城市体力活动相关建成环境的评价工具进展

体力活动水平是影响个体健康重要的、可干预的因素之一[1].经常进行体力活动能够有效减少诸多慢性病,如心血管疾病等发病风险[2,3].建成环境(built environment)指人为建设改造的各种建筑物、场所,尤其指那些可以通过政策、人为行为改变的环境[4].近年来,国外研究者越来越多关注建成(物理)环境对个体体力活动水平的影响[5],以健康生态学模型为理论指导,开展了一系列建成环境与个体体力活动之间的关联研究,在研究内容和方法学上做了有益的探讨和拓展.国外的多项研究结果发现两者之间存在关联[6].     

四城市成年人主观感知建成环境与休闲性体力活动的相关性研究

目的 探讨4城市社区成年居民主观感知的建成环境与休闲性体力活动之间的相关性。方法 2017年6月至2018年7月采用多阶段整群随机抽样方法抽取杭州、苏州、成都和青岛市25～64岁成年人,使用社区环境步行适宜性量表简版和国际体力活动问卷长版评估建成环境和休闲性体力活动水平,采用广义线性混合模型分析主观感知的建成环境与休闲性体力活动的相关性。结果 共纳入有效样本3 789份。调整可能的混杂因素后,公共服务可及性（OR=1.34,95% CI：1.02～1.75）和美观度（OR=1.37,95% CI：1.09～1.73）与居民自报过去一周有休闲性体力活动的可能性呈正相关;类似地,居民进行休闲性步行的可能性与这2个维度也呈正相关。街道连通性与居民休闲性步行水平呈正相关［exp（β）=1.09,95% CI：1.00～1.19］;居住密度［exp（β）=1.000 4,95% CI：1.000 0～1.000 8］越高、体力活动场所可及性［exp（β）=1.09,95% CI：1.00～1.19］越好,美观度［exp（β）=1.11,95% CI：1.00～1.22］越好,居民休闲性体力活动水平越高,达标的可能性也越高。结论 改善社区某些建成环境维度,有望增加居民进行休闲性体力活动的可能性及相应的水平。     

城市体力活动相关建成环境评价工具信度和效度研究进展

体力活动(physical activity)水平是影响个体健康重要的、可干预的因素之一[1].个体保持适当的体力活动水平能够有效降低诸多慢性病,如心血管疾病、呼吸系统疾病等的发病风险[2,3].建成环境(built environment)指人为建设改造的各种建筑物、场所,尤其指那些可以通过政策、人为行为改变的环境[4].建成环境不仅包括公园、公共绿地,还包括人行道、交通流量、公共场所的清洁和维护、社区及社会安全感、区域划分及土地综合利用、人口密度等各个方面[5].近年来,人们的关注点逐渐集中于建成环境与个体体力活动关系的探讨[6,7].国外研究显示[8,9],良好的运动环境会促进人们更多地进行体力活动.围绕建成环境与个体及人群健康间关系的研究证据必将成为日后健康城市建设、城市规划的重要决策依据.而在此类研究中,建成环境和体力活动的评价方法及其测量工具是影响研究真实性的一个重要环节.     

建成环境对南京市儿童青少年体力活动影响

目的 分析不同建成环境特征对江苏省南京地区儿童青少年体力活动水平的影响,为提高儿童青少年体力活动水平提供科学依据.方法 于2018年5-6月采用现况研究设计,使用多阶段整群随机抽样方法,选择南京市12个行政区4～12年级学生(9～17岁儿童青少年)共4 401人进行问卷调查,采用国际上通用体力活动居住环境量表(PANE...     

