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Kidskin was a sun-protection intervention study involving 1776 children attending 33 primary schools in Perth, Western Australia. There were three study groups: a control group, a moderate intervention group and a high intervention group. In addition to receiving a specially designed curricular intervention (1995-1998), the moderate and high intervention groups received an environmental intervention aimed at creating SunSmart schools (1996-1998). The environmental intervention focused on encouraging implementation of "No hat, no play" policies and reducing sun exposure at lunchtime. In 1995 and 1998, observational methods were used to measure children's lunchtime sun exposure (i.e. polysulfone film badges) and hat wearing (i.e. video-taping of children). The proportion of children wearing broad-brimmed hats or legionnaire caps increased in seven of the eight high intervention schools between 1995 and 1998. In three schools, however, the impact was very positive with almost all children wearing these hats in 1998. There was no improvement in wearing these types of hats in either the moderate intervention group or the control group. In terms of sun exposure, there were only small non-significant differences among the three groups in terms of lunchtime sun exposure. The Kidskin program had a positive effect on hat wearing in the playground, but did not change children's use of shade at lunchtime. In this study, disseminating policy guidelines to schools using a mail-only strategy was ineffective, even when combined with an awards program. More information on "champions" who bring about change in schools is required. (Contains 5 tables and 1 figure.)

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Background: The goal of this study was to establish preliminary criterion-referenced cut points for adult pedometer-determined physical activity (PA) related to weight status defined by body mass index (BMI). Methods: Researchers contributed directly measured BMI and pedometer data that had been collected (1) using a Yamax-manufactured pedometer, (2) for a minimum of 3 days, (3) on ostensibly healthy adults. The contrasting groups method was used to identify age- and gender-specific cut points for steps/d related to BMI cut points for normal weight and overweight/obesity (defined as BMI <25 and ≥25 kg/m², respectively). Results: Data included 3127 individuals age 18 to 94 years (976 men, age = 46.8 ± 15.4 years, BMI = 27.3 ± 4.9; 2151 women, age = 47.4 ± 14.9 years, BMI = 27.6 ± 6.4; all gender differences NS). Best estimated cut points for normal versus overweight/obesity ranged from 11,000 to 12,000 steps/d for men and 8000 to 12,000 steps/d for women (consistently higher for younger age groups). Conclusions: These steps/d cut points can be used to identify individuals at risk, or the proportion of adults achieving or falling short of set cut points can be reported and compared between populations. Cut points can also be used to set intervention goals, and they can be referred to when evaluating program impact, as well as environmental and policy changes. [ABSTRACT FROM AUTHOR]

Summary: Built environment attributes may be related to cardio‐metabolic diseases (e.g. type 2 diabetes, heart disease and stroke) and their risk factors, potentially by influencing residents' physical activity. However, existing literature reviews on the built environment and health for the most part focus on obesity as the outcome and rely on cross‐sectional studies. This systematic review synthesized current evidence on longitudinal relationships between built environment attributes and cardio‐metabolic health outcomes among adults and on the potential mediating role of physical inactivity. By searching eight databases for peer‐reviewed journal articles published in the English language between January 2000 and July 2016, the review identified 36 articles. A meta‐analysis method, weighted Z‐test, was used to quantify the strength of evidence by incorporating the methodological quality of the studies. We found strong evidence for longitudinal relationships of walkability with obesity, type 2 diabetes and hypertension outcomes in the expected direction. There was strong evidence for the impact of urban sprawl on obesity outcomes. The evidence on potential mediation by physical activity was inconclusive. Further longitudinal studies are warranted to examine which specific built environment attributes influence residents' cardio‐metabolic health outcomes and how physical inactivity may be involved in these relationships. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the individual, behavioral, social and built environment correlates of body mass index (BMI) in an Australian adult population. METHOD: Using data from 2003 to 2005 on 1151 participants in the RESIDential Environments project (RESIDE), Perth, Western Australia, linear regression was used to construct multivariate models to examine the variance in BMI explained by significant socio-demographic, environmental and health behavior variables. Both self-report and GIS-derived measures of the built environment were examined. RESULTS: Age, gender, hours of work, total physical activity, sedentary leisure time and dietary fat were all associated with BMI (p<=0.05). BMI was not associated with any objective measures of the built environment or social capital, social cohesion or dog ownership but was independently associated with one perceived environment measure (perceived safety from crime). Overall, 3.3% of the variance in BMI was explained by socio-demographic factors, a further 2.7% by health behaviors and a further 1.5% by perceived environment factors. CONCLUSION: Whilst evidence mounts of built environment correlates to physical activity, the demonstrated translation of these effects on BMI remain more elusive. Nevertheless, built environment factors that constrain physical activity warrant further exploration. [ABSTRACT FROM AUTHOR]

