Are buffers around home representative of physical activity spaces among adults?

Visiting natural open spaces in urban areas during pregnancy and its association with daily physical activity

We examined the association between visiting natural open spaces (NOS) and physical activity (PA) at different trimesters of pregnancy. We used GPS and accelerometer data from women residing in Donostia-San Sebastian and Barcelona. Daily visits to NOS were associated with an increase of circa 8 min of moderate to vigorous physical activity (MVPA) in the first and second trimesters of pregnancy. Women who visited NOS were more likely to meet the WHO daily PA guidelines during the first trimester. Visiting NOS can promote PA consistently during pregnancy, improving maternal health and well-being in urban settings.

Urban design and cardio-metabolic risk factors

Accumulating evidence suggests that the built environment may be associated with cardiovascular disease via its influence on health behaviours. The aim of this study was to estimate the associations between traditional and novel neighbourhood built environment metrics and clinically assessed cardio-metabolic risk factors among a sample of adults in Canada. A total of 7171 participants from Albertas Tomorrow Project living in Alberta, Canada, were included. Cardio-metabolic risk factors were clinically measured. Two composite built environment metrics of traditional walkability and space syntax walkability were calculated. Among men, space syntax walkability was negatively associated with systolic and diastolic blood pressure (b = -0.87, 95% CI -1.43, -0.31 and b = -0.45, 95% CI -0.86, -0.04, respectively). Space syntax walkability was also associated with lower odds of overweight/obese among women and men (OR = 0.93, 95% CI 0.87, 0.99 and OR = 0.88, 95% CI 0.79, 0.97, respectively). No significant associations were observed between traditional walkability and cardio-metabolic outcomes. This study showed that the novel built environment metric based on the space syntax theory was associated with some cardio-metabolic risk factors.

Investigating how researcher-defined buffers and self-drawn neighbourhoods capture adolescent availability to physical activity facilities and greenspaces: An exploratory study

BACKGROUND

Modifying the environment is considered an effective population-level approach for increasing healthy behaviours, but associations remain ambiguous. This exploratory study aims to compare researcher-defined buffers and self-drawn neighbourhoods (SDN) to objectively measured availability of physical activity (PA) facilities and greenspaces in adolescents.

METHODS

Seven consecutive days of GPS data were collected in an adolescent sample of 14-18 year olds (n = 69). Using Points of Interest and greenspace data, availability of PA opportunities within activity spaces were determined. We compared 30 different definitions of researcher-defined neighbourhoods and SDNs to objectively measured availability.

RESULTS

Findings showed low agreement for all researcher-defined buffers in measuring the availability of PA facilities in activity spaces. However, results were less clear for greenspace. SDNs also demonstrate low agreement for capturing availability to the PA environment.

CONCLUSION

This exploratory study highlights the inadequacy of researcher-defined buffers and SDNs to define availability to environmental features.

GPS-based activity space exposure to greenness and walkability is associated with increased accelerometer-based physical activity

INTRODUCTION

Built and natural environments may provide opportunities for physical activity. However, studies are limited by primarily using residential addresses to define exposure and self-report to measure physical activity. We quantified associations between global positioning systems (GPS)-based activity space measures of environmental exposure and accelerometer-based physical activity.

METHODS

Using a nationwide sample of working female adults (N = 354), we obtained seven days of GPS and accelerometry data. We created Daily Path Area activity spaces using GPS data and linked these activity spaces to spatial datasets on walkability (EPA Smart Location Database at the Census block group level) and greenness (satellite vegetation at 250 m resolution). We utilized generalized additive models to examine nonlinear associations between activity space exposures and accelerometer-derived physical activity outcomes adjusted for demographic characteristics, socioeconomic factors, and self-rated health.

RESULTS

Higher activity space walkability was associated with higher levels of moderate-vigorous physical activity, and higher activity space greenness was associated with greater numbers of steps per week. No strong relationships were observed for sedentary behavior or light physical activity. Highest levels of moderate-vigorous physical activity were observed for participants with both high walkability and high greenness in their activity spaces.

CONCLUSION

This study contributes evidence that higher levels of physical activity occur in environments with more dense, diverse, and well-connected built environments, and with higher amounts of vegetation. These data suggest that urban planners, landscape architects, and policy makers should implement and evaluate environmental interventions to encourage higher levels of physical activity.

