Karl Parker

Associations between the neighbourhood built environment and out of school physical activity and active travel: An examination from the Kids in the City study.

This studys aim was to examine selected objectively-measured and child specific built environment attributes in relation to proportion of out-of-school time spent in moderate-to-vigorous physical activity (%MVPA) and active travel in a group of ethnically and socio-economically diverse children (n=236) living in Auckland, New Zealand. Street connectivity and distance to school were related to the proportion of trips made by active modes. Ratio of high speed to low speed roads and improved streetscape for active travel were related to %MVPA on weekdays only. Inconsistent results were found for destination accessibility. Local destinations (particularly schools) along a safe street network may be important for encouraging childrens activity behaviours.

Children’s Out-of-School Independently Mobile Trips, Active Travel, and Physical Activity: A Cross-Sectional Examination from the Kids in the City Study

BACKGROUND The study aim was to determine the association between childrens objectively assessed moderate-to-vigorous physical activity (MVPA) and active trips (AT) and independently mobile trips (IM) during out-of-school hours. METHODS Children aged 9 to 13 years (n = 254) were recruited from 9 schools in Auckland, New Zealand between 2011 and 2012. Children completed travel diaries and wore accelerometers for 7 days. Parents provided demographic information. Geographic information systems-derived distance to school was calculated. Accelerometer data were extracted for out of school hours only. Percentage of time spent in MVPA (%MVPA), AT, and IM were calculated. Generalized estimating equations were used to determine the relationship between daily %MVPA and AT and between daily %MVPA and IM, accounting for age, sex, ethnicity, distance to school, day of the week, and numeric day of data collection. RESULTS A significant positive relationship was observed between %MVPA and both AT and IM. For every unit increase in the daily percentage of trips made that were AT or IM, we found an average increase of 1.28% (95% CI 0.87%, 1.70%) and 1.15% (95% CI 0.71%, 1.59%) time in MVPA, respectively. CONCLUSION Childrens AT and IM are associated with increased MVPA during out-of-school hours.

Long-Term Impact on Alcohol-Involved Crashes of Lowering the Minimum Purchase Age in New Zealand

OBJECTIVES We assessed the long-term effect of lowering the minimum purchase age for alcohol from age 20 to age 18 years on alcohol-involved crashes in New Zealand. METHODS We modeled ratios of drivers in alcohol-involved crashes to drivers in non-alcohol-involved crashes by age group in 3 time periods using logistic regression, controlling for gender and adjusting for multiple comparisons. RESULTS Before the law change, drivers aged 18 to 19 and 20 to 24 years had similar odds of an alcohol-involved crash (P = .1). Directly following the law change, drivers aged 18 to 19 years had a 15% higher odds of being in an alcohol-involved crash than did drivers aged 20 to 24 years (P = .038). In the long term, drivers aged 18 to 19 years had 21% higher odds of an alcohol-involved crash than did the age control group (P ≤ .001). We found no effects for fatal alcohol-involved crashes alone and no trickle-down effects for the youngest group. CONCLUSIONS Lowering the purchase age for alcohol was associated with a long-term impact on alcohol-involved crashes among drivers aged 18 to 19 years. Raising the minimum purchase age for alcohol would be appropriate.

Social and built-environment factors related to children's independent mobility: The importance of neighbourhood cohesion and connectedness

Abstract This study examines aspects of neighbourhood social environments (namely, neighbourhood safety, cohesion and connection) and child‐specific built environment attributes in relation to childrens independent mobility. The results suggest that children aged 8–13 years with parents who perceive their neighbourhood as more cohesive and more connected, and are located closer to school, engaged in higher levels of independently mobile trips. The qualitative component of this research revealed that for NZ European, Māori, Samoan and other Pacific parents, ‘people danger’ was the most common concern for letting their children go out alone, whereas for Asian and Indian parents, ‘traffic danger’ was the most common reason for their concern.

