The relationship between perceived neighbourhood walkability and neighbourhood specific walking among Calgarian adults: Preliminary findings from the EcoEUFORIA projectPublic Health in Canada: Reducing Health Inequalities Through Evidence and Action, Canadian Public Health Association Conference, Halifax, Nova Scotia, 1-4 June 2008Gavin McCormack, Alan Shiell, Christine Friedenreich, Patricia Doyle-Baker, & Bev Sandalack

AcknowledgementsEcoEUFORIA teamDr Alan Shiell (PI)Dr Tish Doyle-BakerDr Christine FriedenreichDr Bev SandalackMs Whitney SmithersDr Billie Giles-CortiDr Gavin McCormack

Funding Canadian Institutes of Health Research (project support)Alberta Heritage Foundation for Medical Research (salary support)

Project supportCalgary Health Region, Survey and Evaluation Unit (telephone-interviews)Ms Brianna Butchart, Ms Betsy Setch and Dr Andrea Koop (data entry)

It is becoming too easy to be less physically active!

Even walking the dog does not guarantee physical activity anymore!

Physical activity is being engineered out of our daily lives in many ways

The problem is that being less active increases the risk of developing chronic disease*Katzmarzyk (2000) The economic burden of physical inactivity in Canada. CMAJ; **Paffenberger (1994) Physical activity and personal characteristics associated with depression and suicide in American college men Acta Psychiatr. Scand (

Population-based problems require population-based answers

Creating built environments that are supportive of physical activity is one strategy for increasing physical activity participation at the population level

Why is the built environment important for promoting physical activity at a population level?

Creating supportive built environments has the potential to influence the behaviour of entire communities and populations and not just individuals

Why is the built environment important for promoting physical activity at a population level?

Creating supportive built environments has the potential to influence behaviour over a long time (e.g. many generations) because of its semi-permanency

Why is the built environment important for promoting physical activity at a population level?

Creating supportive built environments can encourage people to be active without them even thinking about it

Major attributes that contribute to a supportive environment for physical activity1,2Land use mix and destinations close to homeRecreational and utilitarian

ConnectivityStreet patterns that make pedestrian movement convenient but motor vehicle movement less convenient

Appeal and aestheticsTrees, architecture, interesting, separation of pedestrians and motor vehicles

Safe placesPersonal safety, traffic safety, evidence of order (i.e. no graffiti or vandalism)

Residential densitySee other people active, surveillance, economically viable for small business

1McCormack et al (2004) An update of recent evidence of the relationship between objective and self-reported measures of the physical environment and physical activity behaviours. Journal of Science and Medicine in Sport2 Humpel et al (2002) Environmental factors associated with adults' participation in physical activity: A review. American Journal of Preventive Medicine

The EcoEUFORIA project

Definition

Economic Evaluation of Using Urban Form to Increase Activity

Overall objective

To examine the cost effectiveness of creating pedestrian-friendly neighbourhoods as a an intervention for increasing physical activity and improving health

Project context

Calgary metropolitan area

The EcoEUFORIA projectMethods (sampling)

Two random samples (n = 2200 each wave)

Wave 1: conducted in Summer/Early fall (August to October, 2007)Wave 2: conducted in Winter/Early spring (January to April, 2008)

Telephone-interview with a follow-up postal surveyInterviews conducted by CHR

Households sampled from directory of listed telephone numbers

One person per household >18 years

The EcoEUFORIA projectMethods (telephone-interviews)

Neighbourhood-specific physical activity behaviour1,2Inside versus outside the neighbourhoodNeighbourhood defined as a 15-minute walk from home

Walking for transportation; walking for recreation; vigorous-intensity physical activity; and moderate-intensity physical activity

Frequency and duration during a usual week

1McCormack, Shiell, Doyle-Baker, Friedenreich, Sandalack, & Giles-Corti (in press). Testing the reliability of neighborhood-specific measures of physical activity among Canadian adults. Journal of Physical Activity and Health2Giles-Corti et al. (2006) Development of a reliable measure of walking within and outside the local neighborhood: RESIDE's Neighborhood Physical Activity Questionnaire. Preventive Medicine

The EcoEUFORIA projectReasons for residential-selection1

Importance of certain neighbourhood characteristics associated with physical activityAffordability, aesthetics, attractive scenery and cleanlinessProximity to: public transport; parks; shops; services; work; recreation; and trailsEase of walking and drivingAccess to places to be physically active

Neighbourhood self-selection

A major limitation of previous research

Psychological variables (TBP) and demographics

Cerin et al (2007). Destinations that matter: Associations with walking for transport. Health and Place

The EcoEUFORIA projectMethods (postal-survey)Included those completing the telephone-survey and agreeing to follow-upTwo follow-up letters sent and incentive for returned surveys

Captured data:Perceptions of neighbourhood walkability (ANEWS)1Social support (dog ownership, club membership, friends and family)Social capital and sense of communitySelf-rated health and height and weightMotor vehicle access and driving behaviourDemographics

1http://www.ipenproject.org (International Physical Activity and Environment Network)

The EcoEUFORIA projectResults to date (wave 1 completed)

N = 2200 telephone-interviews completed (RR 34%)

N = 1813 agreed to postal-survey (RR 82%)

N = 1055 returned completed postal-survey (RR 58%)

Respondents returning the postal-survey are similar on most demographic attributes to those completing the telephone-interview but not agreeing to postal survey

Results

Perceptions of neighbourhood walkability assessed using the Abbreviated Neighbourhood Walkability Scale (ANEWS)

Perceptions of neighbourhood walkability (ANEWS subscales)

*Count of destinations located within 15-minute walk of home; N=1055; Higher scores indicate higher perceived walkability

Results

Where does walking take place in relation to neighbourhoods and how is it associated with walkability?

Where does physical activity take place (participation)?

Prevalence of walking for transport inside the neighbourhood by neighbourhood walkability

*p

Prevalence of walking for recreation inside the neighbourhood by neighbourhood walkability

*p

Where does physical activity take place (minutes)?

(210 minutes/wk = 30 minutes/day or 420 minutes/wk = 60 minutes/day guideline)

Spearmans Rank correlations between perceptions of neighbourhood walkability (ANEWS subscales) and walking inside the neighbourhood

*p

Prevalence of walking inside the neighbourhood by perceived overall walkability

*p

Minutes of walking inside the neighbourhood by perceived overall walkability

*p

ConclusionsMost walking behaviour is undertaken close to home

Different attributes of the built environment are associated with specific types of walking (i.e. for transport versus recreation)

Preliminary analysis adjusting for demographics (age, gender, education, No. children

For more information

Dr Gavin McCormack, PhDAHFMR Postdoctoral Research FellowPopulation Health Intervention Research Centre University of CalgaryPhone: 403-220-8193Email: gmccorma@ucalgary.ca

*Stephen AvenuePoint out that once this is stratified by gender several association become significant