Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project.

BACKGROUND: Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics. METHODS: All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts. RESULTS: Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on. CONCLUSION: Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas.

Assessing Walking and Cycling Environments in the Streets of Madrid: Comparing On-Field and Virtual Audits.

Audit tools are useful for exploring the urban environment and its association with physical activity. Virtual auditing options are becoming increasingly available potentially reducing the resources needed to conduct these assessments. Only a few studies have explored the use of virtual audit tools. Our objective is to test if the Madrid Systematic Pedestrian and Cycling Environment Scan (M-SPACES) discriminates between areas with different urban forms and to validate virtual street auditing using M-SPACES. Three areas (N = 500 street segments) were selected for variation in population density. M-SPACES was used to audit street segments physically and virtually (Google Street View) by two researchers in 2013-2014. For both physical and virtual audits, all analyzed features score significantly different by area (p < 0.05). Most of the features showed substantial (ICC = 0.6-0.8) or almost perfect (ICC ≥ 0.8) agreement between virtual and physical audits, especially neighborhood permeability walking infrastructure, traffic safety, streetscape aesthetics, and destinations. Intra-rater agreement was generally acceptable (ICC > 0.6). Inter-rater agreement was generally poor (ICC < 0.4). Virtual auditing provides a valid and feasible way of measuring residential urban environments. Comprehensive auditor training may be needed to guarantee good inter-rater agreement.

Socio-demographic factors and neighbourhood social cohesion influence adults' willingness to grant children greater independent mobility: A cross-sectional study.

BACKGROUND: In developed countries, children's independent mobility levels are low. Built environmental factors and parental safety concerns are well-known to predict the level of independent mobility adults grant to children. In contrast, the influence of adults' socio-demographic characteristics and neighbourhood social cohesion on children's independent mobility is largely unexplored. This study investigated the influence of adults' socio-demographic factors and neighbourhood social cohesion on distances they would permit children for independent travel and outdoor play. METHODS: In 2013, a random sample of 1293 Australian adults (mean age: 56.1 years, 52 % male, 81 % parents) participated in the Queensland Social Survey (QSS) via computer-assisted telephone interview. Socio-demographic factors measured included age, sex, parental status, education and area-level socio-economic disadvantage. Perceived neighbourhood social cohesion was assessed using a standardised scale. Adults reported the distances children aged 8-12 years should be allowed to walk/cycle to places, and play outdoors without adults. Responses were categorised into 'within sight', < 0.5 kilometres (km) , 0.5-1 km and >1 km. Ordinal logistic regression was used to assess associations of socio-demographic factors and neighbourhood social cohesion with distances adults would permit for children's independent travel and outdoor play. RESULTS: Parents and adults with lower education were less likely to permit greater distances for children's independent travel (OR 0.57 and OR = 0.59, respectively). Women, parents and adults with lower education were less likely to grant children greater distances for independent outdoor play (OR = 0.61, OR = 0.50 and OR = 0.60, respectively). In contrast, adults with higher perceptions of neighbourhood social cohesion were more likely to permit children greater distances for independent travel (OR = 1.05)and outdoor play (OR = 1.05). Adult age and area-level socio-economic disadvantage were not associated with distances adults would permit for independent travel and outdoor play. CONCLUSIONS: Women, parents (particularly those of younger children), adults with lower education and those who perceived neighbourhood social cohesion as being lower were less willing to let children independently travel further away from home. Interventions to increase children's independent mobility may be more effective if targeted to these groups. In addition, increasing neighbourhood social cohesion may help increase adults' willingness to grant children greater independent mobility.

A longitudinal analysis of the influence of the neighborhood built environment on walking for transportation: the RESIDE study.

The purpose of the present analysis was to use longitudinal data collected over 7 years (from 4 surveys) in the Residential Environments (RESIDE) Study (Perth, Australia, 2003-2012) to more carefully examine the relationship of neighborhood walkability and destination accessibility with walking for transportation that has been seen in many cross-sectional studies. We compared effect estimates from 3 types of logistic regression models: 2 that utilize all available data (a population marginal model and a subject-level mixed model) and a third subject-level conditional model that exclusively uses within-person longitudinal evidence. The results support the evidence that neighborhood walkability (especially land-use mix and street connectivity), local access to public transit stops, and variety in the types of local destinations are important determinants of walking for transportation. The similarity of subject-level effect estimates from logistic mixed models and those from conditional logistic models indicates that there is little or no bias from uncontrolled time-constant residential preference (self-selection) factors; however, confounding by uncontrolled time-varying factors, such as health status, remains a possibility. These findings provide policy makers and urban planners with further evidence that certain features of the built environment may be important in the design of neighborhoods to increase walking for transportation and meet the health needs of residents.

