NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries.

BACKGROUND: Built environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa). METHODS: The original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries. RESULTS: The original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs < .40). CONCLUSIONS: The systematic adaptation and initial psychometric evaluation of NEWS-Africa indicates the instrument is feasible and reliable for use with adults of diverse demographic characteristics in Africa. The measure is likely to be useful for research, surveillance of built environment conditions for planning purposes, and to evaluate physical activity and policy interventions in Africa.

Is Your Neighborhood Designed to Support Physical Activity? A Brief Streetscape Audit Tool.

INTRODUCTION: Macro level built environment factors (eg, street connectivity, walkability) are correlated with physical activity. Less studied but more modifiable microscale elements of the environment (eg, crosswalks) may also affect physical activity, but short audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of a 15-item neighborhood environment audit tool with a full version of the tool to assess neighborhood design on physical activity in 4 age groups. METHODS: From the 120-item Microscale Audit of Pedestrian Streetscapes (MAPS) measure of street design, sidewalks, and street crossings, we developed the 15-item version (MAPS-Mini) on the basis of associations with physical activity and attribute modifiability. As a sample of a likely walking route, MAPS-Mini was conducted on a 0.25-mile route from participant residences toward the nearest nonresidential destination for children (n = 758), adolescents (n = 897), younger adults (n = 1,655), and older adults (n = 367). Active transportation and leisure physical activity were measured with age-appropriate surveys, and accelerometers provided objective physical activity measures. Mixed-model regressions were conducted for each MAPS item and a total environment score, adjusted for demographics, participant clustering, and macrolevel walkability. RESULTS: Total scores of MAPS-Mini and the 120-item MAPS correlated at r = .85. Total microscale environment scores were significantly related to active transportation in all age groups. Items related to active transport in 3 age groups were presence of sidewalks, curb cuts, street lights, benches, and buffer between street and sidewalk. The total score was related to leisure physical activity and accelerometer measures only in children. CONCLUSION: The MAPS-Mini environment measure is short enough to be practical for use by community groups and planning agencies and is a valid substitute for the full version that is 8 times longer.

Associations Between Neighborhood Recreation Environments and Adolescent Physical Activity.

BACKGROUND: To examine relations between parents' perceived neighborhood recreation environments and multiple measures of adolescent physical activity (PA). METHODS: Participants (N = 928; age 14.1 [1.4] y, 50.4% girls, and 33.4% nonwhite/Hispanic) and their parents were recruited. Teen moderate to vigorous PA (MVPA) was assessed with 7-day accelerometry. Self-reported total PA, PA near home, and PA at recreation locations were also assessed. Proximity of home to 8 types of recreation facilities was reported by parents. Mixed-model linear regressions relating environments to various measures of PA were adjusted for demographics and neighborhood clustering. RESULTS: Perceiving more availability of recreation facilities around home was related to higher reports of days per week with 60+ minutes of PA (b = 0.153; P < .05), reported PA time near home (b = 0.152; P < .001), PA time at recreation facilities (b = 0.161; P < .001), accelerometer-measured total MVPA (b = 1.741; P < .05), and nonschool MVPA (b = 1.508; P < .01). Adolescents living in lowest quintile of recreation facility availability averaged 27.6 (3.2) minutes per day of total MVPA versus 49.8 (3.5) minutes per day for those living in highest quintile. CONCLUSIONS: Adolescents living in neighborhoods that parents reported having more availability of recreation facilities around homes had higher activity across 5 indicators of PA.

Crime and Physical Activity: Development of a Conceptual Framework and Measures.