Delineating the geographic context of physical activities: A systematic search and scoping review of the methodological approaches used in social ecological research over two decades

BACKGROUND

The social ecological approach suggests that the spatial context among other factors influence physical activity behavior. Ample research documents physical environmental effects on physical activity. Yet, to date inconsistent associations remain, which might be explained by conceptual and methodological challenges in measuring the spatial dimensions of health behavior. We review methods applied to measure the spatial contexts in the social ecological physical activity literature.

METHODS

Online databases and selected reviews were used to identify papers published between 1990 and 2020. A total of 2167 records were retrieved, from which 412 studies that used physical activity as a primary outcome variable, included measures of the physical environment and applied the main principles of the social ecological approach, were included.

RESULTS

Subjective approaches were the dominant method to capture the spatial context of physical activities. These approaches were applied in 67% (n=279) of the studies. From the objective approaches an administrative unit was most prevalent and was applied in 29% (n=118) of the studies. The most comprehensive objective spatial methods that capture the true environmental exposure, were used only in 2% (n=10) of the studies.

CONCLUSIONS

Current social ecological physical activity research applies simple conceptualizations and methods of the spatial context. While conceptual and methodological concerns have been repeatedly expressed, no substantive progress has been made in the use of spatial approaches. To further our understanding on place effects on health, future studies should carefully consider the choice of spatial approaches, and their effect on study results.

Effects of Buffer Size and Shape on the Association of Neighborhood SES and Adult Fruit and Vegetable Consumption

Introduction: Neighborhood environment factors are relevant for dietary behaviors, but associations between home neighborhood context and disease prevention behaviors vary depending on the definition of neighborhood. The present study uses a publicly available dataset to examine whether associations between neighborhood socioeconomic status (NSES) and fruit/vegetable (FV) consumption vary when NSES is defined by different neighborhood sizes and shapes.

Methods: We analyzed data from 1,736 adults with data in GeoFLASHE, a geospatial extension of the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study (FLASHE). We examined correlations of NSES values across neighborhood buffer shapes (circular or street network) and sizes (ranging from 400 to 1,200 m) and ran weighted simple and multivariable regressions modeling frequency of FV consumption by NSES for each neighborhood definition. Regressions were also stratified by gender.

Results: NSES measures were highly correlated across various neighborhood buffer definitions. In models adjusted for socio-demographics, circular buffers of all sizes and street buffers 750 m and larger were significantly associated with FV consumption frequency for women only.

Conclusion: NSES may be particularly relevant for women's FV consumption, and further research can examine whether these associations are explained by access to food stores, food shopping behavior, and/or psychosocial variables. Although different NSES buffers are highly correlated, researchers should conceptually determine spatial areas a priori.

Cohort profile: the Women's Health Accelerometry Collaboration

PURPOSE

This paper describes the Women's Health Accelerometry Collaboration, a consortium of two prospective cohort studies of women age 62 years or older, harmonised to explore the association of accelerometer-assessed physical activity and sedentary behaviour with cancer incidence and mortality.

PARTICIPANTS

A total of 23 443 women (age mean 73.4, SD 6.8) living in the USA and participating in an observational study were included; 17 061 from the Women's Health Study (WHS) and 6382 from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health (WHI/OPACH) Study.

FINDINGS TO DATE

Accelerometry, cancer outcomes and covariate harmonisation was conducted to align the two cohort studies. Physical activity and sedentary behaviour were measured using similar procedures with an ActiGraph GT3X+ accelerometer, worn at the hip for 1 week, during 2011-2014 for WHS and 2012-2014 for WHI/OPACH. Cancer outcomes were ascertained via ongoing surveillance using physician adjudicated cancer diagnosis. Relevant covariates were measured using questionnaire or physical assessments. Among 23 443 women who wore the accelerometer for at least 10 hours on a single day, 22 868 women wore the accelerometer at least 10 hours/day on ≥4 of 7 days. The analytical sample (n=22 852) averaged 4976 (SD 2669) steps/day and engaged in an average of 80.8 (SD 46.5) min/day of moderate-to-vigorous, 105.5 (SD 33.3) min/day of light high and 182.1 (SD 46.1) min/day of light low physical activity. A mean of 8.7 (SD 1.7) hours/day were spent in sedentary behaviour. Overall, 11.8% of the cohort had a cancer diagnosis (other than non-melanoma skin cancer) at the time of accelerometry measurement. During an average of 5.9 (SD 1.6) years of follow-up, 1378 cancer events among which 414 were fatal have occurred.

