Active Living Research

This workshop informed participants about (a) the advantages and disadvantages of using direct observation to assess physical activity and its contexts, (b) published observation tools for assessing physical activity and related contextual variables (e.g., accessibility, usability, and presence of supervision, equipment, and organized activities) in various settings, including school leisure time at school (SOPLAY), community parks and recreation centers (SOPARC), and wilderness areas (SOPARNA); and (c) viable procedures for training and maintaining reliable observers and managing and analyzing data.

Discussion included definitions of behavioral categories of interest, protocols for use (e.g., pacing of observations), coding conventions (i.e., interpretations of common scenarios), observation techniques (e.g., duration, frequency, interval, and time-sampling recording), observer training and recalibration, inter-observer reliability, subject reactivity, activity level validation, and practical issues.  Interactive features included (a) participants completing a short questionnaire, (b) participants using coding sheets while responding to video segments from training DVDs, and (c) experienced researchers providing their own examples relative to events such as training and maintaining observers, purchase and maintenance of observational equipment, accessibility to locations, human subjects consent, assessing reliabilities, and data summary and analyses.

Learning Objectives:

• Explain advantages and disadvantages of various direct observation methods.
• Select from among current observational tools and modify them to suit their individual research needs.
• Interact with experienced observational researchers relative to issues such as observer training, mapping of areas, and data recording, storage, aggregation, summary, and analysis.

Growing awareness about the dangers of a sedentary lifestyle means we need to find more evidence-based ways to add activity to our days. Instant Recess® breaks are scientifically designed to maximize energy expenditure and enjoyment, while minimizing injury risk and perceived exertion for the average, relatively sedentary and overweight individual.  This workshop covered the following: (1) introduction to the Instant Recess® activity break, its theoretical foundation, and a review of literature on the benefits of brief bouts of activity; (2) discussion of how Instant Recess® breaks are developed and utilized effectively in various settings, including schools, worksites, and religious institutions; and (3) interactive session to help develop the ALR Instant Recess® break to be used later in the day at a plenary session of the conference. Attendees learned basic strategies for implementation in the different key settings. This session also demonstrated the use of the KEEN Recess ROI Calculator for attendees to estimate the costs and benefits of Instant Recess® implementation within their own organizations, and broached concerns or questions about intervention adoption and maintenance.

• Identify three benefits of short physical activity breaks.
• Identify four basic components of an Instant Recess® break.
• Identify two strategies for implementing Instant Recess® breaks into settings that they frequent.

his three hour workshop allowed participants to learn about two devices that can help improve measurement of travel behavior, sedentary behavior and the contexts in which they occur.  The workshop focused on GPS devices that can assess travel mode and locations and the SenseCam which is a person worn camera that captures images which can then be coded to ascertain behaviors, built environments and social context.

In part 1 of the workshop presenters introduced the devices, described their research applications, and presented some sample data. In part 2, they taught participants how to use the devices in a research setting, addressing participant compliance issues, device set up and downloads, and IRB issues. Participants wore the devices to collect test data. Part 3 of the workshop focused on processing data, worked examples and participant hands on experience with two programs designed to process GPS data (PALMS) and SenseCam data (Clarity). Part 4 addressed some of the practicalities of purchasing devices, developing pilot projects and writing grants that include these new technologies to improve measurement of active travel and sedentary behavior.

Learning Objectives:

• Explain why technologies like the SenseCam and GPS can improve our ability to measure active commuting and sedentary behaviors and why this is also important for interventions.
• Identify basic skills needed to conduct a study using these devices.
• Demonstrate core skills related to using these devices in future studies.

Effective interventions begin with a comprehensive analysis of existing needs, followed by solutions that address those specific needs.  The Playful City USA program requires communities to conduct a needs assessment, develop action plans for play, and implement and evaluate those plans to increase and enhance communities’ opportunities to play and engage in healthy living.  This workshop reviewed Best Practices in Play case studies from communities across California that are using innovative techniques to promote healthy living.  Participants had a chance to engage in breakout sessions with the workshop facilitators to learn how to adapt these best practices based on the needs and assets of their own community.

