Assessment of direct and indirect associations between children active school travel and environmental, household and child factors using structural equation modelling.

BACKGROUND: Active school travel (AST) is influenced by multiple factors including built and social environments, households and individual variables. A holistic theory such as Mitra's Behavioural Model of School Transportation (BMST) is vital to comprehensively understand these complex interrelationships. This study aimed to assess direct and indirect associations between children's AST and environmental, household and child factors based on the BMST using structural equation modelling (SEM). METHODS: Data were drawn from Neighbourhoods for Active Kids (NfAK), a cross-sectional study of 1102 children aged 8-13 years (school years 5-8) and their parents from nine intermediate and 10 primary schools in Auckland, New Zealand between February 2015 and December 2016. Data were collected using an online participatory mapping survey (softGIS) with children, a computer-assisted telephone interviewing survey (CATI) with parents, and ArcGIS for built environment attributes. Based on the BMST a conceptual model of children's school travel behaviour was specified for SEM analyses ('hypothesised SEM'), and model modification was made to improve the model ('modified SEM'). SEM analyses using Mplus were performed to test the hypothesised/modified SEM and to assess direct and indirect relationships among variables. RESULTS: The overall fit of the modified SEM was acceptable (N = 542; Root mean square error of approximation = 0.04, Comparative fit index = 0.94, Tucker-Lewis index = 0.92). AST was positively associated with child independent mobility, child-perceived neighbourhood safety, and parent-perceived importance of social interaction and neighbourhood social environment. Distance to school, and parental perceptions of convenience and concerns about traffic safety were negatively associated with AST. Parental fears of stranger danger were indirectly related to AST through those of traffic safety. Distance to school and child independent mobility mediated relationships between AST and child school year and sex. CONCLUSIONS: Increasing children's AST requires action on multiple fronts including communities that support independent mobility by providing child friendly social and built environments, safety from traffic, and policies that promote local schools and safe vehicle-free zones around school

A prototype analysis of New Zealand adolescents’ conceptualizations of wellbeing

This research investigated New Zealand adolescents’ (aged 11 to 13, N = 361) perceptions of wellbeing from a prototype perspective. Specifically, three studies examined what constitutes and promotes wellbeing, whether adolescents’ perspectives are aligned with adults’ conceptualizations and academic models of wellbeing, whether socioeconomic status influences adolescents’ conceptualization, and whether wellbeing is prototypically organized. Results showed that wellbeing is prototypically organized as some components are more central to the concept of wellbeing and others more peripheral. Contrary to lay adults’ conceptualizations and popular wellbeing models, adolescents consider enjoyment/having fun, feeling safe, and being kind/helpful as central components of wellbeing, and sense of satisfaction as a peripheral component of wellbeing. Furthermore, low socio-economic status adolescents consider comfort/being wealthy, being focused, good physical health, good values, and success/achievements as more central for wellbeing than high-socioeconomic status adolescents. Consistent with the current literature, positive family relationships, positive friendships, and physical activity/sport were the most frequently reported pathways to wellbeing among adolescents. Overall, researchers and practitioners should consider adolescents’ understanding of wellbeing in the development of wellbeing assessments and interventions

Cross-continental comparison of the association between the physical environment and active transportation in children : a systematic review

Background: The purpose of this systematic review was to determine the relationship between a wide range of physical environmental characteristics and different contexts of active transportation in 6- to 12-year-old children across different continents. Methods: A systematic search was conducted in six databases (Pubmed, Web of Science, Cinahl, SportDiscus, TRIS and Cochrane) resulting in 65 papers, eligible for inclusion. The investigated physical environmental variables were grouped into six categories: walkability, accessibility, walk/cycle facilities, aesthetics, safety, recreation facilities. Results: The majority of the studies were conducted in North America (n = 35), Europe (n = 17) and Australia (n = 11). Active transportation to school (walking or cycling) was positively associated with walkability. Walking to school was positively associated with walkability, density and accessibility. Evidence for a possible association was found for traffic safety and all forms of active transportation to school. No convincing evidence was found for associations between the physical environment and active transportation during leisure. General safety and traffic safety were associated with active transportation to school in North America and Australia but not associated with active transportation to school in Europe. Conclusions: The physical environment was mainly associated with active transportation to school. Continent specific associations were found, indicating that safety measures were most important in relation to active commuting to school in North America and Australia. There is a need for longitudinal studies and studies conducted in Asia, Africa and South-America and studies focusing specifically on active transportation during leisure

