My Way to School Through a Camera Lens: Involving Children to Inform a Policy Recommendation on Active School Travel.

Active school travel (AST) is an effective approach for increasing children's physical activity and independent mobility, but policy supporting AST is lacking. This study aims to explore children's experiences of AST to inform a policy recommendation. Photovoice methodology with a qualitative approach was applied, with children taking pictures on their way to school. This was followed by focus groups where the children explored their experiences of AST based on their photos. The data were analyzed using qualitative content analysis. The results show that the children valued independent mobility and wanted to be involved in decisions about their travels; they also expressed feelings of increased responsibility and personal growth as a consequence. Although the children recognized areas of improvement regarding infrastructure, especially regarding heavy traffic that jeopardized travel safety, they continued using AST. Finally, the children talked about the value of the health and environmental benefits of AST. Opportunities for friendship, play, and making decisions about their own time were highlighted as important incentives. The benefits from AST are many for children, as well as for society. The result has informed policy recommendations for AST, and the children's input will be used to communicate the recommendations. Listening to the voices of children could be a steppingstone toward forming future healthy mobility initiatives. In that process, it is key to include children's perspectives when formulating the AST policy for successful adoption and implementation.

Validating the Perceived Active School Travel Enablers and Barriers - Child (PASTEB-C) questionnaire.

OBJECTIVES: Presently, child-specific tools and instruments related to active school travel (AST) are lacking. This methodological shortcoming often contributes to suboptimal AST behaviour evaluations and intervention programming. The aim of this paper was to develop and validate a theoretically informed child-specific scale regarding multiple perceived barriers and enablers known to impact children's participation in AST. STUDY DESIGN: Mixed methods. METHODS: A mixed-methods and multistudy scale development approach featuring the application of social-ecological theory, a validation pilot study (n = 80), and test-retest study (n = 96) was conducted in collaboration with children in Ontario, Canada. In tandem with completing cognitive interviews and online surveys, multiple analyses, including a qualitative thematic analysis, along with weighted Cohen's kappa, Cronbach's alpha, and confirmatory factor analysis were undertaken. RESULTS: Qualitative analyses of the developed tool addressed face validity concerns related to the response options and definitions of terms used. Following the reliability analyses of 40 items, two confirmatory factor analyses were run to assess the construct validation of perceived AST barriers and enablers, and resulted in the development of the 24-item Perceived Active School Travel Enablers and Barriers - Child (PASTEB-C) questionnaire. CONCLUSION: The developed PASTEB-C questionnaire may be used to inform the programming and development of AST interventions, as well as conduct child-specific AST research.

Equity in temporary street closures: The case of London's Covid-19 'School Streets' schemes.

School Streets are a street space reallocation scheme that has proliferated since the beginning of the Covid-19 pandemic in the UK, reducing motor traffic on streets outside many schools. Utilising a minimum-standards approach to equity, this paper examines the distribution of School Streets closures across social and environmental indicators of equity, and spatially across London's administrative geography. Using a multi-level regression analysis, we show that although School Streets have been equally distributed across several socio-demographic indicators, they are less likely to benefit schools in car-dominated areas of poor air quality, and their spatial distribution is highly unequal. This study presents an example of using environmental and spatial variables alongside more typical sociodemographic indicators in measuring the equity of school travel provision. For policymakers, the findings signal the need to implement complementary policies that can benefit schools with worse air quality, and to accelerate School Street implementation in slower districts.

The impact of Covid-19 on children's active travel to school in Vietnam.

This is among the first studies to provide empirical evidence on active school travel rates and determinants before and after the first Covid-19 lockdown in spring 2020. We have collected and analyzed primary survey data on the school travel patterns of 472 school-age children in Hanoi, Vietnam. The findings show that the Covid-19 pandemic has been quite detrimental: once schools reopened, the prevalence of active school travel decreased from 53% to less than 31%. Where parents, especially mothers, did not face barriers to motorized travel, they assumed the role of chauffeur. Parents who were more concerned about community infections were more motivated to shift children to motorized modes. Walking was more affected than cycling because it was seen as more likely to lead to physical contact and virus transmission. Active school travel dropped more steeply in urban districts (as opposed to poorer, non-urban districts) and in those areas where home-school distances were the largest. It appears that the most common perceptions around barriers to active school travel have been exacerbated during the pandemic as parents and children adapt to "the new normal".

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 ).

Impact of School Location on Children's Air Pollution Exposure.

