Perceived Neighborhood Walkability Research Articles

Physical activity among cancer survivors: do neighborhood walkability and metropolitan size play a role?

To examine associations between walkability, metropolitan size, and physical activity (PA) among cancer survivors and explore if the association between walkability and PA would vary across United States metropolitan sizes. This study used data fromthe 2020 National Health Interview Surveyto examine independent associations of walkability and metropolitan size with engaging in moderate-to-vigorous PA (MVPA) and toexplore the effect modification of metropolitan sizeusing log-binomial regression. The dependent variable was dichotomized as < vs. ≥ 150min/week of MVPA. The predictors were perceived walkability, a total score comprising eight neighborhood attributes, and metropolitan size. Covariates included sociodemographic and health characteristics, geographic region, cancer type, and time since cancer diagnosis. Engaging in 150 + min/wk of MVPA significantlyincreased among cancer survivors (n = 3,405) who perceived their neighborhoods as more walkable (prevalence ratio:1.04; p = 0.004). Engaging in 150 + min/wk of MVPA significantlyincreased among cancer survivors living in mediumand small metropolitan areas vs. those living in largecentral metropolitan areas (prevalence ratio:1.12; p = 0.044). Perceived walkability levels were similar among cancer survivors in nonmetropolitan areas vs. those living in largecentral metropolitan areas. Association between walkability and PA did not significantly vary across metropolitan sizes. Perceived neighborhood walkability is positively associated with MVPA among cancer survivors, regardless of metropolitan size. Findings highlight the importance of investing in the built environment to increase walkability among this population and translating lessons from mediumand small metropolitan areas to other metropolitan areas to address the rural-urban disparity in PA among cancer survivors.

Neighborhood-level social determinants of health and cardioprotective behaviors among church members in New Orleans, Louisiana

BackgroundFavorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana. MethodsParticipants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data). Logistic regression models were used to assess the relation of neighborhood factors with the likelihood of engaging in cardioprotective behaviors: 1) a composite of healthy lifestyle behaviors [fruit and vegetable consumption, physical activity, and a tobacco/nicotine-free lifestyle], 2) medication adherence, and 3) receipt of routine medical care within the past year. ResultsParticipants (n = 302, mean age: 63 years, 77% female, 99% Black) were recruited from 12 churches in New Orleans. After adjusting for demographic and clinical factors, perceived neighborhood walkability or conduciveness to exercise (odds ratio [OR]=1.25; 95% CI: 1.03, 1.53), availability of fruits and vegetables (OR=1.23; 95% CI: 1.07, 1.42), and social cohesion (OR=1.55; 95% CI: 1.22, 1.97) were positively associated with the composite of healthy lifestyle behaviors. After multivariable adjustment, SDI was in the direction of association with all three cardioprotective behavior outcomes, but associations were not statistically significant. ConclusionsIn this predominantly Black, church-based population, neighborhood-level SDoH including the availability of fruits and vegetables, walkability or conduciveness to exercise, and social cohesion were associated with cardioprotective behaviors. Findings reiterate the need to address adverse neighborhood-level SDoH in the design and implementation of health interventions.

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.

Place attachment and walking behaviour: Mediation by perceived neighbourhood walkability

The urban design features of a location are important for facilitating people’s attachment to places. Attachment to particular places, such as residential neighbourhoods, may encourage people to adopt and maintain physical activity routines. Moreover, the ways in which people perceive the built features in their neighbourhood (e.g., neighbourhood walkability) may mediate the relations between place attachment and physical activity behaviour. Therefore, this exploratory study examined the associations between place attachment and neighbourhood-specific physical activity and explored the extent to which perceived neighbourhood walkability mediates these associations. The study included data from 1,800 adults living in Calgary, Canada. Place attachment (including identity and dependence), physical activity, and neighbourhood walkability were self-reported using validated tools. Linear and logistic regression models were applied to estimate the associations between variables. Mediation was assessed using structural equation modelling. Place attachment dimensions were significantly positively associated (p < 0.05) with weekly participation (odds) and time spent walking for transport and recreation. The associations between place attachment and walking for transport were also mediated by perceived neighbourhood walkability. Together, these findings emphasise the crucial role of place attachment, particularly human bonding and relationships with the neighbourhood environment , in supporting physically active lifestyles and promoting public health.