The incidence of injuries traveling to and from school by travel mode

Objective. To assess the absolute and relative risks of youth school-related travel using the New Zealand's no fault accident liability scheme and Census at School datasets. Methods. Injury risk associated with traveling to and from school was assessed by combining census data from the Accident Compensation Commission database, New Zealand's no fault liability accident scheme database and the Census at School survey. Population injury and cost was assessed for incidents during a 2-year period (1 July 2003 to 30 June 2005) and during normal school travel hours (7.30 a.m.–9.00 a.m., 3.00 p.m.–4.30 p.m., weekdays) for youth 5–17 years of age. Results. Overall, 7573 cases were identified as being school travel-related, representing 1.6% of total, and 11.4% school travel period injuries. Walking (30.7%), cycling (30.3%), and motor vehicles (27.7%) provided the majority of injuries. Risk of injury per million trips was highest for cycling (46.1), walking (10.3), and motor vehicle travel (6.1). Conclusion. These data provide the first comprehensive examination of absolute risk of travel to and from school and by transport mode, showing that school-related travel is a relatively safe activity contributing to a minority of all injuries sustained by youth

Keeping kids safe for active travel to school: A mixed method examination of school policies and practices and children's school travel behaviour.

Active school travel contributes to children's physical, mental and social wellbeing. The prevalence of children's active school travel, however, has been declining in many developed countries. Gaining insights into school culture and environments in relation to school travel behaviour is crucial to inform interventions. Using a multiphase mixed methods approach, this study aimed to provide a comprehensive understanding of how school policies and practices supported or inhibited school travel behaviour in Auckland, New Zealand. Data were drawn from Neighbourhoods for Active Kids, a cross-sectional study of 1085 children aged 8-13 years between February 2015 and December 2016. School representatives were interviewed regarding their policies and practices related to school travel behaviour and traffic around school, and the data were analysed thematically. An overarching theme, sub-themes and categories were contextualised for quantitative modelling using objectively measured school variables (school socioeconomic status, active school travel programme, built environments around school). Mixed effects multinomial logistic regression models were employed to determine associations between school travel mode and objectively measured child (sociodemographic characteristics, traffic safety perceptions) and school variables. Safety was the core concept of school travel policies, procedures and programmes. Significant differences in child variables, school socioeconomic status, and cycle lanes and traffic lights around school were found between children who actively travelled or used public transport to school and those driven to school. Overall, this study demonstrated the important role of school policy and procedures and the potential application of an intersectoral approach for interventions to support changes in school travel behaviour.This work was supported by the Health Research Council of New Zealand [grant number 14/436]; and the Medical Research Council [MC_UU_12015/7]. The work was undertaken under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence which was funded by the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust. Melody Smith was supported by a Health Research Council of New Zealand Sir Charles Hercus Research Fellowship [17/013]. Suzanne Mavoa was supported by an Australian National Health and Medical Research Council Early Career Fellowship [No. 1121035]

Results from New Zealand's 2018 Report Card on Physical Activity for Children and Youth.