FUTURE PLANS

Using the harmonised cohort, we will access ongoing cancer surveillance to quantify the associations of physical activity and sedentary behaviour with cancer incidence and mortality.

Does Childcare Work Promote Cardiorespiratory Fitness and Health? A Cross-Sectional Study of Danish Childcare Workers Based on Accelerometry and Heart Rate Measurements

Childcare workers are reported to have poor cardiorespiratory fitness and health. The Goldilocks Work Principle argues that productive work should be designed with the right composition, intensity and alternations of physical behaviors so that workers get fit and healthy. The purpose of this study was to investigate: (1) composition, (2) intensity and (3) alternations of physical behaviors during work and leisure among childcare workers. Data were collected using accelerometers and heart rate monitors over five workdays among 51 childcare workers at five Danish childcare institutions. Workers mainly spent their work time sedentary (43.0%), spent little time (0.7%) at sufficiently high cardiometabolic intensity to increase cardiorespiratory fitness and often alternated between physical behaviors (67.0% occurred in bouts of <5 min). These findings indicate that the workers have a composition of behaviors at work dominated by sedentary time, little time with high cardiometabolic intensity, and frequent alternations between behaviors. During leisure, workers spent more time sedentary (59.4%), more time at high cardiometabolic intensity (3.4%) and less time occurred in bouts <5 min (38.7%). We see a potential for promoting cardiorespiratory fitness and health of childcare workers by redesigning the way they play with the children, so that work time with high cardiometabolic intensity is increased.

The significant places of African American adults and their perceived influence on cardiovascular disease risk behaviors

BACKGROUND

AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults' self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking.

METHODS

We conducted semi-structured interviews with AA adults (N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12.

RESULTS

The average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives' homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives' homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support.

CONCLUSIONS

As we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.

Walkability measures to predict the likelihood of walking in a place: A classification and regression tree analysis

Walkability is a popular and ubiquitous term at the intersection of urban planning and public health. As the number of potential walkability measures grows in the literature, there is a need to compare their relative importance for specific research objectives. This study demonstrates a classification and regression tree (CART) model to compare five familiar measures of walkability from the literature for their relative ability to predict whether or not walking occurs in a dataset of objectively measured locations. When analyzed together, the measures had moderate-to-high accuracy (87.8% agreement: 65.6% of true walking GPS-measured points classified as walking and 93.4% of non-walking points as non-walking). On its own, the most well-known composite measure, Walk Score, performed only slightly better than measures of the built environment composed of a single variable (transit ridership, employment density, and residential density).Thus there may be contexts where transparent and longitudinally available measures of urban form are worth a marginal tradeoff in prediction accuracy. This comparison of walkability measures using CART highlights the importance for public health and urban design researchers to think carefully about how and why particular walkability measures are used.

Exploring factors affecting individual GPS-based activity space and how researcher-defined food environments represent activity space, exposure and use of food outlets

Background

Obesity remains one of the most challenging public health issues of our modern time. Despite the face validity of claims for influence, studies on the causes of obesity have reported the influence of the food environment to be inconsistent. This inconsistency has been attributed to the variability of measures used by researchers to represent the food environments—Researcher-Defined Food Environments (RDFE) like circular, street-network buffers, and others. This study (i.) determined an individual’s Activity Space (AS) (ii.) explored the accuracy of the RDFE in representing the AS, (iii.) investigated the accuracy of the RDFE in representing actual exposure, and (iv.) explored whether exposure to food outlet reflects the use of food outlets.

Methods

Data were collected between June and December 2018. A total of 65 participants collected Global Positioning System (GPS) data, kept receipt of all their food purchases, completed a questionnaire about their personal information and had their weight and height measured. A buffer was created around the GPS points and merged to form an AS (GPS-based AS).

Results

Statistical and geospatial analyses found that the AS size of participants working away from home was positively related to the Euclidean distance from home to workplace; the orientation (shape) of AS was also influenced by the direction of workplace from home and individual characteristics were not predictive of the size of AS. Consistent with some previous studies, all types and sizes of RDFE variably misrepresented individual exposure in the food environments. Importantly, the accuracy of the RDFE was significantly improved by including both the home and workplace domains. The study also found no correlation between exposure and use of food outlets.

Conclusions

Home and workplace are key activity nodes in modelling AS or food environments and the relationship between exposure and use is more complex than is currently suggested in both empirical and policy literature.

