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Introduction: Evidence to date suggests that the built environment has the potential to facilitate and even discourage physical activity. A limitation of previous reviews is that they have typically not been country-specific. We conducted a systematized literature review of quantitative studies that estimated associations between the built environment--which were objectively measured--and walking among Canadian adults. Methods: Five scientific databases were searched for peer-reviewed studies published in all years up to December 31, 2016, that estimated the association between the built environment (i.e. objectively measured using audits and Geographic Information Systems [GIS]) and physical activity among a sample of Canadian adults. The database searches, title and abstract screen, full-text review and data extraction were undertaken by two reviewers. Results: Of 4140 articles identified, 25 met the inclusion criteria. Most studies included data from a single Canadian province. All but two studies were cross-sectional. Most studies captured self-reported walking for transportation and walking for any purpose. Overall walkability and land use were consistently associated with walking for transportation, while proximity to destinations was associated with walking for any purpose. Conclusions: Our review findings suggest that the built environment is potentially important for supporting adult walking. Overall walkability, land use and proximity to destinations appear to be important given their association with transportation walking and walking for any purpose. [ABSTRACT FROM AUTHOR]

Despite evidence suggesting that neighbourhood characteristics are associated with physical activity, very few mixed methods studies investigate how relocating neighbourhood, and subsequent changes in the built environment, influences physical activity. This sequential mixed methods study estimates associations between changes in overall physical activity and transportation walking and cycling and changes in objectively assessed neighbourhood walkability (quantitative phase) and describes perceived barriers and facilitators to physical activity following residential relocation (qualitative phase). During the quantitative phase, self-reported changes in transportation walking, transportation cycling, and overall physical activity following residential relocation were measured using a 5-point scale: (1) a lot less now, (2) a little less now, (3) about the same, (4) a little more now, and (5) a lot more now. Walkability improvers reported a slight increase in transportation walking (mean = 3.29, standard deviation (SD) = 0.87), while walkability decliners reported little or no perceived change in their transportation walking after relocation (mean = 2.96, SD = 1.12). This difference approached statistical significance (p=0.053). Furthermore, walkability decliners reported a slight decrease in transportation cycling (mean = 2.69, SD = 0.96), while walkability improvers reported little or no perceived change in their transportation cycling after relocation (mean = 3.02, SD = 0.84). This difference was statistically significant (p < 0.05). Change in walkability resulting from relocation was not significantly associated with perceived change in overall physical activity. Our qualitative findings suggest that moving to a neighbourhood with safe paths connecting to nearby destinations can facilitate transportation walking and cycling. Some participants describe adjusting their leisure physical activity to compensate for changes in transportation walking and cycling. Strong contributors to neighbourhood leisure physical activity included the presence of aesthetic features and availability of recreational opportunities that allow for the creation of social connections with community and family. [ABSTRACT FROM AUTHOR]

This study examined the individual and joint effects of modifiable risk factors mediating the associations between socioeconomic position (SEP) and morbidity and mortality from cardiovascular diseases (CVD) in a nationally representative sample of adults in Canada. Participants in the Canadian Community Health Survey (n = 289,800) were followed longitudinally for CVD morbidity and mortality using administrative health and mortality data. SEP was measured as a latent variable consisting of household income and individual educational attainment. Mediators included smoking, physical inactivity, obesity, diabetes and hypertension. The primary outcome was CVD morbidity and mortality, defined as the first fatal/nonfatal CVD event during follow-up (median 6.2 years). Generalized structural equation modeling tested the mediating effects of modifiable risk factors in associations between SEP and CVD in the total population and stratified by sex. Lower SEP was associated with 2.5 times increased odds of CVD morbidity and mortality (OR: 2.52, 95% CI: 2.28, 2.76). Modifiable risk factors mediated 74% of associations between SEP and CVD morbidity and mortality in the total population and were more important mediators of associations in females (83%) than males (62%). Smoking mediated these associations independently and jointly with other mediators. The mediating effects of physical inactivity were through joint mediating effects with obesity, diabetes or hypertension. There were additional joint mediating effects of obesity through diabetes or hypertension in females. Findings point to modifiable risk factors as important targets for interventions along with interventions that target structural determinants of health to reduce socioeconomic inequities in CVD. • Lower socioeconomic position was associated with 2.5 times increased odds of CVD morbidity and mortality. • Modifiable risk factors mediated 74% of associations between socioeconomic position and CVD morbidity and mortality. • Modifiable risk factors suggest targets for interventions to reduce socioeconomic inequities in CVD. [ABSTRACT FROM AUTHOR]