The role of school location in children's air pollution exposure and ability to actively commute is a growing policy issue. Well-documented health impacts associated with near-roadway exposures have led school districts to consider school sites in cleaner air quality environments requiring school bus transportation. We analyze children's traffic-related air pollution exposure across an average Detroit school day to assess whether the benefits of reduced air pollution exposure at cleaner school sites are eroded by the need to transport students by bus or private vehicle. We simulated two school attendance scenarios using modeled hourly pollutant concentrations over the school day to understand how air pollution exposure may vary by school location and commute mode. We found that busing children from a high-traffic neighborhood to a school 19 km away in a low-traffic environment resulted in average daily exposures 2 to 3 times higher than children walking to a local school. Health benefits of siting schools away from high-volume roadways may be diminished by pollution exposure during bus commutes. School districts cannot simply select sites with low levels of air pollution, but must carefully analyze tradeoffs between location, transportation, and pollution exposure.

The decline in active school transportation (AST): A systematic review of the factors related to AST and changes in school transport over time in North America.

Active travel to school has declined during the last 50years in North America. During the last decade, the children's active school transportation (AST) literature has grown. This systematic review provides an updated examination of AST correlates, and discusses why school travel mode (STM) share may have changed over time. AST trends are described and a systematic literature review of AST correlates in North America for the period 1990-2016 was conducted. Strength of association between correlates and AST, and relationship direction are assessed and reported. Graphical presentation of correlates included in ≥5 studies were included. Sixty-three studies were identified and reviewed. Distance to school was most strongly associated with AST. Individual, parental and societal correlates had moderate positive associations with AST including: child age, lower parental education, income and other income related factors, race and positive perceptions of AST. Longitudinal studies were few in number, as were studies about exceptional populations, policy, and interventions. AST intervention should focus on key AST correlates. Social and environmental diversity calls for local solutions to school travel challenges. Changes in AST correlates over time should be considered for evaluating existing policy approaches, and to support development of new policy, regulation, design, and program interventions.

Understanding child and parent perceptions of barriers influencing children's active school travel.

BACKGROUND: Physical activity plays a fundamental role in the health and well-being of children. Walking is the most common form of physical activity and the journey to and from school provides an opportunity for children to be active every day. This study examines how child and parent perceptions of barriers to active school travel influences children's behaviour. METHODS: Participants were recruited from 48 elementary schools in Southwestern Ontario, Canada. The study sample includes 1296 children (ages 9-14 years) who live within walking distance of their school, defined as 1.6 km network distance. Chi-square analysis examined differences between child and parent perceptions of barriers to active school travel. Logistic regression models examined how parent and child perceptions of barriers influence active school travel behaviour, while controlling for key intrapersonal, interpersonal, and physical environment factors. RESULTS: The results indicate that there are significant differences in how parents and children perceive barriers to active school travel. Model results find older children, children without siblings, households with no vehicles, and children who live closer to school are most likely to use active school travel. Parent perceptions of barriers are found to have a greater influence on children's active school travel behaviour than children's perceptions. Different perceptions of barriers influence active school travel to school compared to returning home from school. CONCLUSIONS: Child and parent perceptions of barriers to active school travel differ and have different impacts on children's travel behaviour. Understanding how child and parent perceptions of barriers differ can help policymakers and practitioners develop specialized interventions aimed at increasing children's use of active school travel and children's overall physical activity. Interventions used to promote active school travel should focus on safety, as well as perceptions of distance to break parental habits of routinely driving their children to school. Overall, this study highlights the importance of considering both child and parent perceptions to create a safe and accessible environment to allow for an increase in active school travel behaviour among elementary school children who live within walking distance of their school.

Effectiveness of active school transport interventions: a systematic review and update.