BACKGROUND: A common hypothesis is that crime is a major barrier to physical activity, but research does not consistently support this assumption. This article advances research on crime-related safety and physical activity by developing a multilevel conceptual framework and reliable measures applicable across age groups. METHODS: Criminologists and physical activity researchers collaborated to develop a conceptual framework. Survey development involved qualitative data collection and resulted in 155 items and 26 scales. Intraclass correlation coefficients (ICCs) were computed to assess test-retest reliability in a subsample of participants (N = 176). Analyses were conducted separately by age groups. RESULTS: Test-retest reliability for most scales (63 of 104 ICCs across 4 age groups) was "excellent" or "good" (ICC ≥ .60) and only 18 ICCs were "poor" (ICC < .40). Reliability varied by age group. Adolescents (aged 12-17 y) had ICCs above the .40 threshold for 21 of 26 scales (81%). Young adults (aged 18-39 y) and middle-aged adults (aged 40-65 y) had ICCs above .40 for 24 (92%) and 23 (88%) scales, respectively. Older adults (aged 66 y and older) had ICCs above .40 for 18 of 26 scales (69%). CONCLUSIONS: The conceptual framework and reliable measures can be used to clarify the inconclusive relationships between crime-related safety and physical activity.

Developing and Validating an Abbreviated Version of the Microscale Audit for Pedestrian Streetscapes (MAPS-Abbreviated).

PURPOSE: Macroscale built environment factors (e.g., street connectivity) are correlated with physical activity. Less-studied but more modifiable microscale elements (e.g., sidewalks) may also influence physical activity, but shorter audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of an abbreviated 54-item streetscape audit tool with multiple measures of physical activity in four age groups. METHODS: We developed a 54-item version from the original 120-item Microscale Audit of Pedestrian Streetscapes (MAPS). Audits were conducted on 0.25-0.45 mile routes from participant residences toward the nearest nonresidential destination for children (N=758), adolescents (N=897), younger adults (N=1,655), and older adults (N=367). Active transport and leisure physical activity were measured with surveys, and objective physical activity was measured with accelerometers. Items to retain from original MAPS were selected primarily by correlations with physical activity. Mixed linear regression analyses were conducted for MAPS-Abbreviated summary scores, adjusting for demographics, participant clustering, and macroscale walkability. RESULTS: MAPS-Abbreviated and original MAPS total scores correlated r=.94 The MAPS-Abbreviated tool was related similarly to physical activity outcomes as the original MAPS. Destinations and land use, streetscape and walking path characteristics, and overall total scores were significantly related to active transport in all age groups. Street crossing characteristics were related to active transport in children and older adults. Aesthetics and social characteristics were related to leisure physical activity in children and younger adults, and cul-de-sacs were related with physical activity in youth. Total scores were related to accelerometer-measured physical activity in children and older adults. CONCLUSION: MAPS-Abbreviated is a validated observational measure for use in research. The length and related cost of implementation has been cited as a barrier to use of microscale instruments, so availability of this shorter validated measure could lead to more widespread use of streetscape audits in health research.

Construct Validity of the Neighborhood Environment Walkability Scale for Africa.

PURPOSE: The development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries. METHODS: NEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. RESULTS: The overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda. CONCLUSIONS: Of 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.

Disparities in Pedestrian Streetscape Environments by Income and Race/Ethnicity.

Growing evidence suggests that microscale pedestrian environment features, such as sidewalk quality, crosswalks, and neighborhood aesthetics, may affect residents' physical activity. This study examined whether disparities in microscale pedestrian features existed between neighborhoods of differing socioeconomic and racial/ethnic composition. Using the validated Microscale Audit of Pedestrian Streetscapes (MAPS), pedestrian environment features were assessed by trained observers along »-mile routes (N = 2117) in neighborhoods in three US metropolitan regions (San Diego, Seattle, and Baltimore) during 2009 to 2010. Neighborhoods, defined as Census block groups, were selected to maximize variability in median income and macroscale walkability factors (e.g., density). Mixed-model linear regression analyses explored main and interaction effects of income and race/ethnicity separately by region. Across all three regions, low-income neighborhoods and neighborhoods with a high proportion of racial/ethnic minorities had poorer aesthetics and social elements (e.g., graffiti, broken windows, litter) than neighborhoods with higher median income or fewer racial/ethnic minorities (p<.05). However, there were also instances where neighborhoods with higher incomes and fewer racial/ethnic minorities had worse or absent pedestrian amenities such as sidewalks, crosswalks, and intersections (p<.05). Overall, disparities in microscale pedestrian features occurred more frequently in residential as compared to mixed-use routes with one or more commercial destination. However, considerable variation existed between regions as to which microscale pedestrian features were unfavorable and whether the unfavorable features were associated with neighborhood income or racial/ethnic composition. The variation in pedestrian streetscapes across cities suggests that findings from single-city studies are not generalizable. Local streetscape audits are recommended to identify disparities and efficiently allocate pedestrian infrastructure resources to ensure access and physical activity opportunities for all residents, regardless of race, ethnicity, or income level.

