Neighborhood Environment Walkability Scale Research Articles

Built environmental characteristics, physical activity in neighbourhoods of Accra, Ghana

Abstract There is increasing evidence that characteristics of the built environment can influence residents’ lifestyles, physical activity thereby influencing the development of obesity and non-communicable diseases even in low- and middle-income countries. The aim of this study is to describe the characteristics of the built and the social environment of neighbourhoods of Accra, Ghana, and to explore association between neighbourhood characteristics and the physical activity of the residents. A cross-sectional study was conducted in Accra, 12 neighbourhoods were randomly selected based on high and low values of residential density and socioeconomic status. Sociodemographic, household and neighbourhood information were collected with an adapted questionnaire of NEWS (Neighbourhood Environment Walkability Scale) for Africa. Physical activity was assessed by WHO Global Physical Activity Questionnaire and social cohesion by the Perceived Neighbourhood Social Cohesion Questionnaire. Differences between variables by neighbourhood types were analysed using Chi square test and Kruskal Wallis test. Generalized linear model was performed to determine the association between neighbourhood characteristics and residents’ physical activity. The built environmental characteristics of different neighbourhood types and the physical activity of the residents showed significant differences. The associations indicated that individuals living in high residential density neighbourhoods had increased levels of engaging in physical activities. Land use mix, street connectivity, safety, aesthetics and social cohesion of neighbourhoods showed correlation with physical activity of residents. The built environment and social characteristics of neighbourhoods can influence the lifestyle and physical activity of residents in Accra, Ghana. Key messages • High residential density neighbourhoods correlated with higher level of physical activity. • Land use, street connectivity, safety and aesthetic of neighbourhoods and social cohesion showed correlation with physical activity.

What is the role of leisure-time physical activity in the association between neighborhood environmental characteristics and hypertension in older adults? The EpiFloripa Aging Cohort study

BackgroundResearch suggests a link between the urban built environment and blood pressure, potentially mediated by physical activity. This study aims to investigate the relationship between perceived neighborhood characteristics and blood pressure in older adults, as well as the mediating role of walking in this relationship. MethodsData from the third wave of the EpiFloripa Aging Cohort Study in Florianopolis, Brazil (2017–2019; n = 1335) were used for this cross-sectional analysis. Blood pressure was measured using digital devices, and hypertension diagnosis relied on healthcare professionals’ information. The neighborhood environment was assessed with the Abbreviated Neighborhood Environment Walkability Scale, while walking was evaluated with the International Physical Activity Questionnaire. Multilevel logistic regression analyzed the association between the neighborhood environment, blood pressure, and hypertension. Structural equation modeling assessed the mediation effect of walking. ResultsHypertension prevalence was 85.3 %, with 69.0 % having objectively measured elevated blood pressure. Results showed that older adults perceiving better infrastructure for physical activity (OR: 0.88; CI: 0.78–0.99), increased safety in their neighborhood (OR: 0.88; CI: 0.79–0.99), traffic security (OR: 0.88; CI: 0.78–0.99) and better overall perception of the environment (OR: 0.73; IC: 0.55–0.98) had a lower likelihood of self-reported hypertension. The association between self-reported hypertension and overall perception of the environment was partially explained by leisure-time walking (β = -0.01; p < 0.05). ConclusionOur findings suggest that public policies promoting the establishment of safe and supportive spaces for physical activity emerge as essential measures in the prevention and management of hypertension in older adults.

Individually Perceived Parameters of Residential Infrastructure and Their Relationship with Cardiovascular Risk Factors