BACKGROUND: Active school transport (AST) is a promising strategy to increase children's physical activity. A systematic review published in 2011 found large heterogeneity in the effectiveness of interventions in increasing AST and highlighted several limitations of previous research. We provide a comprehensive update of that review. METHODS: Replicating the search of the previous review, we screened the PubMed, Web of Science, Cochrane, Sport Discus and National Transportation Library databases for articles published between February 1, 2010 and October 15, 2016. To be eligible, studies had to focus on school-aged children and adolescents, include an intervention related to school travel, and report a measure of travel behaviors. We assessed quality of individual studies with the Effective Public Health Practice Project quality assessment tool, and overall quality of evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. We calculated Cohen's d as a measure of effect size. RESULTS: Out of 6318 potentially relevant articles, 27 articles reporting 30 interventions met our inclusion criteria. Thirteen interventions resulted in an increase in AST, 8 found no changes, 4 reported inconsistent results, and 5 did not report inferential statistics. Cohen's d ranged from -0.61 to 0.75, with most studies reporting "trivial-to-small" positive effect sizes. Three studies reported greater increases in AST over longer follow-up periods and two Safe Routes to School studies noted that multi-level interventions were more effective. Study quality was rated as weak for 27/30 interventions (due notably to lack of blinding of outcome assessors, unknown psychometric properties of measurement tools, and limited control for confounders), and overall quality of evidence was rated as low. Evaluations of implementation suggested that interventions were limited by insufficient follow-up duration, incomplete implementation of planned interventions, and limited access to resources for low-income communities. CONCLUSIONS: Interventions may increase AST among children; however, there was substantial heterogeneity across studies and quality of evidence remains low. Future studies should include longer follow-ups, use standardized outcome measures (to allow for meta-analyses), and examine potential moderators and mediators of travel behavior change to help refine current interventions. TRIAL REGISTRATION: Registered in PROSPERO: CRD42016033252.

Promoting active student travel: A longitudinal study.

This study investigates the effects of sidewalk modification and bike lane accommodation on students' active travel to schools. The modeling framework assumes that a student's choice for the mode of travel to school is impacted by numerous factors such as neighborhood crime rates, traffic safety, built environment amenities, and socio-demographic factors. A generalized linear model is employed to capture longitudinal changes in the mode share of students who walk or bike to school based on data collected from 53 schools in the city of Seattle, Washington. The modeling results indicate that (1) enhanced sidewalk modifications and bike lane accommodations encourage students walking and biking to school; (2) the implementation of Seattle's student assignment plan helps promote students walking to school possibly due to the change from school choice to neighborhood-based school assignment; (3) the size of the school attendance area is not significantly correlated with students' active travel activities, while the size of school enrollment is negatively associated with walking; (4) in school areas with high employment density, biking to school may be a more attractive option for students; (5) greater crosswalk density may encourage more students to walk to school; (6) the density of bike crashes is negatively associated with students biking to school. In terms of policy implications, transport planners should continually promote walking and biking supportive environments and implement policies to encourage active student travel.

Promoting active travel to school: a systematic review (2010-2016).

BACKGROUND: Interventions aiming to promote active school travel (AST) are being implemented globally to reverse AST decline. This systematic literature provides an update of AST interventions assessing study quality and theory use to examine progress in the field. METHODS: A systematic review was conducted to identify and analyse AST interventions published between 2010 and 2016. Seven databases were searched and exclusion criteria were applied to identify 18 AST interventions. Interventions were assessed using the Active Living by Design (ALBD) Community Action (5P) Model and the Evaluation of Public Health Practice Projects (EPHPP). Methods used to evaluate the effectiveness of each intervention and their outcomes and extent of theory use were examined. RESULTS: Seven out of 18 studies reported theory use. The analysis of the interventions using the ALBD Community Action Model showed that Preparation and Promotion were used much more frequently than Policy and Physical projects. The methodological quality 14 out of 18 included interventions were assessed as weak according to the EPHPP framework. CONCLUSION: Noted improvements were an increase in use of objective measures. Lack of theory, weak methodological design and a lack of reliable and valid measurement were observed. Given that change is evident when theory is used and when policy changes are included extended use of the ALBD model and socio-ecological frameworks are recommended in future.

Active school travel: an evaluation of the Canadian school travel planning intervention.

OBJECTIVE: Active school travel (AST) may provide a significant source of physical activity for children although rates of AST are declining in many countries. The objective of this study was to evaluate the Canadian School Travel Planning (STP) intervention by examining changes in school travel mode and predictors of mode change. METHODS: Schools (n=106) across Canada participated between January 2010 and March 2012. STP committees implemented school-specific strategies to increase active school transport (AST) which included educational strategies, activities and events, capital improvement projects and enforcement initiatives. Travel mode at each school was assessed by a hands-up survey and school travel plans were reviewed for content. RESULTS: Complete data were available for 53 schools. There was no increase in AST at follow-up after one year. There was variation in mode change between schools. Only season of data collection predicted a decrease in AST in the morning (B=-5.36, p<.05). CONCLUSION: This Canadian STP evaluation showed no change in AST after one year. There was evidence of some localized success at nearly half of the participating schools. More robust monitoring and evaluation are needed to examine STP effectiveness.

