Associations between objectively-measured and self-reported neighbourhood walkability on adherence and steps during an internet-delivered pedometer intervention.

John C Spence,Anna Consoli,Anne Vuillemin,Gavin R Mccormack,Tara-Leigh Mchugh,Kerry Mummery,Alberto Nettel-Aguirre

doi:10.1371/journal.pone.0242999

John C Spence, Anna Consoli + Show 5 more

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https://doi.org/10.1371/journal.pone.0242999

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Abstract

Accumulating evidence suggests that the built environment is associated with physical activity. The extent to which the built environment may support adherence to physical activity interventions is unclear. The aim of this study was to investigate whether the neighbourhood built environment constrains or facilitates adherence and steps taken during a 12-week internet-delivered pedometer-based physical activity intervention (UWALK). The study was undertaken in Calgary (Canada) between May 2016 and August 2017. Inactive adults (n = 573) completed a telephone survey measuring sociodemographic characteristics and perceived neighbourhood walkability. Following the survey, participants were mailed a pedometer and instructions for joining UWALK. Participants were asked to report their daily pedometer steps into the online program on a weekly basis for 12 weeks (84 days). Walk Score® estimated objective neighbourhood walkability and the Neighbourhood Environment Walkability Scale-Abbreviated (NEWS-A) measured participants self-reported neighbourhood walkability. Regression models estimated covariate-adjusted associations of objective and self-reported walkability with: 1) adherence to the UWALK intervention (count of days with steps reported and count of days with 10000 steps reported), and; 2) average daily pedometer steps. On average, participants undertook 8565 (SD = 3030) steps per day, reported steps on 67 (SD = 22.3) of the 84 days, and achieved ≥10000 steps on 22 (SD = 20.5) of the 84 days. Adjusting for covariates, a one-unit increase in self-reported walkability was associated on average with 45.76 (95CI 14.91, 76.61) more daily pedometer steps. Walk Score® was not significantly associated with steps. Neither objective nor self-reported walkability were significantly associated with the UWALK adherence outcomes. The neighbourhood built environment may support pedometer-measured physical activity but may not influence adherence to pedometer interventions. Perceived walkability may be more important than objectively-measured walkability in supporting physical activity during pedometer interventions.

Highlights

Regular walking can assist adults in achieving levels of physical activity sufficient to obtain optimal health (i.e., 150 minutes/week of moderate-intensity physical activity) [1]
Perceived walkability may be more important than objectively-measured walkability in supporting physical activity during pedometer interventions
Adults enrolled in pedometer interventions experience an average increase of physical activity of 26.9% from baseline which translates to an average of 2000 more steps per day [14, 19]

Summary

Introduction

Regular walking can assist adults in achieving levels of physical activity sufficient to obtain optimal health (i.e., 150 minutes/week of moderate-intensity physical activity) [1]. Regular walking provides health benefits such as increased physical fitness [6], reduced risk for cardiovascular disease [7], weight loss [8], improved blood pressure [9], and improved depressive symptoms [10]. Despite these potential health benefits, too few adults in North America [11, 12] and elsewhere [13] accumulate sufficient physical activity (including walking) for optimal health. The aim of this study was to investigate whether the neighbourhood built environment constrains or facilitates adherence and steps taken during a 12-week internet-delivered pedometer-based physical activity intervention (UWALK)

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Conclusion