In modern medicine, studies devoted to the assessment of the parameters of residential infrastructure and the population’s attitude towards them have become quite large-scale. Objectives: The aim of the study was to establish associations between individually perceived parameters of residential infrastructure and the main modifiable cardiovascular risk factors (hypertension, obesity, lipid and carbohydrate metabolism disorders) in one of the subjects of the Russian Federation. Methods: The epidemiological study “Study of the influence of social factors on chronic non-communicable diseases” started in 2015 and ended in 2023. The sample was formed by using the stratification method based on the assignment to a medical organization. The study included 1598 respondents aged 35 to 70 years (491 rural residents). The study of infrastructure parameters was conducted based on the subjective opinions of respondents using the neighborhood environment walkability scale (NEWS) questionnaire, divided into eight scales. Logistic regression analysis was used to identify associations between infrastructure parameters and cardiovascular risk factors; the odds ratio (OR) and 95% confidence interval were evaluated. Results: Individually perceived infrastructure parameters of the scale B, reflecting the accessibility of infrastructure facilities, were associated with hypertension [OR = 1.33], obesity [OR = 1.40], and abdominal obesity [OR = 1.59]. Elements of the social infrastructure of the scale C, describing the streets in the residential area, increased the likelihood of developing obesity [OR = 1.42] and visceral obesity [OR = 1.43]. The characteristics of the residential area, represented by the scale D that evaluates pedestrian infrastructure, were associated with all major cardiovascular risk factors (hypertension [OR = 1.65], obesity [OR = 1.62] and abdominal obesity [OR = 1.82], and disorders of lipid [OR = 1.41] and carbohydrate metabolism [OR = 1.44]). Conclusion: Social factors represented by various aspects of infrastructure have become important criteria for determining cardiovascular health. Environmental conditions affect cardiovascular risk factors through behavioral patterns that shape the respondent’s lifestyle. Interventions in urban planning—increasing accessibility to infrastructure facilities for the population, developing a pedestrian-friendly urban environment, improving physical activity resources in areas, planning recreation areas, and landscaping—can become the most important concept for the prevention of cardiovascular diseases.

Arabic translation, cultural adaptation, and pre-testing of neighborhood environment walkability scale for adults-abbreviated (NEWS-A): Arabic NEWS-A

BackgroundImproving neighborhood walkability is critical for sustainable and livable urban development and is associated with increased physical activity. The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) is a tool for assessing neighborhood walkability among adults. Currently, no Arabic version is available for this important walkability scale.ObjectiveTo translate the NEWS-A to Arabic, culturally adapt, and pre-test it for adults.MethodsThe NEWS-A was translated and culturally adapted using Cross-cultural Survey Guidelines and then pre-tested using 65 households selected randomly from the neighborhoods of three districts in Riyadh. After answering the survey, 55 participants took part in a semi-structured cognitive interview, which sought their understanding of the words in the Arabic questionnaire, the clarity of each item, and their suggestions for improvement.ResultsTranslation and adaptation of NEWS-A to Arabic resulted in adding two items (mosque and healthcare center) to section B of the scale (stores, facilities, and other things in your neighborhood) and one related item to section C (access to services). The total individual items became 57 instead of the original 54 items in the English version. Also, we added “ATM machine” to item 14 (Bank/credit union) in section B. In addition, the overall results of the cognitive interview showed that most of the participants understood the intended meaning of the questionnaire (99.5%). Further, 99.8% of the respondents stated that the items were not difficult to comprehend, while 100% of the sample indicated that the sentences were comfortable and not sensitive to them.ConclusionTranslating, adapting, and pre-testing the NEWS-A resulted in retaining all the original items and adding three additional items. The Arabic NEWS-A provides an important tool for future research on neighborhood environment walkability among adults.

Exploring walking behaviour and perceived walkability of older adults in London

IntroductionThere is an emerging imperative to design walkable communities catering to older adults, particularly given the context of an increasingly aging population. However, studies of how older citizens perceive walkability remain scarce. Therefore, this study aims to identify the factors that influence walking behaviours and perceived walkability among senior citizens, whilst also illuminating the associations between them. MethodsA quantitative analysis was conducted on 200 older individuals living in Ealing, London, an area with a large proportion of senior citizens. Utilising the self-developed Neighbourhood Environment Walkability Scale for Older Adults (NEWS-OA), based on the abbreviated version of NEWS, both linear and logistic regression models were employed to decode the data. ResultsOur results show that NEWS-OA is appropriate for assessing perceived walkability among senior citizens and reveal concerns regarding traffic safety. Communities with high walkability are likely to encourage an extended distance, duration, and frequency of walks. However, socioeconomic status (SES) was found to have a less pronounced effect on walking frequency and distance. The study further demonstrates that perceptions of safety were lower among older adults with a high SES. We found that positive perceptions of all the variables tested, except Aesthetics, encouraged walking. Furthermore, the study reveals the crucial influence of these perceptions on older adults’ inclination to walk for various purposes, such as the role of perceived safety in terms of social interaction. ConclusionsThis study offers insights that can be used to make London a more age-friendly and walkable city. It can also serve as a reference for other cities to enhance inclusiveness.

