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Background: Greater public transport use has been linked to higher physical activity levels. However, neither the amount of physical activity associated with each daily public transport trip performed, nor the potential total physical activity gain associated with an increase in trips/day, has been determined. Using objective measures, we aimed to quantify the association between public transport use, physical activity and sedentary time., Methods: A longitudinal study of Australian adults living in Hobart, Tasmania, who were infrequent bus users (≥ 18 years; used bus ≤ 2 times/week). The number of bus trips performed each day was determined from objective smartcard data provided by the public transportation (bus) provider across a 36-week study timeframe. Accelerometer measured steps/day (primary outcome), moderate-to-vigorous physical activity (min/day), and sedentary time (min/day) were assessed across four separate one-week periods., Results: Among 73 participants across 1483 day-level observations, on days that public transport was used, participants achieved significantly more steps (β = 2147.48; 95%CI = 1465.94, 2829.03), moderate to vigorous physical activity (β = 22.79; 95% CI = 14.33, 31.26), and sedentary time (β = 37.00; 95% CI = 19.80, 54.21) compared to days where no public transport trips were made. The largest increase in steps per day associated with a one-trip increase was observed when the number of trips performed each day increased from zero to one (β = 1761.63; 95%CI = 821.38, 2701.87). The increase in the number of steps per day was smaller and non-significant when the number of trips performed increased from one to two (β = 596.93; 95%CI=-585.16, 1779.01), and two to three or more (β = 632.39; 95%CI=-1331.45, 2596.24) trips per day. Significant increases in sedentary time were observed when the number of trips performed increased from zero to one (β = 39.38; 95%CI = 14.38, 64.39) and one to two (β = 48.76; 95%CI = 25.39, 72.12); but not when bus trips increased from two to three or more (β=-27.81; 95%CI=-76.00, 20.37)., Conclusions: Greater public transport use was associated with higher physical activity and sedentary behaviour. Bus use may yield cumulative increases in steps that amount to 15-30% of the daily recommended physical activity target. A policy and public health focus on intersectoral action to promote public transport may yield meaningful increases in physical activity and subsequent health benefits., (© 2024. The Author(s).)

Body mass index (BMI) trajectories that improve over the lifecourse result in better cardiometabolic profiles, but only a small proportion of children of an unhealthy weight show improving BMI trajectories. This study aimed to examine the childhood factors related to diverging BMI trajectories from childhood into adulthood using data from the Childhood Determinants of Adult Health study. A convergent parallel mixed methods design was used. Quantitative data (n = 2206) came from the first (2004-06) and second (2009-11) adult follow-ups of 8498 Australian children (7-15 years) assessed in 1985. Using BMI z-scores, group-based trajectory modelling identified five trajectory groups: Persistently Low, Persistently Average, High Decreasing, Average Increasing and High Increasing. Qualitative data (n = 50) were collected from a sub-group (2016; 38-46 years). Semi-structured interviews with 6-12 participants from each BMI trajectory group focused on individual, social and environmental influences on weight, diet and physical activity across the lifecourse. Log multinomial regression modelling estimated relative risks of trajectory group membership across childhood demographic, behavioural, health, parental and school factors. Qualitative data were thematically analysed using a constant comparative approach. Childhood factors influenced BMI trajectories. Paternal education, main language spoken, alcohol and self-rated health were significant quantitative childhood predictors of BMI trajectory. A distinct 'legacy effect' of parental lifestyle influences during childhood was apparent among interview participants in the Stable and High Decreasing groups, a strong and mostly positive concept discussed by both men and women in these groups and persisting despite phases of unhealthy behaviours. In contrast, the 'legacy effect' was much weaker in the two Increasing BMI groups. This study is the first to simultaneously identify important quantitative and qualitative childhood factors related to divergent BMI trajectories, and to observe a legacy effect of parents' lifestyle behaviours on divergent BMI trajectories. This work provides direction for further exploration of the factors driving divergent BMI trajectories., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Issue Addressed: Public transport (PT) users typically accumulate more physical activity (PA) than motor vehicle users. This mixed methods study aimed to determine acceptability and perceived effectiveness of strategies to increase bus use for PA gain in a regional Australian setting., Methods: In a 2017 online survey, Tasmanian adults (n = 1091) rated the likelihood of increasing their bus use according to ten hypothetical strategies (fare-, incentives-, information- or infrastructure-based). Three focus groups and five interviews (n = 31) included infrequent bus users from the survey to determine reasons for strategy preferences and potential impact on PA., Results: The top three strategies in the survey, with supporting rationale from qualitative data, were: provision of real-time bus information ("…because I can better plan…"); bus-only lanes ("…it just speeds the whole thing up…") and employee incentives/rewards for example bus fare credits ("…it really comes down to money…"). Full-time students favoured cost-saving strategies most and residents in outer suburbs favoured infrastructure-based strategies most. Qualitative data indicated that potential for enhanced certainty, efficiency or cost-savings drove strategy preferences and some strategies may lead to PA gain (eg through the location of Park and Ride facilities)., Conclusions: Real-time information, bus-only lanes and employee incentives/rewards appear most promising for increasing bus use in this population, but tailoring strategies may be required. Discrete PT enhancement strategies may result in PA gain. SO WHAT?: Increasing PA through transport behaviour has been underexplored. The potential for PA gain through greater PT use and discrete PT use enhancement strategies is an important public health consideration., (© 2019 Australian Health Promotion Association.)