Supporting children's participation in active travel: developing an online road safety intervention through a collaborative integrated knowledge translation approach.

Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children's PA. One common barrier to children's engagement in AT, however, is a reported lack of education and training. To support children's participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children's knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.

The intervention design to promote active travel mode among children and adolescents: A systematic review.

Background: Walking and cycling are examples of active travel modes or nonmotorized modes that rely on human physical power rather than fossil fuel consumption. In the context of short-distance journeys, active travel modes are advocated as feeder modes to reduce energy consumption and CO2 emissions. However, in Thailand and many other developing countries, these modes of transportation have not been widely adopted or effectively promoted. The absence of comprehensive campaigns and interventions to promote and facilitate the use of active travel modes has become a major barrier to their adoption, particularly among adolescents who will be future global citizens. Therefore, a campaign or intervention targeting adolescents is imperative to introduce and persuade them to adopt active travel modes. This study aims to provide guidelines for developing a robust intervention strategy to promote active travel modes among adolescents. Methods: This study performed a systematic review to achieve the research goal using a particular search and selection approach. The search strategy has focused on published studies in the English language since 2014 to highlight the most recent trends. The selection process focused on articles relevant to promoting active travel mode among children and adolescents (up to 18 years old) through intervention. Conclusions: A total of 16 studies were included. The findings reveal that successful interventions to promote active travel modes consist of an educational program and activities incorporating gamification to encourage their use. Furthermore, the intervention should last longer than one month to be effective.

Validating the Perceived Active School Travel Enablers and Barriers-Parent (PASTEB-P) Questionnaire to Support Intervention Programming and Research.

A child's ability to participate in active school travel (AST) is complicated by several factors. Of particular note are parental controls, which are informed by their perceptions of the local built and social environments, assessments of their child's skills, and convenience preferences, among other considerations. However, there is currently a lack of AST-specific scales that include validated parental perception measures related to such notable barriers and enablers, or those that tend to frame their AST decision-making processes. Framed within the social-ecological model of health behaviour, the aims of the present paper were thus threefold, specifically to (1) outline and test the construct validity of measures delineating parental perceptions of barriers and enablers to AST, (2) evaluate the reliability and consistency of the developed measures, and (3) connect these measures to develop broader constructs for use in the Perceived Active School Travel Enablers and Barriers-Parent (PASTEB-P) questionnaire. To achieve these aims, a mixed-methods approach featuring cognitive interviews and surveys, along with qualitative (thematic analysis) and quantitative (Cohen's Kappa, McDonald's Omega, and confirmatory factor analysis) analyses, was applied across two studies. The validation processes of the two studies resulted in the development of fifteen items comprising seven distinct constructs (barriers: AST Skills, Convenience, Road Safety, Social Safety, and Equipment Storage; enablers: Supportive Environment and Safe Environment) related to parental perceptions of AST. The developed PASTEB-P questionnaire can be used to inform and evaluate AST intervention programming and can be applied for AST research purposes.

How the Built Environment Moderates Gender Gap in Active Commuting to Schools.

This study investigates the influences of built environmental (BE) factors, network design, and sociodemographic factors on active school travel (AST). Although numerous studies have explored these relationships, this study is trying to assess this issue with a focus on gender differences. Data from a cross-sectional sample of children from first to sixth grades from 16 public primary schools exclusive for girls and boys (N = 1260) in Shiraz collected in November 2019 was used. The analysis of the data revealed that, on average, boys are more willing to walk than girls, but that the boys' tendency to walk is less elastic with respect to distance. Moreover, it is shown that street connectivity for all distance thresholds has a positive relationship with walking level, but the street network choice parameter decreases the chance of walking within an 800 metre threshold. It is demonstrated the need to take gender differences into account in local planning policies to promote AST in a developing country context.

Environmental correlates of adolescent active travel to school in Asia: An ecological study.