Using Geographic Information Systems (GIS) for Targeted National Recruitment of Community-Dwelling Caregivers Managing Dementia-Related Behavioral and Psychological Symptoms: A Recruitment Approach for a Randomized Clinical Trial

Over 16 million caregivers of people living with dementia require support in a range of issues, including self-care, disease education, and guidance for how to manage behavioral and psychological symptoms of dementia (BPSD). Non-pharmacological interventions are needed to address these areas, and online applications have been shown to be safe and effective. To ensure the efficacy of such interventions, racially, ethnically, geographically, and socioeconomically diverse participants must be recruited to increase the generalizability of study outcomes. This protocol paper describes a recruitment plan using Geographic Information Systems (GIS) to reach a representative sample of caregivers across the United States for a national Phase III clinical study. Using publicly available census data from the American Community Survey (ACS), combined with location data for local aging resources such as Area Agencies on Aging (AAA), recruitment will be derived from data analysis conducted in ESRI ArcGIS v10.7.1. Datasets including age, gender, income, and education will be assessed nationally at the county and census tract spatial scale in a nine-step process to develop recruitment priority areas containing high concentrations of eligible participants living in the community. Overall, the current protocol will demonstrate the value of GIS in tailoring targeted outreach strategies to recruit community-dwelling populations through local resource institutions. This novel approach may have far-reaching implications in future recruitment initiatives and help to secure racially/ethnically diverse samples.

Associations of the Neighborhood Built Environment With Physical Activity Across Pregnancy

BACKGROUND

Several features of the neighborhood built environment have been shown to promote leisure-time physical activity (PA) in the general population, but few studies have examined its impact on PA during pregnancy.

METHODS

Data were extracted from 8362 Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort participants (2010-2013). Residential address information was linked to 3 built environment characteristics: number of gyms and recreation areas within a 3-km radius of residence and census block level walkability. Self-reported leisure-time PA was measured in each trimester and dichotomized as meeting PA guidelines or not. Relative risks for cross-sectional associations between neighborhood characteristics and meeting PA guidelines were estimated using Poisson regression.

RESULTS

More gyms and recreation areas were each associated with a greater chance of meeting PA guidelines in models adjusted for sociodemographic characteristics and preexisting conditions. Associations were strongest in the third trimester where each doubling in counts of gyms and recreation areas was associated with 10% (95% confidence interval, 1.07-1.13) and 8% (95% confidence interval, 1.03-1.12), respectively, greater likelihood of meeting PA guidelines. Associations were similar though weaker for walkability.

CONCLUSIONS

Results from a large, multisite cohort suggest that these built environment characteristics have similar PA-promoting benefits in pregnant women as seen in more general populations.

Identifying the Daily Activity Spaces of Older Adults Living in a High-Density Urban Area: A Study Using the Smartphone-Based Global Positioning System Trajectory in Shanghai

The characteristics of the built environment and the configuration of public facilities can affect the health and well-being of older adults. Recognizing the range of daily activities and understanding the utilization of public facilities among older adults has become essential in planning age-friendly communities. However, traditional methods are unable to provide large-scale objective measures of older adults’ travel behaviors. To address this issue, we used the smartphone-based global positioning system (GPS) trajectory to explore the activity spaces of 76 older adults in a high-density urban community in Shanghai for 102 consecutive days. We found that activity spaces are centered around older adults’ living communities, with 46.3% within a 1.5 km distance. The older adults’ daily activities are within a 15 min walking distance, and accessibility is the most important factor when making a travel choice to parks and public facilities. We also found that the travel range and spatial distribution of points of interest are different between age and gender groups. In addition, we found that using a concave hull with Alpha shape algorithm is more applicable and robust than the traditional convex hull algorithm. This is a unique case study in a high-density urban area with objective measures for assessing the activity spaces of older adults, thus providing empirical evidence for promoting healthy aging in cities.

Accuracy of buffers and self-drawn neighbourhoods in representing adolescent GPS measured activity spaces: An exploratory study

BACKGROUND

There continues to be a lack of understanding as to the geographical area at which the environment exerts influence on behaviour and health. This exploratory study compares different potential methods of both researcher- and participant-defined definitions of neighbourhood reflect an adolescent's activity space.