Studies of the relationship between walking and urban form consistently show that pedestrian-friendly neighbourhoods encourage local walking. However, the geographic scale of measurement of the built environment for developing walkability indices and their relationship with different types of walking (e.g. for transport and recreation) has not been fully examined. In this study, objective measures of the built environment were developed at three geographic scales: suburb, census collection district, and 15 min walk neighbourhood for each participant. Walking for transport and recreation within the neighbourhood was measured using the Neighbourhood Physical Activity Questionnaire. The likelihood of walking at all (yes/no) and as recommended for health benefit (150 min per week) were assessed using logistic regression. The walkability index captured a strong positive relationship between urban form and walking for transport, but found no relationship at any scale for recreational walking. Participants walking for transport and living in high versus low walkable areas were 63% more likely to walk at the suburb scale (odds ratio 1.63; 95% confidence interval 1.22-2.18), twice as likely to walk at the census collection district scale, and nearly three times more likely to walk at the 15 min walk scale (odds ration 2.79; 95% confidence interval 2.09-3.73). The scale at which environmental data are measured influenced the strength of the relationship, showing that the neighbourhood 15 min from home was most predictive of transport walking. This has research and policy implications. Standardised scales across studies would both improve comparability of results and enhance understanding of the influences on walking. [ABSTRACT FROM AUTHOR]

This study explored the relationship between neighbourhood design and residents' fear of crime in new suburban housing developments. Self-report and objective data were collected as part of the RESIDential Environments (RESIDE) Project. A neighbourhood form index based on the planning and land-use characteristics that draw people into public space, facilitate pedestrian movement and ensure the presence of 'territorial guardians' was developed for each participant (n=1059) from objective environmental data. With each additional index attribute, the odds of being fearful reduced (trend test p value=0.001), and this persisted even after progressive adjustment for demographics, victimisation, collective efficacy and perceived problems. The findings support the notion that a more walkable neighbourhood is also a place, where residents feel safer, and provides further evidence endorsing a shift away from low density, curvilinear suburban developments towards more walkable communities with access to shops, parks and transit. [ABSTRACT FROM AUTHOR]

Intrapersonal and environmental factors associated with dog walking (N = 483) were examined. A greater proportion of regular (80%) than irregular (59%) dog walkers met the recommended 150 minutes of physical activity per week. Owners who perceived greater social support and motivation from their dogs to walk, and who had access to a dog-supportive park within their neighborhood, were more likely to regularly walk with their dogs, even after adjustment for other well-known correlates of physical activity. The higher level of physical activity of regular dog walkers can be attributed to the additional walking these owners perform with their dogs. [ABSTRACT FROM AUTHOR]