OBJECTIVES: This study aimed to examine the association between country-level environmental correlates and the prevalence of active school travel (AST) in Asia and country-level differences in AST by age and sex. METHODS: This ecological study involved 31 Asian countries. Dependent variables were AST prevalence, AST prevalence difference by age, and by sex. Independent variables were country-level environmental correlates extracted using publicly available datasets, classified into physical and social environments. Association estimates of each dependent variable and each of the independent variables were calculated using univariate linear regression. All variables were standardized to have a mean of 0 and a standard deviation of 1. RESULTS: Results showed that 1 standard deviation (SD) difference in urban population percentage, night-time light, secondary-school enrolment, and prevalence of adult insufficient physical activity were negatively associated with AST prevalence (SD difference: -0.44 (-0.78 to -0.09), -0.40 (-0.76 to -0.04), -0.39 (-0.74 to -0.04), and -0.40 (-0.76 to -0.03), respectively). A 1 SD difference in car per people was associated with a -0.46 (-0.84 to -0.09) difference of AST prevalence by age. A 1 SD difference in PM2.5 concentration and of prevalence of adult insufficient physical activity were associated with a difference of 0.38 (0.01-0.74) and 0.42 (0.03-0.80) difference of AST prevalence by sex. CONCLUSIONS: This study shows that Asian countries with a greater number of people living in urban areas, lower levels of overall adult physical activity and higher levels of night-time light have a lower prevalence of adolescent AST. Country-level physical and social environmental correlates explained some of the regional variance in AST. Future policy actions and interventions for the region need to be contextually sensitive to the environmental correlates that vary between countries.

Perceived Safety Influencing Active Travel to School-A Built Environment Perspective.

Despite the many research studies on active school travel (AST), the number of children walking/cycling to school is decreasing as there is a lack of implementable research evidence. This review through database searches from 2000 to 2020 aims to identify research gaps and explore new perspectives. The articles are selected and screened methodically for systematic presentation of the review. An existing active school travel framework is used to structure and discuss this review paper on mediating factors influencing children's active travel to school, that is the perceived traffic safety, neighborhood safety, and distance to school. Perception of traffic safety could be ameliorated through lateral separation from the traffic, and this could be a new area of research. The neighborhood safety perception may require more research to validate the previous findings. Schools should be located within high-density residential development so that many children can walk to school.

The built environment impacts on route choice from home to school for rural students: A stated preference experiment.

Introduction: Rural roads and built environment in China have been developed enormously, but it is not clear whether these roads fulfill the needs of school children as they need to travel long to school every day. Objective: It is crucial to understand the influencing factors of their travel mode choices to better design future country roads and built environment, aiming to promote physical activities of school children in a safe built environment. Method: This study thus attempts to explore the impacts of rural built environment attributes on children's school travel mode preferences. Eight rural built environment attributes are considered: distance from home to school; the number of intersections passed on the way to school; whether there are sidewalks/bicycle lanes; the traffic speed of school access routes; whether there are separation facilities between motor vehicles and non-motor vehicles; whether there are traffic lights and zebra crossings; availability of greenery such as lawns, flower ponds and street trees and whether there are shops on the way to school and at the school gate. Six hundred and thirty eight valid questionnaires were obtained through face-to-face interviews with school-age children in villages. A multinomial logit model was estimated to unravel the preferences and choices of rural school-age children in different models of school travel using the stated choice data. Results: All the eight attributes have significant impacts on rural children's school travel choices on foot, bicycle, electric bicycle or motorbike. And four rural road design attributes have significant effects on rural children's school travel by private cars. A travel path with pavements or bike lanes, few intersections, low traffic speeds, greenery and shops can facilitate children's school travels on foot or by bike. The conclusions can provide reference for the further upgrading planning, designing and construction of rural roads, as well as enriching the theory and practice of child-friendly villages construction.

Influences of the Built Environment on Rural School Children's Travel Mode Choice: The Case of Chengdu.

Since the reform and opening up of China, the rural built environment has changed dramatically. There is a need to understand how such changes have impacted rural children's school travel mode choice to design the built environment and plan schools accordingly. This paper combines field measurement methods and questionnaires to obtain data on rural children's school travel behavior and uses the multinomial logit (MNL) model to investigate the impacting factors. The results show the following insights: Age has a significant positive impact on children's choice of bicycles and buses. The improvements in road layout and facility conditions are significantly and positively associated with children's choice of electric bicycles for school. There is a significant positive correlation between a good and safe public environment and children's choice of cycling. Furthermore, distance from home to school has a significant impact on the choice of children's school travel mode: the greater the distance to school, the higher the probability that children will choose motorized modes of travel such as buses and private cars. This study provides empirical data and evidence in designing rural transport systems for school children based on their preferences concerning built environment factors.