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Background: This study aimed to compare the overall prevalence, stratified by sex and age group of global physical activity (GPA), active commuting to school (ACS), and sedentary behavior (SB) among adolescents from ten Latin American countries, and to assess the correlation of Development Index with the indicators., Methods: This research is grounded on data from the Global School-Based Student Health Survey (2009-2015) and the 2015 Brazilian National School Health Survey. The prevalence and 95% confidence intervals for GPA (≥5 d/wk), ACS (≥1 d/wk), and SB (>2 h/d) were calculated using the chi-square test to compare the sexes (male; female) and age group (≤13 y; 14 y; 15 y; ≥16 y). We also performed Pearson correlation analysis with the Human Development Index., Results: The prevalence of indicators ranged from 16.1% to 28.2% for GPA, from 56.7% to 71.2% for ACS, and from 20.7% to 62.6% for SB. Boys generally had a higher prevalence of GPA and ACS, and girls had a higher prevalence of SB. The prevalence of the indicators by age group varied between countries, with significant differences observed in some, depending on each indicator. A positive correlation was observed between Human Development Index, GPA, and SB., Conclusion: Health promotion policies must include guidelines that encourage and promote a more active and less sedentary lifestyle among young people in Latin America, considering specific groups, the local socioeconomic context, and differences between countries.

Background: The purpose of this study was to investigate the effects of a walking school bus intervention on children's active commuting to school., Methods: We conducted a randomized controlled trial (RCT) in Houston, Texas (Year 1) and Seattle, Washington (Years 2-4) from 2012 to 2016. The study had a two-arm, cluster randomized design comparing the intervention (walking school bus and education materials) to the control (education materials) over one school year October/November - May/June). Twenty-two schools that served lower income families participated. Outcomes included percentage of days students' active commuting to school (primary, measured via survey) and moderate-to-vigorous physical activity (MVPA, measured via accelerometry). Follow-up took place in May or June. We used linear mixed-effects models to estimate the association between the intervention and outcomes of interest., Results: Total sample was 418 students [M age =9.2 (SD = 0.9) years; 46% female], 197 (47%) in the intervention group. The intervention group showed a significant increase compared with the control group over time in percentage of days active commuting (β = 9.04; 95% CI: 1.10, 16.98; p = 0.015) and MVPA minutes/day (β = 4.31; 95% CI: 0.70, 7.91; p = 0.02)., Conclusions: These findings support implementation of walking school bus programs that are inclusive of school-age children from lower income families to support active commuting to school and improve physical activity., Trail Registration: This RCT is registered at clinicaltrials.gov (NCT01626807)., (© 2024. The Author(s).)

Background: Knowledge of changes in the domains of physical activity (PA) during the transition period from primary to secondary education and the factors associated with these changes, are prerequisites for the design of effective PA promotion strategies. Therefore, the first aim of this study was to systematically review changes in general, leisure-time, school, transport, work, and home PA across the transition from primary to secondary education. The second aim was to systematically review the individual, social, and physical environmental factors that were associated with these changes., Methods: Records published up until September 2023 were retrieved from five electronic databases. We included longitudinal and cross-sectional studies that investigated general or domain-specific PA from 2 years before to 2 years after the transition from primary to secondary education. Information on source, study characteristics, sample characteristics, PA, and factors were extracted from the papers included. We reported the direction of change in general and domain-specific PA and the direction of association of the factors with change in general and domain-specific PA., Results: Forty-eight papers were included in the study. The evidence on changes in PA and associated factors was greatest for general PA. A limited number of the studies investigated the separate domains of leisure-time, school, and transport. Most studies on general and school PA reported a decline in PA, but there were no consistent results for the domains of leisure-time and transport. With respect to the associated factors, evidence was predominantly found for individual factors and to a lesser degree for physical environmental and social environmental factors. None of the factors were consistently associated with changes in general or domain-specific PA during the school transition., Conclusions: For the design of targeted PA promotion strategies, further studies are warranted to explore changes in the specific domains of PA across the transition from primary to secondary education, especially in the domains of leisure-time, transport, home, and work PA. In addition, the interactions between factors at different socioecological levels to influence changes in PA need to be addressed more in the future., Trial Registration: PROSPERO CRD42020190204., (© 2024. The Author(s).)

Background: Over the last decades, the prevalence of AST has decreased significantly. Barriers to active school transport (AST) have been extensively examined in the literature, while psychosocial factors that facilitate AST have received less attention. To our best knowledge, there are currently no reviews on this subject. Therefore, the objective of this review was to scope the literature and identify published research about psychosocial factors related to AST., Methods: Systematic searches conducted in PubMed, Web of Science, TRID, Scopus, and ERIC resulted in a total of 1933 publications, and 77 of them were considered eligible for this review., Results: The results of the included articles were categorised into four psychosocial factors: confidence in ability, attitudes, social support, and social norms, which were all generally positively related to AST, with a few exceptions., Conclusion: The findings of this review indicate that these psychosocial factors may be important to consider when developing interventions and highlight that both children and parents should be involved in the process. This knowledge can serve as a valuable guide for developing interventions to promote AST. However, the evidence base supporting these psychosocial factors requires further investigation to fully understand how and when to incorporate them to maximise AST efficacy., (© 2024. The Author(s).)

Objectives: This study aimed to examine the association between country-level environmental correlates and the prevalence of active school travel (AST) in Asia and country-level differences in AST by age and sex., Methods: This ecological study involved 31 Asian countries. Dependent variables were AST prevalence, AST prevalence difference by age, and by sex. Independent variables were country-level environmental correlates extracted using publicly available datasets, classified into physical and social environments. Association estimates of each dependent variable and each of the independent variables were calculated using univariate linear regression. All variables were standardized to have a mean of 0 and a standard deviation of 1., Results: Results showed that 1 standard deviation (SD) difference in urban population percentage, night-time light, secondary-school enrolment, and prevalence of adult insufficient physical activity were negatively associated with AST prevalence (SD difference: -0.44 (-0.78 to -0.09), -0.40 (-0.76 to -0.04), -0.39 (-0.74 to -0.04), and -0.40 (-0.76 to -0.03), respectively). A 1 SD difference in car per people was associated with a -0.46 (-0.84 to -0.09) difference of AST prevalence by age. A 1 SD difference in PM2.5 concentration and of prevalence of adult insufficient physical activity were associated with a difference of 0.38 (0.01-0.74) and 0.42 (0.03-0.80) difference of AST prevalence by sex., Conclusions: This study shows that Asian countries with a greater number of people living in urban areas, lower levels of overall adult physical activity and higher levels of night-time light have a lower prevalence of adolescent AST. Country-level physical and social environmental correlates explained some of the regional variance in AST. Future policy actions and interventions for the region need to be contextually sensitive to the environmental correlates that vary between countries., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study investigates the influences of built environmental (BE) factors, network design, and sociodemographic factors on active school travel (AST). Although numerous studies have explored these relationships, this study is trying to assess this issue with a focus on gender differences. Data from a cross-sectional sample of children from first to sixth grades from 16 public primary schools exclusive for girls and boys ( N = 1260) in Shiraz collected in November 2019 was used. The analysis of the data revealed that, on average, boys are more willing to walk than girls, but that the boys' tendency to walk is less elastic with respect to distance. Moreover, it is shown that street connectivity for all distance thresholds has a positive relationship with walking level, but the street network choice parameter decreases the chance of walking within an 800 metre threshold. It is demonstrated the need to take gender differences into account in local planning policies to promote AST in a developing country context.