Development of a systems model to visualise the complexity of children's independent mobility

Substantial changes to the built environment, urbanisation patterns, and societal norms have contributed to limiting childrens opportunities for being independently mobile. Several linear causal pathway models have been developed to understand the influences on childrens independent mobility; however feedback loops between and within the various levels of influence cannot be modelled using such an approach. The purpose of this paper is to refine the interrelationships of factors related to childrens independent mobility, taking into account earlier models, broader contextual factors, recent childrens geographies literature, and feedback loops. Systems model components were informed by attributes known to influence childrens independent mobility, related qualitative findings, and the development of a framework that could lend itself to multilevel modelling approaches. This systems model may provide a useful structure for identifying how best to develop and monitor interventions to halt the declining rates of childrens independent mobility.

Neighbourhood built environment associations with body size in adults: mediating effects of activity and sedentariness in a cross-sectional study of New Zealand adults

BackgroundThe aim of this study was to determine the associations between body size and built environment walkability variables, as well as the mediating role of physical activity and sedentary behaviours with body size.MethodsObjective environment, body size (body mass index (BMI), waist circumference (WC)), and sedentary time and physical activity data were collected from a random selection of 2033 adults aged 20–65 years living in 48 neighbourhoods across four New Zealand cities. Multilevel regression models were calculated for each comparison between body size outcome and built environment exposure.Results and DiscussionStreet connectivity and neighborhood destination accessibility were significant predictors of body size (1 SDchange predicted a 1.27 to 1.41 % reduction in BMI and a 1.76 to 2.29 % reduction in WC). Significantrelationships were also observed for streetscape (1 SD change predicted a 1.33 % reduction in BMI) anddwelling density (1 SD change predicted a 1.97 % reduction in BMI). Mediation analyses revealed asignificant mediating effect of physical activity on the relationships between body size and street connectivity and neighbourhood destination accessibility (explaining between 10.4 and 14.6 % of the total effect). No significant mediating effect of sedentary behaviour was found. Findings from this cross-sectional study of a random selection of New Zealand adults are consistent with international research. Findings are limited to individual environment features only; conclusions cannot be drawn about the cumulative and combined effect of individual features on outcomes.ConclusionsBuilt environment features were associated with body size in the expected directions. Objectively-assessed physical activity mediated observed built environment-body size relationships.

Cross‐country comparison of proportion of alcohol consumed in harmful drinking occasions using the International Alcohol Control Study

Abstract Introduction and Aims This study examines the proportion of alcohol markets consumed in harmful drinking occasions in a range of high‐, middle‐income countries and assesses the implications of these findings for conflict of interest between alcohol producers and public health and the appropriate role of the alcohol industry in alcohol policy space. Design and Methods Cross‐sectional surveys were conducted in 10 countries as part of the International Alcohol Control study. Alcohol consumption was measured using location‐ and beverage‐specific measures. A level of consumption defined as harmful use of alcohol was chosen and the proportion of the total market consumed in these drinking occasions was calculated for both commercial and informal alcohol. Results In all countries, sizeable proportions of the alcohol market were consumed during harmful drinking occasions. In general, a higher proportion of alcohol was consumed in harmful drinking occasions by respondents in the middle‐income countries than respondents in the high‐income countries. The proportion of informal alcohol consumed in harmful drinking occasions was lower than commercial alcohol. Discussion and Conclusions Informal alcohol is less likely to be consumed in harmful drinking occasions compared with commercial alcohol. The proportion of commercial alcohol consumed in harmful drinking occasions in a range of alcohol markets shows the reliance of the transnational alcohol corporations on harmful alcohol use. This reliance underpins industry lobbying against effective policy and support for ineffective approaches. The conflict of interest between the alcohol industry and public health requires their exclusion from the alcohol policy space.