METHODS

Seven consecutive days of global positioning system (GPS) tracking data were collected at 15 s intervals using a small exploratory adolescent sample of 14-18 year olds (n = 69) in West Yorkshire, England. A total of 304,581 GPS tracking points were collected and compared 30 different definitions of researcher-defined neighbourhoods including radial, network and ellipse buffers at 400 m, 800 m, 1000 m, 1600 m and 3000 m, as well as participant-defined self-drawn neighbourhoods.

RESULTS

This exploratory study supports emerging evidence cautioning against the use of static neighbourhood definitions for defining exposure. Traditional buffers (network and radial) capture at most 67% of activity space (home radial), and at worst they captured only 3.5% (school network) and range from capturing between 3 and 88% of total time. Similarly, self-drawn neighbourhoods captured only 10% of actual daily movement. Interestingly, 40% of an adolescent's self-drawn neighbourhood was not used. We also demonstrate that buffers capture a range of space (22-95%) where adolescents do not go, thus misclassifying the exposure.

CONCLUSION

Our exploratory findings demonstrate that neither researcher- nor participant-defined definition of neighbourhood adequately captures adolescent activity space. Further research with larger samples are needed to confirm the findings of this exploratory study.

Locations of Physical Activity: Where Are Children, Adolescents, and Adults Physically Active? A Systematic Review

The aim of this systematic review was to examine where physical activity (PA) takes place and how much time children, adolescents and adults spend being physically active within the identified locations. A systematic literature search was carried out in five electronic databases (PubMed, CINAHL, SPORTDiscus, PsycInfo, Scopus). For inclusion, primary studies had to identify locations of PA using device-based or self-report tools, whereas minutes of PA had to be examined using device-based tools only. Thirty-two studies were included, methodological quality and sex/gender sensitivity of the studies were assessed. The narrative data synthesis revealed that the highest average amount of daily moderate-to-vigorous PA was found in home and recreational locations, followed by school and neighborhood locations. In adults, highest average amount of daily moderate-to-vigorous PA was found in neighborhood and home locations followed by workplace and recreational locations. The majority of studies had a low risk of bias in four out of six domains; eight studies reported significant sex/gender differences in location-based PA. The results indicate that different locations are used for PA to a varying degree across the lifespan. Future research on the promotion of PA should focus on location-specific design features that encourage children, adolescents and adults to be physically active.

Urban Form, Socio-Demographics, Attitude and Activity Spaces: Using Household-Based Travel Diary Approach to Understand Travel and Activity Space Behaviors

Very few studies have addressed the gap in literature by examining the travel and activity patterns of travelers in developing countries to inform future land use and socio-economic planning. The major purpose of this paper is to determine the factors related with travel and activity space patterns of residents in Dhaka, Bangladesh. Based on lessons learned from a pilot study, a full study was undertaken using artificial neural network and regression. A network analyst-based shortest path network with road network buffer activity space calculation measure was used in geographic information system. Exploratory and confirmatory factor analyses were used to identify attitudinal factor dimensions. Calculated individual activity spaces were found to range from 0.08 to 10.13 square miles. Trip characteristics were found to be significant predictors of individual activity space. In case of household activity space, D variables (density, design, and destination accessibility) and household characteristics were found as the most significant. Perceived neighborhood amenities, car attachment, monetary concerns, transit preferences, perceived daily travel area and environmental concern were found to shape people’s perception. Weekend activity spaces were more compact than those for weekdays. Individual day-to-day variability was less during weekdays than on the weekend. Female and high-income respondents had smaller activity spaces.

Neighborhood social environments, healthy resources, and adult diabetes: Accounting for activity space exposures

This study broadens contextual environments to include adults' activity spaces-inside and outside the residential neighborhood-to examine how contextual exposures shape type 2 diabetes risk. We use novel longitudinal data from the Los Angeles Family and Neighborhood Survey, construct time-weighted exposure measures of adults' social-structural and healthy resource environments, and execute random effects logistic models predicting the probability of being diabetic. Results indicate that residential and activity space exposures are independently associated with adult diabetes, and that residential and activity space healthy resources combine to influence diabetes risk in synergistic ways. Living in more socioeconomically advantaged neighborhoods reduces diabetes risk, particularly when spending time in activity spaces with greater access to recreational facilities. Moreover, healthier activity space environments may compensate for living in neighborhoods devoid of healthy food options to lessen diabetes risk. Adopting an activity space framework can inform multilevel interventions aimed at alleviating type 2 diabetes and other chronic ailments.