Associations of perceived built environment characteristics using NEWS questionnaires with all-cause mortality and major cardiovascular diseases: The prospective urban rural epidemiology (PURE)-China study

BackgroundDespite increased literature focusing on the role of the built environment (BE) in health, few cohort studies have quantitatively analyzed neighborhood walkability environment in relation to the risk of death and cardiovascular disease (CVD). This longitudinal study aimed at evaluating the association between perceived BE attributeswith mortality and major CVD based on the Prospective Urban Rural Epidemiology study in China (PURE-China). MethodsThe PURE-China study recruited 47,931 participants aged 35–70 years from 12 provinces of China between 2005 and 2009. The perceived BE information, including land use, street, aesthetics, and safety, was collected using the neighborhood environment walkability scale (NEWS) questionnaire, with higher scores indicating a more favorable rating. Two primary outcomes are all-cause mortality and major CVD event. The Cox frailty model with random intercepts was used to assess the association between the perceived total BE/subscales score and outcomes. ResultsOf 32,163 participants included in this study, 19,253 (59.9 %) were women, and the mean (SD) age was 51.0 (9.5) years. After a median follow-up period of 11.7 years (IQR 9.4 – 12.2), we observed that one standard deviation higher of combined BE scores was related to a lower risk of all-cause mortality (HR = 0.85; 95 %CI, 0.80–0.90), and major CVD events (HR = 0.95; 95 %CI, 0.90–0.99). The subscales of perceived BE were related to a lower risk, although a few were not significant. Land use mix-diversity and safety from crime were the two most significant subscales. Stronger risks were observed among urban and female participants. ConclusionFavorable perceived BE characteristics were linked with a lower risk of all-cause mortality and major CVD events in Chinese population, especially in urban areas and females. Our findings can be used by policymakers to take action to mitigate the adverse effect of poor community conditions on health, such as improving local amenities and transport connectivity, providing building paths for walking, running and cycling.

Measuring the Effect of Built Environment on Students’ School Trip Method Using Neighborhood Environment Walkability Scale

School trips affect different aspects, such as air pollution and urban traffic, and of personal wellbeing, such as students’ physical and mental health. The increasing concern about environmental sustainability has prompted a reevaluation of daily activities, including school transportation. While different factors that affect students’ school trips have been investigated in the literature, the effect of the built environment has been evaluated only sporadically in previous studies. To fulfil this knowledge gap, this study aims to investigate the effect of the built environment on students’ school trips by adapting and extending the well-known Neighborhood Environment Walkability Scale (NEWS) questionnaire. The questionnaire survey was conducted with parents from 36 schools in Yazd, Iran, providing a sample of 1688 students aged 7–18 years. The items from the NEWS questionnaire were placed in nine factors by performing factor analysis. The Multinomial Logit Regression model was applied to check the predictive power of these nine factors. It was found that the variables of land use mix-diversity, land use mix-access, crime, age, gender, household income and car ownership had a significant effect on students’ school trips. The more easily students have access to different places, the less they use public services and cars compared with the active travel mode. The use of public services and cars increases with the increase in crime rate along the route to school. The findings indicate that built environment features may impact students’ shift from traditional transportation modes to active alternatives, such as walking and cycling, contributing to the attainment of broader sustainability objectives.

Subjective walkability perceived by children and adolescents living in urban environments: A study protocol for participatory methods and scale development in the WALKI-MUC project.

