Insights into children's independent mobility for transportation cycling-Which socio-ecological factors matter?

The critical need for child and youth perceptions of active living in India: capturing context complexity in rural and urban regions

Background

The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective.

Methods

As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA.

Results

Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST (β = 18.020, 95% CI [5.890 to 30.149], p = 0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood (β =  - 21.921, CI [-36.195 to -7.647], p = 0.003) and perceptions of air pollution (β =  - 12.472, CI [-23.797 to -1.147], p = 0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA (β = 32.391, CI [9.264 to 55.518], p = 0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models.

Conclusions

These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution.

Children's Independent Mobility, School Travel, and the Surrounding Neighborhood

INTRODUCTION

Children's active travel to and from school (AST) and children's independent mobility (CIM) are consistently positively associated with physical activity (PA); however, few researchers have investigated associations between objective measures of the environment and indicators of AST and CIM in national samples.

METHODS

A national sample of 2,067 Canadian parents of 7- to 12-year-old children was recruited in December 2020. Regression analyses were used in 2023 to assess the association between geographic information system measures of park density, blue space, population density, greenspace, intersection density, and CIM and AST to and from school.

RESULTS

Children in areas with high versus low park density (>0.025 vs. ≤0.025) had higher odds of travel to school via active modes (OR: 1.47 [1.14, 1.91], p=0.003). Children in neighborhoods in the highest quartile for neighborhood greenspace (Normalized Difference Vegetation Index) were more likely to travel to home actively than those in areas of lower greenspace (OR: 1.70 [1.18, 2.45], p=0.004). On average, children living in areas in the highest versus the lowest quartile for intersection density were more likely to engage in AST to (OR: 2.43 [1.58, 3.75], p<0.001) and from (OR: 2.77 [1.80, 4.29], p<0.001) school.

CONCLUSIONS

The observed associations underscore a need for city planners and policymakers to ensure sufficient access to parks and neighborhood greenspace, especially if findings are confirmed in longitudinal studies. More research is needed to investigate the role of intersection density in supporting AST and CIM.

Determinants promoting and hindering physical activity in primary school children in Germany: a qualitative study with students, teachers and parents

Background

Determinants affecting children's physical activity (PA) at an early age are of particular interest to develop and strengthen strategies for increasing the levels of children's PA. A qualitative study was conducted to investigate the views of primary school-aged children, their teachers and parents regarding barriers and facilitators to engage in PA.

Methods

Focus groups were conducted separately with primary school children, parents and teachers in a city in Northern Germany between October 2021 and January 2022. The semi- structured focus groups with children and teachers took part in person within school, whereas the focus groups with parents took place online. Data were transcribed verbatim and analysed using thematic analysis. During analysis, the socio-ecological model was identified as useful to map the determinants mentioned and was consequently applied to organize the data.

Results

Teachers (n = 10), parents (n = 18) and children (n = 46) of five primary schools in Germany participated in the focus groups. Participants of the three groups identified similar barriers and facilitators of PA in primary school-aged children, ranging across all four layers of the socio-ecological model. The barriers encountered were the preferences of children for sedentary activities (individual characteristics), the preference of parents to control their child's actions (microsystem), a lack of financial resources from parents and long sitting times in class (mesosystem), and barriers related to rainy weather and Covid-19 restrictions (exosystem). Facilitators mentioned were the childrens' natural tendency to be active (individual characteristics), involvement and co-participation of parents or peers in engaging in PA, support provided by teachers and the school (microsystem), living in rural areas, having sufficient facilities and favorable weather conditions (exosystem).

Conclusion

A range of determinants promoting and hindering PA, ranging across all layers of the socio-ecological model were identified by children, parents and teachers in this study. These determinants need to be kept in mind when developing effective PA intervention programs for primary school-aged children. Future interventions should go beyond individual characteristics to also acknowledge the influence of childrens' social surrounding, including parents, peers and teachers, and the wider (school) environment.

Validating the Perceived Active School Travel Enablers and Barriers - Child (PASTEB-C) questionnaire

OBJECTIVES

Presently, child-specific tools and instruments related to active school travel (AST) are lacking. This methodological shortcoming often contributes to suboptimal AST behaviour evaluations and intervention programming. The aim of this paper was to develop and validate a theoretically informed child-specific scale regarding multiple perceived barriers and enablers known to impact children's participation in AST.