In New Zealand (NZ), 88% of health loss is now caused by non-communicable diseases, in part attributed to low levels of physical activity (PA) and high levels of inactivity, and the downstream impacts of these, including suboptimal blood glucose profiles, body size, and blood pressure.1 While the NZ 2016 PA Report Card on Physical Activity for Children and Youth2 revealed relatively high levels of PA, approximately one-third of NZ children and youth did not meet PA recommendations of ≥60 minutes of moderate-to-vigorous physical activity (MVPA) per day. The purpose of this paper is to summarize the methods for grade calculation and results of the 2018 update of the PA Report Card for NZ

Results from New Zealand's 2018 Report Card on Physical Activity for Children and Youth.

In New Zealand (NZ), 88% of health loss is now caused by non-communicable diseases, in part attributed to low levels of physical activity (PA) and high levels of inactivity, and the downstream impacts of these, including suboptimal blood glucose profiles, body size, and blood pressure.1 While the NZ 2016 PA Report Card on Physical Activity for Children and Youth2 revealed relatively high levels of PA, approximately one-third of NZ children and youth did not meet PA recommendations of ≥60 minutes of moderate-to-vigorous physical activity (MVPA) per day. The purpose of this paper is to summarize the methods for grade calculation and results of the 2018 update of the PA Report Card for NZ

Citizen Science applied to building healthier community environments::advancing the field through shared construct and measurement development

Background Physical inactivity across the lifespan remains a public health issue for many developed countries. Inactivity has contributed considerably to the pervasiveness of lifestyle diseases. Government, national and local agencies and organizations have been unable to systematically, and in a coordinated way, translate behavioral research into practice that makes a difference at a population level. One approach for mobilizing multi-level efforts to improve the environment for physical activity is to engage in a process of citizen science. Citizen Science here is defined as a participatory research approach involving members of the public working closely with research investigators to initiate and advance scientific research projects. However, there are no common measures or protocols to guide citizen science research at the local community setting. Objectives We describe overarching categories of constructs that can be considered when designing citizen science projects expected to yield multi-level interventions, and provide an example of the citizen science approach to promoting PA. We also recommend potential measures across different levels of impact. Discussion Encouraging some consistency in measurement across studies will potentially accelerate the efficiency with which citizen science participatory research provides new insights into and solutions to the behaviorally-based public health issues that drive most of morbidity and mortality. The measures described in this paper abide by four fundamental principles specifically selected for inclusion in citizen science projects: feasibility, accuracy, propriety, and utility. The choice of measures will take into account the potential resources available for outcome and process evaluation. Our intent is to emphasize the importance for all citizen science participatory projects to follow an evidence-based approach and ensure that they incorporate an appropriate assessment protocol. Conclusions We provided the rationale for and a list of contextual factors along with specific examples of measures to encourage consistency among studies that plan to use a citizen science participatory approach. The potential of this approach to promote health and wellbeing in communities is high and we hope that we have provided the tools needed to optimally promote synergistic gains in knowledge across a range of Citizen Science participatory projects

Determining thresholds for spatial urban design and transport features that support walking to create healthy and sustainable cities:findings from the IPEN Adult study

An essential characteristic of a healthy and sustainable city is a physically active population. Effective policies for healthy and sustainable cities require evidence-informed quantitative targets. We aimed to identify the minimum thresholds for urban design and transport features associated with two physical activity criteria: at least 80% probability of engaging in any walking for transport and WHO's target of at least 15% relative reduction in insufficient physical activity through walking. The International Physical Activity and the Environment Network Adult (known as IPEN) study (N=11 615; 14 cities across ten countries) provided data on local urban design and transport features linked to walking. Associations of these features with the probability of engaging in any walking for transport and sufficient physical activity (≥150 min/week) by walking were estimated, and thresholds associated with the physical activity criteria were determined. Curvilinear associations of population, street intersection, and public transport densities with walking were found. Neighbourhoods exceeding around 5700 people per km(2), 100 intersections per km(2), and 25 public transport stops per km(2) were associated with meeting one or both physical activity criteria. Shorter distances to the nearest park were associated with more physical activity. We use the results to suggest specific target values for each feature as benchmarks for progression towards creating healthy and sustainable cities