Walk Score and Neighborhood Walkability: A Case Study of Daegu, South Korea.

Walking is a popular physical activity that helps prevent obesity and cardiovascular diseases. The Walk Score, which measures neighborhood walkability, considers access to nine amenities using a geographic information system but does not deal with pedestrian perception. This study aims to (1) examine the correlation between access to each amenity, an individual component of the Walk Score, and perceived neighborhood walkability and (2) investigate the correlation with the perceived neighborhood walkability by adding variables of pedestrian perception to the existing Walk Score components. This study conducted a survey with 371 respondents in Daegu, South Korea, between 12 October and 8 November 2022. A multiple regression model was used to examine the correlations. The results showed no association between perceived neighborhood walkability and the individual component of the Walk Score. As variables of environmental perception, the fewer hills or stairs, the more alternative walking routes, the better separation between road and pedestrians, and the richer the green space, the more people perceived their neighborhood as walkable. This study found that the perception of the built environment had a more substantial influence on perceived neighborhood walkability than the accessibility to amenities. It proved that the Walk Score should include pedestrian perception and quantitative measurement.

Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents.

Adolescence is a life stage critical to the establishment of healthy behaviours, including physical activity (PA). Factors associated with the built environment have been shown to impact PA across the life course. We examined the sociodemographic differences in, and associations between, perceived neighbourhood walkability, PA, and body mass index (BMI) in South African adolescents. We recruited a convenience sample (n = 143; 13-18 years; 65% female) of students from three high schools (middle/high and low-income areas). Participants completed a PA questionnaire and the Neighbourhood Environment Walkability Scale (NEWS)-Africa and anthropometry measurements. Multivariable linear regression was used to examine various relationships. We found that, compared with adolescents living in middle/high income neighbourhoods, those living in low-income neighbourhoods had lower perceived walkability and PA with higher BMI percentiles. The associations between neighbourhood walkability and PA were inconsistent. In the adjusted models, land use diversity and personal safety were associated with club sports participation, street connectivity was positively associated with school sports PA, and more favourable perceived walkability was negatively associated with active transport. Overall, our findings suggest that the perceived walkability of lower income neighbourhoods is worse in comparison with higher income neighbourhoods, though the association with PA and BMI is unclear.

Higher walkability associated with increased physical activity and reduced obesity among United States adults.

This study examinedassociations among perceived neighborhood walkability, physical activity (PA), and obesity among United States adults. Data from the 2020 National Health Interview Survey were analyzed. Walkability was assessed using a summative scale and was categorized as low, medium, or high. PA was categorized as insufficient (0-149 min/wk) or sufficient (150+ min/wk). Multivariable regressions estimated an association between obesity and BMI and PA/walkability. Mediation analysis was used to partition contribution of PA as a mediator. Effect modification by race and ethnicity in the association between walkability and BMI was explored. The sample included N=31,568 adults. Compared with those in low-walkability neighborhoods, participants in high-walkability neighborhoods had increased odds of sufficient PA (odds ratio[OR] =1.48; 95% CI: 1.30-1.69) and decreased obesity odds (OR=0.76; 95% CI: 0.66-0.87). PA partially mediated the association between walkability and BMI (23.4%; 95% CI: 14.6%-62.7%). The association between walkability and BMI was modified by race and ethnicity (F[5,567] = 2.75; p= 0.018). Among White, Black, Hispanic, and Asian adults, BMI decreased with increasing walkability; among American Indian/Alaska Native and multiracial/other adults, BMI increased with increasing walkability. The findings highlight the importance of investing in the built environment to improve perceptions of walkability and promote PA and healthy weight, as well as developing interventions to target racial and ethnic disparities in these outcomes.

The effect of neighborhood walkability on changes in physical activity and sedentary behavior during a 12-week pedometer-facilitated intervention.