Issues Addressed: The presence or absence of amenities in local neighbourhood environments can either promote or restrict access to opportunities to engage in healthy and/or less healthy behaviours. Rurality is thought to constrain access to facilities and services. This study investigated whether the presence and density of environmental amenities related to physical activity and eating behaviours differs between socioeconomically disadvantaged urban and rural areas in Victoria, Australia., Methods: We undertook cross-sectional analysis of environmental data collected in 2007-08 as part of the Resilience for Eating and Activity Despite Inequality (READI) study. These data were sourced and analysed for 40 urban and 40 rural socioeconomically disadvantaged areas. The variables examined were the presence, raw count, count/km2, and count/'000 population of a range of environmental amenities (fast-food restaurants, all supermarkets (also separated by major chain and other supermarkets), greengrocers, playgrounds, gyms/leisure centres, public swimming pools and public open spaces)., Results: A greater proportion of urban areas had a fast-food restaurant and gym/leisure centre present while more rural areas contained a supermarket and public swimming pool. All amenities examined (with the exception of swimming pools) were more numerous per km2 in urban areas, however rural areas had a greater number of all supermarkets, other supermarkets, playgrounds, swimming pools and public open space per '000 population., Conclusion: Although opportunities to engage in healthy eating and physical activity exist in many rural areas, a lower density per km2 suggests a greater travel distance may be required to reach these.

Using a multilevel study design, this study examined the associations between social characteristics of individuals and neighbourhoods and physical activity among women. Women (n = 1405) recruited from 45 Melbourne (Australia) neighbourhoods of varying socioeconomic disadvantage provided data on social factors and leisure-time: physical activity; walking; and walking in one's own neighbourhood. Individual level social factors were number of neighbours known and social participation. Neighbourhood-level social characteristics (interpersonal trust, norms of reciprocity, social cohesion) were derived by aggregating survey data on these constructs within neighbourhoods. Objective data on crimes within neighbourhoods were obtained from Victoria Police. In bivariable regression models, all social variables at both the individual and neighbourhood level were positively associated with odds of physical activity, walking, and walking in one's own neighbourhood. Associations with individual social participation (associated with all three physical activity variables) and neighbourhood interpersonal trust (associated with overall physical activity only) remained significant in multivariable models. Neither neighbourhood crime against the person nor incivilities were associated with any form of physical activity. These results demonstrate that women who participated in local groups or events and, less consistently, women living in neighbourhoods where residents trusted one another, were more likely to participate in leisure-time physical activity. While redressing macro-level social and economic policies that contribute to neighbourhood inequalities remains a priority, public health initiatives aimed at promoting physical activity could consider focusing on fostering social interactions targeting both individuals and communities. Further investigation of causal mechanisms underlying these associations is required., ((c) 2010 Elsevier Ltd. All rights reserved.)