STUDY DESIGN

Mixed methods.

METHODS

A mixed-methods and multistudy scale development approach featuring the application of social-ecological theory, a validation pilot study (n = 80), and test-retest study (n = 96) was conducted in collaboration with children in Ontario, Canada. In tandem with completing cognitive interviews and online surveys, multiple analyses, including a qualitative thematic analysis, along with weighted Cohen's kappa, Cronbach's alpha, and confirmatory factor analysis were undertaken.

RESULTS

Qualitative analyses of the developed tool addressed face validity concerns related to the response options and definitions of terms used. Following the reliability analyses of 40 items, two confirmatory factor analyses were run to assess the construct validation of perceived AST barriers and enablers, and resulted in the development of the 24-item Perceived Active School Travel Enablers and Barriers - Child (PASTEB-C) questionnaire.

CONCLUSION

The developed PASTEB-C questionnaire may be used to inform the programming and development of AST interventions, as well as conduct child-specific AST research.

Blame attribution analysis of police motor vehicle collision reports involving child bicyclists

BACKGROUND

Injuries resulting from collisions between a bicyclist and driver are preventable and have high economic, personal and societal costs. Studying the language choices used by police officers to describe factors responsible for child bicyclist-motor vehicle collisions may help shift prevention efforts away from vulnerable road users to motorists and the environment. The overall aim was to investigate how police officers attribute blame in child (≤18 years) bicycle-motor vehicle collision scenarios.

METHODS

A document analysis approach was used to analyse Alberta Transportation police collision reports from Calgary and Edmonton (2016-2017). Collision reports were categorised by the research team according to perceived blame (child, driver, both, neither, unsure). Content analysis was then used to examine police officer language choices. A narrative thematic analysis of the individual, behavioural, structural and environmental factors leading to collision blame was then conducted.

RESULTS

Of 171 police collision reports included, child bicyclists were perceived to be at fault in 78 reports (45.6%) and adult drivers were perceived at fault in 85 reports (49.7%). Child bicyclists were portrayed through language choices as being irresponsible and irrational, leading to interactions with drivers and collisions. Risk perception issues were also mentioned frequently in relation to poor decisions made by child bicyclists. Most police officer reports discussed road user behaviours, and children were frequently blamed for collisions.

CONCLUSIONS

This work provides an opportunity to re-examine perceptions of factors related to motor vehicle and child bicyclist collisions with a view to prevention.

Social-Ecological Correlates of Children’s Independent Mobility: A Systematic Review

Children’s independent mobility (IM) is associated with a range of benefits and understanding the factors that influence IM can support creation of effective interventions. The review (Prospero CRD42016042174) systematically summarized the available literature for social-ecological correlates of children’s IM in school-aged children and youth (aged 5–17 years). In this case, 53 studies were included and evaluated six individual, 15 interpersonal, 12 social environment, and 19 built environment- level variables. Most studies originated from Australia (n = 15) and Canada (n = 8) with most published in 2011 or later (n = 48). Variables that were consistently (positively and/or negatively) associated with children’s IM were age, ethnicity/race, child’s perceived competence, ownership of a house/access to house keys, having siblings, parents’ attitude toward IM and perception of child’s confidence, children’s interest in environment and activities, parents’ concern around traffic, housing/residential density, length of residency in one’s home, distance to destinations, and proximity to green space. Given the inter-related social-ecological correlates identified, intervention to promote children’s IM will likely need a multi-level and multi-sectoral approach. However, focus areas of building children’s skills and confidence, helping parents gain confidence in their children’s abilities, assuaging parental traffic concerns, and building environments with shorter distances to destinations of interest for children should be prioritized.

Parent's sociodemographic factors, physical activity and active commuting are predictors of independent mobility to school

Background

Independent mobility (IM) provides young people with many opportunities to increase their autonomy and physical activity (PA). This study aimed to analyse whether the parent’s PA, active commuting to work and sociodemographic factors serve as predictors of IM to school in children and adolescents.