This study aimed to analyze the differences between active commuting to school (ACS) and non-ACS in cognitive performance (CP), and the association of ACS duration with CP. This cross-sectional study included 370 adolescents (males n = 170), with a mean age of 15.28 ± 2.25 years. CP was assessed through an interview, and ACS, extracurricular physical activity, and socioeconomic status was assessed by self-report. Body composition was assessed using the FitnessGram test battery. One in two adolescents did ACS (51.6%). ACS was associated with boys (53.9%), younger adolescents (14.91 ± 2.15 vs. 15.69 ± 2.29), those having school social support (55.0%), and those doing one or more extracurricular physical activities (53.6%), compared to non-ACS participants ( p < 0.05). The analysis of covariance, after controlling for age, sex, school social support, and participation in extracurricular physical activity, showed an effect of ACS on the total cognitive score (F (2,362) = 3.304, p < 0.05). The CP was higher in adolescents with more than 30 min of ACS than non-ACS ( p < 0.05). The influence of ACS duration can be seen in the dimensions of inductive reasoning (ß = 0.134, t = 2.587, p < 0.05) and working memory (ß = 0.130, t = 2.525, p < 0.05). The role of ACS for CP, as well as guidelines for future research, are discussed.

The reduction in locational traffic accident risks through appropriate traffic safety management is important to support, maintain, and improve children's safe and independent mobility. This study proposes and verifies a method to evaluate the risk of elementary school students-vehicle accidents (ESSVAs) at individual intersections on residential roads in Toyohashi city, Japan, considering the difference in travel purposes (i.e., school commuting purpose; SCP or non-school commuting purpose: NSCP), based on a statistical regression model and Empirical Bayes (EB) estimation. The results showed that the ESSVA risk of children's travel in SCP is lower than that in NSCP, and not only ESSVAs in SCP but also most ESSVAs in NSCP occurred on or near the designated school routes. Therefore, it would make sense to implement traffic safety management and measures focusing on school routes. It was also found that the locational ESSVA risk structure is different depending on whether the purpose of the children's travels is SCP or NSCP in the statistical model. Finally, it was suggested that evaluation of locational ESSVA risks based on the EB estimation is useful for efficiently extracting locations where traffic safety measures should be implemented compared to that only based on the number of accidents in the past.

Safe Routes to School (SR2S) interventions have been implemented in many economically developed countries to improve children's engagement in Active School Travel (AST). Evaluations have highlighted inconsistencies in SR2S intervention outcomes, raising questions as to how, why, and under what contextual conditions these interventions work. This review used a Rapid Realist Review (RRR) methodology to build, test, and refine an overarching program theory that unpicks the contextual factors and underlying mechanisms influencing children's engagement in AST. From the 45 included documents, 16 refined Context-Mechanism-Outcome Configurations (CMOCs) were developed and clustered into three partial program theories (i.e., implementor/implementation, child, and parent), with the associated mechanisms of: (1) School Reliance; (2) School Priority; (3) Fun; (4) Pride; (5) Perceived Safety; (6) Distrust; (7) Convenience; (8) Perceived Capabilities; and (9) Reassurance. The overarching program theory delineates the pathways between intervention implementation, children's motivation, parental decision-making, and children's engagement in AST. The findings suggest SR2S interventions can motivate children to engage in AST, but whether this motivation is translated into engagement is determined by parental decision-making. This review is novel for highlighting that many of the factors influencing parental decision-making are contextually driven and appear to be unaddressed by the current suite of SR2S intervention strategies. The review additionally highlights the complexity of parental perceptions of safety, with the traffic and the road environment shaping only part of this multidimensional mechanism. Practitioners and policymakers need to tailor SR2S interventions to local contexts to better influence parental decision-making for children's engagement in AST.

The location of primary public schools in urban areas of developing countries is the focus of this study. In such areas, new schools and modification of the current schools are required, and this process should be developed using rational and broad supporting tools for decision makers, such as optimization models. We propose a realistic coverage location model and a framework to analyze the location of schools. Our approach considers the existing schools and their resizing, the best locations of the new schools that may have different capacities, population coverage, walking distances and budget provisions for building and updating schools. As a case study, we assess the current primary school network in Ciudad Benito Juarez to provide managerial insights. Through the proposed framework, we analyze the current locations of schools and decisions to be made by considering future scenarios in different time periods. The proposed model is quite flexible and easy to adapt to new considerations, allowing it to be applied to regions in developing countries under similar conditions., Competing Interests: The authors have declared that no competing interests exist.

Objectives : We explored whether modes of transport (cycling, walking, public transport or private vehicle) between home and school are associated with mental well-being in children aged 10-17 years, participating in the Irish Health Behaviour in School-aged Children (HBSC) study. Methods : Scores on the World Health Organization Well-being Index and the Mental Health Inventory five-item versions, self-reported life satisfaction, happiness with self, body satisfaction, excellent self-rated health, and multiple health complaints of 9,077 schoolchildren (mean age: 13.99 ± 1.91 years, percentage girls: 52.2%) were compared across modes of transport, unadjusted and adjusted for gender, age, family affluence and area of residence. Results: Those who reported using public transport reported poorer mental well-being than those using other means of transport, but adjusting for sociodemographic variables obscured these differences. The only exception was excellent health, where children who cycled outperformed the other three groups, even after adjustment for sociodemographic variables. Conclusions: Cycling can improve well-being in children. However, in promotion of cycling, social and environmental determinants and inequalities which influence adolescents' and their parents' decisions on modes of transport, need to be considered., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Költő, Gavin, Kelly and Nic Gabhainn.)

Objectives: In Canada, students are increasingly reliant on motorized vehicles to commute to school, and few meet the recommended overall physical activity guidelines. Infrastructure and built environments around schools may promote active commuting to and from school, thereby increasing physical activity. To date, few Canadian studies have examined this research question., Methods: This study is a cross-sectional analysis of 11,006 students, aged 11-20, who participated in the 2016/2017 Ontario Student Drug Use and Health Survey. The remote sensing-derived Normalized Difference Vegetation Index (NDVI), at a buffer of 500 m from the schools' locations, was used to characterize greenness, while the 2016 Canadian Active Living Environments (Can-ALE) measure was used for walkability. Students were asked about their mode of regular commuting to school, and to provide information on several socio-demographic variables. Multivariable logistic regression models were used to quantify associations between active commuting and greenness and the Can-ALE. The resulting odds ratios, and their 95% confidence intervals, were adjusted for a series of risk factors that were collected from the survey., Results: Overall, 21% of students reported active commuting (biking or walking) to school, and this prevalence decreased with increasing age. Students whose schools had higher Can-ALE scores were more likely to be active commuters. Specifically, the adjusted odds ratio (OR) of being an active commuter for schools in the highest quartile of the Can-ALE was 2.11 (95% CI = 1.64, 2.72) when compared with those in the lowest. For children, aged 11-14 years, who attended schools in high dwelling density areas, a higher odds of active commuting was observed among those in the upper quartile of greenness relative to the lowest (OR = 1.41; 95% CI = 0.92, 2.15). In contrast, for lower dwelling density areas, greenness was inversely associated with active commuting across all ages., Conclusion: Our findings suggest that students attending schools with higher Can-ALE scores are more likely to actively commute to school, and that positive impacts of greenness on active commuting are evident only in younger children in more densely populated areas. Future studies should collect more detailed data on residential measures of the built environment, safety, distance between home and school, and mixed modes of commuting behaviours.