This workshop’s panel of experts featured: 1) Rancho Cucamonga’s Healthy RC Kids Partnership committed to developing policies, including land-use and vending policies, educational partnerships, and infrastructure improvements to facilitate opportunities for physical activity and ensure access to nutritious food. 2) City of Baldwin Park Recreation Department returns to its recreational roots through an assessment of existing resources, which prompted them to put all recreation resources into use, from park land to tug-o-war ropes. By using their recreation materials creatively, they increased participation in outdoor activities while creating a cycle in which more visible park use led to even greater participation at parks.

Learning Objectives:

• Analyze successful case studies of communities in California and determine components that have positively impacted the health and well-being of its residents.
• Identify existing assets (human, infrastructure, organizational, policy) in participants’ communities as a first step toward developing creative partnerships to implement more comprehensive healthy living goals.
• Identify and adapt the most relevant model for each participant’s community.

Background
According to a study by the Federal Highway Administration, in 1969 about half of all students walked or bicycled to school. Similar studies showed that today fewer than 15% of all school trips are made by walking or bicycling, and over half of all children arrive at school in private automobiles. This decline in walking and bicycling has had an adverse effect including a risk for a variety of health problems. Safety issues are a big concern for parents, who consistently cite traffic danger as a reason why their children are unable to bicycle or walk to school.

This research describes the analysis results of the 2009 National Household Travel Survey (NHTS) focusing on how students' and/or parents’ view of issues related to the walking and biking environments; and the implication of their attitude on students’ travel behavior. The survey includes latent responses about how students and/or their parents view various aspects of the walking and biking environments. It is hypothesized that students’ and/or their parents’ attitude towards the walk/bike issues would be a factor in their choice of different modes of transportation and their other travel behaviors.

Objectives
The primary objective of this study is to understand the parametric and causal relationship between attitude towards walking and biking environments and students’ travel behavior. Also, it sought to find whether attitude towards specific walk/bike issue may persuade students to make a healthy travel choice.

Methods
The recently released National Household Travel Survey (NHTS) is used for the analysis by sorting and filtering the attitude variables for school-related trips. NHTS is one of the most important surveys of the U.S. Department of Transportation and is conducted periodically to assess the mobility of the American public. The survey gathers trip-related data such as mode of transportation, duration, distance, and purpose, and then links the travel related information to demographic, geographic, and economic data. The 2009 NHTS is a nationally representative survey of travel behavior conducted from April 2008 through April 2009. Using the data sets, Ordered Probit Model is applied for parameters estimation and formulating the likelihood functions. The reason this method is chosen is that the rating for respondents view on walk/bike issue are inherently ordered, although it is a multinomial choice variable. In such cases although the outcome is discrete, the multinomial logit or probit models would fail to account for the ordinal nature of the dependent variable, therefore, ordered models have the power to accommodate the ordered/ranking nature of the dependent variable. In the modeling process, the respondents’ ranked response on their attitude towards the walk/bike issues is considered as the dependent variable. Since the aim of the study is to investigate the effect of attitude on travel behaviors, variable related to the trip-maker, the trip itself and location factors were considered as independent/explanatory variables.

Results
Out of the 22,000 respondents that answered school-related questions about 57% of them lived in a distance of more than 2 miles from their school. Only 7% lived with less than ¼ miles. The majority of respondents stated automobile as their primary mode to and from school (53% to school and 46% from school). A significant percentage of students claimed to use public transit (37% to school and 41% from school). Only 8% and 11% respectively said they walk or bike for their trip to and from school. When the walk/bike issues (the possible reasons for not walking and biking) are concerned the result indicated that distance between home and school and the amount and the speed of traffic along the route are cited by many students and/or their parents as major issues. On the contrary, violence/crimes along route and weather/climate in school/residence area are considered as less of an issue by the majority of respondents. The ordered probit results in this study draws interesting causal relationship between students/parents perception about the walking and biking environment and the explanatory variables such as age and gender of the students, weather the attended school is private or public, travel time to reach to school, grade students are allowed to walk or bike with an adult etc. It is also observed that the attitude the respondents have on the walking and biking environments greatly influence their mode preference. Besides, the socio-demographic and mode-related variables have an influence on the way students or their parents perceive different attributes of the walking and biking environments (or the vice versa).

