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The absence of comprehensive and structured planning strategies for pedestrians, especially for those with functional diversity, promotes the need to address tools that allow broadening the spectrum of their assessment and prioritizing the inclusive development of cities. Therefore, this document describes the application of the Transit Oriented Development Standard guide in an area with mixed uses in Ibague city, as an evaluation tool in the analysis of the principles of walking and connecting. For its general understanding, the terms of Transit Oriented Development, walkability and functional diversity are analyzed. Evidence is presented on the need to project balanced intermodal systems that demonstrate the importance of universal accessibility in urban mobility.
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This study aimed to examine the relationship between Walk Score index with walking to commuting, moderate-to-vigorous physical activity, and screen time in older adults. Georeferenced addresses were entered into the Walk Score platform. Walking to commute and moderate-to-vigorous physical activity were assessed using the International Physical Activity Questionnaire and categorized according to the World Health Organization recommendations. Screen time was analyzed through self-reported time watching television/being on the computer. We used binary logistic regression to estimate the association between variables. Older adults who lived in places with higher Walk Score had a higher prevalence of walking to commuting (odds ratio = 1.73; 95% confidence interval [1.18, 2.55]) and engaging in moderate-to-vigorous physical activity (odds ratio = 1.76; 95% confidence interval [1.05, 2.98]). A relationship also was observed between higher Walk Score and more time in screen time (odds ratio = 1.67; 95% confidence interval [1.19, 2.34]). The results showed that residing in a more walkable neighborhood increased the chances of the older adults spending 3 hr or more in front of a screen.
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Exercício Físico , Tempo de Tela , Humanos , Idoso , Brasil , Caminhada , Autorrelato , Características de Residência , Planejamento AmbientalRESUMO
BACKGROUND & AIMS: While physical inactivity can contribute to chronic diseases, regular activity like walking can help prevent them. In 2010, one in three adults in the U.S. Virgin Islands (USVI) was physically inactive, higher than most U.S. states and territories. There are few walkable destinations and sidewalks along streets in the USVI. Since community- and street-scale design features can influence walking, we convened a 3-day walkability institute in the USVI to (1) learn about physical activity and best practices for design and (2) develop public health infrastructure that supports implementation. Island teams were formed to develop and implement a territory-wide action plan, focused on passing a Complete Streets policy, and demonstration projects on the islands of St. Croix, St. John, and St. Thomas to advance and pass this policy. An example of the demonstration projects and their significance is the completed one in St. Croix, which is the focus of this article. METHODS: Island teams applied critical components of functioning program infrastructure as described in the Component Model of Infrastructure (CMI) such as engaged data, multilevel leadership, responsive plans and planning, and networked partnerships. We evaluated whether a crosswalk installation in St. Croix could alter driver and pedestrian behavior and create a safer environment for pedestrians. Observers recorded pedestrian crossing time, driver speed, and other behaviors before and after crosswalk installation. RESULTS: Pedestrians took significantly fewer average seconds to cross the street in the postdemonstration period (9.83) compared with predemonstration (13.4) (p = .03). Average car speed declined between the predemonstration (24.3) and long-term demonstration periods (p < .01) and from the postdemonstration (24.7) to the long-term demonstration period (18.2) (p < .01). A greater percentage of pedestrians used the crosswalk to cross the street between the postdemonstration (12.5%) and long-term demonstration periods (53.7%) (p < .01). IMPLICATIONS: The demonstration project in St. Croix shows that improvements to built environment infrastructure can increase safety for pedestrians, thus improving walkability in the USVI. We discuss the importance of CMI elements observed in the success of the St. Croix demonstration and its effectiveness in promoting a Complete Streets policy and the lack of these elements on St. John hindering progress there. Public health practitioners can apply the CMI to future physical activity promotion projects in the USVI and other settings as having functioning program infrastructure helps overcome challenges including natural disasters and a global pandemic and can achieve progress toward sustained policy and systems change.
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Pedestres , Adulto , Humanos , Ilhas Virgens Americanas , Exercício Físico , Caminhada , Saúde Pública , Acidentes de Trânsito/prevenção & controle , SegurançaRESUMO
This study aims to analyse the association between walkability index and depressive symptoms and cognitive impairment and test the mediating role of moderate-vigorous physical activity (MVPA) in this relationship among older adults from Florianópolis, Brazil. This is cross-sectional research with data from the third wave of the EpiFloripa Aging cohort study, conducted in 2017-2019. Depressive symptoms were assessed using the short version of the Geriatric Depression Scale (GDS), and cognitive impairment, using the Mini-Mental State Examination (MMSE) scales. The neighbourhood environment was assessed using a walkability index, which considered 500-m network buffers around the participants' homes. Binary logistic regression analysis the association between the walkability index (quartile) and mental health outcomes (yes vs. no). Structural equation modelling evaluated the mediation between the walkability index and cognitive impairment by MVPA with an estimator of dichotomous variables. 1,162 people participated in the study (61.5% women, average age = 73.1). Older adults residing in places with a high and highest walkability index were 38% and 44% less likely to have cognitive impairment, respective. There was no association between depressive symptoms and walkability index in crude nor adjusted analysis. Engaging in MVPA had a partial but not significant effect (14%; p = 0.087), showing a tendency for this relationship to be partially explained by the greater engagement in physical activities in places with greater walkability. Policy planning to prevent and reduce the risks of cognitive impairment should consider factors of the physical environment as determinants in older adults.