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.

Do low-income neighbourhoods have the least green space? A cross-sectional study of Australia's most populous cities.

BACKGROUND: An inequitable distribution of parks and other 'green spaces' could exacerbate health inequalities if people on lower incomes, who are already at greater risk of preventable diseases, have poorer access. METHODS: The availability of green space within 1 kilometre of a Statistical Area 1 (SA1) was linked to data from the 2011 Australian census for Sydney (n = 4.6 M residents); Melbourne (n = 4.2 M); Brisbane (n = 2.2 M); Perth (n = 1.8 M); and Adelaide (n = 1.3 M). Socioeconomic circumstances were measured via the percentage population of each SA1 living on < $21,000 per annum. Negative binomial and logit regression models were used to investigate association between the availability of green space in relation to neighbourhood socioeconomic circumstances, adjusting for city and population density. RESULTS: Green space availability was substantively lower in SA1s with a higher percentage of low income residents (e.g. an incidence rate ratio of 0.82 (95% confidence interval (95% CI) 0.75, 0.89) was observed for SA1s containing ≥20% versus 0-1% low income residents). This association varied between cities (p < 0.001). Adelaide reported the least equitable distribution of green space, with approximately 20% greenery in the most affluent areas versus 12% availability in the least affluent. Although Melbourne had a smaller proportion of SA1s in the top quintile of green space availability (13.8%), the distribution of greenery was the most equitable of all the cities, with only a 0.5% difference in the availability of green space between SA1s containing 0-1% low income households versus those with ≥20%. Inequity of access, however, was reported across all cities when using logit regression to examine the availability of at least 20% (odds ratio 0.74, 95% CI 0.59, 0.93) or 40% (0.45, 0.29, 0.69) green space availability in the more disadvantaged versus affluent neighbourhoods. CONCLUSION: Affirmative action on green space planning is required to redress the socioeconomic inequity of access to this important public health resource.

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.

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.

Can virtual streetscape audits reliably replace physical streetscape audits?

There is increasing recognition that the neighborhood-built environment influences health outcomes, such as physical activity behaviors, and technological advancements now provide opportunities to examine the neighborhood streetscape remotely. Accordingly, the aims of this methodological study are to: (1) compare the efficiencies of physically and virtually conducting a streetscape audit within the neighborhood context, and (2) assess the level of agreement between the physical (criterion) and virtual (test) audits. Built environment attributes associated with walking and cycling were audited using the New Zealand Systematic Pedestrian and Cycling Environment Scan (NZ-SPACES) in 48 street segments drawn from four neighborhoods in Auckland, New Zealand. Audits were conducted physically (on-site) and remotely (using Google Street View) in January and February 2010. Time taken to complete the audits, travel mileage, and Internet bandwidth used were also measured. It was quicker to conduct the virtual audits when compared with the physical audits (χ = 115.3 min (virtual), χ = 148.5 min (physical)). In the majority of cases, the physical and virtual audits were within the acceptable levels of agreement (ICC ≥ 0.70) for the variables being assessed. The methodological implication of this study is that Google Street View is a potentially valuable data source for measuring the contextual features of neighborhood streets that likely impact on health outcomes. Overall, Google Street View provided a resource-efficient and reliable alternative to physically auditing the attributes of neighborhood streetscapes associated with walking and cycling. Supplementary data derived from other sources (e.g., Geographical Information Systems) could be used to assess the less reliable streetscape variables.

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.

Combining GPS with heart rate monitoring to measure physical activity in children: A feasibility study.

The recent development of global positioning system (GPS) receivers with integrated heart rate (HR) monitoring has provided a new method for estimating the energy expenditure associated with children's movement. The purpose of this feasibility study was to trial a combination of GPS surveillance and HR monitoring in 39 primary-aged children from New Zealand. Spatial location and HR data were recorded during a school lunch break using an integrated GPS/HR receiver (1Hz). Children averaged a total distance of 1.10+/-0.56km at speeds ranging from 0 to 18.6kmh(-1). Activity patterns were characterised by short bursts of moderate to high speeds followed by longer periods of slow speeds. In addition, boys averaged higher speeds than girls (1.77+/-0.62kmh(-1) and 1.36+/-0.50kmh(-1), respectively; p=0.003). The percentage of time spent at 0kmh(-1) (stationary) ranged from 0.1% to 21.3% with a mean of 6.4+/-4.6%. These data suggest that while children were relatively active during the lunch period, they spent a substantial portion of time engaged in slow or stationary physical activities. Furthermore, associations between HR, average speed, and stationary time demonstrated that children who moved at faster speeds expended more energy than those who moved at slower speeds. We conclude that the combined approach of GPS and HR monitoring is a promising new method for investigating children's play-related energy expenditure. There is also scope to integrate GPS data with geographic information systems to examine where children play and accumulate physical activity.