Introduction: Poor diet quality has been shown to increase the risk of common chronic diseases that can negatively impact quality of life and burden the healthcare system. Canada's Food Guide evidence-based recommendations provide dietary guidance aimed at increasing diet quality. Compliance with Canada's Food Guide can be assessed with the Canadian Healthy Eating Index (C-HEI), a diet quality score. The recently designed Canadian Diet History Questionnaire II (C-DHQ II), a comprehensive food frequency questionnaire could be used to estimate the C-HEI in Canadian populations with the addition of food group equivalents (representing Canada's Food Guide servings) to the C-DHQ II nutrient database. We describe methods developed to augment the C-DHQ II nutrient database to estimate the C-HEI. Methods: Food group equivalents were created using food and nutrient data from existing published food and nutrient databases (e.g. the Canadian Community Health Survey -- Cycle 2.2 Nutrition [2004]). The variables were then added to the C-DHQ II companion nutrient database. C-HEI scores were determined and descriptive analyses conducted for participants who completed the C-DHQ II in a cross-sectional Canadian study. Results: The mean (standard deviation) C-HEI score in this sample of 446 adults aged 20 to 83 was 64.4 (10.8). Women, non-smokers, and those with more than high school education had statistically significant higher C-HEI scores than men, smokers and those with high school diplomas or less. Conclusion: The ability to assess C-HEI using the C-DHQ II facilitates the study of diet quality and health outcomes in Canada. [ABSTRACT FROM AUTHOR]

Health promotion views collaborations between local governments and citizens as key to improving health and lessening inequities in urban areas. Public parks, which are typically managed by local governments, are key settings for promoting physical activity, positive social interactions and overall well-being. Yet research on civic participation in park management is essentially absent from the health promotion literature. When the City of Calgary began to implement a new policy on off-leash dogs in parks, we had an opportunity to study civic participation in decision-making. We did so by examining policy documents, participating in meetings and conducting interviews. Off-leash parks have particular relevance for health promotion because they may support physical activity and networking for some, but may escalate conflict and deter park use amongst others. In this case study, the local government engaged citizens in developing an overarching off-leash policy for the city as a whole and in implementing the new policy at the level of neighbourhoods. Of the first three parks to be considered under the new policy, an off-leash area was ultimately designated in just one: a park located in a disadvantaged neighbourhood. By exploring this unexpected outcome, our case study suggests thatpublic engagement, as practiced by local policymakers, may differ fromcommunity participation, as endorsed in health promotion. Further reflection on the meaning of ‘public’ is warranted in public health. [ABSTRACT FROM PUBLISHER]

Background: The neighbourhood environment may play an important role in diet quality. Most previous research has examined the associations between neighbourhood food environment and diet quality, and neighbourhood socioeconomic status and diet quality separately. This study investigated the independent and joint effects of neighbourhood food environment and neighbourhood socioeconomic status in relation to diet quality in Canadian adults.Methods: We undertook a cross-sectional study with n = 446 adults in Calgary, Alberta (Canada). Individual-level data on diet and socio-demographic and health-related characteristics were captured from two self-report internet-based questionnaires, the Canadian Diet History Questionnaire II (C-DHQ II) and the Past Year Physical Activity Questionnaire (PAQ). Neighbourhood environment data were derived from dissemination area level Canadian Census data, and Geographical Information Systems (GIS) databases. Neighbourhood was defined as a 400 m network-based 'walkshed' around each participant's household. Using GIS we objectively-assessed the density, diversity, and presence of specific food destination types within the participant's walkshed. A seven variable socioeconomic deprivation index was derived from Canadian Census variables and estimated for each walkshed. The Canadian adapted Healthy Eating Index (C-HEI), used to assess diet quality was estimated from food intakes reported on C-DHQ II. Multivariable linear regression was used to test for associations between walkshed food environment variables, walkshed socioeconomic status, and diet quality (C-HEI), adjusting for individual level socio-demographic and health-related covariates. Interaction effects between walkshed socioeconomic status and walkshed food environment variables on diet quality (C-HEI) were also tested.Results: After adjustment for covariates, food destination density was positively associated with the C-HEI (β 0.06, 95 % CI 0.01-0.12, p = 0.04) though the magnitude of the association was small. Walkshed socioeconomic status was not significantly associated with the C-HEI. We found no statistically significant interactions between walkshed food environment variables and socioeconomic status in relation to the C-HEI. Self-reported physical and mental health, time spent in neighbourhood, and dog ownership were also significantly (p < .05) associated with diet quality.Conclusions: Our findings suggest that larger density of local food destinations may is associated with better diet quality in adults. [ABSTRACT FROM AUTHOR]

Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary services and (v) licensing and identifying pets. This conceptual framework acknowledges the tenets of previous health promotion frameworks, including overlapping and intersecting influences. At the same time, this framework proposes to advance our understanding of health promotion and, more broadly, population health by underscoring interdependence between people and pets as well as the dynamism of urbanized ecologies. [ABSTRACT FROM AUTHOR]

Abstract: This study explored children''s activity spaces. In 2007, children aged 10–12 years (n=1480) completed a survey and mapping activity, and wore a pedometer for seven days. Their parents completed a survey (n=1314). Over half traveled <25% of their ‘neighborhood’, defined as 800m and 1600m network buffers. More local destinations (boys β=−0.022; girls β=−0.013) and parent report of living on a busy road (girls β=−0.43) were associated with smaller activity spaces whereas being independently mobile resulted in larger (girls β=0.28) ones. Traditionally defined neighborhoods may not reflect children''s movements. Freedom, fewer local destinations and traffic safety may be important for increasing spatial ranges. [Copyright &y& Elsevier]

Older adults requiring home care service have a high risk of depression. Instruments for detecting depression among older adults, however, are often too long and detailed for easy administration by nontrained staff in large service-based settings.This study examined the measurement properties (test—retest reliability, concurrent validity, and cross-modality correspondence) of a single-item screener for depressive symptoms among older adults receiving home care services. Reliability was assessed (n = 65) by administering the single-item depression screener to the same participants on two occasions 7 days apart. Validity was assessed (n = 191) by comparing depressed participants from the single-item depression screener versus Geriatric Depression Scale (criterion measure). Responses to the single-item depression screener administered by telephone and face-to-face interview were also compared. Findings suggest that the single-item depression screener has fair levels of reliability, validity, and cross-modality correspondence and could be used among home care recipients as a screening tool, provided that depression status is confirmed via in-depth questionnaires, interviews, or a clinical diagnosis. [ABSTRACT FROM PUBLISHER]

Evidence of associations between neighbourhood built characteristics and sedentary behaviours is mixed. The study aim was to investigate the associations between objectively-derived neighbourhood built characteristics and self-reported sedentary behaviours among Canadian men and women. This study sourced survey data from Alberta's Tomorrow Project (2008; n = 14,785), in which sitting and motor vehicle travel times during the last 7 days was measured. Geographic Information System was used to calculate neighbourhood built characteristics within a 400 m buffer of participant's home and a walkability score was estimated. To estimate the associations between neighbourhood characteristics and sedentary behaviours, covariate-adjusted generalized linear regression models were used. Walkability , 3-way intersections, and population count were positively associated with sitting time. Business destinations and greenness were negatively associated with sitting time. Walkability, 3-way , and 4-way intersections were negatively associated with motor vehicle travel time. Sex-specific associations between neighbourhood characteristics and sedentary behaviour were found. Among men, business destinations were negatively associated with sitting time, and 3-way intersections , population count, and walkability were negatively associated with motor vehicle travel time. Among women, Normalized Difference Vegetation Index was negatively associated with sitting time. Interventions to reduce sedentary behaviours may need to target neighbourhoods that have built characteristics which might support these behaviours. More research is needed to disentangle the complex relationships between different neighbourhood built characteristics and specific types of sedentary behaviour. • Less sitting time was associated with more business destinations and greenness. • More sitting time was associated with more 3-way intersections and population count. • Less motor vehicle time was associated with more 3-way and 4-way intersections. • A unit increase in walkability was associated with a 13-min/week increase in sitting. • Some built environment-sedentary behaviour associations were sex-specific. [ABSTRACT FROM AUTHOR]