Perceived neighbourhood characteristics and depressive symptoms: Potential mediators and the moderating role of employment status

Multiple neighbourhood characteristics have been linked to depressive symptoms. However, few studies have simultaneously considered multiple mechanisms that explain this relationship, and how they might interact. Further, most studies regard exposure to the residential environment as constant, and therefore disregard variation in exposure by individual factors. This study investigates whether and to what extent stress and physical activity mediate the association between neighbourhood characteristics and depression, and also to what extent employment status moderates this relationship. A population-representative survey of n = 11,505 people in the Netherlands was conducted. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9). Neighbourhood characteristics were perceived green and blue space, pleasantness, environmental disturbance, social cohesion and safety. Employment status was combined with place of work to establish two groups: those who were non-working or who worked from home ('at home'), and those who worked somewhere outside of the home ('working'). Multi-group structural equation modelling was employed to understand the theorised relationships for both groups. Perceived environmental disturbance, social cohesion and safety were significantly indirectly related to depressive symptoms via stress, with larger effect sizes in the 'at home' group. Pleasantness was also significantly indirectly related to depressive symptoms via stress, in the 'at home' group only. There was no evidence for physical activity as a mediator. Our findings suggest that neighbourhood social characteristics may have a greater influence on depressive symptoms than physical characteristics. Stress appears to be a key mediator of this relationship. In addition, the neighbourhood appears to exert a greater influence on those who spend more time in their neighbourhood. Interventions to promote mental health should focus on the social environment, and in particular pay attention to those who are spatially confined in poorer quality neighbourhoods.

Adults' leisure-time physical activity and the neighborhood built environment: a contextual perspective

BACKGROUND

Context-free outcome measures, such as overall leisure-time physical activity (LTPA), are habitually applied to study the neighborhood built environment correlates of physical activity. This cross sectional study identifies and empirically tests potential methodological limitations related to the use of context-free measures and discusses how these may help in the interpretation of inconsistent associations between participation in moderate-to-vigorous LTPA and objectively measured neighborhood-level built environment attributes.

METHODS

We employ a public participation geographic information system (PPGIS), an advanced participatory mapping method, to study the spatial distribution of moderate-to-vigorous LTPA among adult urban Finnish residents (n 1322). Secondary sources of GIS land-use and sport facility data were used to disaggregate respondent-mapped LTPA by the behavioral context, such as indoor and outdoor sport facilities, green spaces, and other public open spaces. Associations between the use of the identified LTPA settings and a range of objectively measured neighborhood built environment attributes were studied with multilevel logistic regression models.

RESULTS

Disaggregated by behavioral context, we observed varied and partly opposite built environment correlates for LTPA. The use of indoor and outdoor sport facilities showed no significant associations with their neighborhood availability, but were significantly associated with personal-level attributes. By contrast, participation in LTPA in green and built public open space shared significant associations with access to and availability of neighborhood green space that persisted after controlling for personal-level covariates. Moreover, neighborhood distances up to 1600 m poorly captured participation in moderate-to-vigorous LTPA, as, on average, 40% of visits were located further from home. However, we found the immediate home environment to be an important LTPA setting for the least active participants.

CONCLUSIONS

This study demonstrates that LTPA can be a highly heterogeneous measure regarding both the spatial distribution and the environmental correlates of behavioral contexts. The results show that context-free LTPA outcome measures yield inconsistent associations with built environment exposure variables, challenging the applicability of such measures in designing neighborhood-level built environment interventions.

How do natural features in the residential environment influence women's self-reported general health? Results from cross-sectional analyses of a U.S. national cohort

BACKGROUND

The relationship between health and human interaction with nature is complex. Here we conduct analyses to provide insights into potential health benefits related to residential proximity to nature.

OBJECTIVES

We aimed to examine associations between measures of residential nature and self-reported general health (SRGH), and to explore mediation roles of behavioral, social, and air quality factors, and variations in these relationships by urbanicity and regional climate.

METHODS

Using residential addresses for 41,127 women from the Sister Study, a U.S.-based national cohort, we derived two nature exposure metrics, canopy and non-gray cover, using Percent Tree Canopy and Percent Developed Imperviousness from the National Land Cover Database. Residential circular buffers of 250 m and 1250 m were considered. Gradient boosted regression trees were used to model the effects of nature exposure on the odds of reporting better SRGH (Excellent/Very Good versus the referent, Good/Fair/Poor). Analyses stratified by urbanicity and regional climate (arid, continental, temperate) and mediation by physical activity, social support, and air quality were conducted.