Youth's perceptions of a city or neighbourhood's walkability are important for determining the physical activity (PA) friendliness of their environment. Traditional objective measures of walkability fail to incorporate children and youth's (CY) subjective perceptions of places that they perceive as supportive for play and exercise. Internationally, the most promising subjective measure is the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) questionnaire. Yet, the NEWS-Y is not available for German-speaking adolescents. In the WALKI-MUC project, a combination of participatory research methods is used to identify CY's perceptions of PA-friendly places in Munich, Germany. Based on the findings, a German version of the NEWS-Y (NEWS-Y-G) for subjective walkability measurement is developed. CY aged six to 17 years from neighbourhoods with different objectively-measured walkability, take part in photovoice, walking interviews and mapping to gather their perceptions of PA-friendly places. The participatory study begins with an introductory workshop and concludes with a follow-up workshop, where characteristics of PA-friendly places are discussed in focus groups. In between these workshops, participants complete a photo mission with a walking interview, allowing for individual significance of PA-related places to be shared in a one-on-one setting with the researcher. The findings are used to adapt and translate the NEWS-Y for the German context. The newly developed NEWS-Y-G is then used to measure the subjective walkability perceived by a representative sample of adolescents in Munich. The WALKI-MUC project introduces a participatory methodology for researchers and urban planners to assess subjective walkability with CY. The combination of qualitative and quantitative walkability measurements is described in this study protocol. Findings on PA-friendly places contribute to environmental psychology and the development of the NEWS-Y-G adds a German-language instrument for subjective walkability measurement.

Relationship of the frequency of detection of arterial hypertension and unfavorable infrastructure parameters

The objective of this study is to assess the associative relationship between the main parameters of the infrastructure with arterial hypertension (AH) in a large industrial region (Kuzbass).Materials and methods. The study involved 1598 people (from 35 to 70 years old) living in Kemerovo region. Blood pressure was measured according to the recommendations of the Russian Society of Cardiology / the Russian Medical Society on Arterial Hypertension (2010). The assessment of the territory of the residence zone was carried out according to the subjective opinion of the respondents about the parameters of the infrastructure (questionnaire Neighborhood Environmental Walkability Scale). The format of this structure was highlighted, which was considered unfavourable according to the respondent's answer to the questionnaire.Results. In the course of this study, negative associations with a high risk of developing hypertension were identified for the following infrastructure parameters: inaccessibility of public transport (OR=1,84), remoteness of the workplace (OR=1,60), the lack of sidewalks on the streets (OR=1,66), the remoteness of the pharmacy (OR=1,64), the lack of pedestrian crossings that ensure safety when crossing streets (OR=1,48) and the absence of shadows falling on the sidewalk from the trees (OR=1,31).Conclusion. This study demonstrated the importance of studying the parameters of infrastructure and planning urban space in order to provide a healthoriented space for the population of a particular constituent entity of the Russian Federation.

THE RELATIONSHIP BETWEEN NEIGHBORHOOD INFRASTRUCTURE AND RISK FACTORS IN PATIENTS WITH MYOCARDIAL INFARCTION

HighlightsThe analysis of associations between the elements of the neighboughood area infrastructure and cardiovascular risk factors was performed in a high-risk population of patients with myocardial infarction. This analysis has practical importance for the comprehensive optimization of local preventive approaches. Aim. To study the association of the neighborhood infrastructure parameters with cardiovascular risk factors in patients with myocardial infarction (MI).Material and Methods. The study included 150 patients with MI. On the basis of their subjective opinion expressed by the Neighborhood Environmental Walkability Scale questionnaire, the infrastructure of the area of residence was analyzed, and its favorable and unfavorable parameters were identified. Cardiovascular risk factors were identified based on the survey and medical records.Results. Among all patients with MI, the risk of arterial hypertension with MI was reduced by the presence of a dividing dirt strip in the vicinity of OR 0.32 (95% CI 0.12; 0.83) and accessible public transport OR 0.32 (95% CI 0.10; 0.95), dyslipidemia – the remote location of the restaurant OR 0.50 (95% CI 0.26; 0.97) and the place of work OR 0.32 (95% CI 0.12; 0.86), smoking – distance from a public transport stop OR 0.20 (95% CI 0.04; 0.94) and proximity to a restaurant OR 0.50 (95% CI 0.26; 0.97), physical inactivity – distance from work OR 0.08 (95% CI 0.01; 0.76), stress – remote location of a clothing store OR 0.45 (95% CI 0.22; 0.93), alcohol consumption – compliance of the living area with the conditions necessary for raising children OR 0.27 (95% CI 0.07; 0.97), insufficient consumption of fresh fruits and vegetables – remote location of a pharmacy OR 0.18 (95% CI 0.03; 0.97), the lack of dividing ground strip OR 0.10 (95% CI 0.01; 0.91) and the presence of garbage in the vicinity of OR 0.08 (95% CI 0.01; 0.53), patient satisfaction with the compliance of the living area with the conditions necessary for the upbringing of children OR 0.10 (95% CI 0.01; 0.70). Inadequate street lighting at night contributed to an increased risk of dyslipidemia, OR 3.05 (95% CI 1.04; 8.92), alcohol consumption – proximity to a clothing store OR 2.23 (95% CI 1.08; 4.57).In citizens with MI, a decrease in the risk of arterial hypertension was associated with the presence of a dividing dirt strip in the vicinity of OSH 0.17 (95% CI 0.06; 0.49) and accessible public transport OSH 0.19 (95% CI 0.05; 0.65); stress – with the absence of alternative routes in the vicinity of OSH 0.27 (95% CI 0.09; 0.79); the risk of insufficient consumption of fresh fruits and vegetables – with the distance of the pharmacy OR 0.18 (95% CI 0.03; 0.96), the absence of a dividing dirt strip OR 0.07 (95% CI 0.01; 0.63) and sidewalks in the vicinity of OR 0.14 (95% CI 0.02; 0.89). In rural patients with MI, the risk of stress decreased with the presence of sidewalks in the vicinity of OR 0.21 (95% CI 0.05; 0.99) and accessible public transport OR 0.15 (95% CI 0.03; 0.85).Conclusion. The identification of unfavorable parameters of the territory of residence in patients with MI should contribute to the formation of the concept of a health-preserving environment necessary for further reduction of cardiovascular risks of MI in the population.

