Tracy McMillan

California's Safe Routes to School program: impacts on walking, bicycling, and pedestrian safety

Abstract This article evaluates Californias pioneering Safe Routes to School (SR2S) program, which funds traffic improvement projects designed to improve safety for childrens walking and bicycling to school and to increase the number of children who do so. Through surveys of parents and observations of vehicle and pedestrian traffic before and after project construction, we examined the impacts of 10 traffic improvement projects funded through the SR2S program. We measured changes in perceived safety and in safety-related behaviors associated with childrens trips to school, and examined changes in the number of children walking and bicycling following these improvements. Five of the 10 traffic improvement projects we evaluated showed evidence of a successful impact. The findings have implications for Californias SR2S program and for similar initiatives throughout the country.

Walking, Urban Design, and Health Toward a Cost-Benefit Analysis Framework

The authors examine the magnitude of health benefits from urban design characteristics that are associated with increased walking. Using geocoded travel diary data from Portland, Oregon, regression analyses give information on the magnitude and statistical significance of the link between urban design variables and two-day walking distances. From the coefficient point estimates, the authors link to the health literature to give information on how many persons would realize health benefits, in the form of reductions in mortality risk, from walking increases associated with urban design changes. Using a cost-benefit analysis framework, they give monetized estimates of the health benefits of various urban design changes. The article closes with suggestions about how the techniques developed can be applied to other cost-benefit analyses of the health benefits of planning projects that are intended to increase walking.

A model curriculum for a course on the built environment and public health: training for an interdisciplinary workforce.

Despite growing evidence of the direct and indirect effects of the built environment on public health, planners, who shape the built environment, and public health professionals, who protect the publics health, rarely interact. Most public health professionals have little experience with urban planners, zoning boards, city councils, and others who make decisions about the built environment. Likewise, few planners understand the health implications of design, land use, or transportation decisions. One strategy for bridging this divide is the development of interdisciplinary courses in planning and public health that address the health implications of the built environment. Professional networking and Internet-based searches in 2007 led to the identification of six primarily graduate-level courses in the U.S. that address the links between the built environment and public health. Common content areas in most of the identified courses included planning and public health histories, health disparities, interdisciplinary approaches, air and water quality, physical activity, social capital, and mental health. Instructors of these courses collaborated on course content, assignments, and evaluations to develop a model curriculum that follows an active learning-centered approach to course design. The proposed model curriculum is adaptable by both planning and public health departments to promote interdisciplinary learning. Results show that students gain planning and public health perspectives through this instruction, benefiting from active-learning opportunities. Faculty implementation of the proposed interdisciplinary model curriculum will help bridge the divide between the built environment and public health and enable both planners and public health professionals to value, create, and promote healthy environments.

Mediating Effects of Group Cohesion on Physical Activity and Diet in Women of Color: Health Is Power

Purpose. To determine the effects and mediating factors of a physical activity (PA) or vegetable and fruit (VF) group cohesion intervention. Design. Longitudinal design. Setting. Harris County and Travis County, Texas. Participants. Community-dwelling African-American and Hispanic or Latina women. Intervention. Three hundred ten women were randomized to a PA (n = 204) or VF (n = 106) intervention group. Women met in groups six times over the course of 6 months and were exposed to a group cohesion intervention to promote walking or to increase VF consumption. Measures. Women completed the International PA Questionnaire, National Cancer Institute VF and fat screeners, PA Group Environment Questionnaire, and 7-day accelerometer protocol at baseline and post-intervention. Analyses. The direct and mediated effects of the intervention on outcomes were evaluated using a mediational chain model, controlling for baseline values and covariates using path analysis. Results. Women were middle aged (mean = 44.4 years) and overweight or obese (mean body mass index = 34.0 kg/m2). PA increased and fat consumption decreased for both groups, whereas VF consumption increased for women in VF group only (all p <. 05). Increased task cohesion led to hypothesized increases in psychosocial factors in the PA group but not to behavioral changes. Conclusions. Group cohesion interventions may have psychological and physical health benefits for African-American and Hispanic or Latina women, but refinement of measures and intervention delivery is needed to determine whether hypothesized mediational pathways are valid.

Health is Power: an ecological, theory-based health intervention for women of color.

OBJECTIVE Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas. METHODS The intervention development was guided by group dynamics principles anchored within an ecologic model. RESULTS Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods - integrated into strategies to promote group cohesion - framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. CONCLUSIONS Neighborhood contextual and environmental measures are described to test ecologic factors that may contribute to behavioral maintenance. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance stand to improve health outcomes in vulnerable populations.

Neighborhood sampling: how many streets must an auditor walk?

This study tested the representativeness of four street segment sampling protocols using the Pedestrian Environment Data Scan (PEDS) in eleven neighborhoods surrounding public housing developments in Houston, TX. The following four street segment sampling protocols were used (1) all segments, both residential and arterial, contained within the 400 meter radius buffer from the center point of the housing development (the core) were compared with all segments contained between the 400 meter radius buffer and the 800 meter radius buffer (the ring); all residential segments in the core were compared with (2) 75% (3) 50% and (4) 25% samples of randomly selected residential street segments in the core. Analyses were conducted on five key variables: sidewalk presence; ratings of attractiveness and safety for walking; connectivity; and number of traffic lanes. Some differences were found when comparing all street segments, both residential and arterial, in the core to the ring. Findings suggested that sampling 25% of residential street segments within the 400 m radius of a residence sufficiently represents the pedestrian built environment. Conclusions support more cost effective environmental data collection for physical activity research.

Remaking Minnie Street The Impacts of Urban Revitalization on Crime and Pedestrian Safety

Urban design is frequently identified as a tool to reduce crime and improve traffic safety in urban neighborhoods. In this “before” and “after” evaluation, we assess a major urban revitalization in the Minnie Street neighborhood in Santa Ana, California, in terms of its impacts on crime and pedestrian safety. Conclusions suggest that urban design can help to improve crime and traffic safety in poor urban neighborhoods but that other factors must also be considered.