Objective measurement of children's physical activity geographies: A systematic search and scoping review

Urban density and child health and wellbeing: A scoping review of the literature

This scoping review explores the relationship between urban density and child health and wellbeing, focusing on how urban density has been measured and its association with various child health outcomes. By analysing 53 studies spanning from 1972 to 2023, we identify significant variability in how urban density is defined and measured and mixed evidence regarding its relationship with different child health outcomes. We also highlight context-specific findings, which may be connected to a range of dynamic and interconnected local and socio-cultural factors. While most studies showed mixed or inconclusive results for physical health and mental health and wellbeing, some consistent findings were observed for positive associations between urban density and growth and nutritional status in studies from Asia and Africa, and for negative impacts on child development in studies from Europe and North America. The review highlights the need for improved reporting standards, consistent terminology, and context-specific approaches to better understand and address the complex interplay between urban density and child health. It underscores the importance of considering broader social determinants and the unique experiences of children within urban environments for improved policy, practice and placemaking, advocating for participatory research methods to capture children's perspectives on urban density.

Access to Healthy Built and Natural Environments and Physical Activity and Screen Time in New Zealand Adolescents: A Geospatial Cross-Sectional Study

The built and natural environment can facilitate (un)healthy behaviors in adolescence. However, most previous studies have focused on examining associations between singular aspects of the environment. This study examined the association between the mixture of health-promoting and health-constraining environmental features in a Healthy Location Index (HLI) and physical activity and screen time among adolescents. This cross-sectional study used data from the Built Environment and Active Transport to School (BEATS) Research Program based in Dunedin, New Zealand. Data from 1,162 adolescents with complete demographic, health behavior and spatial records were included in the analysis. The environment was defined using the HLI based on access to health-promoting (e.g., greenspace, blue space, physical activity facility) and health-constraining (e.g., fast-food outlets) features and their mixture. Quantile g-computation and multilevel mixed effects models, with adolescents nested within schools, examined associations between the environment and the two health behaviors. A positive association existed between meeting physical activity guidelines and access to health-promoting environments (OR = 1.23 [95% CI 1.03; 1.47]), particularly blue space. In addition, the mixture of health-promoting and health-constraining environments was also important (ψ = 1.18 [1.01; 1.37]). However, there was limited evidence of an association between the environment and screen time. We provide evidence of a relationship between health-promoting environments, the mix of health-promoting and health-constraining environments, and physical activity among adolescents. The findings support the hypothesis that the environment has the potential to positively influence healthy behaviors of youth, particularly when it comes to physical activity.

Adolescents' perceptions of food outlets in the school neighbourhood and their unhealthy snacking behaviour on the way to and from school

OBJECTIVE

To understand the relationship between adolescents' unhealthy snacking behaviour during their school journey and their perceived and objective measures of food outlet availability in the school neighbourhood.

DESIGN

A cross-sectional survey enquired about socio-demographic information, school transport modes, perceived presence of food outlets in the school neighbourhood and unhealthy food purchase and consumption on the school journey. A geographical information system analysis of the food outlets within 500 m and 1000 m school buffers was undertaken. Data were analysed using generalised linear mixed modelling.

SETTING

All twelve secondary schools in Dunedin, Aotearoa New Zealand, March 2020-June 2022.

PARTICIPANTS

Adolescents aged 13-18 years (n 725) who reported being familiar with their school neighbourhood.

RESULTS

Perceived availability of food outlets in the school neighbourhood was inversely correlated with distance to the closest food outlet from school and positively correlated with food outlet density within 500 m and 1000 m school buffers. Adolescents' purchase and consumption of unhealthy snacks and drinks during the school journey were associated with perceived availability of food outlets and with shorter distance to the closest food outlet from school. Mixed transport users, girls and those living in high-deprivation neighbourhoods had higher odds of purchasing and consuming unhealthy snacks and drinks during the school journey than active transport users, boys and those living in low-deprivation neighbourhoods, respectively.

CONCLUSIONS

Adolescents perceptions of the food environment and close access to food outlets in the school neighbourhood may influence adolescents' food purchase and consumption behaviours during the school journey.