Methods

A total of 684 parents (52.8% mothers) and their offspring (56.4% girls) were included in this study, which was performed in Granada (Spain) and Valparaíso (Chile). The parents self-reported their sociodemographic characteristics, PA and mode of commuting to work. The mode of commuting to and from school and the offspring accompaniment mode were reported. T-test and chi-square test were used to study quantitative and qualitative differences by parental gender, respectively. Binary logistic regression models (odds ratio = OR) and stepwise analysis were performed to study the association between the parents’ sociodemographic variables and IM to school.

Results

Adolescents showed higher IM to school than children (58.9% vs 40.2%; p < 0.001). No car availability and shorter distance to work were positively associated with higher IM to school in children (OR = 2.22 and 2.29, respectively). Mothers' lower salary/month (OR = 2.75), no car availability (OR = 3.17), and mother passive commuting to work (OR = 2.61) were positively associated with higher IM to school in adolescents. The main predictor of IM to school in children and adolescents was no car availability (OR = 6.53).

Conclusion

Parental sociodemographic factors, such as salary, distance to work and car availability, were associated more strongly with IM than parental PA and active commuting to work.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12942-021-00280-2.

Anterior cruciate ligament injury: towards a gendered environmental approach

BACKGROUND

The anterior cruciate ligament (ACL) injury rate for girls/women has not changed in over 20 years, and they remain 3-6 times more likely to experience injury compared with boys/men. To date, ACL injury prevention and management has been approached from a sex-based biological point of view which has furthered our understanding of injury risk factors, mechanisms, and prevention and rehabilitation programmes. However, the traditional sex-based approach does not take into account the growing recognition of how sex and gender (a social construct) are 'entangled' and influence each other.

OBJECTIVE

This paper discusses the curious absence of gender as an influencer in the dialogue surrounding ACL injuries. We propose adding gender as a pervasive developmental environment as a new theoretical overlay to an established injury model to illustrate how gender can operate as an extrinsic determinant from the presport, training and competition environments through to ACL injury and the treatment environment.

APPROACH

We draw on social epidemiological theories of the embodiment of gender and health to provide plausible examples of how gender may influence ACL injury, and demonstrate the opportunity for new, interdisciplinary research in the field.

CONCLUSION

Over 20 years of research has failed to decrease the ACL injury rate disparity between girls/women and boys/men. Embedding gender in the study of ACL injury will heighten awareness of possible influences outside the traditional biological elements, challenge us to think about the inextricable 'entanglement' of sex and gender, and inform more effective approaches to ACL injury prevention and treatment.

Housing and Community Environments vs. Independent Mobility: Roles in Promoting Children's Independent Travel and Unsupervised Outdoor Play

Children’s independent mobility (CIM) has declined dramatically in recent decades despite its benefits in facilitating childhood development, promoting physical activity, and combating the obesity epidemic. This US-based study examines the impacts of housing and neighborhood environments on two modes of CIM—home-based independent travel to non-school destinations and unsupervised outdoor play—while considering personal and social factors. A bilingual parent/guardian survey was distributed to public elementary schools in Austin, Texas, asking about children’s travel and play, housing and neighborhood environments, and personal and social factors. A Google Street View audit was conducted to capture additional housing-related information. Logistic regressions were used to predict CIM. For second to fifth graders (N = 525), less than two-thirds of the parents would allow children’s independent travel to non-school destinations (62%) and unsupervised outdoor play (57.9%), with the majority limited to a short distance (five-minute walk) and a few destinations (e.g., friend’s/relative’s home). Stranger danger was a negative predictor and the presence of friend’s/relative’s home was a positive predictor for both modes of CIM. Quality of neighborhood environment was another positive correlate for independent travel to non-school destinations. Significant personal and social factors were also identified. Study findings demonstrated the impacts of physical environments on CIM and the potential of using relevant interventions to promote children’s health and development.

Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

BACKGROUND

Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement.

METHODS

The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan.

RESULTS

Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit.