While sex and socio-economic disparities in physical activity have been well documented, not all disadvantaged women are inactive. This study aimed to examine correlates of achieving recommended levels of physical activity among women of low socio-economic position. In 2005, a population-based sample of 291 women with low educational attainment provided survey data on leisure time physical activity (LTPA). Participants reported potential personal (enjoyment and self-efficacy; barriers; intentions; guilt and priorities; routines and scheduling; occupational physical activity; television viewing), social (support from family/friends; social participation; sport/recreation club membership; dog ownership) and environmental (aesthetics; safety; local access; footpaths; interesting walks; busy roads to cross; heavy traffic) correlates of physical activity. Nearly 40% of participants achieved recommended LTPA (150 min week(-1)). Multivariable analyses revealed that higher levels of self-efficacy for walking [prevalence ratio (PR) 2.05, 95% confidence interval (CI) 1.19-3.53], higher enjoyment of walking (PR 1.48, 95% CI 1.04-2.12), greater intentions to be active (PR 1.97, 95% CI 1.12-3.45) and having set routines for physical activity (PR 1.91, 95% CI 1.18-3.09) were significantly associated with achieving recommended LTPA. Personal factors were the characteristics most strongly associated with achieving recommended levels of LTPA among women from socio-economically disadvantaged backgrounds.

This study examined the influence of childhood socioeconomic position (SEP) and social mobility on activity and fitness tracking from childhood into adulthood. In a prospective cohort of 2,185 Australian adults (aged 26-36 years), first examined in 1985 (at ages 7-15 years), self-reported physical activity and cardiorespiratory fitness (subsample only) were measured. SEP measures included retrospectively reported parental education (baseline) and own education (follow-up). There was little evidence of a relation between childhood SEP and activity tracking, but high childhood SEP (maternal education) was associated with a 59% increased likelihood of persistent fitness, and medium childhood SEP (paternal and parental education) was associated with a 33%-36% decreased likelihood of persistent fitness. Upward social mobility was associated with a greater likelihood of increasing activity (38%-49%) and fitness (90%), and persistently high SEP was associated with a greater likelihood of increasing activity (males: 58%) and fitness (males and females combined: 89%). In conclusion, persistently high SEP and upward social mobility were associated with increases in activity and fitness from childhood to adulthood. Findings highlight socioeconomic differentials in activity and fitness patterns and suggest that improvements in education may represent a pathway through which physical activity levels can be increased and health benefits achieved.

Objective: To examine how fitness in both childhood and adulthood is associated with adult obesity and insulin resistance., Research Design and Methods: A prospective cohort study set in Australia in 2004-2006 followed up a cohort of 647 adults who had participated in the Australian Schools Health and Fitness Survey in 1985 and who had undergone anthropometry and cardiorespiratory fitness assessment during the survey. Outcome measures were insulin resistance and obesity, defined as a homeostasis model assessment index above the 75th sex-specific percentile and BMI >or=30 kg/m(2), respectively., Results: Lower levels of child cardiorespiratory fitness were associated with increased odds of adult obesity (adjusted odds ratio [OR] per unit decrease 3.0 [95% CI 1.6-5.6]) and insulin resistance (1.7 [1.1-2.6]). A decline in fitness level between childhood and adulthood was associated with increased obesity (4.5 [2.6-7.7]) and insulin resistance (2.1 [1.5-2.9]) per unit decline., Conclusions: A decline in fitness from childhood to adulthood, and by inference a decline in physical activity, is associated with obesity and insulin resistance in adulthood. Programs aimed at maintaining high childhood physical activity levels into adulthood may have potential for reducing the burden of obesity and type 2 diabetes in adults.