Place-Based Developmental Research: Conceptual and Methodological Advances in Studying Youth Development in Context

Scientists have, for some time, recognized that development unfolds in numerous settings, including families, schools, neighborhoods, and organized and unorganized activity settings. Since the turn of the 20th century, the body of mainstream neighborhood effects scholarship draws heavily from the early 20th century Chicago School of Sociology frameworks and have been situating development in neighborhood contexts and working to identify the structures and processes via which neighborhoods matter for a range of developmental outcomes, especially achievement, behavioral and emotional problems, and sexual activity. From this body of work, two new areas of developmental scholarship are emerging. Both areas are promising for advancing an understanding of child development in context. First, cultural-developmental neighborhood researchers are advancing neighborhood effects research that explicitly recognizes the ways that racial, ethnic, cultural, and immigrant social positions matter for neighborhood environments and for youths' developmental demands, affordances, experiences, and competencies. This body of work substantially expands the range of developmental outcomes examined in neighborhood effects scholarship to recognize normative physical, emotional, cognitive, behavioral, social, and cultural competencies that have largely been overlooked in neighborhood effects scholarship that espoused a more color-blind developmental approach. Second, activity space neighborhood researchers are recognizing that residential neighborhoods have important implications for broader activity spaces-or the set of locations and settings to which youth are regularly exposed, including, for example, schools, work, organized activities, and hang-outs. They are using newer technologies and geographic frameworks to assess exposure to residential neighborhood and extra-neighborhood environments. These perspectives recognize that time (i.e., from microtime to mesotime) and place are critically bound and that exposures can be operationalized at numerous levels of the ecological system (i.e., from microsystems to macrosystems). These frameworks address important limitations of prior development in context scholarship by addressing selection and exposure. Addressing selection involves recognizing that families have some degree of choice when selecting into settings and variables that predict families' choices (e.g., income) also predict development. Considering exposure involves recognizing that different participants or residents experience different amounts of shared and nonshared exposures, resulting in both under-and over-estimation of contextual effects. Activity space scholars incorporate exposure to the residential neighborhood environments, but also to other locations and settings to which youth are regularly exposed, like schools, after-school settings, work, and hang-outs. Unfortunately, the cultural-development and activity space streams, which have both emerged from early 20th century work on neighborhood effects on development, have been advancing largely independently. Thus, the overarching aim of this monograph is to integrate scholarship on residential neighborhoods, cultural development, and activity spaces to advance a framework that can support a better understanding of development in context for diverse groups. In Chapters I and II we present the historical context of the three streams of theoretical, conceptual, and methodological research. We also advance a comprehensive cultural-developmental activity space framework for studying development in context among children, youth, and families that are ethnically, racially, and culturally heterogeneous. This framework actively recognized diversity in ethnic, racial, immigrant, and socioeconomic social positions. In Chapters III-V we advance specific features of the framework, focusing on: (1) the different levels of nested and nonnested ecological systems that can be captured and operationalized with activity space methods, (2) the different dimensions of time and exposures or experiences that can be captured and operationalized by activity space methods, and (3) the importance of settings structures and social processes for identifying underlying mechanisms of contextual effects on development. Structures are setting features related to the composition and spatial arrangement of people and institutions (e.g., socioeconomic disadvantage, ethnic/racial compositions). Social processes represent the collective social dynamics that take place in settings, like social interactions, group activities, experiences with local institutions, mechanisms of social control, or shared beliefs. In Chapter VI, we highlight a range of methodological and empirical exemplars from the United States that are informed by our comprehensive cultural-developmental activity space framework. These exemplars feature both quantitative and qualitative methods, including method mixing. These exemplars feature both quantitative and qualitative methods, including method mixing. The exemplars also highlight the application of the framework across four different samples from populations that vary in terms of race, ethnicity, gender, age, socioeconomic status (SES), geographic region, and urbanicity. They capture activity space characteristics and features in a variety of ways, in addition to incorporating family shared and nonshared activity space exposures. Finally, in Chapter VII we summarize the contributions of the framework for advancing a more comprehensive science of development in context, one that better realizes major developmental theories emphasizing persons, processes, contexts, and time. Additionally, we offer a place-based, culturally informed developmental research agenda to meet the needs of an increasingly diverse population.

Measuring environmental exposures in people's activity space: The need to account for travel modes and exposure decay

BACKGROUND

Accurately quantifying people's out-of-home environmental exposure is important for identifying disease risk factors. Several activity space-based exposure assessments exist, possibly leading to different exposure estimates, and have neither considered individual travel modes nor exposure-related distance decay effects.

OBJECTIVE

We aimed (1) to develop an activity space-based exposure assessment approach that included travel modes and exposure-related distance decay effects and (2) to compare the size of such spaces and the exposure estimates derived from them across typically used activity space operationalizations.