Aim: The aims of this study were (1) to examine the associations between self-reported health-related quality of life (HRQoL), health-related physical fitness (cardiorespiratory fitness, muscular strength, and speed-agility), and mode of commuting to and from school in Spanish children, and separately by gender and (2) to analyse the difference in cardiorespiratory fitness by mode of commuting to and from school by gender., Methods: We conducted a cross-sectional analysis that included 415 children aged 8.47 ± 0.36 years from 14 schools in Granada, Spain. The HRQoL outcome was assessed using the valid and reliable KINDL-R questionnaire, which covers six life dimensions, children's physical fitness was assessed using the ALPHA fitness test battery, and while commuting to and from school was assessed using the valid, reliable, and feasible 'Mode and Frequency of Commuting To and From School Questionnaire'., Results: Cardiorespiratory fitness was positively correlated with all dimensions of HRQoL in boys, whereas higher muscular strength (standing long jump) was positively correlated with the emotional wellbeing dimension in girls. In addition, boys who actively commute to school (walking) presented better cardiorespiratory fitness. Moreover, children who actively commuted to school (walking) presented better scores for the emotional wellbeing, family, and school dimensions, as well as total scores (both, p  < .05) of HRQoL., Conclusion: In our study, HRQoL was positively correlated with cardiorespiratory fitness in boys (all dimensions), whereas muscular strength (standing long jump) was positively correlated with the emotional wellbeing dimension only in girls. Active commuting to and from school was associated with higher levels of cardiorespiratory fitness, school dimension, and KINDL-R total score. Improving cardiorespiratory fitness might be especially useful to improve HRQoL in children, and vice versa.

Aim: Using a longitudinal design, the purpose of this study was to test a model integrating perceptions of the school neighbourhood environment with constructs from the Theory of Planned Behaviour (TPB) to predict transport-related cycling among Chinese college students. Methods: A sample of 630 ( M age  = 18.95 years; SD  = 1.16) Chinese college students completed baseline measures that included perceptions of the school neighbourhood environment, TPB constructs, transport-related cycling, and covariates. Of those, 547 students ( M age  = 18.90 years; SD  = 0.92) also completed measures of transport-related cycling one month later. Results: Findings showed that intention had a direct effect on students' transport-related cycling, while attitudes, subjective norm, and perceived behavioural control predicted cycling indirectly via intention. Perceptions of the school neighbourhood environment did not provide an indirect effect on cycling via the TPB constructs, although some perceived environmental factors had indirect effects on intention via attitudes and subjective norm. Further, those who perceived better street connectivity showed a larger intention-cycling relationship than those who perceived less street connectivity. Conclusions: Findings of this study highlight the importance of integrating perceptions of the school neighbourhood environment with the TPB constructs to explain transport-related cycling through both intention formation and action control (i.e. translating intention into behaviour). The identified moderator of perceived street connectivity on the intention-cycling relationship suggests that efficient cycling routes may impact action control of cycling. Future research applying dual process and action control models beyond TPB may contribute to the identification of the multilevel determinants of transport-related cycling.

Introduction: Active commuting to school could help increasing physical activity levels among adolescents. However, there is limited understanding on how the relationship between the environment in school surroundings, as well the distance to school, could affect this behavior., Aim: To analyze the characteristics of the environment and distance between house and school with objective measures and their association with active commuting between adolescents of Curitiba, Brazil., Methods: 493 adolescents were interviewed and 124 schools evaluated. The study variables included the schools' surroundings accessibility characteristics obtained through systematic observation, and the distance between home to school was determined through Geographic Information Systems (GIS) data., Results: The presence of "safety signs" was inversely associated with active commuting (PR = 0.78; 95%CI 0.67-0.91; p = 0.003), as well distance 1,501-3,000 m (PR = 0.53; 95%CI 0.40 - 0.71; p < 0.001) and ≥ 3,501 m (PR 0.29; 95%CI 0.18 - 0.45; p < 0.001). Overall, schools' surroundings showed walking friendly characteristics., Conclusion: Traffic safety and distance to school were associated with active commuting to school among the study participants. Policies aiming at integrating access to school and traffic safety could help to promoting active commuting among adolescents.

Objectives: We aimed to systematically review parental barriers towards children and adolescents' active transport to school (ATS) in the scientific literature and to provide a categorization of the barriers identified in the studies., Methods: A search was conducted through seven online databases, from the beginning of the database to March 2018., Results: A total of 27 of the identified studies met the inclusion criteria. The main parental barriers reported by parents of children (21 studies) were built environment, traffic safety, distance, crime-related safety and social support. The main parental barriers reported by parents of adolescents (6 studies) were built environment (street connectivity), distance, traffic safety and physical and motivation barriers. The parental barriers associated with ATS were mainly related to the built environment and traffic safety., Conclusions: It is crucial to involve parents through interventions to reduce the perception of safety and to increase awareness of the importance of ATS. In addition, these strategies should be complemented by environmental changes performed by local governments.

Objectives: To study the extent to which home-to-school distance and neighbourhood walkability were associated with self-reported active travel to school (ATS) (eg, walking, cycling), and to explore how distance moderates the effect of walkability on ATS, among 10-11 years old., Design: Cross-sectional study., Setting: Data were collected between May 2015 and May 2016 in partnership with the Growing Up in Scotland Study, a nationally representative longitudinal cohort study., Participants: 713 children (male (n=330) and female (n=383) 10-11 years old) from Studying Physical Activity in Children's Environments across Scotland., Primary and Secondary Outcome Measures: Children who actively travelled to/from school categorised as active all (100% of ATS) and active 60%+ (at least 60% of ATS); home-to-school road/path network distance (<0.5 km, 0.5 to <1 km, 1 to <1.5 km, 1.5 to <2 km, 2 km+); home neighbourhood walkability (i.e., composite measure of road/path intersection density and dwelling density) (in quintiles)., Results: Distance and walkability were both associated with ATS. The likelihood of ATS for all or most journeys decreased with increasing distance. Compared with 'most' walkable areas (Q1), the odds of active all were significantly lower within least walkable areas (Q5 OR 0.45, 95% CI 0.21 to 0.99), and odds of active 60% + were significantly less in Q2-Q5 (lowest odds Q5 OR 0.20, 95% CI 0.07 to 0.47). Regarding walkability and distance interactions, for all distance categories, higher walkability increased the probability of ATS (for most school journeys)., Conclusion: Walkability was positively associated with ATS within all distance categories, with the relationship between walkability and ATS more complex than the clear-cut association between distance and ATS. A more walkable environment had a larger effect on the probability of reaching the 60% threshold of school journeys using ATS than the probability of always travelling in an active manner. Investment is needed in existing less walkable neighbourhoods to provide infrastructure to support opportunities for children's ATS., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)

Active commuting to school has health implications for young people. Previous research has shown the need to consistently define the concept of "active commuter", given that assessment as well as comparison between studies may be hindered by current discrepancies in frequency criteria. Using a sample of 158 Spanish students (12th-13th grade, 60.8% girls), the current study aimed to compare several cut-off criteria to rigorously identify the frequency of weekly active trips to school in order to categorize adolescents as active or passive commuters, and to analyze whether the threshold living distance to school is associated with the different trip cut-off criteria. Percentages of active commuters ranged from 75% to 88.6%, varying significantly depending on the cut-off criteria (5-10 active trips/week) used. The results also support the need to be stricter in the selection of a cut-off criterion when the distance to the school becomes shorter. Our findings highlight the importance of following a standard criterion to classify individuals as active or passive commuters, considering the characteristics of the context in which each study is conducted.

Background: While promoting active commuting to school can positively affect children's daily physical activity levels, effectively engaging community members to maximize program impact remains challenging. We evaluated the initial utility of adding a technology-enabled citizen science engagement model, called Our Voice, to a standard Safe Routes to School (SRTS) program to enhance program engagement activities and student travel mode behavior., Methods: In Investigation 1, a prospective controlled comparison design was used to compare the initial year of the Santa Clara County Public Health Department's SRTS program, with and without the Our Voice engagement model added, in two elementary schools in Gilroy, California, USA. School parents served as Our Voice citizen scientists in the SRTS + Our Voice school. In Investigation 2, the feasibility of the combined SRTS + Our Voice methods was evaluated in a middle school in the same district using students, rather than adults, as citizen scientists. Standard SRTS program engagement measures and student travel mode tallies were collected at the beginning and end of the school year for each school., Results: In the elementary school investigation (Investigation 1), the SRTS + Our Voice elementary school held twice as many first-year SRTS planning/encouragement events compared to the SRTS-Alone elementary school, and between-school changes in walking/biking to school rates favored the SRTS + Our Voice school (increases of 24.5% vs. 2.6%, P < .001). The Investigation 2 results supported the feasibility of using students to conduct SRTS + Our Voice in a middle school-age population., Conclusions: The findings from this first-generation study indicated that adding a technology-enabled citizen science process to a standard elementary school SRTS program was associated with higher levels of community engagement and walking/biking to school compared to SRTS alone. The approach was also found to be acceptable and feasible in a middle school setting.

