Understanding and promoting walking for transport in adults

BACKGROUND. The benefits of physical activity for physical and mental health and well-being are well evidenced. Despite this, a substantial proportion of the adult population in England do not meet current recommended guidelines for physical activity leading to a significant burden on individuals, health services and the economy. Strategies are needed which lead to sustainable increases in physical activity at the population level. Walking is a free and accessible behaviour which is acceptable to most people and can be incorporated into everyday activities. Walking for transport is a type of walking which is undertaken specifically to travel from one point to another to reach a destination. Gaining an understanding of behavioural and contextual influences on walking for transport is important to facilitate specificity in designing effective interventions. Evaluating both the implementation and effectiveness of interventions to promote walking for transport in real-world settings may help to improve interventions and determine how they can be implemented at scale to impact population levels of physical activity. The research in this thesis aimed to contribute to the evidence base relating to understanding the factors influencing and the promotion of walking for transport in adults to address the problem of how to increase population levels of physical activity to improve health and well-being. Eight research articles are presented which used data collected as part of three research projects: Impact of Constructing Non-motorised Networks and Evaluating Changes in Travel (iConnect), Walking Works and Fitter for Walking. RESULTS. The Transport and Physical Activity Questionnaire (TPAQ) was developed and its measurement properties for assessing different domains of physical activity were tested. It was found to be suitable for use in comprehensively assessing transport and physical activity behaviour with comparable reliability and validity to other similar measures. A new 13-item scale was developed to assess adults perceptions of the environment in the neighbourhood (PENS) in the UK context. This was found to have comparable reliability to other similar scales. Using PENS and TPAQ, walking for transport was found to be positively associated with perceptions of supportive infrastructure, availability of local amenities, and general environment quality in the residential neighbourhood. Walking to and from work was found to be positively associated with the perceived presence of convenient walking routes, suitable pavements, maintained pavements or convenient public transport in the workplace neighbourhood. Walking to and from work was also positively associated with employees who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking. It was negatively associated with employees perceptions that they lived too far away from work to walk, walking was less convenient than using a car for commuting, they did not have time to walk, they needed a car for work, or they had always travelled the same way. In a community-based intervention to promote walking for transport, a wide variety of small-scale environmental changes were made which were led by local authorities (e.g. removal of encroaching vegetation, new/improved pedestrian signage, new dropped kerbs/kerb improvements, and new, repaired or improved footpaths) or by communities (e.g. planting bulbs, shrubs or bedding plants, clean-up days and litter pick-ups). Additional activities were undertaken to help increase awareness of the benefits of walking and promote the newly improved routes (e.g. led walks, themed walks, development of maps/resources and community events). After 12 months, there was a decrease in pedestrian route use overall and in four out of the five case studies where data collection took place. However, after 14-20 months there was an increase in pedestrian route use overall and in all case studies. Participants in the intervention perceived the main impacts to be improved physical and social environments. Implementing the intervention was found to be complex and required considerable resource and time. Processes required for implementation of the intervention were identified which included planning, preparation and delivery phases. Adaptability of the intervention to fit the local context was highlighted as being critical for successful programme delivery. In a whole-workplace walking to work intervention, no changes in walking behaviour were observed which may have resulted from barriers in using volunteer employee walking champions to deliver activities, the programme components not being delivered as originally intended, the types of activities which were delivered, and lack of awareness and participation by employees. CONCLUSIONS. A range of factors operating at different levels which influence walking for transport behaviour in adults were identified, confirming the need for specificity in studying both the behaviour and the contexts in which the behaviour is undertaken. Evidence is provided of the barriers and facilitators for implementing community-based and workplace interventions which aim to promote the behaviour. These should be addressed to maximise the effectiveness of interventions. Researchers, practitioners and policy-makers should take these research findings into consideration in the future design, planning and implementation of co-produced, multi-level interventions which aim to promote walking for transport. Future research should identify causal factors influencing walking for transport, improve intervention content and optimise intervention implementation. Researchers should address methodological limitations of work in this area, including the application of more rigorous study designs and the use of more reliable and valid measures of walking for transport and overall physical activity. Together this will maximise the potential impact of walking for transport interventions for promoting physical activity and improving health and well-being at the population level

Cellular localization and trafficking of vascular adhesion protein-1 as revealed by an N-terminal GFP fusion protein

