Built Environments And Child Health in WalEs and AuStralia (BEACHES): a study protocol.

INTRODUCTION: Childhood obesity and physical inactivity are two of the most significant modifiable risk factors for the prevention of non-communicable diseases (NCDs). Yet, a third of children in Wales and Australia are overweight or obese, and only 20% of UK and Australian children are sufficiently active. The purpose of the Built Environments And Child Health in WalEs and AuStralia (BEACHES) study is to identify and understand how complex and interacting factors in the built environment influence modifiable risk factors for NCDs across childhood. METHODS AND ANALYSIS: This is an observational study using data from five established cohorts from Wales and Australia: (1) Wales Electronic Cohort for Children; (2) Millennium Cohort Study; (3) PLAY Spaces and Environments for Children's Physical Activity study; (4) The ORIGINS Project; and (5) Growing Up in Australia: the Longitudinal Study of Australian Children. The study will incorporate a comprehensive suite of longitudinal quantitative data (surveys, anthropometry, accelerometry, and Geographic Information Systems data) to understand how the built environment influences children's modifiable risk factors for NCDs (body mass index, physical activity, sedentary behaviour and diet). ETHICS AND DISSEMINATION: This study has received the following approvals: University of Western Australia Human Research Ethics Committee (2020/ET000353), Ramsay Human Research Ethics Committee (under review) and Swansea University Information Governance Review Panel (Project ID: 1001). Findings will be reported to the following: (1) funding bodies, research institutes and hospitals supporting the BEACHES project; (2) parents and children; (3) school management teams; (4) existing and new industry partner networks; (5) federal, state and local governments to inform policy; as well as (6) presented at local, national and international conferences; and (7) disseminated by peer-reviewed publications.

Children's neighbourhood physical environment and early development: an individual child level linked data study.

BACKGROUND: Identification of features of the neighbourhood physical environment that have a causal association with positive child development is important for promoting long-term developmental health. Previous research on these associations have been conducted at the neighbourhood level, and do not account for individual variation in exposure to these features. METHODS: This cross-sectional study utilised de-identified linked administrative data. Neighbourhood features were measured with Geographic Information Systems and identified within a 1600 m service area around the child's home address. The study population included a random selection of 5024 Western Australian children who participated in the 2012 Australian Early Development Census (AEDC; median age 5 years, 5 months). Multi-level logistic regressions modelled the odds of children scoring in the bottom 10% on the physical, social or emotional AEDC domains as an outcome of neighbourhood features. RESULTS: After adjustment for individual and neighbourhood sociodemographic factors, lower odds of physical vulnerability were associated with increased neighbourhood residential density, presence of railway station, and higher counts of playgroups and kindergartens. Larger areas of neighbourhood home-yard space were associated with increased odds of physical and social vulnerability. Presence of high-quality green spaces was associated with lower odds of social vulnerability. Increased road traffic exposure was associated with higher odds of social and emotional vulnerability. CONCLUSIONS: The neighbourhood physical environment has a weak but significant association with early childhood development. Future research should consider the interplay between the neighbourhood environment and proximal influences, including parenting attributes and socioeconomic status, and how they influence early child development.

The effect of proximity on park and beach use and physical activity among rural adolescents.

BACKGROUND: Associations between access to environments and levels of physical activity (PA) among adolescents have been established; however the influence of neighborhood design barriers (eg, major roads) on these relationships is less understood. METHODS: In 2006, adolescents (n = 1304) in rural Western Australia completed the Up4it Physical Activity Survey measuring frequency and duration of organized and nonorganized physical activity by season. Geographic Information Systems (GIS) were used to objectively measure distance to nearest park and beach and busy road barriers en route to these destinations. RESULTS: Proximity to parks and beaches was associated with use of these environments for PA among adolescents, but this relationship attenuated after adjustment for presence of a major road. Park and beach use was positively associated with achieving recommended levels of PA. Paradoxically, proximity to these environments was not associated with achieving recommended levels of PA. Results suggest access to parks and beaches is necessary but may be insufficient to achieve recommended levels of PA. These relationships varied by season. CONCLUSIONS: Strategies should be put in place to encourage use of proximate supportive environments. Planning neighborhoods to reduce barriers to access and interventions to overcome seasonal variations in behavior may improve participation levels among adolescents.

The impact of the built environment on health across the life course: design of a cross-sectional data linkage study.

INTRODUCTION: The built environment is increasingly recognised as being associated with health outcomes. Relationships between the built environment and health differ among age groups, especially between children and adults, but also between younger, mid-age and older adults. Yet few address differences across life stage groups within a single population study. Moreover, existing research mostly focuses on physical activity behaviours, with few studying objective clinical and mental health outcomes. The Life Course Built Environment and Health (LCBEH) project explores the impact of the built environment on self-reported and objectively measured health outcomes in a random sample of people across the life course. METHODS AND ANALYSIS: This cross-sectional data linkage study involves 15 954 children (0-15 years), young adults (16-24 years), adults (25-64 years) and older adults (65+years) from the Perth metropolitan region who completed the Health and Wellbeing Surveillance System survey administered by the Department of Health of Western Australia from 2003 to 2009. Survey data were linked to Western Australia's (WA) Hospital Morbidity Database System (hospital admission) and Mental Health Information System (mental health system outpatient) data. Participants' residential address was geocoded and features of their 'neighbourhood' were measured using Geographic Information Systems software. Associations between the built environment and self-reported and clinical health outcomes will be explored across varying geographic scales and life stages. ETHICS AND DISSEMINATION: The University of Western Australia's Human Research Ethics Committee and the Department of Health of Western Australia approved the study protocol (#2010/1). Findings will be published in peer-reviewed journals and presented at local, national and international conferences, thus contributing to the evidence base informing the design of healthy neighbourhoods for all residents.

How far do children travel from their homes? Exploring children's activity spaces in their neighborhood.

This study explored children's activity spaces. In 2007, children aged 10-12 years (n=1480) completed a survey and mapping activity, and wore a pedometer for seven days. Their parents completed a survey (n=1314). Over half traveled <25% of their 'neighborhood', defined as 800 m and 1600 m network buffers. More local destinations (boys ß=-0.022; girls ß=-0.013) and parent report of living on a busy road (girls ß=-0.43) were associated with smaller activity spaces whereas being independently mobile resulted in larger (girls ß=0.28) ones. Traditionally defined neighborhoods may not reflect children's movements. Freedom, fewer local destinations and traffic safety may be important for increasing spatial ranges.