Drinking patterns vary by gender, age and country-level income: Cross-country analysis of the International Alcohol Control Study: Drinking patterns by gender, age and country-level income

Abstract Introduction and Aims Gender and age patterns of drinking are important in guiding country responses to harmful use of alcohol. This study undertook cross‐country analysis of drinking across gender, age groups in some high‐and middle‐income countries. Design and Methods Surveys of drinkers were conducted in Australia, England, Scotland, New Zealand, St Kitts and Nevis (high‐income), Thailand, South Africa, Mongolia and Vietnam (middle‐income) as part of the International Alcohol Control Study. Drinking pattern measures were high‐frequency, heavier‐typical quantity and higher‐risk drinking. Differences in the drinking patterns across age and gender groups were calculated. Logistic regression models were applied including a measure of country‐level income. Results Percentages of high‐frequency, heavier‐typical quantity and higher‐risk drinking were greater among men than in women in all countries. Older age was associated with drinking more frequently but smaller typical quantities especially in high‐income countries. Middle‐income countries overall showed less frequent but heavier typical quantities; however, the lower frequencies meant the percentages of higher risk drinkers were lower overall compared with high‐income countries (with the exception of South Africa). Discussion and Conclusions High‐frequency drinking was greater in high‐income countries, particularly in older age groups. Middle‐income countries overall showed less frequent drinking but heavier typical quantities. As alcohol use becomes more normalised as a result of the expansion of commercial alcohol it is likely frequency of drinking will increase with a likelihood of greater numbers drinking at higher risk levels.

Influencing Condom Use by Gay and Bisexual Men for Anal Sex Through Social Marketing: A Program Evaluation of Get it On!!

Encouraging gay, bisexual, and other men who have sex with men (MSM) to use condoms for anal sex has been a cornerstone of HIV prevention initiatives globally for several decades. In New Zealand, Get it On!!, a social marketing program, sought to influence gay and bisexual men to use a condom “every time” for anal sex. To assess the effectiveness of Get it On!, an integrated program evaluation approach including evaluation rubrics was utilized. Self-report data were collected from 960 men using an online survey and a paper-based survey administered at a large, gay community event. The men reported they were exposed to the campaign messages, understood them well, and engaged with the program. Importantly, the men reported Get it On! encouraged them to take action, including being more conscious about using a condom for sex. Get it On! performed well in regard to encouraging a culture accepting of condom use. Significantly, the evaluation found the greater the exposure to Get it On!, the more likely a man was to report using a condom for anal sex. Overall, the campaign is likely contributing to New Zealand’s relatively high rates of condom use and the low incidence of HIV infection among MSM. This strongly suggests the campaign should be continued and enhanced as a key HIV prevention strategy.

Policy-Relevant Behaviors Predict Heavier Drinking in Both On and Off Premises and Mediate the Relationship Between Heavier Alcohol Consumption and Age, Gender, and Socioeconomic Status-Analysis from the International Alcohol Control Study.

BACKGROUND Our goal was to investigate the role of behaviors amenable to policy change in mediating the relationship between alcohol consumption in off and on premises, age, and 2 measures of socioeconomic status (education and income). METHODS A cross-sectional general population survey was analyzed by using Bayesian path analysis to understand direct and mediating pathways. A total of 1,900 drinkers (past 6 months), aged 18 to 65 years, living in households with landline phones participated in the study. Measures were as follows: typical quantities of alcohol consumed per occasion, frequency of drinking, both off and on premise; gender, age groups; and years of education, personal income, prices paid, time of purchase, and liking for alcohol advertisements. RESULTS Later times of purchase predicted larger quantities consumed (on and off premise) and more frequent drinking (on premise only). Younger people and males purchased later, and this mediated their heavier consumption. Lower prices paid predicted larger quantities consumed (on premise) and higher frequency of drinking (off premise). Younger and male respondents paid lower prices, and this mediated larger quantities consumed on premise and more frequent drinking off premise. Less well educated paid lower prices, and this mediated drinking more frequently off premise among this group. Liking for alcohol ads predicted drinking larger quantities and higher frequency both off and on premise. Younger and male respondents reported greater liking for ads, and this mediated their consumption of larger quantities and more frequent drinking both on and off premise. Those with higher income drank larger amounts on premise and more frequently on and off, but there were no mediating effects from the policy-relevant variables. CONCLUSIONS Heavier drinking patterns by young people and those less well educated could be ameliorated by attention to alcohol policy.