苏州市社区建成环境与居民体力活动的关联分析

目的 了解苏州市居民体力活动水平,探索社区建成环境与居民体力活动的关联。方法 2017年采用多阶段整群随机抽样方法抽取苏州市25~64岁常住人群进行面对面调查,采用国际体力活动量表长卷（IPAQ-L）评估居民体力活动水平,采用居民环境步行量表简表（NEWS-A）评价社区建成环境主观感知。结果 苏州市居民过去1周总体力活动水平M=3 610.42 MET-min/w,以工作相关体力活动水平为主,交通、家务及休闲相关体力活动水平较低。控制社会人口学因素后,公共服务可及性与社区居民的总体力活动水平呈负相关（OR=0.522,95%CI：0.329~0.830）,场所设施多样性与工作相关体力活动水平呈负相关（OR=0.701,95%CI：0.492~0.999）,步行和自行车道设施与工作相关体力活动水平呈正相关（OR=1.603,95%CI：1.004~2.559）;交通安全与交通相关体力活动水平呈负相关（OR=0.642,95%CI：0.416~0.990）;住宅密度与休闲相关体力活动水平呈正相关（OR=1.001,95%CI：1.000~1.002）;此外,社区美观与舒适的主观感知程度越高,工作、交通、家务及总体力活动水平越高（OR=1.889,95%CI：1.176~3.033;OR=1.671,95%CI：1.120~2.495;OR=1.775,95%CI：1.143~2.756;OR=1.593,95%CI：1.079~2.350）。结论 完善步行道和自行车道设施、提高社区的美观和舒适程度对于增加居民体力活动有重要作用。     

杭州市城区成年居民步行时间与建成环境主观感知的关联分析

目的 了解杭州市城区成年居民步行与建成环境主观感知之间的关系。方法 2012年采用多阶段分层随机抽样方法选取杭州市城区25~59岁居民开展面对面问卷调查。采用国际体力活动量表长版(IPAQ-L)和社区步行环境量表简版(NEWS-A)评价居民过去1周交通出行相关步行时间、休闲性步行时间以及建成环境主观感知。利用多因素logistic回归法分析步行与建成环境主观感知得分的关联性。结果 杭州市城区成年居民过去1周总体力活动得分M=2 766 met·min^-1·week^-1,平均1周休闲相关步行时间为90 min,平均1周交通相关步行时间则为100 min。控制年龄、BMI、婚姻状况、工作状态、文化程度、居住社区类型、总体力活动水平后,男性(OR=0.764,95%CI:0.588~0.992)和女性(OR=0.633,95%CI:0.481~0.833)的休闲性步行时间均与场所设施可及性维度得分呈负相关,女性休闲性步行时间还与住宅密度维度得分呈负相关(OR=0.997,95%CI:0.996~0.999),女性交通出行相关步行时间则与步行道/自行车道维度得分呈正相关(OR=1.537,95%CI:1.138~2.075)。男性交通出行相关步行时间与建成环境主观感知各维度得分的关联均无统计学意义。结论 可通过改善步行道/自行车道等建成环境促进成年居民的交通相关步行时间,开展成年人步行的环境干预时需要考虑性别差异。     

体力活动相关环境对健康的影响

<正>随着各城市生态环境建设与城市健康城市建设要求的提出以及《国家环境与健康行动计划(2007年—2015年)》的正式启动,在城市化高速的发展背景下,对体质健康水平和生活方式问题的研究越显示出其研究的紧迫性,城市环境与体力活动的关系成为很多国家研究的热点。然而,我国的体力活动相关环境对健康影响方面的研究至今还鲜有报道,这是环境卫生学面临的又一探索性领域。     

杭州市城区初中生体力活动行为与认知状况调查

目的 了解杭州市城区初中生体力活动行为与认知情况.方法 选取杭州市4549名城区初中生进行自填式问卷调查,了解初中生校内外体力活动、静态活动和对体力活动的看法.结果 4549名初中生中仅7.50％每天体力活动时间≥60 min.初中生每日校外做作业约2h,周末约3h,其他坐着活动的时间每日≥30 min和周末约2h的比例最高.初中生每天60 min参加体力活动保持健康的知晓率仅为24.63％,不同年级和性别的学生对体力活动作用的认识差异有统计学意义(P＜0.05).结论 杭州市城区初中生仍然缺乏体力活动和相关知识,应开展干预活动促进其体力活动的水平.     

