Strategies and effects of school-based interventions to promote active school transportation by bicycle among children and adolescents: a systematic review.

BACKGROUND: Promoting cycling to school may benefit establishing a lifelong physical activity routine. This systematic review aimed to summarize the evidence on strategies and effects of school-based interventions focusing on increasing active school transport by bicycle. METHODS: A literature search based on "PICo" was conducted in eight electronic databases. Randomized and non-randomized controlled trials with primary/secondary school students of all ages were included that conducted pre-post measurements of a school-based intervention aimed at promoting active school travel by bicycle and were published in English between 2000 and 2019. The methodological quality was assessed using the "Effective Public Health Practice Project" tool for quantitative studies. Applied behavior change techniques were identified using the "BCT Taxonomy v1". Two independent researchers undertook the screening, data extraction, appraisal of study quality, and behavior change techniques. RESULTS: Nine studies investigating seven unique interventions performed between 2012 and 2018 were included. All studies were rated as weak quality. The narrative synthesis identified 19 applied behavior change techniques clustered in eleven main groups according to their similarities and a variety of 35 different outcome variables classified into seven main groups. Most outcomes were related to active school travel and psychosocial factors, followed by physical fitness, physical activity levels, weight status, active travel and cycling skills. Four studies, examining in total nine different outcomes, found a significant effect in favor of the intervention group on bicycle trips to school (boys only), percentage of daily cycling trips to school, parental/child self-efficacy, parental outcome expectations, moderate-to-vigorous intensity physical activity (total, from cycling, before/after school), and total basic cycling skills. Seven of these outcomes were only examined in two studies conducting the same intervention in children, a voluntary bicycle train to/from school accompanied by adults, including the following clustered main groups of behavior change techniques: shaping knowledge, comparison of behavior, repetition and substitution as well as antecedents. CONCLUSIONS: The applied strategies in a bicycle train intervention among children indicated great potential to increase cycling to school. Our findings provide relevant insights for the design and implementation of future school-based interventions targeting active school transport by bicycle. TRIAL REGISTRATION: This systematic review has been registered in the international prospective register of systematic reviews "PROSPERO" at (registration number: CRD42019125192 ).

What socio-demographic characteristics of university students in Southern Germany predict their urban nature connectedness?

Promoting mental health addresses a global societal challenge. Nature connectedness, or relatedness to natural systems, is associated with increased well-being and mental health. Among urban populations, nature connectedness has been reported as lower. Nature connectedness in urban settings has been somewhat overlooked by researchers. This cross-sectional online study addressed this issue by identifying socio-demographic predictors of urban nature connectedness among 165 students, aged 20 to 40, from the Technical University of Munich. Analysis of the data from 153 female university students was conducted using ordinal regressions, (a) separately and (b) merged with their 12 male counterparts. A separate gender analysis for males could not be performed, due to sample size limitations. Although access to nature and a considerable nature dose in terms of frequency and duration of nature contact were noted, possibly achieved through the engagement in outdoor activities, urban nature connectedness was rather low. Results showed that urban nature connectedness was negatively predicted by living in a rural area and positively predicted by engagement in outdoor activities and increased hours per week spent in nature. This information can help researchers operationalize the construct of urban nature connectedness. Furthermore, it can aid the development of interventions aimed at promoting urban nature connectedness, by encouraging urban inhabitants to (repeatedly) get in contact with and spend time in provided high-quality urban nature (e.g., during outdoor activities). To draw conclusions about causality, further research is required to identify a clear cause-effect relationship between socio-demographic characteristics and urban nature connectedness. Based on a researched dose-response relationship, a(n) (inter)national recommendation for the duration of nature contact should be established to promote urban nature connectedness and, therewith, health in urban inhabitants. Future research should also investigate further potential individual influencing factors, as well as gender and within/between-country differences among urban inhabitants.

Translation, cultural adaptation and validation of the basic psychological needs satisfaction in active commuting to and from school (BPNS-ACS) scale in Polish students.