METHODS

We used 7-day-long global positioning system (GPS)-enabled smartphone-based tracking data of 269 Dutch adults. People's GPS trajectory points were classified into passive and active travel modes. Exposure-related distance decay effects were modeled through linear, exponential, and Gaussian decay functions. We performed cross-comparisons on these three functional decay models and an unweighted model in conjunction with four activity space models (i.e., home-based buffers, minimum convex polygons, two standard deviational ellipses, and time-weighted GPS-based buffers). We applied non-parametric Kruskal-Wallis tests, pair-wise Wilcoxon signed-rank tests, and Spearman correlations to assess mean differences in the extent of the activity spaces and correlations across exposures to particulate matter (PM2.5), noise, green space, and blue space.

RESULTS

Participants spent, on average, 42% of their daily life out-of-home. We observed that including travel modes into activity space delineation resulted in significantly more compact activity spaces. Exposure estimates for PM2.5 and blue space were significantly (p < 0.05) different between exposure estimates that did or did not account for travel modes, unlike noise and green space, for which differences did not reach significance. While the inclusion of distance decay effects significantly affected noise and green space exposure assessments, the decay functions applied appear not to have had any impact on the results. We found that residential exposure estimates appear appropriate for use as proxy values for the overall amount of PM2.5 exposure in people's daily lives, while GPS-based assessments are suitable for noise, green space, and blue space.

SIGNIFICANCE

For some exposures, the tested activity space definitions, although significantly correlated, exhibited differing exposure estimate results based on inclusion or exclusion of travel modes or distance decay effect. Results only supported using home-based buffer values as proxies for individuals' daily short-term PM2.5 exposure.

Park Area and Physical Activity Among Children and Adolescents: Findings From the Healthy Communities Study

BACKGROUND

There is currently a nationwide effort to bring parks and green spaces within a 10-minute walk of the home. We examined the association between park area within 1 km of a child's residence and self-reported park-specific physical activity (PA) along with accelerometer-derived moderate to vigorous physical activity (MVPA).

METHODS

A subsample of K through eighth-grade youth (n = 493) from the Healthy Communities Study reported whether they engaged in park-specific PA during the last 24 hours and wore an accelerometer for up to 7 days. Park area was defined as the percentage of park land in a 1 km Euclidean buffer around the participant's residence, categorized into quintiles. Analysis consisted of logistic and linear regression modeling with interaction effects that controlled for clustering within communities.

RESULTS

Regression models estimated greater park-specific PA for participants in the fourth and fifth quintiles of park land. Age, sex, race ethnicity, and family income were unrelated to park-specific PA. Accelerometer analysis indicated that total MVPA was unrelated to park area. Older children (β = -8.73, P < .001) and girls (β = -13.44, P < .001) engaged in less MVPA. Seasonality significantly predicted both park-specific PA and total MVPA.

CONCLUSION

Increasing park area is likely to improve youth PA patterns, lending support for the 10-minute walk initiative.

Investigating where adolescents engage in moderate to vigorous physical activity and sedentary behaviour: An exploratory study

BACKGROUND

There is a persistent lack of understanding on the influence of the environment on behaviour and health. While the environment is considered an important modifiable determinant of health behaviour, past research assessing environments often relies on static, researcher-defined buffers of arbitrary distance. This likely leads to misrepresentation of true environmental exposures. This exploratory study aims to compare researcher-defined and self-drawn buffers in reflecting the spaces and time adolescents engage in physical activity (PA) and sedentary behaviour. It also investigates if adolescent's access the PA facility and greenspace nearest their home or school for PA, as well as examine how much time adolescents spent in PA at any PA facilities and greenspaces.

METHODS

Adolescents (aged 14-18 years; n = 34) were recruited from schools in West Yorkshire, England. Seven consecutive days of global positioning system (GPS) and accelerometer data were collected at 15 second intervals. Using ArcGIS, we compared 30 different researcher-defined buffers including: radial, network and ellipse buffers at 400m, 800m, 1000m, 1600m and 3000m and participant-defined self-drawn neighbourhoods to objectively measured PA and sedentary space and PA time. Location of PA was also compared to Points of Interest data to determine if adolescents use the nearest PA facility or greenspace to their home or school and to examine how much PA was undertaken within these locations.

RESULTS

Our exploratory findings show the inadequacy of researcher-defined buffer size in assessing MVPA space or sedentary space. Furthermore, less than 35% of adolescents used the greenspaces or PA facilities nearest to their home or school. Approximately 50% of time spent in PA did not occur within the home, school, PA facility, or greenspace environments.