Pedometer-facilitated interventions encourage physical activity via the accumulation of steps. Mixed evidence suggests that neighborhood walkability might influence the effectiveness of physical activity interventions, including pedometer-facilitated interventions. Our study investigated the moderating effect of neighborhood walkability on immediate (4-week) and short-term (12-week) changes in self-reported neighborhood-specific leisure and transportation walking, leisure-based moderate and vigorous-intensity physical activity, and leisure-based screen time during a pedometer-facilitated intervention (UWALK). This quasi-experiment undertaken in Calgary (Canada) compared behavior changes during the 12-week intervention between two neighborhood groups classified as 'walkable' or 'car dependent' based on Walk Score®. Of the 573 volunteers (adults in the contemplation and preparation stages of physical activity behavior change), 466 participated in UWALK. Surveys captured sociodemographic characteristics, perceived neighborhood walkability, neighborhood preferences, motivation, physical activity and screen-based leisure. Covariate-adjusted linear mixed models estimated the differences in physical activity and leisure screen time between the neighborhood walkability groups at baseline, 4-weeks, and 12-weeks. UWALK participants included mostly females (83%) and had an average age of 49.2 years. Weekly minutes of walking for transport inside the neighborhood was higher (p < .001) among participants from walkable versus car dependent neighborhoods at baseline (42.5 vs. 21.1), 4-weeks (81.2 vs. 48.2), and 12-weeks (87.2 vs. 48.0). Regardless of neighborhood walkability, all physical activity outcomes were higher and leisure screen time lower at 4-weeks and 12-weeks compared with baseline. We found no significant neighborhood group by time interactions. Pedometer-facilitated interventions may be effective for supporting short-term changes in physical activity and sedentary behavior even among adults residing in low walkable neighborhoods.

Differences in Rural Built Environment Perceptions Across Demographic and Social Environment Characteristics.

The benefits of physical activity to health and obesity prevention are well established. However, attributes of the built environment influence participation in physical activity. The purpose of this study is to assess differences in perceptions of neighborhood walkability across demographic characteristics and social environment factors among rural residents. In a telephone survey, adult respondents (N = 448) across nine rural counties in a southeastern state answered questions about perceived neighborhood walkability, demographic characteristics, and their neighborhood social environment. Study recruitment for a convenience sample occurred through collaborations with local community organizations. Prevalence of destinations and barriers were estimated according to demographic and neighborhood social environment characteristics. Multiple logistic regression models assessed the association of demographic and neighborhood social environment characteristics with neighborhood walkability and calculated adjusted prevalence. Relaxing places to walk were the most often reported destinations (62.0%), followed by retail destinations (45.7%), and communal destinations (42.6%). Traffic was the most reported barrier to safe walking (40.4%), followed by animals (37.5%), and crime (30.5%). Perceptions of retail and communal destinations varied by age and race. Perceptions of traffic and crime as barriers varied by race, weight status, and income. Community belonging and social cohesion were associated with lower perceptions of barriers. Study findings present demographic characteristics and social environment attributes as key factors that shape perceived neighborhood walkability. Findings can help inform programmatic efforts and environmental change strategies to improve walking in rural areas.

The Relationship between Walkability and Place Attachment and the Mediating Role of Neighborhood-Based Social Interaction

This study aims to provide insights in the relation between neighborhood walkability and place attachment and the mediating role of (satisfaction with) social interaction. Both objective and perceived walkability are tested. To analyze these relations, two structural equation models are estimated on data collected among 251 residents of different neighborhoods across the Netherlands. The results show that perceived neighborhood walkability is a stronger predictor of place attachment than objective walkability. Perceived walkability has both a positive direct effect on place attachment and an indirect effect, via neighborhood-based social interaction. Objective walkability only has a positive direct effect on place attachment.

Associations Between Perceived Neighborhood Walkability and Device-Based Physical Activity and Sedentary Behavior Patterns in Older Adults.

Neighborhood walkability has been associated with self-reported sedentary behavior (SB) and self-reported and objective physical activity. However, self-reported measures of SB are inaccurate and can lead to biased estimates, and few studies have examined how associations differ by gender and age. The authors examined the relationships between perceived neighborhood walkability measured with the Physical Activity Neighborhood Environment Scale (scored 1.0-4.0) and device-based SB and physical activity in a cohort of community-dwelling older adults (N = 1,077). The authors fit linear regression models adjusting for device wear time, demographics, self-rated health, and accounting for probability of participation. The Higher Physical Activity Neighborhood Environment Scale was associated with higher steps (+676 steps/point on the Physical Activity Neighborhood Environment Scale, p = .001) and sit-to-stand transitions (+2.4 transitions/point, p = .018). Though not statistically significant, stratified analyses suggest an attenuation of effect for those aged 85 years and older and for women. Consistent with previous literature, neighborhood walkability was associated with more steps, though not with physical activity time. The neighborhood environment may also influence SB.

