS: Sequence alignment is a promising method of linking GPS and travel diary data in large population datasets, especially if limitations in the trip detection algorithm are addressed.

Kids in the city study: research design and methodology.

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

Utility of accelerometer thresholds for classifying sitting in office workers.

OBJECTIVE: To investigate the utility of a variety of Actical accelerometer count thresholds for determining sitting time in a sample of office workers. METHODS: Data were collected from 21 participants in Auckland, New Zealand, between December 2009 and January 2010. Participants wore a hip-mounted Actical accelerometer and thigh-mounted activPAL inclinometer (criterion) for a 48-h period. Raw inclinometer and accelerometer data for each 15s epoch of wear time were matched by date and time. Candidate accelerometer count thresholds for sitting classification were compared with the criterion measure using receiver operating characteristic analyses. Agreement in sitting time classification was determined using Bland-Altman methodology. RESULTS: Significant differences in area under the curve (AUC) values by threshold criteria were found (p<0.001). A threshold of 0 counts provided the highest combined sensitivity and specificity (AUC 0.759, 95%CI 0.756, 0.761). The 95% limits of agreement for time spent sitting were wide, at 328min (range -30.8, 297.5). CONCLUSION: A threshold of 0 counts/15s epoch with Actical accelerometers is likely to yield the most accurate quantification of sitting in office-based workers, however the wide limits of agreement found indicate limited utility of this threshold to accurately distinguish sitting time in office-based workers.

Examining commute routes: applications of GIS and GPS technology.

OBJECTIVE: The application of geographic information systems (GIS) to describe commute route elements is commonplace, yet the accuracy of GIS-estimated commute routes is not clear. This study compared GIS-estimated commute routes against actual routes traveled as measured using global positioning systems (GPS) to examine differences in urban form surrounding travel routes across different buffer sizes and travel modes. METHODS: Thirty-seven adults from Auckland, New Zealand participated in the study between January and March 2008. Participants wore GPS units and completed a travel log for 7 days. GPS data were integrated into a GIS database to ascertain commute routes. RESULTS: Overall, 29 commute journeys were appropriately captured by GPS. Levels of agreement between actual and shortest commute routes were dependent on the buffer size selected, built environment variable examined, and travel mode. CONCLUSIONS: Despite technical difficulties, GPS assessment of routes traveled is recommended to provide an accurate assessment of commute journey urban form elements.

Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study: research design and methodology.

BACKGROUND: Built environment attributes are recognized as being important contributors to physical activity (PA) engagement and body size in adults and children. However, much of the existing research in this emergent public health field is hindered by methodological limitations, including: population and site homogeneity, reliance on self-report measures, aggregated measures of PA, and inadequate statistical modeling. As an integral component of multi-country collaborative research, the Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study seeks to overcome these limitations by determining the strengths of association between detailed measures of the neighborhood built environment with PA levels across multiple domains and body size measures in adults and children. This article outlines the research protocol developed for the URBAN Study. METHODS AND DESIGN: The URBAN Study is a multi-centered, stratified, cross-sectional research design, collecting data across four New Zealand cities. Within each city, 12 neighborhoods were identified and selected for investigation based on higher or lower walkability and Maori demographic attributes. Neighborhoods were selected to ensure equal representation of these characteristics. Within each selected neighborhood, 42 households are being randomly selected and an adult and child (where possible) recruited into the study. Data collection includes: objective and self-reported PA engagement, neighborhood perceptions, demographics, and body size measures. The study was designed to recruit approximately 2,000 adults and 250 children into the project. Other aspects of the study include photovoice, which is a qualitative assessment of built environment features associated with PA engagement, an audit of the neighborhood streetscape environment, and an individualized neighborhood walkability profile centered on each participant's residential address. Multilevel modeling will be used to examine the individual-level and neighborhood-level relationships with PA engagement and body size. DISCUSSION: The URBAN Study is applying a novel scientifically robust research design to provide urgently needed epidemiological information regarding the associations between the built environment and health outcomes. The findings will contribute to a larger, international initiative in which similar neighborhood selection and PA measurement procedures are utilized across eight countries. Accordingly, this study directly addresses the international priority issues of increasing PA engagement and decreasing obesity levels.