CONCLUSION

Our exploratory findings help to begin to quantify the inadequacy of researcher-defined, and self-drawn buffers in capturing adolescent MVPA and sedentary space, as well as time spent in PA. Adolescents often do not use PA facilities and greenspaces nearest their home and school and a large proportion of PA is achieved outside PA facilities and greenspaces. Further research with larger samples are needed to confirm the findings of this exploratory study.

Associations Between Parent's Perceived Neighborhood Environment and Objectively Measured Walkability With Their Children's Physical Activity

BACKGROUND

Neighborhoods are one setting to promote children's physical activity. This study examined associations between neighborhood features and children's physical activity and whether season or socioeconomic status modified these associations.

METHODS

Parents (n = 641) of children aged 6-10 years completed the Neighborhood Environment Walkability Scale-Abbreviated. Walkability was objectively measured at 400, 800, and 1200 m around the centroid of participants' postal codes. Children's physical activity was measured via StepsCount pedometers and parental report. Regression analyses were performed with interaction terms for season and socioeconomic status. Multiple imputation was used primarily to triangulate the results for children with missing steps data (n = 192).

RESULTS

Higher perceived residential density and traffic hazards were significantly associated with lower squareroot transformed parental-reported physical activity and steps per day, respectively. Higher perceived aesthetics was associated with higher squareroot transformed parental-reported physical activity. Socioeconomic status modified 2 associations though they were not significant upon stratification. During winter months, better perceived infrastructure and safety for walking was associated with higher squareroot transformed parental-reported physical activity. No other significant associations emerged.

CONCLUSION

Residential density, traffic hazards, and aesthetics are important for children's physical activity. Few associations were modified by socioeconomic status or season. The need for objective and subjective measures of the neighborhood environment and children's physical activity is apparent.

Urban environment and health behaviours in children from six European countries

BACKGROUND

Urban environmental design is increasingly considered influential for health and wellbeing, but evidence is mostly based on adults and single exposure studies. We evaluated the association between a wide range of urban environment characteristics and health behaviours in childhood.

METHODS

We estimated exposure to 32 urban environment characteristics (related to the built environment, traffic, and natural spaces) for home and school addresses of 1,581 children aged 6-11 years from six European cohorts. We collected information on health behaviours including total amount of overall moderate-to-vigorous physical activity, physical activity outside school hours, active transport, sedentary behaviours and sleep duration, and developed patterns of behaviours with principal component analysis. We used an exposure-wide association study to screen all exposure-outcome associations, and the deletion-substitution-addition algorithm to build a final multi-exposure model.

RESULTS

In multi-exposure models, green spaces (Normalized Difference Vegetation Index, NDVI) were positively associated with active transport, and inversely associated with sedentary time (22.71 min/day less (95 %CI -39.90, -5.51) per interquartile range increase in NDVI). Residence in densely built areas was associated with more physical activity and less sedentary time, and densely populated areas with less physical activity outside school hours and more sedentary time. Presence of a major road was associated with lower sleep duration (-4.80 min/day (95 %CI -9.11, -0.48); compared with no major road). Results for the behavioural patterns were similar.

CONCLUSIONS

This multicohort study suggests that areas with more vegetation, more building density, less population density and without major roads are associated with improved health behaviours in childhood.

The Importance of Outdoor Spaces during the COVID-19 Lockdown in Aotearoa—New Zealand

The novel Coronavirus (COVID-19) outbreak and its extensive variants have caused drastic changes to people’s habits and routines in many countries worldwide, including Aotearoa—New Zealand. The levels of lockdown and/or movement limitations affected how people used outdoor spaces, often keeping them away from nature’s benefits. The COVID-19 pandemic and the measures adopted to control it provide an interesting experiment investigating the links between nature exposure, recreational use of outdoor spaces, and people’s health and wellbeing under extreme conditions. Using an online survey distributed during lockdown and based on 212 responses, this article explores the different typologies of the outdoor spaces that people had access to during lockdown and the associated physical activities practised. It investigates how outdoor space affects our emotional response and how such space and related activities can help us cope with confinement. The results of this study enable us to better understand those spatial elements and characteristics of outdoor spaces that are essential to people’s wellbeing, especially in unusual circumstances where access is restricted.