Conclusions
The modelings as well as the descriptive results give a significant insight for local communities, planning officials and municipal government in providing walk/bike friendly routes to and from school. This study signifies that planners and transportation service providers ought to give appropriate attention to this latent variable (attitude/perception towards the walking and biking environments) along with revealed preference variables.

Support/Funding
California State University, Northridge.

Background
Home-to-school distance is consistently identified as the strongest barrier to active school transportation. However, what is a walkable distance remains unclear as most studies used subjective measures of distance. It is possible that this threshold may vary by physical and socioeconomic contexts. A better understanding of the threshold of walkable distance will inform school planning and development. In addition to distance, measures of other environmental factors have also relied on subjective measures or objective yet aggregated measures (i.e., not specifying the environmental measure for individual students’ school travel).

Objectives
1) To identify the threshold of walkable distance for elementary school children and examine if this threshold varies by physical and socioeconomic contexts; 2) to examine the impacts of individualized, objective school travel environment and personal and social factors on children’s walking-to-school behaviors.

Methods
A combination of parental survey and GIS analyses (n=2,597) was used in this cross-sectional study. The survey was conducted in 20 public elementary schools in the Austin Independent School District. The school sample is representative of the diverse physical and socio-demographic characteristics of the district. The survey collected information for students’ school travel modes, personal and social factors, and parents’ perceptions of school travel environment. Based on the address information from the survey, students’ home-to-school routes were generated in GIS and used as individualized units for the GIS analyses of objective school travel environment. The GIS-generated shortest routes showed moderate to high validity when being compared with the actual home-to-school routes drawn by parents (n=30).

Bivariate and descriptive analyses were used to examine the threshold of walkable distance and the bivariate associations among the objective distance, the parental perception of walkable (close enough) distance, and the outcome of walking to/from school. Structural Equation Modeling (SEM) was conducted to examine the impact of individualized, objective school travel environment, and personal and social factors on walking to/from school. Clustering effect by school was addressed using the multilevel SEM approach.

Results
The percentages of “Yes” and “No” for “parental perception of close-enough distance” and “behavioral outcome of walking to/from school” in each distance range (0.125 mile interval) helped to visualize the threshold of walkable distance (Figure 1 and Table 1). The threshold is defined as the point where the percentage of “No” for “perceiving distance as close enough for walking” (or “actually walking to/from school”) starts to exceed the percentage of “Yes” (Figure 1).

The walkable threshold for the “outcome of walking to/from school” is 0.5 mile for the whole sample, and is 0.625 mile and 0.375 mile respectively, for the inner-city schools and the suburban schools. Compared to inner-city schools, suburban schools have a much higher threshold for “parental perception of close-enough distance” (1.125 mile for suburban vs. 0.625 mile for inner-city), likely because other environmental features (safety, aesthetics, maintenance) are more favorable in suburban neighborhoods. However, the threshold for “actually walking to/from school” is higher in inner-city schools (O.625 mile) than in inner-city schools (0.325 miles), possibly because some lower-income children in these schools are “captive walkers” with no transportation options except walking.

Figure 2 presents SEM results. Among individualized, objective environmental measures, the objective distance (OR=0.375, P<0.001) and the presence of freeway barrier (OR=0.394, P<0.5) are two significant barriers to walking to/from school. Among personal and social factors, parental education, car ownership, personal barriers (time constraint, etc.), and school bus service availability are negative correlates, while the number of family members, positive attitude toward walking, and positive peer influence are positive correlates.

Conclusions
The analysis of individualized, objective physical environment re-confirmed the negative impacts of distance and freeway barrier on walking to/from school. The results suggest the importance/potential of centrally-located neighborhood schools and barrier (freeway)-free attendance areas in promoting active school transportation. The context-specific thresholds for walkable distance provide important evidence for future school planning and development.