BACKGROUND: To promote active commuting to and from school, it is pertinent to understand the motivational factors that influence the choice of this form of transportation. OBJECTIVE: Translation, cultural adaptation and analysis of the factor structure as well as psychometric properties of the Basic Psychological Needs and Satisfaction in Active Commuting to and from School (BPNS-ACS) scale among Polish students and examination of the distribution of the scale scores according to gender, mode of commuting to and from school and the frequency of using bicycle for this purpose. MATERIAL AND METHODS: Data from 475 Polish students aged 11-18, including 53.9% of girls were analysed. The Confirmatory Factor Analysis of the Polish version of the BPNS-ACS, U Mann-Whitney and Kruskal Wallis H tests were performed. RESULTS: The BPNS-ACS consists of 12 items forming three dimensions: autonomy, competence and relatedness need satisfaction. The scale has acceptable psychometric properties: χ2(51)=195.424 (p ˂ 0.001); χ2/df=3.832; CFI=0.944, TLI=0.927, RMSEA=0.077 (90%CI 0.066-0.089), AIC=249.424, BIC=361.833, GFI=0.937, AGFI=0.904. BPNC-ACS scores on factors corresponding to the three basic psychological needs differ based on gender, mode of commuting to and from school and the frequency of cycling to or from school. CONCLUSIONS: Further exploration of the function of basic psychological needs in active commuting to and from school among Polish adolescents may be conducted using an adapted version of the BPNS-ACS scale.

Adaptation of the Behavioural Regulation in Active Commuting to School (BR-ACS) Questionnaire in Portuguese Youth.

This study aimed to translate and adapt the psychometric properties of the Behavioural Regulation in Active Commuting to School (BR-ACS) questionnaire to young Portuguese students. This study had two stages: (1) translation and adaptation of the questionnaire; (2) evaluation of the psychometric properties. A sample of 338 participants (212 female, 126 male) aged 11 to 19 years (Mage = 15.6 ± 2.1) from 31 cities and Madeira island participated in this study. The confirmatory factor analysis suggested an acceptable fit to the data for the first-order and third-order measurement models. The composite reliability values ranged from 0.71 (identified regulation) to 0.90 (integrated regulation), demonstrating internal consistency. The AVE values ranged from 0.40 (amotivation) to 0.69 (integrated regulation), demonstrating an acceptable convergent validity for all constructs. The model estimation had an acceptable fit, with values akin to those of the first-order tested model. Finally, the results of the multigroup analysis for the successive restricted models (CFI < 0.010 and RMSEA < 0.015) point out that the null hypothesis of factor invariance between gender cannot be rejected. The psychometric properties demonstrates the suitability of this questionnaire among Portuguese youths aged 11 to 19. This questionnaire will help understand the motivation aspects that underpin active commuting to school and consequently help to increase physical activity among Portuguese adolescents.

Study Protocol of a School-Based Randomized Controlled Trial to Promote Cycling to School Among Students in Germany Using Intervention Mapping: The ACTS Project.

Background: Despite a high rate of bicycle ownership, the prevalence of cycling to school among children and adolescents in Germany has been constantly low. Cycling to school can contribute to meeting the physical activity recommendations, which the majority of children and adolescents in Germany do not meet. Methods: By using intervention mapping, this study protocol describes the systematic planning process of a school-based intervention in Germany aimed to increase the number of days on which students cycle to school and to increase their physical activity levels. To make sure that the intervention will match the needs of students, we conducted a concept mapping study investigating what students need to cycle to school, as perceived by students, parents, and teachers. The logic model of change was based on an integration of the self-determination theory and the social-ecological model. We structured our intervention as two phases, a preparatory phase with weekly components for and a practical phase with a daily repeated component of the targeted behavior. In the 8-week preparatory phase, teachers, parents, and peers will be involved. The content of the 12-week practical phase will involve peers only and was considered promising based on the findings from a systematic review that we conducted to identify the effective strategies of school-based interventions to promote cycling to school among children and adolescents. Overall, our intervention includes 27 behavior change techniques. A researcher, student assistants, teachers, and other collaborators will implement the intervention; a whole-of-school approach with components performed before, during, and after school was chosen. As a study design, we decided to draft a two-arm three-level cluster randomized controlled trial. Both the effect and process evaluation were prepared. In the first instance, approximately 250 students of 12-15 years of age from grade 7 or 8, who attend a secondary school of intermediate or high educational level located in (sub)urban regions in Southern Germany, will pilot the intervention. Discussion: We expect to provide an effective and sustainable intervention for students, which gives insights into the mechanisms of change concerning the behavior of cycling to school and its influence on physical activity levels.

