Jessa K. Engelberg

Co-benefits of designing communities for active living: an exploration of literature

To reverse the global epidemic of physical inactivity that is responsible for more than 5 million deaths per year, many groups recommend creating “activity-friendly environments.” Such environments may have other benefits, beyond facilitating physical activity, but these potential co-benefits have not been well described. The purpose of the present paper is to explore a wide range of literature and conduct an initial summary of evidence on co-benefits of activity-friendly environments. An extensive but non-systematic review of scientific and “gray” literature was conducted. Five physical activity settings were defined: parks/open space/trails, urban design, transportation, schools, and workplaces/buildings. Several evidence-based activity-friendly features were identified for each setting. Six potential outcomes/co-benefits were searched: physical health, mental health, social benefits, safety/injury prevention, environmental sustainability, and economics. A total of 418 higher-quality findings were summarized. The overall summary indicated 22 of 30 setting by outcome combinations showed “strong” evidence of co-benefits. Each setting had strong evidence of at least three co-benefits, with only one occurrence of a net negative effect. All settings showed the potential to contribute to environmental sustainability and economic benefits. Specific environmental features with the strongest evidence of multiple co-benefits were park proximity, mixed land use, trees/greenery, accessibility and street connectivity, building design, and workplace physical activity policies/programs. The exploration revealed substantial evidence that designing community environments that make physical activity attractive and convenient is likely to produce additional important benefits. The extent of the evidence justifies systematic reviews and additional research to fill gaps.

Ciclovía participation and impacts in San Diego, CA: The first CicloSDias

OBJECTIVE Ciclovía or Open Streets initiatives support physical activity through cycling/rolling, and walking/running. We evaluated San Diegos first Open Streets event, CicloSDias, to document attendance, reach and marketing, and effects on social cohesion, businesses, and physical activity. METHODS The comprehensive evaluation consisted of a city-wide survey 1 week before and after the event (n=805), counts of event attendees, and surveys of event attendees (n=713) and businesses (n=26). RESULTS An estimated 8311 people attended the event. Attendees had an average of 144 min (SD=85) of physical activity, 97% met the 30 min/day guideline, and 39% met the 150 min/week guideline during the event. 27% of attendees would have been inactive without the event. Awareness of the event was 10% before and 26% after the event. When comparing event attendees to San Diego residents, Latinos and non-White race/ethnicities were under-represented. Restaurants/pubs, services, and most retail stores excluding liquor stores and food markets reported positive or neutral impacts on business. CONCLUSION Open Street initiatives are promising ways to promote physical activity and are desired by the community. Positive effects were observed for physical activity, social cohesion, and businesses, though reach should be expanded to include more underserved community members. Evaluating Open Streets is important for sustaining and improving these efforts.

Socioeconomic and race/ethnic disparities in observed park quality

BackgroundThough park presence and access disparities are well studied for their associations with physical activity (PA), disparities in the availability and quality of amenities and facilities within parks have been infrequently examined.MethodsFive hundred forty-three parks from 472 block groups in the Seattle, WA and Baltimore, MD regions were audited using the Environmental Assessment of Public Recreation Spaces (EAPRS) to assess presence and quality (e.g., condition, cleanliness) of amenities (e.g., restrooms, seating) and facilities (e.g., fields, courts). General linear model regressions investigated Census 2000-derived neighborhood race/ethnicity and income main effect and interactive relationships with 7 park quality summary scores: 1) trails, 2) open space, 3) sports facilities, 4) PA facilities count, 5) PA facilities quality, 6) aesthetics, and 7) overall amenities, controlling for park size. The regions were analyzed separately due to differing race/ethnicity distributions.ResultsIn the Seattle region, neighborhood income was significantly negatively associated with sports quality score (p < .043), PA facilities total count (p < .015) and the overall amenities quality score (p < .004) (unexpected direction). In the Baltimore region, neighborhood race/ethnicity (percent White/non-Hispanic) was significantly positively related to the open spaces quality score (p < .011) (expected direction). A significant income-by-race/ethnicity interaction was found for PA facilities quality (p = .014), with high-percent minority neighborhoods having higher quality parks in high- vs. low-income neighborhoods, yet was opposite in mostly White/non-Hispanic neighborhoods. The other income-by-race/ethnicity interaction was for overall amenities quality score (p = .043), where scores in high-percent minority neighborhoods were best in high- vs. low-income neighborhoods. There was little difference in scores within mostly White or mixed neighborhoods by income.ConclusionsPatterns of association of neighborhood race/ethnicity and income with park qualities differed between regions. In the Seattle region, “equitable differences” were found, where lower income neighborhoods had better park quality on average. In the Baltimore region, park quality was more consistently negatively associated with income and race/ethnic diversity, and complex interactions of race/ethnicity by income were detected. These findings emphasize the need to explore other factors that may explain variations in park quality, like local policy, citizen involvement in park decision-making, park funding and allocation, sources of funding and park priorities.