Support/Funding
This study is supported by a grant from the Robert Wood Johnson Foundation Active Living Research Program.

Background
Walking to school is promoted as a healthy alternative to being driven to school. However, private automobile transportation remains the predominant travel mode chosen by the parents, with its mode share of 55% as of 2001 (McDonald 2007). In addition to personal factors, studies found many environmental factors associated with school travel behaviors. Distance by far has shown to be the strongest environmental predictor of school travel mode choice, followed by safety and weather (Martin and Carlson 2005, McDonald 2007, Salmon et al. 2007). However, shortening the distance to school is not simple, as it requires long-term, multi-level policy and environmental changes, such as school siting, zoning, and land development policies/practices.

Objectives
This research probes into what environmental factors, other than distance, require further attention when developing strategies to encourage walking to school. Utilizing pairs of children matched in their home locations but varied in their school mode choice, this study offers insights into more readily modifiable environmental features than the physical distance, that can help parents shift their children's school travel mode from automobile transportation to walking.

Methods
This study was conducted in 22 elementary schools in Austin, Texas, representing a wide range of ethnic and economic compositions (2.3%-97.0% eligible for special lunch, and 5.2%-94.9% Hispanic, TEA). It used two rounds of recently completed parental surveys (response rates=22.7% and 34.2%). The survey instrument was developed based on the literature and three previously validated instruments (Varni et al. 2001, McMillan 2003, Forman et al. 2008). This study analyzed a subset of 699 walker-driver pairs with each pair attending the same school and living in the same or close (≤ 200 feet) home locations. "Walkers" versus "drivers" in this abstract refer to parents of children who walked versus drove their children to school. Geographic Information System was used to geocode home locations and to generate the shortest routes to school to determine the distance. Paired sample t-tests were used to assess the statistical significance (p<0.05) of the differences between walkers and drivers.

Results
From the 699 pairs of children, 76.5% were Hispanic (78.0% for walkers and 75.0% for drivers); the mean grade was 1.79 (1.90 and 1.68, respectively); 46.5% (46.2% and 46.8%) were boys; and 81.4% (82.7% and 80.3%) qualified for special lunch. Over 20% among drivers were college graduates, compared to 7.7% among walkers. Car ownership was slightly higher for drivers with 1.67 cars per household compared to 1.41 for walkers.

Although the distance was the same in each pair, walkers were more likely to consider the distance to be close enough for walking than drivers (72.6% vs. 61.7%). Notably, 61.7% of the drivers still considered the distance to school to be walkable, confirming the presence of other important environmental and personal barriers to walking. Compared to drivers, walkers were more likely to agree that both their children and they walk quite often in the daily routine; they enjoy walking with their children; and their children think walking to school is "cool." Walkers also perceived their environments to be convenient and quiet, and have social supports, such as seeing other children in their neighborhoods walking to school and having family and friends supporting the idea of walking to school. Findings also showed some evidence of residential self-selection, as walkers were more likely to consider "close to my child's school" and "easy to walk around," when choosing current neighborhood locations.

The major determinants for parents to drive their children were safety concerns. Drivers were significantly more concerned about their children getting lost, being taken or hurt by a stranger, being attacked by stray dogs, and being hit by a car, while walking to school. In addition, drivers felt more strongly about driving being easier and faster than walking.

Regarding the quality of home-to-school routes, walkers were more likely to report the presence of parks, while drivers were more likely to perceive convenience stores (which often accompany gas stations in our study area), bus stops, large office buildings, and roads with busy traffic. Walkers responded more negatively about the sidewalk conditions, which can be explained by the fact that
only those who use the sidewalks (i.e., walkers) will be aware of problems such as maintenance and blockage.

Conclusions
Walkers' attitudes toward walking and perceptions of their neighborhood environments were more positive than drivers'. The major parental determinants for driving their children were safety concerns related to traffic, crime, injury and being lost. Policies and environmental improvements to enhance safety of child pedestrians appear to be the key to facilitate mode shift from driving to walking. Continued efforts to improve sidewalk conditions and social supports seem important to keep current walkers walking (more).