Evidence of associations between neighbourhood built characteristics and sedentary behaviours is mixed. The study aim was to investigate the associations between objectively-derived neighbourhood built characteristics and self-reported sedentary behaviours among Canadian men and women. This study sourced survey data from Alberta's Tomorrow Project (2008; n = 14,785), in which sitting and motor vehicle travel times during the last 7 days was measured. Geographic Information System was used to calculate neighbourhood built characteristics within a 400 m buffer of participant's home and a walkability score was estimated. To estimate the associations between neighbourhood characteristics and sedentary behaviours, covariate-adjusted generalized linear regression models were used. Walkability, 3-way intersections, and population count were positively associated with sitting time. Business destinations and greenness were negatively associated with sitting time. Walkability, 3-way, and 4-way intersections were negatively associated with motor vehicle travel time. Sex-specific associations between neighbourhood characteristics and sedentary behaviour were found. Among men, business destinations were negatively associated with sitting time, and 3-way intersections, population count, and walkability were negatively associated with motor vehicle travel time. Among women, Normalized Difference Vegetation Index was negatively associated with sitting time. Interventions to reduce sedentary behaviours may need to target neighbourhoods that have built characteristics which might support these behaviours. More research is needed to disentangle the complex relationships between different neighbourhood built characteristics and specific types of sedentary behaviour. [ABSTRACT FROM AUTHOR]

Walking and bicycling to school (active school transportation, AST) has been in decline for decades in North America and globally with the rise of automobility. This cross-sectional study estimated associations between the built environment and AST in seven Canadian communities. We observed the travel behaviours of almost 118,000 students at 552 schools. Using beta regression, we modeled the proportion of children using AST, considering built environment and social environment factors around schools. Across all schools, the average proportion of children using AST was 54.3% (SD 18.9%), with variability among cities from a low of 39.5% (SD 22.1%) in Laval, Quebec to 69.7% (SD 18.1%) in Montreal, Quebec. Overall, several modifiable road design features were associated with AST, including the presence of school crossing guards, cycling infrastructure, Walk Score® and traffic signal density. There was variability in the directionality and statistical significance of associations with design variables across cities, suggesting that the local context and directed local interventions are important to support AST. Natural experiment studies are necessary to examine local approaches related to the built environment to increase AST and ensure appropriate new policy and program interventions are developed. [ABSTRACT FROM AUTHOR]

Background: Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers' physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies. Methods: Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers' physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019. Results: A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving). Conclusions: The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships. Protocol registration: The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341). [ABSTRACT FROM AUTHOR]

Few studies examine associations between objectively-calculated neighbourhood built environment attributes and objectively-assessed sedentary behaviour in different geographical locations, especially in highly-populated environments. Additionally, no study, to our knowledge, has investigated associations between objective measures of neighbourhood built environment attributes and objectively-assessed sedentary behaviours in middle-aged adults, despite the fact that this is a critical stage of life when age-related functional decline begins. We examined the associations between neighbourhood built environment attributes with the total, and patterns of, objectively-assessed sedentary behaviours in a densely-populated area in Asia. Data from 866 adults (ages 40 to 64) living in Japan were included. Four classifications of sedentary behaviours, including daily total sedentary time, duration and number of long (≥30 min) sedentary bouts and breaks per sedentary hour, were estimated using hip-worn accelerometers. Individual (population density, availability of destinations, number of intersections, and distance to the nearest park) and composite (walkability and Walk Score®) neighbourhood built environment indices were calculated using geographic information systems. Covariate-adjusted multilevel linear mixed effects models were used to estimate the associations between the neighbourhood built environment attributes and sedentary behaviours. Population density and availability of destinations were positively associated with sedentary behaviours; however, the number of intersections was negatively associated with sedentary behaviours. No associations were observed between the distance to the nearest park and sedentary behaviours. There were positive associations between walkability and total sedentary time, and duration and the number of long sedentary bouts. Walk Score® was positively associated with total sedentary time and the number of long sedentary bouts. These findings suggest that urban design attributes supportive of walking (except for the number of intersections) may encourage sedentary behaviour among middle-aged adults living in densely-populated environments. [ABSTRACT FROM AUTHOR]

