Abstract
BackgroundNumerous cross-sectional studies have consistently demonstrated an association between attributes of urban form or ‘walkability’ and individual- and population-level physical activity (PA) patterns. However, in the absence of longitudinal research, the self-selection problem undermines the claim that a walkable built form produces more physically active people. Through a longitudinal pilot study of ‘imminent movers’ in Ontario using a quasi-experimental approach, we sought to examine the feasibility of longitudinal methods that would produce stronger evidence for a causal relationship between the built environment and PA levels.MethodsParticipants were recruited using publicly available real estate listings. Successful recruits were sent a PA diary to track their activity for a week, and were also scheduled for a 45-min phone interview that collected demographic details, neighbourhood perceptions and self-efficacy for walking, and verified the PA diary. Following their move, participants were given the same tasks and then sorted into groups based on changes in their neighbourhood walkability (measured with Walk Score) from baseline to follow-up.ResultsThere were challenges in recruiting a sufficient number of participants and counter-factuals to examine the relationship between changes in walkability and PA. Our limited sample showed a substantial decrease in Walk Score over the entire sample, from an average of 45.8 to 30.6, with most participants moving to less walkable areas. From baseline to follow-up, the largest declines in reported self-efficacy for walking were to grocery stores, banks, and for entertainment. For the entire sample, utilitarian PA decreased, while recreational and job-related PA increased.ConclusionsThis pilot study highlighted the methodological challenges involved in collecting quasi-experimental evidence on the effect of walkable environments on PA. Additionally, the low sample size and the tendency for most participants to move to less walkable areas meant there were insufficient counter-factuals for study of the effect of walkability on PA. Despite these challenges, we saw important changes in self-efficacy for walking that were commensurate with changes to the built environment. In sum, while longitudinal research on health and the built environment is urgently needed, recruiting an adequate sample size for a quasi-experimental study such as this is extremely challenging.
Highlights
Numerous cross-sectional studies have consistently demonstrated an association between attributes of urban form or ‘walkability’ and individual- and population-level physical activity (PA) patterns
Eligible study participants were those living in a census metropolitan area (CMA), census division (CD), or census subdivision (CSD) in the province of Ontario, the bulk of our participants were from the Greater Golden Horseshoe Area
Despite the need, there are few studies of the effect of the built environment on physical activity that involve a change in individuals’ exposure to a walkable neighbourhood. In this longitudinal pilot study, we sought to determine: i) whether we could recruit and retain a longitudinal sample of people from households that were known to be moving residential location imminently, and if the recruits’ planned moves would entail enough change in the walkability of their residential environment to provide adequate counter-factuals for study; ii) whether perceptions of the neighbourhood and residents’ self-efficacy for walking changed from baseline to follow-up, and whether this change was associated with a change in neighbourhood walkability; iii) whether we could measure pre- and post-move physical activity with a tolerable level of respondent burden and accuracy, and whether the direction of change was consistent with expectations
Summary
Numerous cross-sectional studies have consistently demonstrated an association between attributes of urban form or ‘walkability’ and individual- and population-level physical activity (PA) patterns. One popular approach to measuring neighbourhood walkability is through Walk Score® [12] This publically available metric is commonly used in real estate listings because of the positive connections between walkability and property values [12,13,14], and it has been employed by various scholars in studies on health and the built environment [9, 15,16,17]. Most published studies that aim to link walking behaviors with walkability are cross-sectional and ecological in nature, preventing researchers from being able to make causal inferences regarding the observed relationship [20]. Some studies have attempted to statistically control for this bias [21, 22], it is widely acknowledged that longitudinal research on individuals and households is needed to fully control for potential selection bias [8, 9, 19, 21, 23]
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