Support/Funding
This study was funded by two grants from the Robert Wood Johnson Foundation's Active Living Research program (Grant ID: 65539 and 65695).

Background
Changes in physical activity (PA) levels can be observed among youth. The majority of 11 year olds in Denmark do meet the recommend level of PA; the majority of 15 year olds do not. The chances of not meeting the recommended level of PA as adults are correlated with not meeting them at 15. For that reason, reducing the number of 15 year olds that do not meet the recommended level of PA is of great interest. There are many hypotheses as to what causes these changes, but no consensus has been reached. One hypothesis currently explored in Denmark is that youth are more active if they live in an attractive neighborhood with abundant possibilities for them to be physically active. However, relatively little is known about where youth like to be active, the activity hotspots, and how these sites look. A large scale neighborhood renewal project, with focus on increasing the possibilities for youth to be active, is currently being executed by the City of Copenhagen. This neighborhood renewal project provided a unique opportunity to study the changes in activity levels in this neighborhood in a natural experiment that will include both baseline and follow-up measurements.

Objectives
The overall objective of the When Cities Move Children (WCMC) study is to determine the effects of urban renewal on objectively measured physical activity levels and activity patterns among youth (10-16yrs old) living in a deprived area with 40 % having a multi-ethnic background, in Copenhagen, Denmark. The specific objective for this paper is to identify and describe hotspots for physical activity of the study participants at baseline.

Methods
For our baseline study, carried out in spring 2010, 551 youth enrolled at three public schools were asked to wear an accelerometer (ActiGraph GT3X) and a GPS (Qstarz BT-Q1000X) for 7 days (5 week days, 2 weekend days) to determine their level of activity and movement patterns. Their GPS position was recorded every 15 seconds and their activity level was recorded every 2 seconds.

Accelerometer data were compiled using the computer software Propero, recently developed by researchers at the University of Southern Denmark. Data were examined for extreme accelerometer values (above 20.000 counts and negative values) and participants were included in further analysis if they had at least 4 valid days (including at least 1 weekend day) of at least 8 hours wear time between 6am and midnight. Non-wear was defined as 60 or more minutes of consecutive zeros, allowing for two activity epochs in each block of non-wear.

All GPS and accelerometer data were compiled and joined using an internet based computer program, the Physical Activity Location Measurement System (PALMS), developed by researchers at the Center for Wireless & Population Health Systems at the University of California, San Diego. The outputs PALMS produces consist of filtered and cleaned GPS points linked with PA data for those points. All PALMS outputs were imported into ArcGIS, a Geographic Information Software package, which enabled inclusion of environmental data. ArcGIS served as platform for further analysis and identification of neighborhood activity hotspots. Neighborhood activity hotspots were defined as all locations with a least 5 different individual hotspots. For each participant individual hotspots consist of all locations where at least 4 consecutive GPS points that are part of an activity bout can be found within a 50 meter radius. An activity bout was defined as a period of at least 5 minutes of at least moderate activity (using Freedsons age adjusted cut-off points), allowing for maximum 2 minutes of activity below this threshold.

Results
Accelerometer data were downloaded for 454 participants, and 271 participants qualified for inclusion in further analysis. Based on data from these participants, neighborhood activity hotspots primarily consist of schoolyards, sports facilities and shared backyards between multistory social housing complexes. Our results also show age, gender and time differences with different areas being popular for different age groups, at different times of the day, and at different days of the week.

Conclusions
Shared backyards to large social housing areas are crucial places for PA among many of our respondents, suggesting that these sites deserve more attention in future studies. Our study furthermore shows the potential of combining accelerometer, GPS and GIS data, but the large amount of data, and need for specialized software and advanced GIS tools to work with the data means that many methodological and technical challenges remain to be solved.

Support/Funding
This study was supported by the The TrygFonden Centre for Applied Research in Health Promotion and Disease Prevention.