Evidence suggests a positive effect of dog ownership on physical activity. However, most previous studies used self-reported physical activity measures. Additionally, it is unknown whether owning a dog is associated with adults' sedentary behaviour, an emerging health risk factor. In this study, physical activity and sedentary behaviour were objectively collected between 2013 and 2015 from 693 residents (aged 40–64 years) living in Japan using accelerometer devices. Multivariable linear regression models were used, adjusted for several covariates. The means of total sedentary time and the number of long (≥ 30 min) sedentary bouts were 26.29 min/day (95% CI − 47.85, − 4.72) and 0.41 times/day (95% CI − 0.72, − 0.10) lower for those who owned a dog compared to those not owning a dog, respectively. Compared with non-owners, dog-owners had significantly higher means of the number of sedentary breaks (95% CI 0.14, 1.22), and light-intensity physical activity (95% CI 1.31, 37.51). No significant differences in duration of long (≥ 30 min) sedentary bouts, moderate, vigorous, and moderate-to-vigorous-intensity physical activity were observed between dog-owners and non-owners. A novel finding of this study is that owning a dog was associated with several types of adults' sedentary behaviours but not medium-to-high-intensity physical activities. These findings provide new insights for dog-based behavioural health interventions on the benefits of dog ownership for reducing sedentary behaviour. [ABSTRACT FROM AUTHOR]

This study estimated the associations between neighbourhood characteristics and self-reported body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) risk categories among Canadian men and women. Using data from the Alberta's Tomorrow Project (n = 14,550), we estimated 3- and 4-way intersections, business destinations, population count, and normalized difference vegetation index (NDVI) within a 400 m radius of participant's home. Intersections, business destinations, and population count (z-scores) were summed to create a walkability score. Four-way intersections and walkability were negatively associated with overweight and obesity. Walkability was negatively associated with obesity. NDVI was negatively associated with high-risk WHR and population count and walkability positively associated with high-risk WHR. Among men, population count and walkability were negatively associated with obesity, and business destinations and walkability were negatively associated with overweight and obesity. Among women, NDVI was negatively associated with overweight (including obesity), obesity, and high-risk WC. Interventions promoting healthy weight could incorporate strategies that take into consideration local built environment characteristics. [ABSTRACT FROM AUTHOR]

Few Canadian studies have examined whether or not associations between neighbourhood walkability and physical activity differ by sex. We estimated associations between perceived neighbourhood walkability and physical activity among Canadian men and women. This study included cross-sectional survey data from participants in 'Alberta's Tomorrow Project' (Canada; n = 14,078), a longitudinal cohort study. The survey included socio-demographic items as well as the International Physical Activity Questionnaire (IPAQ) and the abbreviated Neighbourhood Environment Walkability Scale (NEWS-A), which captured perceived neighbourhood built characteristics. We computed subscale and overall walkability scores from NEWS-A responses. Covariate-adjusted generalized linear models estimated the associations of participation (≥10 min/week) and minutes of different types of physical activity, including transportation walking (TW), leisure walking (LW), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with walkability scores. Walkability was positively associated with participation in TW, LW, MPA and VPA and minutes of TW, LW, and VPA. Among men, a negative association was found between street connectivity and VPA participation. Additionally, crime safety was negatively associated with VPA minutes among men. Among women, pedestrian infrastructure was positively associated with LW participation and overall walkability was positively associated with VPA minutes. Notably, overall walkability was positively associated with LW participation among men and women. Different perceived neighbourhood walkability characteristics might be associated with participation and time spent in different types of physical activity among men and women living in Alberta. Interventions designed to modify perceptions of neighbourhood walkability might influence initiation or maintenance of different types of physical activity. [ABSTRACT FROM AUTHOR]

Background: Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury.Methods: First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist's route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries.Discussion: This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team's national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation. [ABSTRACT FROM AUTHOR]