Physical activity in youth dance classes.

BACKGROUND AND OBJECTIVES: The majority of youth are not meeting the US Department of Health and Human Services physical activity guidelines. Dance is a popular activity, particularly for girls, and has the potential to increase physical activity for many youth. This study investigated physical activity of children and adolescents in 7 dance types: ballet, hip-hop, jazz, Latin-flamenco, Latin-salsa/ballet folklorico, partnered, and tap. METHODS: Data were collected in 17 private studios and 4 community centers in San Diego, California. A total of 264 girls from 66 classes participated (n =154 children; n = 110 adolescents). Physical activity was measured with accelerometers, and activity levels during class were calculated. RESULTS: Participants recorded an average of 17.2 ± 8.9 minutes of moderate-to-vigorous physical activity (36% of class), but this varied by age and dance type. For children, dance type differences were observed with percent of class in moderate-to-vigorous physical activity ranging from 13.6% (Latin-flamenco) to 57% (hip-hop). For adolescents, there were no differences across dance types. Children were more active than adolescents in all types except ballet. Children and adolescents were more active in private compared with community center classes. CONCLUSIONS: Overall, physical activity in youth dance classes was low; 8% of children and 6% of adolescents met the Centers for Disease Control and Prevention 30-minute guideline for after-school physical activity during dance. To increase physical activity in dance classes, teaching methods could be employed to increase activity in all types, or emphasis could be placed on greater participation in more active dance types.

Contribution of streetscape audits to explanation of physical activity in four age groups based on the Microscale Audit of Pedestrian Streetscapes (MAPS).

Ecological models of physical activity emphasize the effects of environmental influences. "Microscale" streetscape features that may affect pedestrian experience have received less research attention than macroscale walkability (e.g., residential density). The Microscale Audit of Pedestrian Streetscapes (MAPS) measures street design, transit stops, sidewalk qualities, street crossing amenities, and features impacting aesthetics. The present study examined associations of microscale attributes with multiple physical activity (PA) measures across four age groups. Areas in the San Diego, Seattle, and the Baltimore metropolitan areas, USA, were selected that varied on macro-level walkability and neighborhood income. Participants (n = 3677) represented four age groups (children, adolescents, adults, older adults). MAPS audits were conducted along a 0.25 mile route along the street network from participant residences toward the nearest non-residential destination. MAPS data were collected in 2009-2010. Subscale and overall summary scores were created. Walking/biking for transportation and leisure/neighborhood PA were measured with age-appropriate surveys. Objective PA was measured with accelerometers. Mixed linear regression analyses were adjusted for macro-level walkability. Across all age groups 51.2%, 22.1%, and 15.7% of all MAPS scores were significantly associated with walking/biking for transport, leisure/neighborhood PA, and objectively-measured PA, respectively. Supporting the ecological model principle of behavioral specificity, destinations and land use, streetscape, street segment, and intersection variables were more related to transport walking/biking, while aesthetic variables were related to leisure/neighborhood PA. The overall score was related to objective PA in children and older adults. Present findings provide strong evidence that microscale environment attributes are related to PA across the lifespan. Improving microscale features may be a feasible approach to creating activity-friendly environments.