There has been a decline in children's use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired intervention to promote students' AST in winter conditions. Methods: Thirty-five students, who were aged 12⁻13 years, and 34 parents from the north of Sweden participated in the study. Data were collected using photovoice and open questions in a questionnaire and analyzed using qualitative content analysis. Results: The results show that involvement and togetherness motivated the students to use AST. In addition, during the project, the parents changed to have more positive attitudes towards their children's use of AST. The students reported that using AST during wintertime is strenuous but rewarding and imparts a sense of pride. Conclusion: Interventions for increasing students' AST in winter conditions should focus on the motivational aspects for both children and parents. For overcoming parental hesitation with regards to AST during winter, addressing their concerns and empowering the students are key factors. To increase the use of AST all year around, targeting the challenges perceived during the winter is especially beneficial., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Background: Active commuting to school (ACS) is associated with increased physical activity and lowered risk of obesity. In observational studies, ACS was associated with child self-efficacy, parent self-efficacy, and parent outcome expectations, although few experiments have assessed changes in these behavioral constructs., Aim: This study examined the effects of a bicycle train intervention (BTI) on child self-efficacy, parent self-efficacy, and parent outcome expectations in a diverse, low socioeconomic status population., Method: Data were from a 2014 BTI pilot randomized controlled trial (RCT) on fourth to fifth graders aged 9 to 12 years, n = 54, from four schools serving low-income populations in Seattle, Washington. The BTI was a group of children and study staff who cycled together to/from school daily, while controls received no intervention. Responses to validated child self-efficacy, parent self-efficacy, and parent outcome expectations questionnaires ranged from 1 to 3. Adjusted linear mixed effects models estimated standardized coefficients for child self-efficacy, parent self-efficacy, and parent outcome expectations comparing intervention and controls from Time 1 (preintervention) to Time 2 (final 4-6 weeks of intervention)., Results: The intervention group had increases in child self-efficacy of 0.84 standard deviations (95% confidence interval [CI] [0.37, 1.31]), parent self-efficacy of 0.46 standard deviations (95% CI [0.05, 0.86]), and parent outcome expectations of 0.47 standard deviations (95% CI [0.17, 0.76]) compared with controls from Times 1 to 2 (all ps <.05)., Conclusion: A BTI improved child self-efficacy, parent self-efficacy, and parent outcome expectations, which warrants a larger RCT to examine long-term changes to these behavioral constructs and ACS.

Physical inactivity among children is a significant public health concern. Active school travel (AST) methods, such as walking and wheeling to school, can be a valuable way to increase children's levels of daily physical activity. In Canada, Active and Safe Routes to School (ASRTS), a national health promotion initiative, has led the campaign for AST through its flagship school travel plan (STP) program. At present little is known about the on-the-ground implementation processes that impede or facilitate the success of STPs. Through a thematic analysis of 18 interviews with STP facilitators and 4 focus groups with the larger STP committees, our study evaluates the factors shaping the functioning of STP interventions at ten elementary schools participating in a regional ASRTS program in Southwestern Ontario. Our analysis yielded six themes that have implications for STP implementation and sustainability: 1) accounting for school context; 2) establishing committee capacity and leadership; 3) supporting STP action; 4) responsiveness to external and internal barriers; 5) engaging schools at the grassroots level; and 6) building future champions. We draw from Lewin's Field Theory and discuss the forces affecting STP committees to frame our findings in a way that can be discussed to support the building of efficient, effective, and viable AST intervention environments., (Copyright © 2018. Published by Elsevier Ltd.)

Background: Physical activity plays a fundamental role in the health and well-being of children. Walking is the most common form of physical activity and the journey to and from school provides an opportunity for children to be active every day. This study examines how child and parent perceptions of barriers to active school travel influences children's behaviour., Methods: Participants were recruited from 48 elementary schools in Southwestern Ontario, Canada. The study sample includes 1296 children (ages 9-14 years) who live within walking distance of their school, defined as 1.6 km network distance. Chi-square analysis examined differences between child and parent perceptions of barriers to active school travel. Logistic regression models examined how parent and child perceptions of barriers influence active school travel behaviour, while controlling for key intrapersonal, interpersonal, and physical environment factors., Results: The results indicate that there are significant differences in how parents and children perceive barriers to active school travel. Model results find older children, children without siblings, households with no vehicles, and children who live closer to school are most likely to use active school travel. Parent perceptions of barriers are found to have a greater influence on children's active school travel behaviour than children's perceptions. Different perceptions of barriers influence active school travel to school compared to returning home from school., Conclusions: Child and parent perceptions of barriers to active school travel differ and have different impacts on children's travel behaviour. Understanding how child and parent perceptions of barriers differ can help policymakers and practitioners develop specialized interventions aimed at increasing children's use of active school travel and children's overall physical activity. Interventions used to promote active school travel should focus on safety, as well as perceptions of distance to break parental habits of routinely driving their children to school. Overall, this study highlights the importance of considering both child and parent perceptions to create a safe and accessible environment to allow for an increase in active school travel behaviour among elementary school children who live within walking distance of their school.

Background: The aim of this study was to investigate how sleep, screen time, active school travel and sport and/or exercise participation associates with moderate-to-vigorous physical activity (MVPA) in nationally representative samples of Norwegian 9- and 15-y-olds, and whether these four behaviors at age nine predict change in MVPA from age nine to 15 years., Method: We pooled cross-sectional accelerometer and questionnaire data from 9- (n = 2366) and 15-y-olds (n = 1554) that participated in the first (2005/06) and second (2011/12) wave of the Physical Activity among Norwegian Children Study to investigate cross-sectional associations. To investigate prospective associations, we used data from a sub-sample that participated in both waves (at age nine and 15 years, n = 517)., Results: Cross-sectional analyses indicated a modest, inverse association between screen time and MVPA among 9- (- 2.2 min/d (95% CI: -3.1, - 1.3)) and 15-y-olds (- 1.7 min/d (95% CI: -2.7, - 0.8)). Compared to their peers with 0-5 min/d of active travel to school, 9- and 15-y-olds with ≥16 min/d accumulated 7.2 (95% CI: 4.0, 10.4) and 9.0 (95% CI: 3.8, 14.1) more min/d of MVPA, respectively. Nine-y-old boys and 15-y-olds reporting ≥8 h/week of sports and/or exercise participation accumulated 14.7 (95% CI: 8.2, 21.3) and 17.9 (95% CI: 14.0, 21.8) more min/d of MVPA, respectively, than those reporting ≤2 h/week. We found no cross-sectional association between sleep duration and MVPA in either age group. None of the four behaviors predicted change in MVPA from age nine to 15 years (p ≥ 0.102)., Conclusion: Active travel to school and sport/exercise participation may be important targets for future interventions aimed at increasing MVPA in children and adolescents. However, future studies are needed to determine causality.