A Participatory Assessment of Perceived Neighbourhood Walkability in a Small Urban Environment

Walkability has become a research topic of great concern for preserving public health, especially in the era of the COVID-19 outbreak. Today more than ever, urban and transport policies, constrained by social distancing measures and travel restrictions, must be conceptualized and implemented with a particular emphasis on sustainable walkability. Most of the walkability models apply observation and subjective methods to measure walkability, whereas few studies address walkability based on sense perception. To fill this gap, we aim at investigating the perceived neighbourhood walkability (PNW) based on sense perception in a neighbourhood of Brussels. We designed a survey that integrates 22 items grouped into 5 dimensions (cleanness, visual aesthetics, landscape and nature, feeling of pressure, feeling of safety), as well as the socio-demographic attributes of the participants. Using various statistical methods, we show that socio-demographics have almost no effects on perceived neighbourhood walkability. Nonetheless, we found significant differences between groups of different educational backgrounds. Furthermore, using a binomial regression model, we found strong associations between PNW and at least one item from each grouping dimension. Finally, we show that based on a deep neural network for classification, the items have good predictive capabilities (78% of classification accuracy). These findings can help integrate sense perception into objective measurement methods of walkable environments. Additionally, policy recommendations should be targeted based on differences of perception across socio-demographic groups.

Functional Limitations and Perceived Neighborhood Walkability Among Urban Dwelling Older Adults.

Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p < 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p < 0.05) and more walking hazards (b = −0.26, p < 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.

Perceived Neighborhood Walkability is Associated with Recent Falls in Urban Dwelling Older Adults.

Background and Purpose:In rural communities, perceptions of neighborhood walkability, the rating of how easy it is to walk in an area, influence engagement in physical activity outside the home. This has not been studied in older adults residing in urban settings. Additionally, it is not known how perceived walkability is associated with falls. Therefore, the purpose of this study was to first describe the perceptions of neighborhood walkability in urban-dwelling older adults based on recent fall history and then examine associations between recent falls and neighborhood walkability constructs after controlling for fall risk factors.Methods:Urban-dwelling older adults (N = 132) 65 years and older without cognitive dysfunction or uncontrolled comorbidity completed a survey assessing health status, physical activity, and walkability using the Neighborhood Environment Walkability Scale-Abbreviated. Group assignment was based on recent fall history. Between-group comparisons of demographic and walkability constructs were completed using analysis of variance. Logistic regression was used to examine associations between walkability constructs and recent falls after controlling for covariates.Results and Discussion:Poorer perception of land use was significantly associated with recent falls. Questions assessing the ease of walking to a store or transit stop may be valuable in understanding fall risk in older adults living in urban settings.Conclusions:Perceptions of neighborhood walkability are lower in urban-dwelling older adults with a history of falling.

Examining moderators of the effectiveness of a web- and video-based computer-tailored physical activity intervention.

Understanding for whom behaviour change interventions work is important, however there is a lack of studies examining potential moderators in such interventions. This study investigated potential moderators on the effectiveness of a computer-tailored intervention to increase physical activity among Australian adults. People who had <150 min of moderate-vigorous physical activity (MVPA) a week, able to speak and read English, aged ≥18 years, lived in Australia, and had internet access were eligible to participate. Participants recruited through social media, emails, and third-party databases, were randomly assigned to either the control (n = 167) or intervention groups (n = 334). Physical activity was measured objectively by ActiGraph GT3X and also by self-report at baseline and three months. Three-way interaction terms were tested to identify moderators (i.e., demographic characteristics, BMI, and perceived neighbourhood walkability). The results showed that the three-way interaction was marginally significant for sex on accelerometer measured MVPA/week (p = 0.061) and steps/day (p = 0.047). The intervention appeared to be more effective for women compared to men. No significant three-way interactions were found for the other potential moderators. Strategies to improve levels of personalisation may be needed so that physical activity interventions can be better tailored to different subgroups, especially sex, and therefore improve intervention effectiveness.

Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults.

Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition.Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability.Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = −0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = −0.004, 95% CI [−0.01, −0.00]).Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.

