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Objective: This study aimed to examine the prevalence of adolescent active travel to school (ATS) across 31 countries and territories in Asia, overall and by age group, sex and body mass index (BMI) category., Design: Cross-sectional study., Setting: 31 Asian countries., Participants: 152 368 adolescents aged 13-17 years with complete data for age, sex, measured weight and height and active travel to school from 31 Asian countries from the Global School-based student Health Survey (GSHS)., Primary Outcome: Self-reported active travel to school categorised into passive (0 days) and active (1-7 days)., Results: Overall prevalence of adolescent ATS in Asia based on random-effect meta-analysis was 55%, ranging from 18% (UAE) to 84% (Myanmar). There was limited subregional variation: 47% in the Eastern Mediterranean (EM), 56% in the South East Asia and 64% in the Western Pacific. Summarised by random-effect meta-analysis, being an older adolescent aged 16 years and older (vs younger age below 16 years: OR: 1.08; 95% CI: 1.00 to 1.16) was positively associated with ATS. This association was strongest in EM countries. Summarised by random-effect meta-analysis, females (vs males: OR: 0.79; 95% CI: 0.71 to 0.89) and adolescents with overweight/obesity (vs underweight and normal BMI: OR: 0.92; 95% CI: 0.86 to 0.99) were less likely to use ATS. Association with sex was strongest in EM countries. Heterogeneity was considerable in all meta-analyses., Conclusion: The prevalence of adolescent ATS in Asia varies substantially. Overall, older and male adolescents, and adolescents with underweight and normal BMI category are more likely to actively travel to school. However, the main contributor to differences in ATS between and within regions remain unknown. Although there is substantial scope for improving ATS rates in Asia, any policy actions and interventions should be cognisant of local built, social and natural environmental contexts that may influence active travel behaviour., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Travelling to school by car diminishes opportunities for physical activity and contributes to traffic congestion and associated noise and air pollution. This meta-analysis examined sociodemographic characteristics and built environment associates of travelling to school by car compared to using active transport among New Zealand (NZ) adolescents. Four NZ studies (2163 adolescents) provided data on participants' mode of travel to school, individual and school sociodemographic characteristics, distance to school and home-neighbourhood built-environment features. A one-step meta-analysis using individual participant data was performed in SAS. A final multivariable model was developed using stepwise logistic regression. Overall, 60.6% of participants travelled to school by car. When compared with active transport, travelling to school by car was positively associated with distance to school. Participants residing in neighbourhoods with high intersection density and attending medium deprivation schools were less likely to travel to school by car compared with their counterparts. Distance to school, school level deprivation and low home neighbourhood intersection density are associated with higher likelihood of car travel to school compared with active transport among NZ adolescents. Comprehensive interventions focusing on both social and built environment factors are needed to reduce car travel to school.

Background: Active school travel (AST) is influenced by multiple factors including built and social environments, households and individual variables. A holistic theory such as Mitra's Behavioural Model of School Transportation (BMST) is vital to comprehensively understand these complex interrelationships. This study aimed to assess direct and indirect associations between children's AST and environmental, household and child factors based on the BMST using structural equation modelling (SEM)., Methods: Data were drawn from Neighbourhoods for Active Kids (NfAK), a cross-sectional study of 1102 children aged 8-13 years (school years 5-8) and their parents from nine intermediate and 10 primary schools in Auckland, New Zealand between February 2015 and December 2016. Data were collected using an online participatory mapping survey (softGIS) with children, a computer-assisted telephone interviewing survey (CATI) with parents, and ArcGIS for built environment attributes. Based on the BMST a conceptual model of children's school travel behaviour was specified for SEM analyses ('hypothesised SEM'), and model modification was made to improve the model ('modified SEM'). SEM analyses using Mplus were performed to test the hypothesised/modified SEM and to assess direct and indirect relationships among variables., Results: The overall fit of the modified SEM was acceptable (N = 542; Root mean square error of approximation = 0.04, Comparative fit index = 0.94, Tucker-Lewis index = 0.92). AST was positively associated with child independent mobility, child-perceived neighbourhood safety, and parent-perceived importance of social interaction and neighbourhood social environment. Distance to school, and parental perceptions of convenience and concerns about traffic safety were negatively associated with AST. Parental fears of stranger danger were indirectly related to AST through those of traffic safety. Distance to school and child independent mobility mediated relationships between AST and child school year and sex., Conclusions: Increasing children's AST requires action on multiple fronts including communities that support independent mobility by providing child friendly social and built environments, safety from traffic, and policies that promote local schools and safe vehicle-free zones around school.