CONCLUSION

Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

Safety aspects of riding with children: Descriptive analysis of adult riders' self-report

Active transport, including cycling, is promoted as an effective way of increasing children's physical activity and health. Parents can support children's riding by riding with them and it is important to address relevant safety issues. Little is known about parents' experience of safety-relevant aspects of riding with children. Participants in the Safer Cycling Study in New South Wales, Australia, who reported that they had ridden with children in the last 12 months were questioned about how they ride with children, and their experience of safety issues and crashes. Among the 187 respondents who had ridden with children on their bicycle, the most common form of carrier was a rear-mounted seat (48%) followed by a trailer (29%). Many respondents (79%) identified risks specific to riding carrying children, including those linked with specific carrier types and with use of footpaths. Most (92%) indicated that they change their behaviour when carrying a child on their bicycle; for example, riding more slowly, more carefully, and away from roads. Among crashes with a child on the bicycle, most were falls. Among the 345 participants who had ridden to accompany a child on a bicycle, approximately three quarters identified risks specific to accompanying children, such as managing the child's limited skill, awareness and predictability. Ninety-seven percent reported behavioural changes including positioning themselves as a barrier for their child and caution crossing roads. Findings suggest strategies to support parents in riding safely with children.

Individual, social and neighbourhood correlates of cycling among children living in disadvantaged neighbourhoods

OBJECTIVES

To describe cycling behaviours and examine individual, social and neighbourhood correlates of cycling among children living in socio-economically disadvantaged neighbourhoods.

DESIGN

Cross-sectional.

METHODS

Mothers of 289 children (46% boys) aged 8-15 (mean 12±2.2) years living in disadvantaged neighbourhoods in Victoria, Australia were surveyed about their child's cycling frequency and duration in a typical week. Perceptions of cycling, cycling ability, cycling behaviours and road safety were proxy- and self-reported by mothers. Shortest road distance from home to school was determined using a Geographic Information System. Multivariable logistic regression analyses examined associations between individual, social and neighbourhood variables and cycling frequency (>once/week) and duration (>60min/week).

RESULTS

Overall, 70% of boys and 49% of girls cycled>once/week; rates of cycling for >60min/week were 60% and 32%, respectively. Children had greater odds of cycling>once/week if they enjoyed cycling for fun (OR=13.3, 95%CI=2.0, 86.9). Children had greater odds of cycling for >60min/week if they enjoyed cycling for fun (OR=17.1, 95%CI=1.7, 167.7) or if they were allowed to cycle on main roads (OR=3.2, 95%CI=1.1, 9.1). Children who had to cross several roads to access play areas had lower odds of cycling for >60min/week (OR=0.3, 95%CI=0.1, 0.7).

CONCLUSIONS

Future research should investigate strategies to increase children's enjoyment of cycling, independent mobility and safe access by cycling to key destinations such as play areas.

Children's Transport Built Environments: A Mixed Methods Study of Associations between Perceived and Objective Measures and Relationships with Parent Licence for Independent Mobility in Auckland, New Zealand

Children's independent mobility is declining internationally. Parents are the gatekeepers of children's independent mobility. This mixed methods study investigates whether parent perceptions of the neighbourhood environment align with objective measures of the neighbourhood built environment, and how perceived and objective measures relate to parental licence for children's independent mobility. Parents participating in the Neighbourhood for Active Kids study (n = 940) answered an open-ended question about what would make their neighbourhoods better for their child's independent mobility, and reported household and child demographics. Objective measures of the neighbourhood built environment were generated using geographic information systems. Content analysis was used to classify and group parent-reported changes required to improve their neigbourhood. Parent-reported needs were then compared with objective neighbourhood built environment measures. Linear mixed modelling examined associations between parental licence for independent mobility and (1) parent neighbourhood perceptions; and (2) objectively assessed neighbourhood built environment features. Parents identified the need for safer traffic environments. No significant differences in parent reported needs were found by objectively assessed characteristics. Differences in odds of reporting needs were observed for a range of socio-demographic characteristics. Parental licence for independent mobility was only associated with a need for safer places to cycle (positive) and objectively assessed cycling infrastructure (negative) in adjusted models. Overall, the study findings indicate the importance of safer traffic environments for children's independent mobility.

Precision medicine and healthy living: The importance of the built environment

The built environment encompasses the major physical spaces, including buildings, streets, homes, schools, parks, playgrounds and other infrastructure in which we live, work and play. In an ideal world, the built environment should support and facilitate a healthy engagement in physical activity across the lifespan. However, in the context of an environment characterized by increased mechanization and urbanization, physical inactivity and higher levels of overweight and obesity, too many settings are not conducive to physical activity and/or are not safe and walkable. In the knowledge that there are multiple challenges to redress the low levels of physical activity seen in many parts of the world, this paper provides some examples of opportunities for healthy living (HL) in a built environment characteristic of an increasingly urbanized world. Particular foci include opportunities for HL fostered in child-friendly cities, in which walkability is high, and active transport is encouraged and supported.