Recent studies of vascular adhesion protein-1 (VAP-1) have greatly advanced our understanding of the important role this protein plays in the establishment and progression of inflammatory disease. To facilitate more detailed studies on the function of VAP-1, we developed a GFP-fusion protein that enabled us to monitor the trafficking of the protein in three selected cell types: hepatic sinusoidal endothelial cells, liver myofibroblasts and an hepatic stellate cell line (LX-2). The fusion protein was detected as punctate cytoplasmic GFP staining, but was present only at low levels at the cell surface in all cell types studied. The subcellular distribution of the protein was not altered in a catalytically inactive mutant form of the protein (Tyr471Phe) or in the presence of exogenous VAP-1 substrate (methylamine) or inhibitor (semicarbazide). The GFP-VAP-1 protein was localized to the Golgi apparatus (GM-130), endoplasmic reticulum (GRP94) and early endosomes (EEA-1). Additional staining for VAP-1 revealed that the overexpressed protein was also present in vesicles that were negative for GFP fluorescent signal and did not express EEA-1. We propose that these vesicles are responsible for recycling the fusion protein and that the fluorescence of the GFP moiety is quenched at the low pH within these vesicles. This feature of the protein makes it well suited for live cell imaging studies where we wish to track protein that is being actively trafficked within the cell in preference to that which is being recycled. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00702-013-1003-3) contains supplementary material, which is available to authorized users

The capabilities and human rights of high performance athletes

High performance athletes participate and function in sports systems where exploitative behaviours may become manifest. These behaviours potentially violate an individual athlete’s human rights. Using the Capability Approach first outlined by Amartya Sen the paper details how a more precise analysis of human rights, in the context of high performance sport, may be arrived at. Using in-depth narrative accounts from high performance athletes, data illustrate how athlete maltreatment is related to individual capabilities and functionings. The loss of individual freedoms infringes accepted notions of human rights. The implications for practice concern how human rights may be protected within and for systems of high performance production

Experiencing the felt difficulty of sport coaching violence. Evidence and reflections from the arts-informed practitioner education event, ways of seeing sport coaching violence

Amidst a backdrop of global patterns of abuse identified in various high-performance sport settings, this study is anchored on a commitment to bring to life the voices of abused athletes and to educate practitioners on the topic of abuse in sport. The case combined previously collected data (Kavanagh, 2014; Kavanagh et al. 2017) and, guided by art-informed pedagogy, led to the construction of an immersive audio-visual experience. Sport practitioners (including coaches and sport psychologists) were invited to attend the exhibition to be confronted by and with(in) athletes’ verbatim stories of abuse. Sixty-four participants attended the exhibition, of those, thirty-one attendees completed a post-event questionnaire and seven attendees participated in semi-structured interviews, providing an in-depth insight into their experiences of the event. In this paper we share our experience of creating the exhibition and the themes generated from the qualitative data: (1) practitioners experienced the physical space of the event as ‘moving’ and ‘difficult’ both physically and emotionally, and; (2) this ‘felt difficulty’ reverberated beyond the event, compelling participants to reflexively make sense of their emotions and reflect upon their own practice. We make recommendations for the potential of arts-informed pedagogy within future practitioner education contexts to afford engagement with critical contemporary topics underpinning applied practice

Correlates of walking and cycling for transport and recreation: factor structure, reliability and behavioural associations of the perceptions of the environment in the neighbourhood scale (PENS).

BACKGROUND: Emerging evidence suggests that walking and cycling for different purposes such as transport or recreation may be associated with different attributes of the physical environment. Few studies to date have examined these behaviour-specific associations, particularly in the UK. This paper reports on the development, factor structure and test-retest reliability of a new scale assessing perceptions of the environment in the neighbourhood (PENS) and the associations between perceptions of the environment and walking and cycling for transport and recreation. METHODS: A new 13-item scale was developed for assessing adults' perceptions of the environment in the neighbourhood (PENS). Three sets of analyses were conducted using data from two sources. Exploratory and confirmatory factor analyses were used to identify a set of summary environmental variables using data from the iConnect baseline survey (n = 3494); test-retest reliability of the individual and summary environmental items was established using data collected in a separate reliability study (n = 166); and multivariable logistic regression was used to determine the associations of the environmental variables with walking for transport, walking for recreation, cycling for transport and cycling for recreation, using iConnect baseline survey data (n = 2937). RESULTS: Four summary environmental variables (traffic safety, supportive infrastructure, availability of local amenities and social order), one individual environmental item (street connectivity) and a variable encapsulating general environment quality were identified for use in further analyses. Intraclass correlations of these environmental variables ranged from 0.44 to 0.77 and were comparable to those seen in other similar scales. After adjustment for demographic and other environmental factors, walking for transport was associated with supportive infrastructure, availability of local amenities and general environment quality; walking for recreation was associated with supportive infrastructure; and cycling for transport was associated only with street connectivity. There was limited evidence of any associations between environmental attributes and cycling for recreation. CONCLUSION: PENS is acceptable as a short instrument for assessing perceptions of the urban environment. Previous findings that different attributes of the environment may be associated with different behaviours are confirmed. Policy action to create supportive environments may require a combination of environmental improvements to promote walking and cycling for different purposes.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Non-occupational sitting and mental well-being in employed adults