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This study follows up on the article 'Walkability Index for Elderly Health: A Proposal', published in 2020, as well its validation in the Historic Center of Porto, published in 2021. The 2020 article presented the theoretical and methodological bases relating qualities of public spaces, the walkability of older adults, and the direct benefits on health. The 2021 article validated the applicability of the index in the Historic Center of Porto, Portugal. Both articles incorporated the factor 'slope', solving a criticism evidenced in related literature about the slope being ignored in older adults' walking conditions studies. The present study, however, aims to validate the conceptual design of the Walkability Index for Elderly Health (WIEH) in the Brazilian context at the historic center of Vitória. The methodology included the analysis and evaluation of public spaces regarding the pedestrian network-urban fabric, urban scene, and safety-and the presence of slopes and/or stairways. Subsequently, these spaces were classified according to the WIEH, ascertaining their level of adequacy for older adults' walkability. The results show that paths friendly to older adults are rare and that the problems encountered focus primarily on the low quality of the pedestrian network and not on the existence of slopes and stairways.
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Planejamento Ambiental , Características de Residência , Idoso , Brasil , Humanos , Portugal , CaminhadaRESUMO
The appropriate area for walking, related to the flow of walking, on the sidewalks and crossing (walka-bility) influences the practice of physical activity. However, there is no evidence of meta-analyses that have evaluated this association. Therefore, this study presents a protocol to assess the association be-tween walkability and physical activity. The systematic review protocol was conducted following the PRISMA 2020 guidelines and will includes a search in the following databases: PubMed, SPORT-Discus, LILACS, Web of Science, Scopus, Embase, and Cochrane. It will include observational studies, cross-sectional and longitudinal, that assessed the association between walkability in the neighborhood and physical activity. The process of study selection will be conducted independently by two reviewers. The process will start by reading the titles and abstracts of interest, followed by the full reading of the articles through the Rayyan platform. We will assess the methodological and indi-vidual quality across the studies utilizing the Newcastle Ottawa Scale (NOS) and the Chi-Squared test (I2). To test the influence of variables in the meta-analysis results, we will use, whenever possible, the meta-regression technique. The meta-analysis results will be presented as Odds Ratio (OR) with 95% confidence interval, through a random or fixed-effects model, according to estimate of clinical, statistical, and methodological heterogeneity. If possible, stratifications will be performed according to age group, sex, and physical activity levels.With the expected results, we hope that the knowledge will be useful to encourage the implementation of public policies for walkability in the neighborhood to increase physical activity levels
A área adequada para caminhada, relacionada ao fluxo de caminhada, nas calçadas e travessias (walkability) influencia na prática de atividade física. No entanto, não há evidências de meta-análises que tenham avaliado essa associação. Portanto, este estudo apresenta um protocolo para avaliar a as-sociação entre walkability e atividade física. O protocolo de revisão sistemática será realizado seguin-do as recomendações do PRISMA 2020 e incluirá uma busca nas seguintes bases de dados: PubMed, SPORTDiscus, LILACS, Web of Science, Scopus, Embase e Cochrane. Serão incluídos estudos observacionais, transversais e longitudinais, que avaliaram a associação entre walkability na vizinhan-ça e atividade física. O processo de seleção dos estudos será conduzido de forma independente por dois revisores. O processo terá início pela leitura dos títulos e resumos de interesse, seguido da leitura completa dos artigos por meio da plataforma Rayyan. Avaliaremos a qualidade metodológica e in-dividual entre os estudos utilizando a Escala de Newcastle Ottawa (NOS) e o teste Qui-Quadrado (I2). Para testar a influência das variáveis nos resultados da meta-análise, utilizaremos, sempre que possível, a técnica de meta-regressão. Os resultados da meta-análise serão apresentados como Odds Ratio (OR) com intervalo de confiança de 95%, por meio de um modelo de efeitos aleatórios ou fixos, de acordo com a estimativa clínica, estatística e metodológica da heterogeneidade. Se possível, serão realizadas estratificações de acordo com faixa etária, sexo e níveis de atividade física. Com os resulta-dos do estudo, esperamos que o conhecimento seja útil para incentivar a implementação de políticas públicas de walkability no bairro para aumentar os níveis de atividade física
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Exercício Físico , Metanálise em Rede , Revisão Sistemática , Estágios do Ciclo de VidaRESUMO
We conducted a systematic review to describe and summarize possible associations between the walkability index, overweight, and obesity. Systematic searches using seven electronic databases and reference lists were conducted to identify papers published until December 2017. Observational studies, describing associations using regression-based statistical methods, published in English and Portuguese, reporting markers of overweight and obesity, and involving adults (≥18 years) were included. Of the 2469 references initially retrieved, ten were used for the descriptive synthesis. Seven studies showed significant inverse associations between walkability and overweight and obesity, however, all were cross-sectional studies. High risk of bias scores were observed in "selection bias" and "withdrawals and dropouts". All studies were published in high-income countries with sample sizes ranging among 75 to 649,513 participants. Weight and height as measures for determining BMI tended to be self-reported. Indicators of walkability, such as land-use mix, street connectivity and residential density were used as components of the indices. Based on this review, more studies should be conducted in low, middle, and middle-high income countries, using longitudinal designs that control neighborhood self-selection; other indicators of the neighborhood environment, such as food access, physical activity facilities, sidewalks, and safety and crime prevention should be considered.