OUT-OF-HOME MOBILITY, DAILY WORKING MEMORY, AND NEIGHBORHOOD WALKABILITY IN HEALTHY OLDER ADULTS

Abstract Out-of-home mobility could enhance cognitive performance, but environmental contexts — such as neighborhood walkability — may influence the associations. This study examined daily out-of-home mobility in relation to daily cognitive performance in healthy older adults and the moderator effects of neighborhood walkability therein. Participants wore a custom-built mobile GPS sensor („uTrail“) and completed smartphone-based working memory assessments for 15 days, and responded to the baseline Neighborhood Environment Walkability Scale. Analyses included 947 days’ data from 109 Swiss older adults aged 65 to 89 years. Out-of-home mobility (i.e., out-of-home time, maximum distance from home) were extracted from the GPS data. Multilevel models showed that daily out-of-home time and daily maximum distance from home were not associated with daily working memory performance across the study sample, but the associations were moderated by neighborhood walkability. Out-of-home time and maximum distance from home were positively (vs. negatively) associated with working memory performance in participants who lived in neighborhood with higher (vs. lower) street connectivity and more (vs. less) access to places for walking and cycling. Additionally, maximum distance from home were positively (vs. negatively) associated with working memory performance in participants in neighborhood with lower (vs. higher) mixture of land use. To conclude, spending more time out of home and travelling longer distance away from home could be beneficial for daily cognitive performance of older adults who lived in well-connected and higher-walkable and -bikeable neighborhood. Travelling longer distance could also benefit those who lived in a neighborhood with a lower mixture of land use.

Associations of built environment characteristic using NEWS questionnaires with major cardiovascular diseases and all-cause mortality