Background: Emerging evidence suggests that sedentary behaviour may be adversely associated with physical health, but few studies have examined the association with mental well-being. Purpose: This study examined the association of four nonoccupational sedentary behaviours, individually and in total, with mental well-being in employed adults. Methods: Baseline data from the evaluation of Well@Work, a national workplace health promotion project conducted in the UK, were used. Participants self-reported sitting time whilst watching television, using a computer, socialising and travelling by motorised transport. Mental well-being was assessed by the 12-item version of the general health questionnaire. Analyses were conducted using multiple linear regression. Results: In models adjusted for multiple confounders, TV viewing, computer use and total non-occupational sitting time were adversely associated with general health questionnaire-12 assessed mental well-being in women. Computer use only was found to be adversely associated with mental well-being in men. Conclusion: Sedentary behaviour may be adversely associated with mental well-being in employed adults. The association may be moderated by gender. © The Society of Behavioral Medicine 201

Reliability and validity of the transport and physical activity questionnaire (TPAQ) for assessing physical activity behaviour

No current validated survey instrument allows a comprehensive assessment of both physical activity and travel behaviours for use in interdisciplinary research on walking and cycling. This study reports on the test-retest reliability and validity of physical activity measures in the transport and physical activity questionnaire (TPAQ)

Workplace policies and practices promoting physical activity across England: what is commonly used and what works?

Purpose Many adults fail to achieve sufficient moderate-to-vigorous physical activity (MVPA). Understanding how workplaces most effectively promote physical activity can benefit public health. Design/methodology/approach Data were collected via two online surveys. Firstly, 3,360 adults employed at 308 workplaces across England self-reported their MVPA, activity status at work and frequency of journeys made through active commuting. From this sample, 588 participants reported on the policies and practices used in their workplace to promote physical activity. Factor and cluster analysis identified common practice. Regression models examined the association between the workplace factors and engagement in physical activity behaviours. Findings Five factors emerged: targeting active travel, information about physical activity outside the workplace, facilities and onsite opportunities, sedentary behaviour, and information about physical activity within the workplace. Further, five clusters were identified illustrate how the factors are typically being utilised by workplaces across England. Commonly used practices related to promoting active travel,reducing sedentary behaviour and the provision of information but these practices were not associated with meeting MVPA guidelines. The provision of facilities and onsite exercise classes was associated with the most positive physical activity behaviour outcomes; however, these structures were rarely evident in workplaces. Originality/value. Previous research has identified a number of efficacious actions for promoting physical activity in the workplace, however, research investigating which of these are likely to be acceptable to worksites is limited. The present study is the first to combine these two important aspects. Five common profiles of promoting physical activity in worksites across England were identified and related to physical activity outcomes. Guidance is given to workplace managers to enable them to maximise the resources they have for the greatest gains in employee health. Where feasible, facilities and classes should be provided to achieve the most positive outcomes

Evaluation of the implementation of an intervention to improve the street environment and promote walking for transport in deprived neighbourhoods

Background:Levels of physical activity remain low, particularly in deprived areas. Improving the street environment to promote walking for transport using a community engagement approach is a potential strategy to increase physical activity. An understanding of the implementation of this intervention approach is needed to facilitate further research, replication and scale-up. The aim of this study was to evaluate the implementation of the Fitter for Walking (FFW) intervention in deprived neighbourhoods.Methods:FFW was delivered in five regions of England between August 2008 and March 2012 and aimed to use a community engagement approach to improve the street environment to promote walking for transport. Implementation was assessed in relation to reach; dosage; implementation processes and adaptation; and factors influencing implementation. Three data sources were used: focus groups and face-to-face interviews with coordinators; implementation logs; and participation records.Results:Reach: 155 community groups participated in FFW engaging 30,230 local residents. Dosage: A wide variety of environmental improvements were implemented by local authorities (LAs) (42 projects) and by communities (46 projects). Examples of LA-led improvements included removal of encroaching vegetation, new/improved pedestrian signage, new dropped kerbs/kerb improvements and new, repaired or improved footpaths. Examples of community-led improvements included planting bulbs, shrubs or bedding plants, clean-up days and litter pick-ups. In 32 projects, no environmental improvements were implemented. Promotional and awareness-raising activities were undertaken in 81 projects. Examples included led walks, themed walks, development of maps/resources to promote improved routes and community events. Processes and adaptation: The need for a planning phase, a preparatory phase, and a delivery phase with a four step process were identified. Adaptability to local context was important. Factors influencing implementation: Five key themes were identified in relation to the barriers and facilitators of implementing FFW: local knowledge and contacts; intervention delivery; coordinator role; working with LAs and other partners; and working with communities.ConclusionsFFW is one of few reported interventions which have used a community engagement approach to change the street environment to promote walking for transport in deprived neighbourhoods. Delivering these types of interventions is complex and requires considerable resource and time. A set of recommendations and an implementation framework are proposed for future delivery of this and similar types of programme

Bright spots, physical activity investments that work: Workplace Challenge

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0