Effect of telephone counseling on physical activity for low-active older people in primary care: a randomized, controlled trial.

OBJECTIVES: To assess the long-term effectiveness of a telephone counseling intervention on physical activity and health-related quality of life in low-active older adults recruited through their primary care physician. DESIGN: Randomized, controlled trial. SETTING: Three primary care practices from different socioeconomic regions of Auckland, New Zealand. PARTICIPANTS: One hundred and eighty-six low-active adults (aged 65) recruited from their primary care physicians' patient databases. INTERVENTION: Eight telephone counseling sessions over 12 weeks based on increasing physical activity. Control patients received usual care. MEASUREMENTS: Change in physical activity (as measured using the Auckland Heart Study Physical Activity Questionnaire) and quality of life (as measured using the Short Form-36 Health Survey (SF-36)) over a 12-month period. RESULTS: Moderate leisure physical activity increased by 86.8 min/wk more in the intervention group than in the control group (P=.007). More participants in the intervention group reached 2.5 hours of moderate or vigorous leisure physical activity per week after 12 months (42% vs 23%, odds ratio=2.9, 95% confidence interval=1.33-6.32, P=.007). No differences on SF-36 measures were observed between the groups at 12 months. CONCLUSION: Telephone-based physical activity counseling is effective at increasing physical activity over 12 months in previously low-active older adults.

Physical activity in preschoolers: understanding prevalence and measurement issues.

Accurate physical activity quantification in preschoolers is essential to establish physical activity prevalence, dose-response relationships between activity and health outcomes, and intervention effectiveness. To date, best practice approaches for physical activity measurement in preschool-aged children have been relatively understudied. This article provides a review of physical activity measurement tools for preschoolers, an overview of measurement of preschoolers' physical activity, and directions for further research. Electronic and manual literature searches were used to identify 49 studies that measured young children's physical activity, and 32 studies that assessed the validity and/or reliability of physical activity measures with preschool-aged children. While no prevalence data exist, measurement studies indicate that preschool children exhibit low levels of vigorous activity and high levels of inactivity, boys are more active than girls, and activity patterns tend to be sporadic and omnidirectional. As such, measures capable of capturing differing activity intensities in very short timeframes and over multiple planes are likely to have the most utility with this population. Accelerometers are well suited for this purpose, and a number of models have been used to objectively quantify preschoolers' physical activity. Only one model of pedometer has been investigated for validity with preschool-aged children, showing equivocal results. Direct observation of physical activity can provide detailed contextual information on preschoolers' physical activity, but is subjective and impractical for understanding daily physical activity. Proxy-report questionnaires are unlikely to be useful for determining actual physical activity levels of young children, and instead may be useful for identifying potential correlates of activity. Establishing validity is challenging due to the absence of a precise physical activity measure, or 'criterion', for young children. Both energy expenditure (EE) and direct observation have been considered criterion measures in the literature; however, EE is influenced by multiple variables, so its use as a physical activity 'criterion' is not ideal. Also, direct observation is inherently subjective, and coding protocols may result in failure to capture intermittent activity, thereby limiting its utility as a physical activity criterion. Accordingly, these issues must be taken into account where EE or direct observation are used to validate physical activity instruments. A combination of objective monitoring and direct observation may provide the best standard for the assessment of physical activity measurement tools. Ideally, the convergent validity of various physical activity tools should be investigated to determine the level of agreement between currently available measures. The correlational approaches commonly employed in the assessment of physical activity measures do not reveal this relationship, and can conceal potential bias of either measure.

Pedometer accuracy in physical activity assessment of preschool children.

Yamax SW-200 pedometer validity during unstructured free play was assessed in 13 preschool children aged 4.1+/-0.6 years using the Children's Activity Rating Scale (CARS). Pedometer validity and hip placement reliability were also assessed during straight line walking. Data were analysed using regression analyses, 95% upper and lower prediction intervals and 95% limits of agreement. The prediction intervals for pedometry were wide when using the CARS as a criterion. Limits of agreement and prediction intervals for directly observed step counts were also wide for pedometers, calling into question their acceptability for use with preschoolers. Limitations of employing the CARS direct observation approach as a criterion measure of physical activity are also discussed.