RESULTS

A 10% increase in canopy and non-gray cover within 1250 m buffer was associated with 1.02 (95% CI: 1.00-1.03) and 1.03 (95% CI: 1.01-1.04) times the odds of reporting better SRGH, respectively. Stronger associations were observed for the urban group and for continental climate relative to other strata. Social support and physical activity played a more significant mediation role than air quality for the full study population.

DISCUSSION

Findings from this study identified a small but important beneficial association between residential nature and general health. These findings could inform community planning and investments in neighborhood nature for targeted health improvements and potential societal and environmental co-benefits.

Accelerometer and GPS Data to Analyze Built Environments and Physical Activity

Purpose: Most built environment studies have quantified characteristics of the areas around participants' homes. However, the environmental exposures for physical activity (PA) are spatially dynamic rather than static. Thus, merged accelerometer and global positioning system (GPS) data were utilized to estimate associations between the built environment and PA among adults. Methods: Participants (N = 142) were recruited on trails in Massachusetts and wore an accelerometer and GPS unit for 1-4 days. Two binary outcomes were created: moderate-to-vigorous PA (MVPA vs. light PA-to-sedentary); and light-to-vigorous PA (LVPA vs. sedentary). Five built environment variables were created within 50-meter buffers around GPS points: population density, street density, land use mix (LUM), greenness, and walkability index. Generalized linear mixed models were fit to examine associations between environmental variables and both outcomes, adjusting for demographic covariates. Results: Overall, in the fully adjusted models, greenness was positively associated with MVPA and LVPA (odds ratios [ORs] = 1.15, 95% confidence interval [CI] = 1.03, 1.30 and 1.25, 95% CI = 1.12, 1.41, respectively). In contrast, street density and LUM were negatively associated with MVPA (ORs = 0.69, 95% CI = 0.67, 0.71 and 0.87, 95% CI = 0.78, 0.97, respectively) and LVPA (ORs = 0.79, 95% CI = 0.77, 0.81 and 0.81, 95% CI = 0.74, 0.90, respectively). Negative associations of population density and walkability with both outcomes reached statistical significance, yet the effect sizes were small. Conclusions: Concurrent monitoring of activity with accelerometers and GPS units allowed us to investigate relationships between objectively measured built environment around GPS points and minute-by-minute PA. Negative relationships between street density and LUM and PA contrast evidence from most built environment studies in adults. However, direct comparisons should be made with caution since most previous studies have focused on spatially fixed buffers around home locations, rather than the precise locations where PA occurs.

Implications of Geographic Information Systems (GIS) for targeted recruitment of older adults with dementia and their caregivers in the community: A retrospective analysis

5.5 million Americans are living with Alzheimer's dementia (AD) or related dementias. Developing evidence-based interventions for these people and their caregivers (dyads) is a public health priority, and is highly dependent on recruiting representatives from the community. Precision recruitment methodologies are needed to improve the efficiency of this process. Geographic Information Systems (GIS) offer the potential to determine location trends of an older adult population of people living with dementia in the community and their caregivers.

American Community Survey (ACS) 2015 5-year estimates were analyzed at the census tract level in ESRI ArcMap v. 10.5.1. Datasets included summarized estimates of age, gender, income, and education in Maryland. Using a two-step process, geographic regions were identified in ArcMap that contained various combinations of available data variables. These areas were compared to participant locations from a previously completed traditional recruitment effort to determine overlap (Dementia Behavior Study - R01AGO41781).

The largest number of existing participants were identified in derived regions defined by combining age, education, gender, and income variables; predicting 184 (79%) of 234 participants regardless of the population density within census tracts. 208 (89%) were identified when matching this variable combination to the highest density census tracts (city/urban), and 66 (28%) in regions with the lowest population density (rural).

This study successfully defined specific geographic regions in the state of Maryland that overlapped with a large number of known dementia dyad locations obtained via traditional recruitment efforts. Implications for these findings allow for more targeted recruitment efforts of difficult to recruit populations, and less utilization of resources for doing so.

Would increasing access to recreational places promote healthier weights and a healthier nation?

Addressing gaps in evidence on causal associations, this study tested the hypothesis that better access to recreational places close to home helps people to maintain lower body mass index (BMI) using a retrospective longitudinal study design and up to 6 years of data for the same individuals (1,522,803 men and 183,618 women). Participants were military veterans aged 20-64 who received healthcare through the U.S. Department of Veterans Affairs in 2009-2014 and lived in a metropolitan area. Although there were cross-sectional associations, we found no longitudinal evidence that access to parks and fitness facilities was associated with BMI for either men or women in the full sample or in subgroups of residential movers and stayers. Our findings suggest that simply increasing the number of parks and fitness facilities may not be enough to achieve needed population-level reductions in weight.

