Built environment and physical activity in adolescents: Use of the kernel density estimation and the walkability index.

ABSTRACT

The availability of places for physical activity (PA) and the walkability of the neighborhood can impact the level of PA of adolescents. However, studies of this nature are still limited in Latin America. This study had two objectives: 1- using kernel density estimative, it investigated whether individuals living near PA places that are more intensely distributed than dispersed are more likely to be sufficiently active; 2-checked whether adolescents who live in neighborhoods with better walkability have a greater chance of being sufficiently active. Were evaluated 292 adolescents and PA was measured by accelerometry. Were measured five environmental variables for composing the walkability index. 98 PA points (places) were identified and destinations within these areas were geocoded and kernel density estimates (KDE) of places intensity were created using kernels (radius) of 400m (meters), 800, 1200 and 1600m. Using Logistic Regression, the association between the intensity of PA places (classified into quartiles Q1(smallest)-Q4(largest)) and the probability of being "Sufficient PA"; and the association between walkability (quartiles Q1(least)-Q4(highest)) and the probability of being "PA Sufficient " were estimated (p≤0.05). There were associations only for the intensities of places with the largest radius. Among adolescents who lived in places with higher intensity compared with lower intensity places 1200m (Q3, OR 2.18 95% CI 1.12-4.22; Q4, OR 2.77 95% CI 1.41-5.43) and 1600m (Q3, OR 3.68 95%CI 1.86-7.30; Q4, OR 3.69 95%CI 1.86-7.30) were more likely to be "Sufficient PA". There were also associations for walkability, where those living in places with better walkability (Q4, OR 2.58 95% CI 1.33-5.02) had greater chances of being "Sufficient PA" compared to Q1. In conclusion, living in places with bigger densities and better walkability increases adolescent's chances of being "Sufficient PA".