上海市浦东新区不同人群体力活动现况调查

目的 了解不同人群总体体力活动水平和不同种类体力活动分布情况。方法 采用多阶段按比例随机抽样和整群抽样相结合的方法，抽取公务员、公司职员、高中生、社区居民、流动人口共计3555人，用国际体力活动量表长卷进行调杳。结果 五类人群合计完全静坐、体力活动不活跃、活跃和高度活跃的比例分别为205％、10．1％、26．5％和42．9％；高度活跃以社区居民最高为65．6％，完全静坐以流动人口最高为33．1％；在不同类型人群和不同性别组的人群中，除流动人口男性外，其他调查对象在4个单项活动中交通行程体力活动活跃达标率都是最高的，闲暇体力活动较少。结论 目前人群中最主要的体力活动仍是交通行程为主，闲暇体力活动较少，流动人口呈现两级分化。     

杭州市城区初中教职工体力活动水平的影响因素分析

目的 了解杭州市城区初中教职工体力活动水平及其影响因素。方法 2009年对杭州市3个城区的所有初中教职工进行横断面问卷调查。利用国际体力活动量表评价体力活动水平,采用Kruskal-Wallis秩和检验和多分类logistic回归法分析教职工体力活动水平的影响因素。结果 1 497名教职工达到低、中、高水平体力活动的比例分别为40.8%、40.6%和18.6%。与低水平体力活动的教职工相比较,年龄≥45岁（OR＝1.576,95%CI：1.128～2.201）和感到有一些压力（OR＝1.490,95%CI：1.141～1.946）的教职工达到中等水平体力活动的概率高。体力活动得分高（OR＝1.070,95%CI：1.002～1.143）、男性（OR＝3.088,95%CI：2.162～4.409）、同事经常/总是一起参加运动（OR＝2.903,95%CI：1.587～5.312）、同事有时一起参加运动（OR＝1.900,95%CI：1.160～3.110）和家附近有步行可达的地方（OR＝1.657,95%CI：1.022～2.688）达到高水平体力活动的概率高。婚姻状况、社会经济水平、工作年数、BMI、学历、同事鼓励参加运动与教职工增加体力活动水平的关联则无统计学意义。结论 杭州市城区初中教职工的体力活动水平有待加强,开展体力活动促进需要考虑年龄、性别、工作压力和支持性的工作及居住环境等因素影响。     

The built environment and recreational physical activity among adults in Curitiba, Brazil

Objective

To examine the relationship between objective measures of the built environment (BE) and recreational physical activity (PA) in adults from Curitiba, Brazil.

Method

A phone survey was carried among a random sample of 1206 people. Walking during leisure time (WLT) and moderate and vigorous recreational PA (MVPA) was measured using IPAQ. Characteristics of the BE were determined in an area of 500 m surrounding respondent's homes. Multivariate logistic regression analysis was used to estimate the associations between recreational PA and BE.

Results

After adjusting for confounders, WLT was associated with area income level US$971.45-3341.64 vs. US$167.05-461.06 (25.7% vs. 11.1% POR = 2.5; 95% CI = 1.5-4.4), having ≥ 2 gyms vs. none (26.1% vs. 12.7%, POR = 1.9; 95% CI = 1.2-3.0) and distance to recreation centers, 1769.1-2835.5 km vs. 2835.6-10,212.3 km (22.1% vs. 11.0%, POR = 2.3; 95% CI = (1.0-2.5). MVPA was associated with neighborhood income US$971.45-3341.64 vs. US$167.05-461.06 (47.6% vs. 22.0% POR = 3.0; 95% CI = 1.5-5.9) and having ≥ 2 gyms vs. none (41.7% vs. 26.0%, POR = 1.5; 95% CI = 1.11-2.1).

Conclusion

The presence of some recreational facilities for PA was associated with recommended levels of PA during leisure time in Curitiba, Brazil.     

Associations between the built environment and physical activity among adults with low socio-economic status in Canada: a systematic review