Pathways between neighbourhood walkability and mental wellbeing: A case from Hankow, China

IntroductionTo integrate community liveability with public health concerns, urban design theories place increasingly put emphasis on promoting pedestrian friendly neighbourhoods with good walkability. A plethora of studies have investigated the association between walkability and mental wellbeing, but few attempts have been made to systematically synthesize the pathways of their mutual relationship in the Chinese context. Therefore, this study aims to establish a theoretical model and to validate the socio-psychosocial pathways between neighbourhood walkability and mental wellbeing through four designated mediators, i.e. mitigation of environmental stressors, walking behaviours, social cohesion, and sense of community. MethodA total of 786 data valid samples in Wuhan were adopted for the final analysis. The outcome variable is the mental wellbeing, which is measured by the adapted World Health Organization Well-Being Index (WHO-5). A second-order construct is established to denote the perceived neighbourhood walkability, which is measured with an adapted Walkability Scale-Abbreviated (NEWS-A). Several mediators, including the mitigation of environmental stressors, walking behaviours, social cohesion, and sense of community, are measured via a self-reported questionnaire with the seven-point Likert scale. Both the direct and indirect effects of walkability on mental wellbeing are quantified with the partial least squares (PLS) model. ResultThe perceived neighbourhood walkability is a multi-dimensional characteristics concept. The neighbourhood walkability is positively associated with mental wellbeing, and mitigation of environmental stressors, walking behaviours, social cohesion, and sense of community significantly mediate the positive influence of neighbourhood walkability on mental wellbeing. The indirect influence of perceived neighbourhood walkability on mental wellbeing through these mediators is stronger than its direct influence. ConclusionThis study validates multiple important socio-psychosocial pathways between perceived neighbourhood walkability and the mental wellbeing in a typical metropolitan area with a dense population in the Chinese context. Results are consistent with the findings in developed countries. This study deepens the understanding to promote healthier urban settings by improve neighbourhood walkability.

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

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.

Abbreviated Neighborhood Environment Walkability scale in persons with multiple sclerosis: Initial validation of score inferences

IntroductionThere is increasing interest in perceptions of the built environment as a correlate of physical activity among persons with multiple sclerosis (MS). This study examined if scores from the Abbreviated Neighborhood Environment Walkability Scale (NEWS-A) provide a valid inference regarding features of the environment in MS. MethodsParticipants completed a cross-sectional survey that included the NEWS-A as well as a demographic and clinical characteristics measure and the Social Provisions Scale (SPS). Walk Scores® were calculated based on residential addresses. We examined Spearman's Rank-Order Correlations (rs) among NEWS-A subscales with Walk Scores®, social environment, and individual factors, and interpreted the correlations based on a nomological network informed by a social-ecological model. ResultsThere were complete data for 566 participants with MS. There were large correlations between NEWS-A land-use mix diversity, land-use mix access, infrastructure for safety and walking with Walk Scores® (rs = 0.51–0.57). There were medium correlations between NEWS-A residential density, street connectivity, and crime with Walk Scores® (rs = 0.31–0.48), and small correlations between NEWS-A aesthetics and traffic hazards with Walk Scores® (rs = 0.04–0.10). There were small-medium correlations between all other NEWS-A subscales with SPS, marital status, age, and PDDS (rs = 0.01–0.39). ConclusionsOur results provide initial evidence for the validity of NEWS-A scores as a measure of perceived neighborhood walkability that may be associated with health behaviors in MS.

Combining Accelerometry and GPS to Assess Neighborhood-Based Physical Activity: Associations With Perceived Neighborhood Walkability

This study explored associations between perceived neighborhood walkability and neighborhood-based physical activity (NB-PA) and assessed possible moderation effects of the amount of time spent in the home neighborhood and individual characteristics (i.e., educational level and health-related problems). In 2016 to 2017, 509 Dutch adults, living in the South Limburg area, were included. Context-specific PA levels were measured using the Actigraph GT3X+ accelerometer and the Qstarz BTQ1000XT GPS-logger. Perceived neighborhood walkability, level of education, work status, and health-related quality of life were measured with validated self-report instruments. Results showed that individuals with a lower level of education or health-related problems spent more time in the home neighborhood. The perceived neighborhood walkability only affected NB-PA for individuals spending a relatively large amount of time in their home neighborhood. PA-facilitating features in the home neighborhood, for example, aesthetics, were only associated with more NB-PA for individuals without health-related problems or with a higher level of education.