Abstract Background The WHO of 2016 reports that cardiovascular diseases (CVDs) represent the leading cause of death in most countries and China has one of the highest prevalence of CVDs[1-2]. In order to reduce the burden of CVD risk factors, environmental interventions have become increasingly recognized as necessary approaches to health promotion and diseases prevention[3]. Pervious evidence mainly from the western countries, examined the effects of built environment on health (i.e. physical activity, mental health, self-reported health scale and CVD risk factors) , while the potential impact on CVDs has not been fully explored[4]. Thus, the aim of this study is to evaluate the longitudinal relationships between perceived built environment attributes using neighborhood environment walkability scale (NEWS) questionnaire and the CVDs in Chinese adults, to explore the different between urban and rural areas, and to provide a logical foundation for both research and policy making. Methods PURE-China is a prospective cohort study, recruiting participants aged 35–70 years from 115 urban and rural communities in 12 provinces of China between 2005 and 2009[5]. Baseline including NEWS information was collected using standardized questionnaires. Participants without any NEWS data and with baseline CVDs were excluded. The primary outcome is the composite of major CVD events and all-cause mortality. The main exposure variables including land use mix-diversity, land use-access, streets connectivity, infrastructure for walking and cycling, aesthetics, safety from traffic, safety from crime, and community satisfaction. Cox frailty model with random intercepts to account for cluster were used to assess the association between total built environment score/ subscales score and the time to occurrence of events. Based and fully-adjusted model were estimated and presented as HR and 95%CI. Interactions and stratified subgroup analysis were also tested. Results A total of 32,534 PURE participants were included with averaged 51 years old and 59.9% females. During a median follow-up period of 11.7 years (IQR 9.4 – 12.2), we documented 3298 (10.2%) new CVD events and 1639 (5.1%) all cause deaths. Table 1 summarizes based models and adjusted models results. For composite outcomes, higher level of land use access (HR, 1.06; 95%CI, 1.01-1.11), aesthetics (HR, 1.07; 95%CI, 1.02-1.12), safety from crime (HR, 1.06; 95%CI, 1.01-1.10), community satisfaction (HR, 1.04; 95%CI, 1.00-1.09), combined BE metrics (HR, 1.05; 95%CI, 1.01-1.10) were associated with a lower risk of composite outcome in adjusted model. For major CVD events more statistically significant differences were observed. Conclusions and Relevance High level of specific BE characteristics were associated with lower risk of all-cause mortality and CVD in China. Our findings may guide policy makers on how to implement BE measures to easing the burden of CVDs and premature deaths.Table 1

Investigation of Perceived Walkability of Neighborhood Environment According to Physical Activity Level and Body Composition of Adults during the COVID-19 Pandemic

This research examined the relationship between physical activity status and perceived walkability in the neighborhood environment during the Covid-19 pandemic. A total of 88 volunteer adults, 45 females and 43 males, aged 18-65 participated in the study. An online IPAQ-Short Form and Neighborhood Environment Walkability Scale were administered to the participants. In addition, daily step counts were determined to determine objective physical activity levels. The collected data were analyzed by correlation and t test in SPSS program. According to analysis of step counts, there was a significant difference between the physical activity groups (p&amp;lt;0.05). Only the aesthetics of neighborhood environment subscale scores were significantly different between those with high intensity physical activity compared to those with low and moderate intensity physical activity (p&amp;lt;0.05). According to the analysis results, mean step count and mean IPAQ scores were identified to have positive moderate level of correlation (r = 0.27, p = 0.01). There were no statistically significant differences between the mean walkability perception of the neighborhood environment subscale scores according to body composition (p&amp;gt;0.05). As a result, in this process, the status of adults' perceptions of the neighborhood environment regarding physical activity was examined; During the Covid-19 pandemic, features of the built environment did not increase physical activity and walking, and their effects were not as expected. In conclusion; the most important reasons for this are the measures taken by the administrators to protect people, the conditions affecting the pandemic such as the threat and uncertainty that the pandemic

The obesogenic environment and incident cardiovascular disease in The Maastricht Study

Abstract Background The built environment has been identified as an upstream determinant of cardiovascular disease (CVD) in which neighborhood walkability and healthy food environments may promote increased physical activity and healthier dietary intake. Our aim is to determine if these neighborhood environments are associated with decreased incidence. Methods Data from 6,563 participants of The Maastricht Study and Geoscience and Health Cohort Consortium between the ages of 40-75 without history of CVD were analyzed. Objective walkability was measured by the 7-component Dutch Walkability Index while the food environment was an aggregate score of available food outlets, within 1000m Euclidian buffers around residential addresses of participants. Perceived walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Incident CVD was obtained from a follow-up questionnaire. A Cox regression analysis was performed with CVD morbidity time to event outcomes adjusting for demographic and socioeconomic covariates. Results Over a median follow-up of 7.2 years (1.0-12.0 years), 975 cases were reported. The most walkable neighborhoods were not associated with incident CVD for both perceived (HR: .80; 95% CI = .64, 1.00) and objective (HR: 1.14; 95% CI = .91, 1.43) neighborhood environment measures compared to those living in the least walkable neighborhoods. When considering individual CVD conditions, participants had statistically significant lower incidence of peripheral vascular disease in the highest perceived walkable neighborhoods (HR: .57; 95% CI = .41, .78). The healthiest food environments (HR: .84; 95% CI = .66, 1.06) were not related to incident CVD. Conclusions Objectively measured walkability and neighborhood food environment were not associated with overall incident CVD with participants in our study. We found perceived neighborhood walkability to be associated with lower incident peripheral vascular disease. Key messages • Research on the obesogenic environment should additionally be carried out in other regions to gain additional understanding of its effect on cardiovascular disease. • Further study on the impact of walkable environments on individuals with peripheral vascular disease should be considered to understand its effect with this population.