ObjectiveTo synthesize literature on the associations between the built environment and physical activity among adults with low socio-economic status (SES) in Canada.MethodsUsing a pre-specified study protocol (PROSPERO ID: CRD42019117894), we searched seven databases from inception to November 2018, for peer-reviewed quantitative studies that (1) included adults with low SES living in Canada and (2) estimated the association between self-reported or objectively measured built characteristics and self-reported or objectively measured physical activity. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Findings were synthesized using a narrative approach.SynthesisOf the 8338 citations identified by our search, seven studies met the inclusion criteria. Most studies included adults living in one province (Alberta, British Columbia, Ontario, or Quebec), with one study including a national sample. All studies were cross-sectional, and none controlled for residential self-selection. Sampling designs and data collection strategies were heterogeneous. Sample sizes ranged between 78 and 37,241 participants. Most studies measured SES using household income. Street connectivity, greenness, destination density, and walkability were positively associated with physical activity. Relative to the objectively measured built environment, associations between the self-reported built environment and physical activity were less consistent. Studies were of fair to good quality.ConclusionFindings suggest that the neighbourhood built environment is associated with physical activity among adults with low SES in Canada. More rigorous study designs are needed to determine whether or not the built environment and physical activity are causally related within this vulnerable population.     

GPS-based built environment measures associated with adult physical activity

Studies often rely on home locations to access built environment (BE) influences on physical activity (PA). We use GPS and accelerometer data collected for 288 individuals over a two-week period to examine eight GPS-derived BE characteristics and moderate-to-vigorous PA (MVPA) and light-to-moderate-vigorous PA (LMVPA). NDVI, parks, blue space, pedestrian-orientated intersections, and population density were associated with increased odds of LMVPA and MVPA, while traffic air pollution and noise were associated with decreased odds of LMVPA and MVPA. Associations varied by population density and when accounting for multiple BE measures. These findings provide further information on where individuals choose to be physically active.     

Mapping the development of research on physical activity and the built environment

Objective

The importance of the built environment for physical activity has been recognized in recent decades, resulting in new research. This study aims to understand the current structure of physical activity and built environment (PABE) research and identify gaps to address as the field continues to rapidly develop.

Methods

Key PABE articles were nominated by top scholars and a snowball sample of 2764 articles was collected in 2013 using citation network links. Article abstracts were examined to determine research focus and network analysis was used to examine the evolution of scholarship.

Results

The network included 318 PABE articles. Of these, 191 were discovery-focused, examining the relationship between physical activity and built environment; 79 were reviews summarizing previous PABE work; 38 focused on theory and methods for studying PABE; six were delivery-focused, examining PABE interventions; and four addressed other topics.

Conclusions

Network composition suggested that PABE is in the discovery phase, although may be transitioning given the large number and central position of review documents that summarize existing literature. The small amount of delivery research was not well integrated into the field. PABE delivery researchers may wish to make explicit connections to the discovery literature in order to better integrate the field.     

Development and application of a moveability index to quantify possibilities for physical activity in the built environment of children

Several studies show that urban forms are environmental correlates of physical activity. Most of these studies used data based on questionnaires while only a few used geographic information systems (GIS) to objectively assess urban forms. Based on GIS data, we applied a kernel density method to measure urban forms and combined these measures to a moveability index to assess the opportunities for physical activity in the German intervention region of the IDEFICS study. In this proof-of-principal analysis, we linked the moveability index with physical activity data obtained from the baseline survey of the IDEFICS study. Regression analyses revealed a modest but significant impact of the built environment on the physical activity of 596 school children in the study region, supporting the potential application of the moveability index.     

Safety perceptions of older adults on an urban greenway: Interplay of the social and built environment

BackgroundCreating neighbourhood places for older adults to be socially and physically active is a global health priority. Safety is integral to older adult mobility. In greenway research, perceived safety is often only partially or superficially explored. Our study comprehensively examines older adults’ experiences and perceived safety for walking on a new urban greenway in Vancouver, Canada—the Arbutus Greenway.MethodsWe integrated mixed methods: i) observational count data to describe the use and context of the greenway over 3 years (2017; 2018; 2019), and; ii) semi-structured interviews with older adults at two time points (2017, n = 27; 2019, n = 16).Resultsand discussion: We conducted thematic analysis to illuminate older adults' experiences across three safety domains: personal safety, traffic safety, and security. Built environment features such as benches, paving, road markings, and natural foliage buffers intersected with elements of the social environment to influence older adults’ perceived safety. While the greenway supported active transportation, leisure, and social engagement for many older adults, certain factors also provoked fears, especially for older adults with mobility limitations. We advocate for a multidimensional lens to better understand how urban interventions influence perceived safety, and identify practical solutions to encourage mobility for all ages and abilities.