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Sobrepeso/epidemiologia , Características de Residência , Caminhada , Adulto , Humanos , Estudos Observacionais como AssuntoRESUMO
RATIONALE: Residents of neighbourhoods with high destination accessibility (higher population density, more-interconnected streets, and better access to services, public transport and parks) are more physically active. Evidence on the factors that underlie these associations is sparse and inconsistent. OBJECTIVE: We examined (1) five socio-demographic and four non-destination perceived neighbourhood attributes as moderators of the relationship between objectively-assessed destination accessibility and moderate-to-vigorous physical activity (MVPA); (2) perceived indicators of destination accessibility as mediators of those relationships; and, (3) the generalizability of findings across 14 cities. METHODS: Data were from the International Physical Activity and Environment Network (IPEN) Adult study (Nâ¯=â¯6822), which provided comparable objective and perceived environmental variables and accelerometer-based MVPA from 14 cities across 10 countries. Mediation and mediation moderation analyses were performed. RESULTS: Objective net residential density, public transport density, and number of parks in the neighbourhood were consistently associated with MVPA across all examined socio-demographic groups and non-destination perceived neighbourhood characteristics. However, only the association between number of parks and MVPA was mediated by its conceptually-comparable perceived indicator. While the associations of objective intersection density and land use mix with MVPA were moderated by both gender and perceived pedestrian infrastructure/safety, only the latter moderating effects were mediated by the conceptually-comparable perceived indicators. Perceived neighbourhood safety and/or aesthetics moderated the associations of objective ratio of retail/civic land to total area and distance to nearest transport stop with MVPA. These associations were not mediated by the conceptually-comparable perceived indicators. CONCLUSION: Densely populated neighbourhoods with access to public transport and parks have the potential to significantly and equitably contribute to adults' MVPA on a global scale. Perceived neighbourhood aesthetics, pedestrian-friendliness and safety can magnify the positive effects of mixed-use neighbourhoods on residents' MVPA by interacting with the perceived ease of access to a variety of destinations.
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Exercício Físico/psicologia , Acessibilidade aos Serviços de Saúde/normas , Características de Residência/classificação , Adulto , Idoso , Bélgica , Brasil , China , Colômbia , Estudos Transversais , República Tcheca , Dinamarca , Planejamento Ambiental , Estudos Epidemiológicos , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , México , Pessoa de Meia-Idade , Nova Zelândia , Parques Recreativos/normas , Parques Recreativos/estatística & dados numéricos , Percepção , Meios de Transporte/normas , Meios de Transporte/estatística & dados numéricos , Reino Unido , Estados UnidosRESUMO
BACKGROUND: Relationships between several built environment factors and physical activity and walking behavior are well established, but internationally-comparable built environment measures are lacking. The Microscale Audit of Pedestrian Streetscapes (MAPS)-Global is an observational measure of detailed streetscape features relevant to physical activity that was developed for international use. This study examined the inter-observer reliability of the instrument in five countries. METHODS: MAPS-Global was developed by compiling concepts and items from eight environmental measures relevant to walking and bicycling. Inter-rater reliability data were collected in neighborhoods selected to vary on geographic information system (GIS)-derived macro-level walkability in five countries (Australia, Belgium, Brazil, Hong Kong-China, and Spain). MAPS-Global assessments (n = 325) were completed in person along a ≥ 0.25 mile route from a residence toward a non-residential destination, and a commercial block was also rated for each residence (n = 82). Two raters in each country rated each route independently. A tiered scoring system was created that summarized items at multiple levels of aggregation, and positive and negative valence scores were created based on the expected effect on physical activity. The intraclass correlation coefficient (ICC) was computed for scales and selected items using one-way random models. RESULTS: Overall, 86.6% of individual items and single item indicators showed excellent agreement (ICC ≥ 0.75), and 13.4% showed good agreement (ICC = 0.60-0.74). All subscales and overall summary scores showed excellent agreement. Six of 123 items were too rare to compute the ICC. The median ICC for items and scales was 0.92 with a range of 0.50-1.0. Aesthetics and social characteristics showed lower ICCs than other sub-scales, but reliabilities were still in the excellent range (ICC ≥ 0.75). CONCLUSION: Evaluation of inter-observer reliability of MAPS-Global across five countries indicated all items and scales had "good" or "excellent" reliability. The results demonstrate that trained observers from multiple countries were able to reliably conduct observations of both residential and commercial areas with the new MAPS-Global instrument. Next steps are to evaluate construct validity in relation to physical activity in multiple countries and gain experience with using MAPS-Global for research and practice applications.