Background: There is limited knowledge of physical activity (PA) patterns among high school students. High schools plays an important role as context for the students, but it is uncertain to what extent schools influence student participation in PA during leisure time. The purpose of this study is to describe patterns of PA and assess variations between schools and classes in PA, in a large cohort of Danish high school students., Methods: Self-reported cross-sectional data came from The Danish National Youth Study, comprising a total of 70,674 students attending 119 different schools and 3213 classes. Multilevel logistic regressions were applied to evaluate the association between socio-demographic variables and patterns of PA, and to assess the impact of schools and classes on PA measures., Results: Students whose parents have achieved a lower level of education, older students and girls of perceived ethnic minority generally participated less in several forms of PA during leisure time. Substantial variations between schools were observed in terms of participation in PA at school during leisure time and in terms of use of active transportation to and from school. The school-level accounted for 9% (intra-class correlation coefficient (ICC) = 0.09 (95% CI: 0.06-0.11)) and 8% (ICC = 0.08 (95% CI: 0.07-0.11)) of the variation for participation in PA during leisure time and active transportation., Conclusion: Overall, students whose parents achieved a lower level of education, older students and girls of perceived ethnic minority represent vulnerable groups in relation to participation in several forms of PA during leisure time. The ICCs indicate that schools, in particular, have the potential to influence participation in PA at school during leisure time and active transportation to and from school. Thus, high schools should encourage and facilitate activities aimed at engaging students in PA during leisure time as well as encourage active transportation.

Background: Active school transport (AST) is a promising strategy to increase children's physical activity. A systematic review published in 2011 found large heterogeneity in the effectiveness of interventions in increasing AST and highlighted several limitations of previous research. We provide a comprehensive update of that review., Methods: Replicating the search of the previous review, we screened the PubMed, Web of Science, Cochrane, Sport Discus and National Transportation Library databases for articles published between February 1, 2010 and October 15, 2016. To be eligible, studies had to focus on school-aged children and adolescents, include an intervention related to school travel, and report a measure of travel behaviors. We assessed quality of individual studies with the Effective Public Health Practice Project quality assessment tool, and overall quality of evidence with the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. We calculated Cohen's d as a measure of effect size., Results: Out of 6318 potentially relevant articles, 27 articles reporting 30 interventions met our inclusion criteria. Thirteen interventions resulted in an increase in AST, 8 found no changes, 4 reported inconsistent results, and 5 did not report inferential statistics. Cohen's d ranged from -0.61 to 0.75, with most studies reporting "trivial-to-small" positive effect sizes. Three studies reported greater increases in AST over longer follow-up periods and two Safe Routes to School studies noted that multi-level interventions were more effective. Study quality was rated as weak for 27/30 interventions (due notably to lack of blinding of outcome assessors, unknown psychometric properties of measurement tools, and limited control for confounders), and overall quality of evidence was rated as low. Evaluations of implementation suggested that interventions were limited by insufficient follow-up duration, incomplete implementation of planned interventions, and limited access to resources for low-income communities., Conclusions: Interventions may increase AST among children; however, there was substantial heterogeneity across studies and quality of evidence remains low. Future studies should include longer follow-ups, use standardized outcome measures (to allow for meta-analyses), and examine potential moderators and mediators of travel behavior change to help refine current interventions., Trial Registration: Registered in PROSPERO: CRD42016033252.

Background: Many Canadian schools offer breakfast programs; however, students' engagement in these programs is low, while breakfast skipping is highly prevalent among youth. This study examined whether the availability of breakfast programs supports adolescents' regular breakfast eating, and identified characteristics of breakfast skippers who are not using these programs., Methods: Data from 30,771 secondary school students from Ontario and Alberta, Canada, participating in Year 3 (2014-2015) of the COMPASS study were used for descriptive and logistic regression analyses. Participants were categorized by self-reported breakfast eating and school breakfast program use., Results: Sixteen percent of participants reported using school breakfast programs. Breakfast skipping was highly prevalent among participants, regardless of their breakfast program use. Characteristics significantly associated with program use included traveling to school via public transit or a school bus, being a bullying victim, and having a high school connectedness score. A desire to lose weight and non-involvement in school sports were significantly associated with being a "breakfast skipper/nonprogram user.", Conclusions: School breakfast programs do not consistently support regular breakfast eating, even among adolescents actively engaged in these programs. Future research should identify and evaluate practices to bolster participation in breakfast programs and promote regular breakfast eating among adolescents., (© 2018, American School Health Association.)

Background: Descriptive data on active transportation in children focuses on the trip to school and has relied on subjective reports. The purpose of this study was to use objective measures to describe total active transportation and active transportation to common destinations within children., Methods: This was a descriptive study of 388 children aged 10-13 years from Kingston, Ontario, Canada. Participants wore a Garmin GPS watch during waking hours for seven days. Personal Activity Measurement Location System software used the GPS data to identify trips, time spent in each trip and the trip modality (walking, bicycle or vehicle). Google Maps software was used to identify trip destinations., Results: A total of 8875 trips were identified. Most (69%) trips were made by vehicle; 25% were made by walking and 6% by bicycle. Mean time spent in active transportation was 10.3 min/day (95% CI: 7.4, 14.5). Time spent in active transportation was higher for boys (12.1 min/day [95% CI: 8.8, 17.0) than for girls (8.5 min/day [95% CI: 6.1, 12.0]) and increased from 7.7 min/day (95% CI: 5.5, 11.1) at age 10 to 14.3 min/day (95% CI: 10.3, 19.9) at age 13. Time spent in active transportation was lower in the winter by comparison to the other seasons. The four most common active transportation destinations were the participant's home, school, other people's homes, and parks or greenspace with 69%, 39%, 37% and 32% of participants walking or bicycling to these destinations at least once over the 7-day measurement period., Conclusion: Over 65% of trips made and time spent travelling occurred in a vehicle. When active transportation was used, the most common destinations were home, school, other people's homes, and parks.

Background: Interventions aiming to promote active school travel (AST) are being implemented globally to reverse AST decline. This systematic literature provides an update of AST interventions assessing study quality and theory use to examine progress in the field., Methods: A systematic review was conducted to identify and analyse AST interventions published between 2010 and 2016. Seven databases were searched and exclusion criteria were applied to identify 18 AST interventions. Interventions were assessed using the Active Living by Design (ALBD) Community Action (5P) Model and the Evaluation of Public Health Practice Projects (EPHPP). Methods used to evaluate the effectiveness of each intervention and their outcomes and extent of theory use were examined., Results: Seven out of 18 studies reported theory use. The analysis of the interventions using the ALBD Community Action Model showed that Preparation and Promotion were used much more frequently than Policy and Physical projects. The methodological quality 14 out of 18 included interventions were assessed as weak according to the EPHPP framework., Conclusion: Noted improvements were an increase in use of objective measures. Lack of theory, weak methodological design and a lack of reliable and valid measurement were observed. Given that change is evident when theory is used and when policy changes are included extended use of the ALBD model and socio-ecological frameworks are recommended in future.

An exploratory spatial analysis investigates the location of schools in Calgary (Canada) in relation to air pollution and active transportation options. Air pollution exhibits marked spatial variation throughout the city, along with distinct spatial patterns in summer and winter; however, all school locations lie within low to moderate pollution levels. Conversely, the study shows that almost half of the schools lie in low walkability locations; likewise, transitability is low for 60% of schools, and only bikability is widespread, with 93% of schools in very bikable locations. School locations are subsequently categorized by pollution exposure and active transportation options. This analysis identifies and maps schools according to two levels of concern: schools in car-dependent locations and relatively high pollution; and schools in locations conducive of active transportation, yet exposed to relatively high pollution. The findings can be mapped and effectively communicated to the public, health practitioners, and school boards. The study contributes with an explicitly spatial approach to the intra-urban public health literature. Developed for a moderately polluted city, the methods can be extended to more severely polluted environments, to assist in developing spatial public health policies to improve respiratory outcomes, neurodevelopment, and metabolic and attention disorders in school-aged children., Competing Interests: The authors declare no conflict of interest.