In the post-World War II era, there have been dramatic changes to the environment that appear to be having a detrimental impact on the lifestyles and incidental physical activities of young people. These changes are not trivial and have the potential to influence not only physical health, but also mental health and child development. However, the evidence of the impact of the built environment on physical activity to date is inconsistent. This review examines the evidence on the association between the built environment and walking for transport as well as physical activity generally, with a focus on methodological issues that may explain inconsistencies in the literature to date. It appears that many studies fail to measure behaviour-specific environmental correlates, and insufficient attention is being given to differences according to the age of study participants. Higher levels of out-of-school-hours physical activity and walking appear to be significantly associated with higher levels of urban density and neighbourhoods with mixed-use planning, especially for older children and adolescents. Proximate recreational facilities also appear to predict young people's level of physical activity. However, there are inconsistencies in the literature involving studies with younger children. Independent mobility increases with age. For younger children, the impact of the built environment is influenced by the decision-making of parents as the gatekeepers of their behaviour. Cross-cultural differences may also be present and are worthy of greater exploration. As children develop and are given more independent mobility, it appears that the way neighbourhoods are designed - particularly in terms of proximity and connectivity to local destinations, including schools and shopping centres, and the presence of footpaths - becomes a determinant of whether children are able, and are permitted by their parents, to walk and use destinations locally. If older children and adolescents are to enjoy health and developmental benefits of independent mobility, a key priority must be in reducing exposure to traffic and in increasing surveillance on streets (i.e. 'eyes-on-the-street') through neighbourhood and building design, by encouraging others to walk locally, and by discouraging motor vehicle use in favour of walking and cycling. Parents need to be assured that the rights and safety of pedestrians (and cyclists) - particularly child pedestrians and cyclists - are paramount if we are to turn around our 'child-free streets', now so prevalent in contemporary Australian and US cities. There remains a need for more age- and sex-specific research using behaviour- and context-specific measures, with a view to building a more consistent evidence base to inform future environmental interventions. [ABSTRACT FROM AUTHOR]

Issue Addressed: This qualitative research explored the relationship between dog ownership and dog-related, social environmental and physical environmental factors associated with walking with a dog.Methods: Seven focus groups with dog owners (n=51) were conducted. A pre-determined discussion guide was used and transcripts were analysed as group data, using content analysis to identify common themes.Results: Many of the physical environmental barriers and facilitators that influenced dog owners to walk were similar to those found in the literature for general walking. However, a number of key motivators for walking, specific to dog owners, were identified. Dog owners reported that their dog was a strong source of motivation, companionship and social support that encouraged them to walk with their dog. The availability and accessibility of public open space (POS) for dogs and the provision of dog-related infrastructure within POS were also important environmental factors that affected whether owners walked with their dog.Conclusions: Results from this qualitative study were used to develop the Dogs and Physical Activity (DAPA) tool which is now being used to measure the walking behaviour of dog owners. [ABSTRACT FROM AUTHOR]

This qualitative study investigated why women of low socio-economic status (SES) are less physically active than women of higher-SES. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low-SES women. A social-ecological framework, taking into account intrapersonal, social and environmental level influences, was adopted to guide the development of interview questions and interpretation of data. Thematic analysis identified a number of key influences on physical activity that varied by SES. These included negative early life/ family physical activity experiences (a consistent theme among those of low-/mid-SES); participation in a wider range of physical activities in leisure time (high-SES); greater priority given to television viewing (low-SES); lack of time due to work commitments (low-SES); lack of time due to family commitments (high-SES); and neighbourhood-level barriers (low-SES). Financial costs were not perceived as a key barrier by women in any SES group. Public health strategies aimed at reducing SES inequalities in physical activity might focus on overcoming negative early experiences/attitudes to physical activity, reducing television viewing and promoting a wider variety of different types of physical activity, and addressing neighbourhood safety and other barriers to physically active lifestyles in socio-economically disadvantaged areas. [ABSTRACT FROM AUTHOR]

Objective: This paper presents the results of the evaluation of measured suntan and parent-reported sun exposure in participating children after 2 years of the Kidskin study, a 5-year school-based sun protection intervention undertaken in Perth, Western Australia (1995-1999).Methods: The study involves three groups: a control, a "moderate", and a "high" intervention group. Participants were 5 or 6 years of age at the beginning of the study. Control schools received the standard Health Education curriculum, while intervention schools received a multicomponent intervention including a specially designed curriculum. Children in the high intervention group also received program materials over the summer vacation and were offered sun-protective swimwear at low cost. At the end of the second summer, suntan was measured and parents completed a questionnaire about their child's sun-related behavior.Results: Children in the intervention groups--especially the high group--were less tanned at the end of the summer; this effect was greater for the back than for the forearms. These children were also reported to have received less sun exposure and made greater use of sun protection measures.Conclusion: Intensive school-based interventions can reduce tanning and reported sun exposure in children. [ABSTRACT FROM AUTHOR]