This systematic review summarised and evaluated the evidence for associations between school travel modes in children aged 5-13 years and perceived physical environments as well as social and sociodemographic characteristics. A computerised electronic search was performed for English articles published between January 2000 and July 2017. Data were extracted, study quality was assessed, and findings were analysed using a vote-counting technique. Thirty-seven studies met the inclusion criteria and were reviewed. Active school travel was associated positively with safety, walkability and neighbourhood social interactions, and negatively with travel distance and car ownership. Risk of bias, poor sampling methods and lack of external validity were common study limitations. Generally insufficient findings were reported for social characteristics., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To examine the acceptability of introducing standing workstations in elementary-school classrooms; and to quantify changes in children's time spent sitting, standing, and walking; step counts; sit-to-stand transitions; and musculoskeletal discomfort., Methods: A controlled trial was conducted in two elementary schools in Auckland, New Zealand (March-May 2012). Participants were 30 third and fourth graders (n = 23 intervention, n = 7 control). Intervention classes received standing workstations; control class retained usual sitting desks. Children wore ActivPAL monitors over 7 days at baseline and during the fourth week of the intervention., Results: Children spoke enthusiastically of the standing workstations. School staffs were supportive of the standing workstations because they offered "flexibility in learning". Overall, children in the intervention group sat less (intervention: 8.27 (1.45), mean (SD); control: 9.00 (0.80) h/day), stood longer (3.75 (0.88); 2.85 (0.30) h/day), and engaged in fewer transitions from sitting to standing (93 (17); 98 (26) counts) compared to the control group. Effect size ranged from small-large (-0.49; 95% confidence limits (0.64)%, 0.71; (0.48), -0.96; (0.54)% respectively). Results for time spent stepping and step counts were unclear., Conclusion: Standing workstations can be successfully integrated in classroom environments and appear to decrease overall sedentariness., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Introduction: Walking and cycling can be beneficial to health. Restrictions for motor vehicles outside schools could be one way to encourage activity but few evaluations exist. We aimed to explore the potential of such a scheme on children's active commuting, intervention mechanisms, and the utility of routinely collected data for evaluation.Methods: Restricted access for motor vehicles on road sections directly outside two Cambridge schools (one primary school [5-11 years] and one secondary school [11-16 years]) were implemented in April 2021. Teachers conducted hands-up travel surveys in March and May, 2021. All schools had facilities for storing bikes. Online surveys were distributed to parents, staff, local residents, and business owners between May and July, 2021, to assess travel behaviours and perceptions. We conducted observations at schools and interviews with a survey subsample to gain insights into intervention mechanisms, analysed using a thematic approach. Data for air quality and traffic volumes were available from February to September, 2021.Findings: 457 respondents completed the online survey, 13 interviews were conducted, and 40 classes completed both hands-up surveys. 18 (15%) of 117 primary school children and 30 (68%) of 44 secondary school children travelled to school without adult supervision according to parental reports. Hands-up survey data indicated no change in active commuting at the secondary school and a 2% increase at the primary school. The schemes improved perceptions of safety for pedestrians and cyclists at the primary school; however, residents still had concerns as motorists' compliance and safety were highlighted as key issues in both schools. Routinely collected, continuous air quality data were found to be particularly useful, but traffic volume data were less useful because of the timing of data collection and cost of sensors.Interpretation: It is possible that such schemes implemented with enforcement are necessary but not sufficient to encourage changes in commuting. Before a larger study could be done, the scheme design needs refinement to improve potential effectiveness.Funding: UK Medical Research Council. [ABSTRACT FROM AUTHOR]