Background: There is a paucity of intervention studies assessing active travel to school as a mechanism to increase physical activity. This paper describes the impact of a community-wide intervention on active travel to primary schools in 2 Irish towns., Methods: This was a repeat cross-sectional study of a natural experiment. Self-report questionnaires were completed by 5th and 6th grade students in 3 towns (n = 1038 students in 2 intervention towns; n = 419 students in 1 control town) at baseline and by a new group of students 2 years later at follow-up. The absolute change in the proportion of children walking and cycling to school (difference in differences) was calculated., Results: There was no overall intervention effect detected for active travel to or from school. This is despite an absolute increase of 14.7% (1.6, 27.9) in the proportion of children that indicated a preference for active travel to school in the town with the most intensive intervention (town 2)., Conclusions: Interventions designed to increase active travel to school hold some promise but should have a high-intensity mix of infrastructural and behavioral measures, be gender-specific, address car dependency and focus on travel home from school initially.

Walking to/from school could promote children's physical activity and help combat childhood obesity. Parental attitudes have been identified as one of the important predictors. But it is unclear what factors shape parental attitudes, and how those in turn influence children's school travel. This study addresses this gap of knowledge by examining the mediating effect of parental attitudes for the relationships between personal, social, and built environmental factors and children's walking-to/from-school behaviors. Survey data (N=2597) were collected from 20 public elementary schools in Austin, Texas, measuring students' typical school travel mode; personal, social, and built environmental factors related to walking-to/from-school; and relevant parental attitudes. The analysis was conducted in M-plus 6.11 to test the proposed conceptual framework using a structural equation model (SEM). Parental attitudes showed significant mediating effects on walking-to/from-school behaviors. Older child, positive peer influence, walkable home-to-school distance, and favorable walking environments were associated with more enjoyment and lower attitudinal barriers, and in turn increased likelihood of walking to/from school. Being Hispanic, increased car ownership, and stronger traffic safety concerns reduced enjoyment and increased attitudinal barriers, and thus decreased likelihood of walking to/from school. This study highlighted the importance of using multilevel interventions to reduce attitudinal barriers and increase enjoyment of walking to/from school. Collaborations among different stakeholders are needed to address environmental issues (e.g., safety concerns) and social factors (e.g., peer influence), while being sensitive to personal factors (e.g., age, ethnicity, and car ownership)., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Whereas children's active travel to school (ATS) has confirmed benefits, only a few large national surveys of ATS exist., Methods: Using data from the Health Behavior in School-aged Children (HBSC) 2009-2010 US survey, we conducted a logistic regression model to estimate the odds ratios of ATS and a linear regression model to estimate the adjusted mean differences of the percentage of ATS within a school., Results: Overall, 21.4% of children engaged in at least one way of active travel to or from school. ATS was less common for trips to school than from school. Greater distance to school was a major barrier preventing children from ATS. Children living in large cities were more likely to engage in ATS, and schools located in a large city had higher proportions of ATS rate. Children having lower family satisfaction, or engaging in a greater number of physically active days during the past week were all more likely to engage in ATS., Conclusions: Although ATS is low among US children, significant variation exists. HBSC is a promising data source for an ATS study. As the first study to explore the variation of ATS at school level, this research contributes uniquely to current knowledge., (© 2016, American School Health Association.)

Physical inactivity among children is on the rise. Active transport to school (ATS), namely walking and cycling there, adds to children's activity level. Little is known about how exposures along actual routes influence children's transport behavior. This study examined how natural and built environments influence mode choice among Dutch children aged 6-11 years. 623 school trips were tracked with global positioning system. Natural and built environmental exposures were determined by means of a geographic information system and their associations with children's active/passive mode choice were analyzed using mixed models. The actual commuted distance is inversely associated with ATS when only personal, traffic safety, and weather features are considered. When the model is adjusted for urban environments, the results are reversed and distance is no longer significant, whereas well-connected streets and cycling lanes are positively associated with ATS. Neither green space nor weather is significant. As distance is not apparent as a constraining travel determinant when moving through urban landscapes, planning authorities should support children's ATS by providing well-designed cities., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: The purpose of this study is to increase our understanding of environmental correlates that are associated with route choice during active transportation to school (ATS) by comparing characteristics of actual walking and cycling routes between home and school with the shortest possible route to school., Methods: Children (n = 184; 86 boys, 98 girls; age range: 8-12 years) from seven schools in suburban municipalities in the Netherlands participated in the study. Actual walking and cycling routes to school were measured with a GPS-device that children wore during an entire school week. Measurements were conducted in the period April-June 2014. Route characteristics for both actual and shortest routes between home and school were determined for a buffer of 25 m from the routes and divided into four categories: Land use (residential, commercial, recreational, traffic areas), Aesthetics (presence of greenery/natural water ways along route), Traffic (safety measures such as traffic lights, zebra crossings, speed bumps) and Type of street (pedestrian, cycling, residential streets, arterial roads). Comparison of characteristics of shortest and actual routes was performed with conditional logistic regression models., Results: Median distance of the actual walking routes was 390.1 m, whereas median distance of actual cycling routes was 673.9 m. Actual walking and cycling routes were not significantly longer than the shortest possible routes. Children mainly traveled through residential areas on their way to school (>80% of the route). Traffic lights were found to be positively associated with route choice during ATS. Zebra crossings were less often present along the actual routes (walking: OR = 0.17, 95% CI = 0.05-0.58; cycling: OR = 0.31, 95% CI = 0.14-0.67), and streets with a high occurrence of accidents were less often used during cycling to school (OR = 0.57, 95% CI = 0.43-0.76). Moreover, percentage of visible surface water along the actual route was higher compared to the shortest routes (walking: OR = 1.04, 95% CI = 1.01-1.07; cycling: OR = 1.03, 95% CI = 1.01-1.05)., Discussion: This study showed a novel approach to examine built environmental exposure during active transport to school. Most of the results of the study suggest that children avoid to walk or cycle along busy roads on their way to school.

Background: Active commuting to school may provide a significant source of physical activity in youth. Previous school-based intervention studies have shown a positive effect on increasing the frequency of active commuting to school in the short-term. However, how the observed effects are after the intervention remains to be investigated. The objective of the present study was to investigate the effects of a school-based intervention on active commuting to school at 6-month follow-up., Methods: A total of 494 children ages 8-11 years from 5 primary schools were invited to the study. The schools were non-randomly allocated into control or experimental group. The experimental group received a 6-month programme focused on increasing active commuting to school, while the control group received no intervention. Frequency and mode of commuting to school were measured using a questionnaire at pre-intervention, post-intervention and 6-month follow-up. Children with valid data on commuting to school and provided data for sex, age and distance from home were included in this study (n= 206)., Results: There was a significant difference in the change of number of walk and bike travels per week between groups at 6-month follow-up (Control-Group = -0.4 ± 0.3; Experimental-Group = 0.6 ± 0.2;p = 0.019). Regarding the frequency of mode of commuting, only a change in walking to school was significantly different between the groups at 6-month follow-up (Difference Follow-up-Post-intervention) (Control-Group = -0.6 ± 0.3; Experimental-Group = 0.7 ± 0.2;p = 0.004)., Conclusions: A 6-month school-based intervention focused on increasing active commuting to school could be effective strategy for increasing the frequency of active commuting to school even beyond the period of intervention., (© The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Purpose: Little is known about patterns of active commuting to school (ACS) among school-aged children in China. This study examines mode of transport to school in China and associations with physical and mental well-being among national representative children., Methods: Data came from National Puberty Research Collaboration. Commuting mode to school was self-reported and categorized as three categories: walking, cycling, and passive commuting to school. Body mass index, percentage body fat (PBF, measured by skinfold thickness), waist circumference (WC) was measured, and depressive symptoms was assessed by Children's Depression Inventory., Results: A total of 12,151 girls and 9,445 boys from grade 4 to grade 12 participated in this study. Totally 39.9% of Chinese children walked and 15.9% cycled to school, 44.2% traveled by passive commuting mode. ACS was predictive of lower body mass index, PBF, and WC. Children who commuted via active modes had body mass index, PBF, and WC scores of .167 (95% confidence interval [CI] .274-.060), .566 (95% CI .270-.862), and .724 (95% CI .423-1.025) points lower, respectively, than those who used passive transport. ACS was associated with .855 lower odds of being obese (p < .001) and .907 lower (p < .001) odds of having depressive symptoms compared with children using passive transport., Conclusions: ACS is correlated with better physical and mental well-being. Sustainable transport planning aimed at increasing active travel to school among Chinese children and adolescents is in great need., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Declines in physical activity (PA) in children and youth have contributed to increases in childhood overweight and obesity. The Safe Routes to School (SRTS) program was developed to promote school active transportation (AT) and reverse the trend., Methods: Adopting concepts of a realist approach, this article seeks to understand strategies of adoption that worked in the Canadian and United States context. Inclusion criteria consisted of adoption of SRTS program, identification and definition of SRTS, implementation in Canada /United States, and partnership identified., Results: Partnerships focused on increasing the number of children using AT to school. With unique political and funding atmospheres, a common strategy was developing multilevel comprehensive partnerships to mobilize knowledge and resources, as well as to align intervention planning. Key successes, tools used to measure success, as well as benefits, challenges and lessons learned from partnerships were identified., Conclusion: This article is the first attempt to examine SRTS at the state/provincial/city level to understand key adoption strategies using a realist approach. It found collaborative community-research partnerships that initiated SRTS and created cultural shifts in communities from the individual to policy level. Researchers, schools and communities interested in increasing school AT should consider SRTS as a valuable approach., (© 2015, American School Health Association.)