Associations between Children's Physical Activity and Neighborhood Environments Using GIS: A Secondary Analysis from a Systematic Scoping Review

Regular participation in physical activity is essential for children's physical, mental, and cognitive health. Neighborhood environments may be especially important for children who are more likely to spend time in the environment proximal to home. This article provides an update of evidence for associations between children's physical activity behaviors and objectively assessed environmental characteristics derived using geographical information system (GIS)-based approaches. A systematic scoping review yielded 36 relevant articles of varying study quality. Most studies were conducted in the USA. Findings highlight the need for neighborhoods that are well connected, have higher population densities, and have a variety of destinations in the proximal neighborhood to support children's physical activity behaviors. A shorter distance to school and safe traffic environments were significant factors in supporting children's active travel behaviors. Areas for improvement in the field include the consideration of neighborhood self-selection bias, including more diverse population groups, ground-truthing GIS databases, utilising data-driven approaches to derive environmental indices, and improving the temporal alignment of GIS datasets with behavioral outcomes.

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.

Measuring the Built Environment in Studies of Child Health-A Meta-Narrative Review of Associations

Although the built environment (BE) is important for children’s health, there is little consensus about which features are most important due to differences in measurement and outcomes across disciplines. This meta-narrative review was undertaken by a multi-disciplinary team of researchers to summarise ways in which the BE is measured, and how this links to children’s health. A structured search of four databases across the relevant disciplines retrieved 108 relevant references. The most commonly addressed health-related outcomes were active travel, physical activity and play, and obesity. Many studies used objective (GIS and street audits) or standardised subjective (perceived) measurements of the BE. However, there was a wide variety, and sometimes inconsistency, in their definition and use. There were clear associations between the BE and children’s health. Objective physical activity and self-reported active travel, or obesity, were positively associated with higher street connectivity or walkability measures, while self-reported physical activity and play had the strongest association with reduced street connectivity, indicated by quieter, one-way streets. Despite the high heterogeneity found in BE measures and health outcomes, the meta-narrative approach enabled us to identify ten BE categories that are likely to support children’s health and be protective against some non-communicable disease risk factors. Future research should implement consistent BE measures to ensure key features are explored. A systems approach will be particularly relevant for addressing place-based health inequalities, given potential unintended health consequences of making changes to the BE.

Improving spatial data in health geographics: a practical approach for testing data to measure children's physical activity and food environments using Google Street View

Background

Geographic information systems (GIS) are often used to examine the association between both physical activity and nutrition environments, and children’s health. It is often assumed that geospatial datasets are accurate and complete. Furthermore, GIS datasets regularly lack metadata on the temporal specificity. Data is usually provided ‘as is’, and therefore may be unsuitable for retrospective or longitudinal studies of health outcomes. In this paper we outline a practical approach to both fill gaps in geospatial datasets, and to test their temporal validity. This approach is applied to both district council and open-source datasets in the Taranaki region of Aotearoa New Zealand.

Methods

We used the ‘streetview’ python script to download historic Google Street View (GSV) images taken between 2012 and 2016 across specific locations in the Taranaki region. Images were reviewed and relevant features were incorporated into GIS datasets.

Results

A total of 5166 coordinates with environmental features missing from council datasets were identified. The temporal validity of 402 (49%) environmental features was able to be confirmed from council dataset considered to be ‘complete’. A total of 664 (55%) food outlets were identified and temporally validated.

Conclusions

Our research indicates that geospatial datasets are not always complete or temporally valid. We have outlined an approach to test the sensitivity and specificity of GIS datasets using GSV images. A substantial number of features were identified, highlighting the limitations of many GIS datasets.

The association between natural environments and childhood mental health and development: A systematic review and assessment of different exposure measurements

BACKGROUND

Several studies have assessed the relationship between exposure to natural environments (NEs) and childhood mental health and development. In most cases, a positive association has been found, but results are inconsistent, and the strength of association is unclear. This inconsistency may reflect the heterogeneity in measurements used to assess NE.

OBJECTIVES

This systematic review aims to identify the most common NE metrics used in childhood mental health and development research. Our second aim is to identify the metrics that are most consistently associated with health and assess the relative strength of association depending on type of NE exposure measurement, in terms of metric used (i.e., measurement technique, such as remote sensing), but also rate (i.e., spatial and temporal exposure).

METHODS

We used the PRISMA protocol to identify eligible studies, following a set of pre-defined inclusion criteria based on the PECOS strategy. A number of keywords were used for retrieving relevant articles from Medline, Embase, PsychINFO, and Web of Science databases between January 2000-November 2020. From these, we extracted data on type of NE measurement and relative association to a number of indicators of childhood mental health and development. We conducted a systematic assessment of quality and risk of bias in the included articles to evaluate the level of evidence. Case studies and qualitative studies were excluded.