Contextual factors related to implementation of classroom physical activity breaks

Brief structured physical activity in the classroom is effective for increasing student physical activity. The present study investigated the association between implementation-related contextual factors and intervention implementation after adoption of a structured classroom physical activity intervention. Six elementary-school districts adopted structured classroom physical activity programs in 2013–2014. Implementation contextual factors and intervention implementation (structured physical activity provided in past week or month, yes/no) were assessed using surveys of 337 classroom teachers from 24 schools. Mixed-effects models accounted for the nested design. Availability of resources (yes/no, ORs = 1.91–2.93) and implementation climate z-scores (ORs = 1.36–1.47) were consistently associated with implementation. Teacher-perceived classroom behavior benefits (OR = 1.29) but not student enjoyment or health benefits, and time (OR = 2.32) and academic (OR = 1.63) barriers but not student cooperation barriers were associated with implementation (all z-scores). Four implementation contextual factor composites had an additive association with implementation (OR = 1.64 for each additional favorable composite). Training and technical assistance alone may not support a large proportion of teachers to implement structured classroom physical activity. In addition to lack of time and interference with academic lessons, school climate related to whether administrators and other teachers were supportive of the intervention were key factors explaining whether teachers implemented the intervention. Evidence-based implementation strategies are needed for effectively communicating the benefits of classroom physical activity on student behavior and improving teacher and administrator climate/attitudes around classroom physical activity.

Reliability between online raters with varying familiarities of a region: Microscale Audit of Pedestrian Streetscapes (MAPS)

Background To test inter-rater reliability of the online Microscale Audit of Pedestrian Streetscapes (MAPS) tool between raters with varying familiarities of Phoenix, Arizona. Methods The online MAPS tool, based on the MAPS in-field audit tool and scoring system, was used for audits. Sixty route pairs, 141 segment pairs, and 92 crossing pairs in Phoenix were included. Each route, segment or crossing was audited by two independent raters: one rater in Phoenix and the other in San Diego, California, respectively. Item, subscale scores, and total scores reliability analyses were computed using Kappa or intra-class correlation coefficient (ICC). Results The route overall score had substantial reliability (ICC: 0.832). Of the route subscale and overall scores, sixteen out of twenty had moderate to substantial reliability (ICC: 0.616-0.906), and the four subscales had fair reliability (ICC: 0.409-0.563). Sixteen out of twenty scores in segment and crossing sections demonstrated fair to substantial reliability (ICC: 0.448-0.897), and the remaining four had slight reliability (ICC: 0.348-0.364). Conclusions Most of the online MAPS items, subscales, and overall scores demonstrated fair to substantial reliability between raters with varied familiarities of the Phoenix area. Results support use of online MAPS to measure microscale elements of the built environment by raters unfamiliar with a region.

Distracted Driving Behaviors and Beliefs among Older Adults

Distracted driving, and especially cell phone use, is a prevalent contributor to crashes. Older drivers have an increased risk of committing safety errors while driving, especially with distraction. The objective of this study was to characterize phone-related distractions in older drivers (age > 65) and identify intervention strategies likely to reduce cell distraction. A 64-question survey was offered online and on paper. A distracted driving scale (DDS) was created by summing responses on 11 distracted driving questions related to phone use (possible score range 0 to 44). Linear regression was performed to identify variables associated with a higher DDS score. A total of 363 older drivers completed the survey; the mean age was 73 and 56% were female. 60% of older adults reported using their cell phone while driving at least some of the time. Participants perceived their own ability as capable or very capable when driving and using: handheld phone (40%); hands-free phone (78%); other tasks (38%) while driving. 32% of older adults who drive minors reported driving while distracted. 30% of those who work felt obligated to take work-related calls. Variables associated with distracted driving include younger age, driving more miles, perceived hands-free skill, smart phone ownership, and being employed or self-employed. State laws and potential loss of insurance coverage with distracted driving were cited as effective penalties. Older adults are engaging in distracted driving, including with minors in the car. Education, state laws, and altering insurance coverage may mitigate this behavior.

Social Marketing and If You Can't Fix It, Feature It!

IYCFIFI is one of the most powerful marketing axioms we know and it’s too often overlooked in social marketing. The classic corporate example is the glue developed by a 3M researcher that wasn’t quite sticky enough. By featuring the shortcoming, they created a ‘‘sticky note’’ empire. The underlying principle is simple: What you treat as a ‘‘negative’’—a liability—may in fact be your program’s greatest asset. It’s a different way to approach the management of potential barriers. Instead of hiding or minimizing whatever you consider a negative, lead with it. In other words, if you can’t fix it, feature it!