Purpose: The aim of this study was to examine (a) whether distance from home to school is a determinant of active commuting to school (ACS), (b) the relationship between distance from home to heavily used facilities (school, green spaces, and sports facilities) and the weight status and cardiometabolic risk categories, and (c) whether ACS has a positive impact on schoolchildren's health., Method: A cross-sectional study was conducted with 956 schoolchildren aged 10 to 12 years from the province of Cuenca, Spain. Height, weight, fat mass, waist circumference, blood pressure, fasting plasma lipid profile, insulin, fitness, physical activity, and ACS were measured. Distances from home to facilities were measured by a geographic information system, and a validated metabolic syndrome index was used., Findings: Children living closer to school (less than 600 m) commuted actively to school more frequently than children living further away (more than 800 m). Normoweight boys lived further away from sports facilities than overweight/obese peers, and children presenting higher cardiometabolic risk levels lived closer to school than those who did not. No differences were found between children who daily walked/cycled to school and those commuting actively to school less frequently in body mass index, metabolic syndrome index, fitness, and physical activity., Conclusions: ACS had no positive impact on schoolchildren's health. Distance to school is an indicator of active commuting. However, it seems that not enough physical activity is done to prevent obesity and cardiometabolic risk factors in rural areas., (© 2014 Society for Public Health Education.)

Objective: To test a modified integrative model (IM) in explaining parents' intention toward active commuting to school (ACS) and children's ACS., Methods: Parents of fourth graders (N = 857) completed a survey assessing factors associated with ACS. A modified IM was developed and tested using structural equation modeling., Results: The IM demonstrated good model fit (RMSEA = .04, CFI = .97, TLI = .97). Perceived barriers, self-efficacy, and health beliefs/outcome evaluation predicted parents' intention directly and children's ACS indirectly, with self-efficacy as the strongest predictor. Intention, in turn, predicted children's ACS. Similar findings emerged in a replication using the urban subsample data., Conclusions: The IM may enable health behavior researchers to design effective interventions to promote ACS.

Objective: To determine whether active school travel is associated with muscular fitness, which is an emerging marker of youth health., Methods: Handgrip strength, vertical jump and vertical jump peak power were measured in n=6829 English schoolchildren (53% males, age 12.9 ± 1.2 years) between 2007 and 2011. Participants were grouped according to self-reported habitual school travel modality., Results: Cyclists had greater handgrip strength than passive travelers. Vertical jump height was greater in walkers and cyclists compared with passive travelers. Jump peak power was also higher in walkers than in the passive travel group. Compared with passive travelers, cyclists had a higher (age, sex and BMI-adjusted) likelihood of good handgrip strength (OR 1.42, 95%CI;1.14-1.76) and walkers were more likely to have good measures for vertical jump peak power (OR 1.14, 95%CI;1.00-1.29). Cyclists' likelihood of having good handgrip strength remained significantly higher when adjusted for physical activity (OR 1.29, 95%CI;1.08-1.46)., Conclusion: Muscular fitness differs according to school travel habits. Cycling is independently associated with better handgrip strength perhaps due to the physical demands of the activity. Better muscular fitness may provide another health-related reason to encourage active school travel., (Copyright © 2014. Published by Elsevier Inc.)

We used an agent-based model to examine the impact of the walking school bus (WSB) on children's active travel to school. We identified a synergistic effect of the WSB with other intervention components such as an educational campaign designed to improve attitudes toward active travel to school. Results suggest that to maximize active travel to school, children should arrive on time at "bus stops" to allow faster WSB walking speeds. We also illustrate how an agent-based model can be used to identify the location of routes maximizing the effects of the WSB on active travel. Agent-based models can be used to examine plausible effects of the WSB on active travel to school under various conditions and to identify ways of implementing the WSB that maximize its effectiveness.

Objective: Identify non-distance factors related to children's active transport (AT) to school, including parental, home, and environment characteristics. Understanding the factors related to children's AT to school, beyond distance to school, could inform interventions to increase AT and children's overall physical activity., Study Design: Participants were in the Neighborhood Impact on Kids Study, a longitudinal, observational cohort study of children aged 6-11 and their parents in King County, WA and San Diego County, CA between 2007 and 2009. Parents reported frequency and mode of child transport to school, perceived neighbourhood, home and family environments, parental travel behaviours, and sociodemographics., Methods: Children living less than a 20 minute walk to school were in this analysis. Children classified as active transporters (walked/bicycled to or from school at least once per week) were compared with those not using AT as often., Results: Children using AT were older and had parents who reported themselves using active transport. Having a family rule that restricts the child to stay within sight of the parent or home and more parent working hours were related to lower odds of a child using AT., Conclusions: Children's AT to school is associated with parental AT to work and other locations. Interventions should be considered that enable whole family AT, ameliorate safety concerns and decrease the need for parental supervision, such as walking school buses., (Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to investigate the association between self-efficacy, enjoyment, and volitional control with active commuting, as well as to analyze the impact of social support from parents, friends, and teachers with active commuting to school., Methods: Participants in this cross-sectional study were 625 students (male: 46.3%) aged 10 to 15years from Porto, Portugal (2010/2011). A questionnaire was used to assess active commuting to/from school (walk/cycle), self-efficacy, enjoyment, volitional control and social support. Binary logistic regression was performed to identify significant associations between targeted variables and active commuting., Results: The results show positive associations in crude analyses for all variables, except for enjoyment for walk/cycle to school. In the adjusted model, higher likelihood of active commuting was found among students who reported having higher self-efficacy (OR=2.10; CI95%: 1.07; 4.11) to walk/cycle to school as well as among adolescents who reported being encouraged by their parents (OR=3.66; CI95%: 1.55; 8.69), and having the partnership of friends in active journeys (OR=4.31; CI95%: 1.79; 10.37)., Conclusion: Self-efficacy, encouragement from parents and companionship from friends were important indicators of active commuting to school among Portuguese adolescents. These findings provide support for further research to identify and understand factors that predict and explain the active commuting., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Active school transport (AST) is an important source of children's daily physical activity (PA). However, decreasing rates of AST have been reported in multiple countries during the last decades. The purpose of the present study was to examine the socio-demographic and school-level correlates of AST., Methods: A stratified sample of children (N = 567, mean age = 10.0 years; 57.8% female) was recruited in the Ottawa area. Four sources of data were used for analyses: 1) child questionnaire including questions on school travel mode and time; 2) parent questionnaire providing information on household socio-demographic characteristics; 3) school administrator survey assessing school policies and practices pertaining to PA; and 4) school site audit performed by the study team. Generalized linear mixed models were used to identify socio-demographic and school-level correlates of AST while controlling for school clustering., Results: Individual factors associated with higher odds of AST were male gender (OR = 1.99; 95% CI = 1.30-3.03), journey time <5 minutes vs. >15 minutes (OR = 2.26; 95% CI = 1.17-4.37), and 5-15 minutes vs. >15 minutes (OR = 2.27; 95% CI = 1.27-4.03). Children were more likely to engage in AST if school administrators reported that crossing guards were employed (OR = 2.29; 95% CI = 1.22-4.30), or if they expressed major or moderate concerns about crime in the school neighbourhood (OR = 3.34; 95% CI = 1.34-8.32). In schools that identified safe routes to school and where traffic calming measures were observed, children were much more likely to engage in AST compared to schools without these features (OR = 7.87; 95% CI = 2.85-21.76). Moreover, if only one of these features was present, this was not associated with an increased likelihood of AST., Conclusion: These findings suggest that providing crossing guards may facilitate AST. Additionally, there was a synergy between the identification of safe routes to school and the presence of traffic calming measures, suggesting that these strategies should be used in combination.