Measuring spatio-temporal accessibility to emergency medical services through big GPS data

Medical accessibility is an important indicator for evaluating the effectiveness of public health services. However, the previous medical accessibility studies mainly focus on spatial accessibility without considering temporal variation in population distribution which is significant for evaluating access to emergency medical service (EMS). This paper proposes a model of spatio-temporal accessibility to EMS called ST-E2SFCA based on adapting the enhanced two-step floating catchment area (E2SFCA) method. We apply our method to the greater Tokyo area for a large volume of GPS dataset with millions of users and compare the accessibility difference over space and time. To evaluate our model, we also analyze the distinction of our model over different weight sets and compare the performance of ST-E2SFCA with the traditional E2SFCA. The result shows that our method can illustrate the temporal difference and is suitable for measuring the spatio-temporal accessibility to EMS, thus can guide the hospital location selection and urban planning.

Natural movement: A space syntax theory linking urban form and function with walking for transport

Walking to get to and from local destinations including shops, services, and transit stops is a major source of adults' health-related physical activity. Research has been using space syntax measures in examining how urban form is related to such routine walking for transport. This paper proposes to apply a theory of space syntax, natural movement, which posits street layout as a primary factor influencing pedestrian movement. Discussing how this theory can link urban form (street layout) and function (land use) with walking for transport, we propose a research agenda to produce new insights and advance methods in active living research.

Capturing exposure in environmental health research: challenges and opportunities of different activity space models

Background

The built environment health promotion has attracted notable attention across a wide spectrum of health-related research over the past decade. However, the results about the contextual effects on health and PA are highly heterogeneous. The discrepancies between the results can potentially be partly explained by the diverse use of different spatial units of analysis in assessing individuals’ exposure to various environment characteristics. This study investigated whether different residential and activity space units of analysis yield distinct results regarding the association between the built environment and health. In addition, this study examines the challenges and opportunities of the different spatial units of analysis for environmental health-related research.

Methods

Two common residential units of analysis and two novel activity space models were used to examine older adults’ wellbeing in relation to the built environment features in the Helsinki Metropolitan Area, Finland. An administrative unit, 500 m residential buffer, home range model and individualized residential exposure model were used to assess the associations between the built environment and wellbeing of respondent’s (n = 844).

Results

All four different spatial units of analysis yield distinct results regarding the associations between the built environment characteristics and wellbeing. A positive association between green space and health was found only when exposure was assessed with individualized residential exposure model. Walkability index and the length of pedestrian and bicycle roads were found to positively correlate with perceived wellbeing measures only with a home range model. Additionally, all units of analysis differed from each other in terms of size, shape, and how they capture different contextual measures.

Conclusions

The results show that different spatial units of analysis result in considerably different measurements of built environment. In turn, the differences derived from the use of different spatial units seem to considerably affect the associations between environment characteristics and wellbeing measures. Although it is not easy to argue about the correctness of these measurements, what is evident is that they can reveal different wellbeing outcomes. While some methods are especially usable to determine the availability of environmental opportunities that promote active travel and the related health outcomes, others can provide us with insight into the mechanisms how the actual exposure to green structure can enhance wellbeing.

Using Individual GPS Trajectories to Explore Foodscape Exposure: A Case Study in Beijing Metropolitan Area

With the growing interest in studying the characteristics of people’s access to the food environment and its influence upon individual health, there has been a focus on assessing individual food exposure based on GPS trajectories. However, existing studies have largely focused on the overall activity space using short-period trajectories, which ignores the complexity of human movements and the heterogeneity of the spaces that are experienced by the individual over daily life schedules. In this study, we propose a novel framework to extract the exposure areas consisting of the localized activity spaces around daily life centers and non-motorized commuting routes from long-term GPS trajectories. The newly proposed framework is individual-specific and can incorporate the internal heterogeneity of individual activities (spatial extent, stay duration, and timing) in different places as well as the dynamics of the context. A pilot study of the GeoLife dataset suggests that there are significant variations in the magnitude as well as the composition of the food environment in different parts of the individual exposure area, and residential environment is not representative of the overall foodscape exposure.