Measuring walkability and bikeability for health equity and intervention research: a scoping review

ABSTRACT The purpose of this study was to describe self-report and audit-based measurement tools of neighbourhood walkability and bikeability for health equity and intervention research. We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We searched MEDLINE via PubMed, Embase, Web of Science, and SPORTDiscus with full text via EBSCO in March 2022. We extracted data from a total of 35 papers which reported on 23 self-report and 15 audit-based measures assessing walkability and bikeability. Studies spanned multiple regions including Africa, America, Australia, and Europe, but most were conducted in the United States (n = 15), followed by Australia (n = 6). The most used self-report measure was the Neighbourhood Environment Walkability Scale (NEWS), while the audit tools Pedestrian Environment Data Scan and Bridge the Gap Street Segment Tool were each used in two studies. The priority populations most often studied were residents of low socio-economic status/high disadvantage neighbourhoods, racialized groups, women, youth, older adults, and rural populations. Ultimately, there is no one tool that can be recommended for use in all contexts and with all priority populations; rather, tools may require adaptations to specific contexts and populations of interest.

Exploring the Walkability of Senior Citizens in a Densely Populated Neighborhood of Chennai, India—A Structural Equation Modeling Approach

Walking is the most sustainable, safe, and active mode of transportation among the elderly. There is growing evidence that the built environment influences walkability. However, little research has been conducted to assess the perceived built environment correlates for senior citizens walking in low- and middle-income countries. This paper explores the relationship between built environment characteristics and the walkability of senior citizens in Triplicane, Chennai, India. Seniors aged 60 years and above, both men and women, living in Triplicane, Chennai, were interviewed (n = 221). Personal characteristics and perceived built environment factors were assessed using the Neighborhood Environment Walkability Scale for India (NEWS India). Data were analyzed using SPSS 26 and AMOS 21 software. Structural equation modeling (SEM) was conducted to examine the association between the built environment characteristics and the walkability of senior citizens. The results show that built environment attributes, namely pedestrian safety infrastructure, physical barriers of the neighborhood, and aesthetics, have a high impact on walkability among senior citizens.

O.5.1-5 Influence of the parental perception of the neighborhood environment on physical activity and active school commuting in Ecuadorian children

Abstract Purpose Physical inactivity among children is considered a multidimensional problem. This study examines the relationships between parents' perceptions of the neighborhood environment with physical activity (PA) and active school commuting among urban children from Cuenca-Ecuador. Methods A cross-sectional study was conducted between October 2018 and March 2019 among 1028 children (8 to 12 years old) and their parents/guardians. Children's PA levels were objectively measured using accelerometers (Actigraph). Parent's perceptions of their neighborhood aesthetics, traffic, and crime hazards were assessed using the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) parent version. Active school commuting (ASC) was evaluated using a validated tool applied to the children. Children who reported walking or using a bicycle to commute to and from school five days a week were classified as active commuters. Multivariate ordinary least squares and logistic regressions models were performed to determine associations between parents' perceptions of the neighborhood environment with PA and ASC, respectively. Results Complete data were available from 711 children (52% female) and 521 parents. The parental perceptions of the neighborhood aesthetics (Mean: 2.68; DE:0.75) and traffic hazards (Mean: 2.44; DE:0.44) were not associated with children's physical activity. Neighborhood crime safety (Mean:2.64; DE:0.74) score was negatively associated with the children's vigorous physical activity (Mean:14.50 minutes/day; DE:8.66) level (β = -1.52 minutes/day; DE = 0.52; p &amp;lt; 0.004). After adjusting for walking distance and car ownership, parental perception of neighborhood aesthetics, traffic, and crime hazards were not associated with ASC. Conclusions Crime hazard was identified as the main barrier to children's vigorous PA. The neighborhood environment seems not to be associated with children's ASC. Future studies should identify the determinants for ASC, and comprehensive policies are urgently needed to overcome crime hazards in Ecuador Funding source Universidad de Cuenca, Universidad Politécnica Salesiana Sede Cuenca.