Background: Active transport to school is associated with higher levels of physical activity in children. Promotion of active transport has therefore gained attention as a potential target to increase children's physical activity levels. Recent studies have recognized that the distance between home and school is an important predictor for active travel among children. These studies did not yet use the promising global positioning system (GPS) methods to objectively assess active transport. This study aims to explore active transport to school in relation to the distance between home and school among a sample of Dutch elementary school children, using GPS., Methods: Seventy-nine children, aged 6-11 years, were recruited in six schools that were located in five cities in the Netherlands. All children were asked to wear a GPS receiver for one week. All measurements were conducted between December 2008 and April 2009. Based on GPS recordings, the distance of the trips between home and school were calculated. In addition, the mode of transport (i.e., walking, cycling, motorized transport) was determined using the average and maximum speed of the GPS tracks. Then, proportion of walking and cycling trips to school was determined in relation to the distance between home and school., Results: Out of all school trips that were recorded (n=812), 79.2% were classified as active transport. On average, active commuting trips were of a distance of 422 meters with an average speed of 5.2 km/hour. The proportion of walking trips declined significantly at increased school trip distance, whereas the proportion of cycling trips (β=1.23, p<0.01) and motorized transport (β=3.61, p<0.01) increased. Almost all GPS tracks less than 300 meters were actively commuted, while of the tracks above 900 meters, more than half was passively commuted., Conclusions: In the current research setting, active transport between home and school was the most frequently used mode of travel. Increasing distance seems to be associated with higher levels of passive transport. These results are relevant for those involved in decisions on where to site schools and residences, as it may affect healthy behavior among children.

Objective: Active school travel (AST) may provide a significant source of physical activity for children although rates of AST are declining in many countries. The objective of this study was to evaluate the Canadian School Travel Planning (STP) intervention by examining changes in school travel mode and predictors of mode change., Methods: Schools (n=106) across Canada participated between January 2010 and March 2012. STP committees implemented school-specific strategies to increase active school transport (AST) which included educational strategies, activities and events, capital improvement projects and enforcement initiatives. Travel mode at each school was assessed by a hands-up survey and school travel plans were reviewed for content., Results: Complete data were available for 53 schools. There was no increase in AST at follow-up after one year. There was variation in mode change between schools. Only season of data collection predicted a decrease in AST in the morning (B=-5.36, p<.05)., Conclusion: This Canadian STP evaluation showed no change in AST after one year. There was evidence of some localized success at nearly half of the participating schools. More robust monitoring and evaluation are needed to examine STP effectiveness., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: To estimate the proportion of children living within walking distance who walk to school in Toronto, Canada and identify built and social environmental correlates of walking., Methods: Observational counts of school travel mode were done in 2011, at 118 elementary schools. Built environment data were obtained from municipal sources and school field audits and mapped onto school attendance boundaries. The influence of social and built environmental features on walking counts was analyzed using negative binomial regression., Results: The mean proportion observed walking was 67% (standard deviation=14.0). Child population (incidence rate ratio (IRR) 1.36), pedestrian crossover (IRR 1.32), traffic light (IRR 1.19), and intersection densities (IRR 1.03), school crossing guard (IRR 1.14) and primary language other than English (IRR 1.20) were positively correlated with walking. Crossing guard presence reduced the influence of other features on walking., Conclusions: This is the first large observational study examining school travel mode and the environment. Walking proportions were higher than those previously reported in Toronto, with large variability. Associations between population density and several roadway design features and walking were confirmed. School crossing guards may override the influence of roadway features on walking. Results have important implications for policies regarding walking promotion., (Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.)

Background: Active commuting to school (ACS; walking or cycling to school) appears promising for decreasing children's obesity risk, although long-term studies are sparse. The aim was to examine whether kindergarten ACS was associated with fifth-grade adiposity., Methods: This study was a secondary analysis of the Early Childhood Longitudinal Study, Kindergarten (n=7938). Enrollment in kindergarten (1998-1999) was nationally representative of the United States and follow-up occurred in 2004. Kindergarten ACS was the main exposure variable and fifth-grade BMI z-score was the main outcome measure. Covariates included (1) neighborhood safety and BMI z-score in kindergarten and (2) demographics (i.e., age, gender, race/ethnicity, socioeconomic status, single- vs. two-parent households, region of country, and urbanicity in fifth grade). Three interactions were included: school travel*neighborhood safety; school travel*BMI z-score (kindergarten); and school travel*socioeconomic status. Analysis of covariance accounted for the complex sampling design., Results: Kindergarten ACS was associated with lower BMI z-score in fifth grade. The interaction of school travel*neighborhood safety indicated that children from less-safe neighborhoods who did ACS in kindergarten had a lower fifth-grade BMI z-score (p<0.05) than their peers who did not do ACS in kindergarten (i.e., in terms of BMI, this difference was -0.49 kg/m(2) for children of average height in less-safe neighborhoods)., Conclusion: Among children from less-safe neighborhoods, kindergarten ACS independently predicted lower BMI z-score in fifth grade among a national US cohort. Interventions and policies to increase ACS among young children, especially from unsafe neighborhoods, are warranted and should address parents' safety concerns.

Purpose: State Safe Routes to School (SRTS) programs provide competitive grants to local projects that support safe walking, bicycling, and other modes of active school travel (AST). This study assessed changes in rates of AST after implementation of SRTS projects at multiple sites across four states., Design: One-group pretest and posttest., Setting: Florida, Mississippi, Washington, and Wisconsin., Subjects: Convenience sample of 48 completed SRTS projects and 53 schools affected by a completed SRTS project., Intervention: State-funded SRTS project., Measures: AST was measured as the percentage of students walking, bicycling, or using any AST mode. SRTS project characteristics were measured at the project, school, and school neighborhood levels., Analysis: Paired-samples t-tests were used to assess changes in AST. Bivariate analysis was used to identify SRTS project characteristics associated with increases in AST. Data were analyzed separately at the project (n = 48) and school (n = 53) levels., Results: Statistically significant increases in AST were observed across projects in all four states. All AST modes increased from 12.9% to 17.6%; walking from 9.8% to 14.2%; and bicycling from 2.5% to 3.0%. Increases in rates of bicycling were negatively correlated with baseline rates of bicycling., Conclusion: State-funded SRTS projects are achieving one of the primary program goals of increasing rates of AST. They may be particularly effective at introducing bicycling to communities where it is rare. The evaluation framework introduced in this study can be used to continue tracking the effect of state SRTS programs as more projects are completed.