Applying GPS to enhance understanding of transport-related physical activity.

The purpose of the paper is to review the utility of the global positioning system (GPS) in the study of health-related physical activity. The paper draws from existing literature to outline the current work performed using GPS to examine transport-related physical activity, with a focus on the relative utility of the approach when combined with geographic information system (GIS) and other data sources including accelerometers. The paper argues that GPS, especially when used in combination with GIS and accelerometery, offers great promise in objectively measuring and studying the relationship of numerous environmental attributes to human behaviour in terms of physical activity and transport-related activity. Limitations to the use of GPS for the purpose of monitoring health-related physical activity are presented, and recommendations for future avenues of research are discussed.

Travel perceptions, behaviors, and environment by degree of urbanization.

OBJECTIVES: This study examines how engagement in transport-related physical activity (TPA), perceptions of the commute route, actual travel distance, and perceptions of travel distance vary by degree of urbanization in rural and remote areas of Central Queensland, Australia. METHOD: A random, cross-sectional sample of 1230 adults aged 18 years and over residing in rural and remote Central Queensland were surveyed by telephone in October-November 2006. Engagement in and attitudes towards TPA, perceptions of the commute route, actual travel distances, and perceived appropriate travel distances for TPA were assessed. RESULTS: For this study 765 adults were eligible for the analysis as they traveled to an occupation. Overall, 86% of the sample commuted to their occupation by motorized modes, 71% of individuals recognized 5 km or less as an appropriate distance to travel via TPA modes, and 45% of respondents reported travel distances less than five kilometers (km) to reach their workplace. Participants from small rural and remote settings more frequently traveled greater than 20 km to reach their occupation, reported fewer sidewalks and shops, and less heavy traffic enroute compared to respondents in large rural settings. CONCLUSION: Infrastructure for, and participation in TPA varies according to degree of urbanization. Future work in this area should target the substantial population that recognizes they could engage in TPA. As such, increasing TPA participation in these settings likely requires a cultural shift and infrastructure improvements.

Travel behavior and objectively measured urban design variables: associations for adults traveling to work.

Mixed land use, residential density, street connectivity, and commute distance have been identified as potential variables affecting transport-related physical activity (TPA) behaviors. In this study, objectively measured urban design variables and TPA behaviors for adults who commuted to an occupation (n=364) were examined. Utilitarian walking and cycling for other purposes were not investigated. Commute distance was negatively associated with TPA behaviors. Logistic regression analysis identified respondents who commuted through the most connected streets were more likely to engage in TPA modes to access their occupation (OR=6.9) when compared to those traveling along the least connected. No other associations between TPA behaviors and urban variables were shown. Improved street connectivity and reduced commute distances will likely support TPA.

Are Measures Derived From Land Use and Transport Policies Associated With Walking for Transport?

BACKGROUND: There is growing urgency for higher quality evidence to inform policy. This study developed geographic information system spatial measures based on land use and transport policies currently used in selected Australian states to assess which, if any, of these measures were associated with walking for transport. METHODS: Overall, 6901 participants from 570 neighborhoods in Brisbane, Australia, were included. Participants reported their minutes of walking for transport in the previous week. After a review of state-level land use and transport policies relevant to walking for transport across Australia, 7 geographic information system measures were developed and tested based on 9 relevant policies. Data were analyzed using multilevel multinomial logistic regression. RESULTS: Greater levels of walking for transport were associated with more highly connected street networks, the presence of public transport stops, and having at least 2 public transport services per hour. Conversely, neighborhoods with shorter cul-de-sac lengths had lower levels of walking for transport. There was no evidence of associations between walking for transport and street block lengths less than 240 m or traffic volumes. CONCLUSIONS: These findings highlight the need for urban design and transport policies developed by governments to be assessed for their impact on transport-related physical activity.