Self-perception of the neighborhood environment, cognitive impairment and functional limitations in community-dwelling older adults: A cross-sectional study

AimsIt is important to identify the association between characteristics of the neighborhood environment, cognitive impairment and functional limitations to organize early and effective intervention strategies. MethodsA cross-sectional survey of 308 community-dwelling older adults was conducted. Logistic Regression analyses were performed to verify the associations between self-perceived characteristics of the neighborhood environment (Neighborhood Environment Walkability Scale), cognitive impairment (Mini-Mental State Examination) and functional limitations (mobility, lower limb muscle strength and balance). ResultsSignificant negative associations were observed: (1) better infrastructure, traffic and safety and mobility limitation; (2) better infrastructure and muscle weakness; (3) better safety and balance limitation; and (4) better streets/sidewalks and cognitive impairment. On the other hand, positive associations were observed between poor safety with mobility limitation and muscle weakness. ConclusionsOur findings contribute to greater knowledge about neighborhood characteristics regarding mental and physical health in community-dwelling older adults.

Choosing the Bicycle as a Mode of Transportation, the Influence of Infrastructure Perception, Travel Satisfaction and Pro-Environmental Attitude, the Case of Milan

The present study investigates how infrastructure perception, travel satisfaction and pro-environmental attitudes influence the motivations for choosing cycling as a mode of transport. The effects of demographic variables and mobility habits are also taken into account. Data are collected via a survey with cyclists living in Milan and the surrounding areas. The survey comprises a first set of items to explore the cyclists’ transportation habits and three self-assessment questionnaires: The Neighbourhood Environment Walkability Scale (NEWS)—A Short Form, The Satisfaction with Travel Scale (STS) and the Environmental Attitudes Inventory (EAI). A series of different multiple linear regression analyses and mediation models are conducted. The findings suggest that the frequency of cycling may be explained based on several factors. Males report cycling more frequently, younger adults report lower frequencies of bicycle use and the urban setting is more significantly related to bicycle use. Moreover, the results highlight the significant positive role of the perception of neighbourhoods (especially those with an easy access to non-residential areas) and of pro-environmental attitudes (especially of personal conservation behaviour) in promoting the frequency of bicycling, with the mediation effect of the variable ‘purpose of bicycle use’ (for leisure or to reach a destination) as well. Based on these findings, policymakers should focus on tailored strategies to promote cycling in different users.

Association of perceived and objective neighborhood walkability with accelerometer-measured physical activity and sedentary time in the Maastricht Study.

We investigated the association of neighborhood walkability with accelerometer-measured physical activity (PA) and sedentary behavior (SB) and examined whether objective and subjective measures of walkability resulted in similar findings. PA and SB from the first 7689 Maastricht Study participants ages 40-75 from 2010 to 2017 were measured using accelerometers for 7 days. Mean daily step count, light-intensity PA, moderate- to vigorous- intensity PA (MVPA), and SB were calculated. Objective walkability was measured by the 7-component Dutch Walkability Index within 500 m Euclidean buffers around residential addresses of participants. Subjective walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Linear regression models analyzed the associations of walkability with PA and SB, controlling for potential confounders. Objective walkability was negatively associated with light intensity PA in the most walkable quartile (b = -14.58, 95% CI = -20.94, -8.23). Compared to participants living in the least walkable neighborhoods, those in the most walkable quartile had statistically significantly higher SB levels (b = 11.64, 95% CI = 4.95, 18.32). For subjective walkability, mean daily step count was significantly higher in the most walkable quartile (b = 509.60, 95% CI = 243.38, 775.81). Higher subjective walkability was positively associated with MVPA (b = 4.40, 95% CI = 2.56, 6.23). Living in a neighborhood with higher objective walkability was associated with lower levels of PA and higher SB levels while higher subjective walkability was associated with higher levels of PA. These results show discordant findings and thus, the effect of walkability on participant PA and SB within our sample is to be determined.