RESULTS

After screening of title (283 studies included), abstract, and full article, 45 studies were included in our review. A majority of which were conducted in North America and Europe (n = 36; 80%). The majority of studies used land use or land covers (LULC, n = 24; 35%) to determine exposures to NEs. Other metrics included the normalized difference vegetation index (NDVI), expert measures (e.g., surveys of data collection done by experts), surveys (e.g., self-reported assessments), and use of NE (e.g., measures of a participant's use of NE such as through GPS tracts or parent reports). Rate was most commonly determined by buffer zones around residential addresses or postal codes. The most consistent association to health outcomes was found for buffers of 100 m, 250 m, 500 m, and within polygons boundaries (e.g., census tracts). Six health categories, academic achievement, prevalence of doctor diagnosed disorders, emotional and behavioral functioning, well-being, social functioning, and cognitive skills, were created post hoc. We found sufficient evidence between NDVI (Landsat) and emotional and behavioral well-being. Additionally, we found limited evidence between LULC datasets and academic achievement; use of NE, parent/guardian reported greenness, and expert measures of greenness and emotional and behavioral functioning; and use of NE and social functioning.

DISCUSSION

This review demonstrates that several NE measurements must be evaluated further before sufficient evidence for a potential association between distinct NE exposure metrics and childhood mental health and development can be established. Further, we suggest increased coordination between research efforts, for example, by replication of studies and comparing different NE measurements systematically, so that effect sizes can be confirmed for various health outcomes. Finally, we recommend implementing research designs that assess underlying pathways of nature-health relations and utilize measurement techniques that adequately assess exposure, access, use, and perception of NEs in order to contribute to a better understanding of health impacts of surrounding natural environments.

Neighbourhood natural space and the narrowing of socioeconomic inequality in children's social, emotional, and behavioural wellbeing

INTRODUCTION

The natural environment may benefit children's social, emotional and behavioural wellbeing, whilst offering a lever to narrow socioeconomic health inequalities. We investigated whether immediate neighbourhood natural space and private gardens were related to children's wellbeing outcomes and whether these relationships were moderated by household income.

METHODS

A nationally representative sample of 774 children (55% female, 10/11 years old) from the Studying Physical Activity in Children's Environments across Scotland study. Social, emotional and behavioural difficulty scores (Strengths and Difficulties Questionnaire) represented wellbeing outcomes. Percentage of total natural space and private gardens within 100m of the child's residence was quantified using Ordnance Survey's MasterMap Topography Layer®. Linear regression, including interaction terms, explored the two main research questions.

RESULTS

A 10% increase in residential natural space was associated with a 0.08 reduction (-0.15, -0.01; 95%CI) in Emotional Problem scores and a 0.09 improvement (0.02, 0.16; 95%CI) in Prosocial Behaviour scores. Household income moderated the associations between % natural space and private gardens on Prosocial Behaviour scores: for natural space, there was a positive relationship for those in the lowest income quintile (0.25 (0.09, 0.41; 95%CI)) and a null relationship for those in the highest quintile (-0.07 (-0.16, 0.02; 95%CI)). For private garden space, there was a positive relationship for those in the highest quintile (0.15 (0.05, 0.26; 95%CI)) and negative relationship with those in the lowest quintile (-0.30 (-0.50, -0.07, 95%CI)).

CONCLUSION

The natural environment could be a lever to benefit those from less advantaged backgrounds, particularly the development of prosocial behaviours.

Sociodemographic and Built Environment Associates of Travel to School by Car among New Zealand Adolescents: Meta-Analysis

Travelling to school by car diminishes opportunities for physical activity and contributes to traffic congestion and associated noise and air pollution. This meta-analysis examined sociodemographic characteristics and built environment associates of travelling to school by car compared to using active transport among New Zealand (NZ) adolescents. Four NZ studies (2163 adolescents) provided data on participants' mode of travel to school, individual and school sociodemographic characteristics, distance to school and home-neighbourhood built-environment features. A one-step meta-analysis using individual participant data was performed in SAS. A final multivariable model was developed using stepwise logistic regression. Overall, 60.6% of participants travelled to school by car. When compared with active transport, travelling to school by car was positively associated with distance to school. Participants residing in neighbourhoods with high intersection density and attending medium deprivation schools were less likely to travel to school by car compared with their counterparts. Distance to school, school level deprivation and low home neighbourhood intersection density are associated with higher likelihood of car travel to school compared with active transport among NZ adolescents. Comprehensive interventions focusing on both social and built environment factors are needed to reduce car travel to school.