Translation and Validation of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) Scale in Young Portuguese Students.

Active commuting to and from school (ACS) is a strategy to enhance physical activity levels in youths. To promote ACS, it is important to understand the factors that lead to this behaviour. With this in mind, an adaptation of the Basic Psychological Needs in Exercise Scale for ACS was developed, named the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) scale. This study aimed to translate and evaluate the psychometric properties of the BPNS-ACS scale in young Portuguese students. A cross-sectional study was designed. A total of 338 students (212 girls, 126 boys), aged between 11 and 19 years old from 31 Portuguese cities participated in this study. To provide validity evidence based on the questionnaire's internal structure, confirmatory factor analyses were performed to test the three dimensions of the BNPS-ACS scale. The results of the confirmatory factor analysis indicated an acceptable fit to the data. The internal consistency of the measures was accepted as the composite reliability values ranged from 0.78 to 0.94. The evaluation of psychometric properties provided evidence of the adequacy of this questionnaire among Portuguese youth aged 11 to 19 years old.

Socio-Demographic Correlates of Cycling to School among 12- to 15-Year Olds in Southern Germany.

Depending on the region and urbanization level, the rate of cycling to school in Germany varies largely. The influence of distance from home to school, educational level, the school's region, and parents' socio-demographic characteristics on cycling to secondary school in Germany is unclear. Therefore, this study analyzed students' and parents' socio-demographic correlates of cycling to school, including separate analyses by gender, among 12- to 15-year-olds attending different (sub)urban schools in Southern Germany. In 2019, 121 students (girls: 40.5%, boys: 59.5%) aged 13.1 ± 0.9 and 42 parents (mothers: 81%, fathers: 19%) aged 47.8 ± 5.5 participated. Students completed a self-report questionnaire; parents completed a self- and proxy-report questionnaire. In total, between 61.7% and 67.5% of students sometimes cycled to school. Binary logistic regressions revealed that being a girl, increasing age, attending an intermediate educational level combined with a suburban school region (small or medium-sized town), increasing distance from home to school, and having parents who did not cycle to work led to declining odds of cycling to school. Many 12- to 15-year-olds sometimes cycled to school in (sub)urban school regions in Southern Germany. As several socio-demographic characteristics correlated with cycling to school, this should be considered when developing a future school-based bicycle intervention.

Gender Influence on Students, Parents, and Teachers' Perceptions of What Children and Adolescents in Germany Need to Cycle to School: A Concept Mapping Study.

Active commuting to school is highly recommended for several reasons, and in the decision-making process for doing so, a child interacts with parents and teachers. Until now, these three interactors' gender-specific perspectives on children and adolescents' need for cycling to school have been unavailable. Thus, our concept mapping study analyzed the needs of 12- to 15-year-olds in Germany for cycling to and from school daily, as perceived by students, parents, and teachers stratified by gender. From November 2019 to February 2020, 136 students, 58 parents, and 29 teachers participated. Although 87.8% of girls and 100% of boys owned a bicycle, only 44.4% of girls and 72.9% of boys cycled to school. On average, girls cycled to school on 1.6 ± 2.0 days a week and boys on 2.7 ± 2.0 days a week. A "bicycle and related equipment," the "way to school," and "personal factors" were reported needs, perceived by students and teachers of both genders and by mothers. Girls reported the additional gender-specific need for "social behavior in road traffic," mothers and female teachers reported "role of parents," and female teachers reported a "sense of safety." This study's findings could inspire the development of school-based bicycle interventions.