Children's Independent Mobility: Current Knowledge, Future Directions, and Public Health Implications

Environmental changes significantly impact health behavior. Active travel behavior is mostly affected by increasing motorization, urban sprawl, and traffic safety. Especially for children, active and independent travel can contribute to physical activity, social and motor development, and other health-related outcomes. A reduced number of children engaging in independent mobility over the last 20 years demanded researchers to further examine the construct of children’s independent mobility. By examining relevant literature, this narrative review aims to provide the current state of knowledge on children’s independent mobility, and identify future directions in research, as well as practical implications. From a public health perspective, considering children’s independent mobility in intervention programs is recommended, since it is associated with numerous health and environmental benefits. To develop interventions, multilevel socio-ecological influences on children’s independent mobility are widely examined; however, evidence is limited due to heterogeneous measurements and a lack of high-quality prospective studies. To oppose the decline in children’s independent mobility, further analysis using comparable measures is needed to understand the determinants of children’s independent mobility and to enable international comparison.

Parents' and adolescents' perception of traffic- and crime-related safety as correlates of independent mobility among Belgian adolescents

The independent mobility (IM), defined as the freedom of young people to travel without adult supervision, has been related to the physical activity time, the acquisition of personal autonomy, to less intense fear of crime, and to a stronger feeling of being part of their community and other health and social benefits. The aims of this study were to compare parents’ and adolescents’ traffic- and crime-related safety perceptions of their neighborhood and to analyze the associations of these perceptions with adolescents’ IM. A total of 291 adolescents and their parents completed the Neighborhood Environment Walkability Scale (NEWS) questionnaire. Multilevel (two-level models: individual level—neighborhood level) regression analyses were conducted to examine whether the environmental perceptions differed between parents and adolescents and the association between the parental and adolescents’ perception to the IM and the active independent mobility (AIM). Parents reported a more negative perception of traffic (except for amount and speed) and crime-related safety. Adolescents’ environmental perceptions were not associated with their IM but parental perceptions of traffic- and crime-related safety were associated with IM and with active IM, although not all associations were in the expected direction. Future urban policy efforts should address environments where parents perceive sufficient levels of safety to increase the levels of IM in adolescents.

Social and physical environmental correlates of independent mobility in children: a systematic review taking sex/gender differences into account

BACKGROUND

Children's independent mobility (CIM) is an important contributor to physical activity and health in children. However, in the last 20 years CIM has significantly decreased. To develop effective intervention programs to promote CIM, the impact of the environment on CIM must be identified. This review seeks to provide an overview of sex/gender-specific socio-ecological correlates of CIM.

METHODS

A systematic literature search of five databases (PubMed, PsycInfo, Scopus, Medline, Web of Science) was conducted with a priori defined eligibility criteria and identified 1838 potential articles published between January 1990 and November 2017. Two independent reviewers screened the literature and identified and rated methodological quality of the studies. Related factors of CIM were summarized separately for CIM license (parental permission to travel independently) and CIM destination (destinations to which a child travels independently), and separately for boys and girls using a semi-quantitative method.

RESULTS

Twenty-seven peer-reviewed journal articles were identified which examined the relationship between the social and physical environment and CIM. Only seven studies reported results divided by sex/gender. Most associations between the environment and CIM were found in the expected direction (positive or negative) or not associated at all. The social environment seemed to be more influential for ensuring CIM than the physical environment. Neighborhood safety, fear of crime and stranger, parental support, and perception of traffic were important social environmental factors influencing CIM, while car ownership, distance, and neighborhood design were relevant physical environmental attributes. Few studies examined sex/gender-related environmental correlates of independent mobility, and those findings were inconsistent.

CONCLUSION

The findings of this systematic review serve as suggestions for intervention programs to increase CIM and to identify future directions in research. To establish a robust comprehension of the impact of the social and physical environment on CIM, further sex/gender-sensitive studies using comparable measurements for CIM and environmental correlates are needed.