Social and built-environment factors related to children's independent mobility: The importance of neighbourhood cohesion and connectedness.

This study examines aspects of neighbourhood social environments (namely, neighbourhood safety, cohesion and connection) and child-specific built environment attributes in relation to children's independent mobility. The results suggest that children aged 8-13 years with parents who perceive their neighbourhood as more cohesive and more connected, and are located closer to school, engaged in higher levels of independently mobile trips. The qualitative component of this research revealed that for NZ European, Maori, Samoan and other Pacific parents, 'people danger' was the most common concern for letting their children go out alone, whereas for Asian and Indian parents, 'traffic danger' was the most common reason for their concern.

An integrated curriculum approach to increasing habitual physical activity in children: a feasibility study.

A relatively new concept is that of "integrating" physical activity throughout the school curriculum, thereby teaching children about lifestyle physical activity in a variety of contexts. One method by which this may be achieved is by utilizing pedometers as a motivational and educational tool for measuring accumulated physical activity. No research is available that shows in-depth integration of physical activity into the curriculum or that investigates the efficacy of pedometer use for this purpose. The purposes of this study were to (1) design and implement a 4-week elementary school curriculum unit, based around pedometer walking and (2) quantify, using pedometry, the physical activity levels of children (N = 78) prior to, and during, the unit implementation. Results showed that more than one half of the participants were achieving >15,000 steps daily, and children were significantly more active on weekdays than weekends (p = .0001). Boys were more active than girls at baseline (p = .01) and during intervention weekdays (p = .03). Differences between baseline and intervention weekdays were nonsignificant for the complete sample; however, significant increases in step counts were observed when the children with low activity levels, especially females, were examined separately. Overall, the integration of physical activity using pedometer-based activities is feasible. However, any increases in activity may be restricted to children who are least active.

The development of a model of community garden benefits to wellbeing.

Community gardens contribute to community wellbeing by influencing the nutritional and social environment. The aim of this research was to develop a model that communicates the many benefits of community garden participation as described in the academic literature, to a diverse audience of laypersons. This model is an example of effective knowledge translation because the information is able to be more than simply understood but also practically applied. From April to August 2015, a model depicting the many benefits of community garden participation was prepared based on a global, critical literature review. The wellbeing benefits from community garden participation have been grouped into factors influencing the nutritional health environment and factors influencing the social environment. The graphic chosen to form the basis of the model is a fractal tree of life. In October 2015, to test the models comprehension and to obtain stakeholder feedback this model was presented to a diverse group of community members, leaders and workers from the Tamaki region of Auckland, New Zealand. The model we present here effectively and clearly translates knowledge obtained from the academic literature on the benefits to wellbeing from community garden participation into a tool that can be used, adapted and developed by community groups, government agencies and health promoters.

Children's Out-of-School Independently Mobile Trips, Active Travel, and Physical Activity: A Cross-Sectional Examination from the Kids in the City Study.

BACKGROUND: The study aim was to determine the association between children's objectively assessed moderate-to-vigorous physical activity (MVPA) and active trips (AT) and independently mobile trips (IM) during out-of-school hours. METHODS: Children aged 9 to 13 years (n = 254) were recruited from 9 schools in Auckland, New Zealand between 2011 and 2012. Children completed travel diaries and wore accelerometers for 7 days. Parents provided demographic information. Geographic information systems-derived distance to school was calculated. Accelerometer data were extracted for out of school hours only. Percentage of time spent in MVPA (%MVPA), AT, and IM were calculated. Generalized estimating equations were used to determine the relationship between daily %MVPA and AT and between daily %MVPA and IM, accounting for age, sex, ethnicity, distance to school, day of the week, and numeric day of data collection. RESULTS: A significant positive relationship was observed between %MVPA and both AT and IM. For every unit increase in the daily percentage of trips made that were AT or IM, we found an average increase of 1.28% (95% CI 0.87%, 1.70%) and 1.15% (95% CI 0.71%, 1.59%) time in MVPA, respectively. CONCLUSION: Children's AT and IM are associated with increased MVPA during out-of-school hours.