Prevalence of Physical Activity among Adolescents from 105 Low, Middle, and High-income Countries.

INTRODUCTION: Physical activity (PA) is a beneficial health behaviour, however most adolescents worldwide are physically inactive. Updated information on the prevalence and trends of PA is important to inform national and international authorities and support countries' public health policies and actions. This study aimed to present the worldwide, regional, and national prevalence of PA participation according to its frequency in adolescents. METHODS: This study is based on cross-sectional surveys of adolescents' populations from several countries and all regions worldwide. The sample comprised 520,533 adolescents (251,788 boys; 268,745 girls), from 105 countries and regions. RESULTS: Most adolescents engaged in PA up to 3 days/week (57.1%; 95% CI: 56.9; 57.2). The prevalence of engaging in PA every day decreases over the age from 28.2% at age of 11-12 years (95% CI: 27.4; 29.0) to 21.2% at age of 16-17 years (95% CI: 20.3; 22.0) among boys; and from 19.4% (95% CI: 18.5; 20.2) to 11.1% (95% CI: 10.1; 12.0) among girls. For boys and girls who engaged in PA 5-6 days/week, the prevalence increases from countries with the lowest human development index to countries with the highest. Cambodia (7.3%, 95% CI: 3.8; 10.8), Philippines (7.7%, 95% CI: 5.6; 9.7), Sudan (8.8%, 95% CI: 4.7; 12.9), Timor-Leste (8.9%, 95% CI: 5.5; 12.3), and Afghanistan (10.1%, 95% CI: 6.1; 14.1) were the countries with the lowest prevalence of sufficient PA. CONCLUSIONS: National, regional, and worldwide data on the prevalence of physical activity in adolescents highlights the importance of improving the global levels of PA, especially in girls. Identifying the factors causing the age-related decrease in physical activity levels will permit public health entities to define priority actions and policies against physical inactivity.

Strategies and effects of promising school-based interventions to promote active school transportation by bicycle among children and adolescents: protocol for a systematic review.

BACKGROUND: Active school travel by bike may provide appropriate means to promote physical activity through commuting to and from school, expanding the mobility during leisure time, and integrating a lifelong positive behavior routine. However, bicycling seems to be a less common form of active school transport and declining cycling to school trends in some European countries have been observed. Therefore, effective interventions aiming at promoting biking to school are warranted. To gain a better understanding of effective programs, the systematic review will summarize strategies and effects of school-based interventions targeted on positively influencing active school travel by bicycle. METHODS: The databases ERIC, PsycINFO, PSYNDEX, PubMed, Scopus, SPORTDiscus, SURF, and Web of Science will be searched utilizing a detailed search strategy according to "PICo". Consequently, there will be no restriction regarding the outcomes measured in studies. For inclusion in the review, the identified primary studies (i.e. randomized and non-randomized controlled trials) should be published between 2000 and 2019 due to their current relevance, and written in English. The screening, data extraction, and appraisal of study quality as well as behavior change techniques will be undertaken by two independent researchers. To assess the methodological quality of every included study, the quality assessment tool "Effective Public Health Practice Project" for quantitative studies will be used. Behavior change techniques will be identified by utilizing the "BCT Taxonomy v1". If data permits, meta-analyses for intervention effects will be conducted where appropriate. DISCUSSION: The planned systematic review can provide information about how bicycling is considered in school-based interventions as an effective strategy to promote active commuting to school among students. In this regard, the conclusions drawn from the review will establish a basis for researchers to plan and implement a comprehensive cycling intervention in the school setting. SYSTEMATIC REVIEW REGISTRATION: PROSPEROCRD42019125192.