Wanda Wendel-Vos

Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): a study programme protocol

Introduction Growing evidence suggests that close contact with nature brings benefits to human health and well-being, but the proposed mechanisms are still not well understood and the associations with health remain uncertain. The Positive Health Effects of the Natural Outdoor environment in Typical Populations in different regions in Europe (PHENOTYPE) project investigates the interconnections between natural outdoor environments and better human health and well-being. Aims and methods The PHENOTYPE project explores the proposed underlying mechanisms at work (stress reduction/restorative function, physical activity, social interaction, exposure to environmental hazards) and examines the associations with health outcomes for different population groups. It implements conventional and new innovative high-tech methods to characterise the natural environment in terms of quality and quantity. Preventive as well as therapeutic effects of contact with the natural environment are being covered. PHENOTYPE further addresses implications for land-use planning and green space management. The main innovative part of the study is the evaluation of possible short-term and long-term associations of green space and health and the possible underlying mechanisms in four different countries (each with quite a different type of green space and a different use), using the same methodology, in one research programme. This type of holistic approach has not been undertaken before. Furthermore there are technological innovations such as the use of remote sensing and smartphones in the assessment of green space. Conclusions The project will produce a more robust evidence base on links between exposure to natural outdoor environment and human health and well-being, in addition to a better integration of human health needs into land-use planning and green space management in rural as well as urban areas.

Environmental determinants of outdoor play in children: a large-scale cross-sectional study.

BACKGROUND Outdoor play is a cheap and natural way for children to be physically active. PURPOSE This study aims to identify physical as well as social correlates of outdoor play in the home and neighborhood environment among children of different age groups. METHODS Cross-sectional data were derived from 6470 parents of children from 42 primary schools in four Dutch cities by means of questionnaires (2007-2008). Multivariate sequential Poisson GEE analyses were conducted (2010) to quantify the correlation between physical and social home and neighborhood characteristics and outdoor play among boys and girls aged 4-6 years, 7-9 years, and 10-12 years. RESULTS This study showed that next to proximal (home) environmental characteristics such as parental education (RR=0.93-0.97); the importance parents pay to outdoor play (RR=1.32-1.75); and the presence of electronic devices in the childs own room (RR=1.04-1.15), several neighborhood characteristics were significantly associated with childrens outdoor play. Neighborhood social cohesion was related to outdoor play in five of six subgroups (RR=1.01-1.02), whereas physical neighborhood characteristics (e.g., green neighborhood type, presence of water, diversity of routes) were associated with outdoor play in specific subgroups only. CONCLUSIONS Neighborhood social cohesion was related to outdoor play among children of different age and gender, which makes it a promising point of action for policy development. Policies aimed at improving physical neighborhood characteristics in relation to outdoor play should take into account age and gender of the target population.

Personal and Environmental Characteristics Associated with Choice of Active Transport Modes versus Car Use for Different Trip Purposes of Trips up to 7.5 Kilometers in The Netherlands

Introduction This explorative study examines personal and neighbourhood characteristics associated with short-distance trips made by car, bicycle or walking in order to identify target groups for future interventions. Methods Data were derived from ‘Mobility Research Netherlands (2004–2009; MON)’, a dataset including information regarding trips made by household members (n = ±53,000 respondents annually). Using postal codes of household addresses, MON data were enriched with data on neighbourhood typologies. Multilevel logistic modelling was used to calculate odds ratio (OR) of active transport versus car use associated with four different trip purposes (shopping (reference), commuting, taking or bringing persons or sports). A total of 277,292 short distance trips made by 102,885 persons were included in analyses. Results Compared to women shopping, women less often take active transport to sports clubs (OR = 0.88) and men less often take active transport for shopping (OR = 0.92), or for bringing or taking persons (OR = 0.76). Those aged 25–34 years (OR = 0.83) and 35–44 years (OR = 0.96) were more likely to use active transport for taking or bringing persons than persons belonging to the other age groups (relative to trips made for shopping by those 65 years or over). A higher use of active transport modes by persons with an university or college degree was found and particularly persons living in urban-centre neighbourhoods were likely to use active transport modes. Conclusion In developing policies promoting a mode shift special attention should be given to the following groups: a) men making short distance trips for taking or bringing persons, b) women making short distance trips to sport facilities, c) persons belonging to the age groups of 25–44 years of age, d) Persons with a primary school or lower general secondary education degree and persons with a high school or secondary school degree and e) persons living in rural or urban-green neighbourhoods.

Greener living environment healthier people?: Exploring green space, physical activity and health in the Doetinchem Cohort Study.

BACKGROUND Evidence is emerging that more green space in the living environment is associated with better health, partly via the pathway of physical activity. OBJECTIVES We explored the cross-sectional and longitudinal associations between green space and physical activity and several health indicators in the Doetinchem Cohort Study. METHODS A random sample of men and women aged 20-59years at baseline was measured max 5 times with 5year-intervals in the period 1987-2012. Data of round 3-5 were used. Measurements were based on examinations (height, weight, blood pressure) or questionnaires (physical activity, perceived health, depressive symptoms, chronic conditions). The percentage of green space (mainly urban and agricultural green) around the home address (125m and 1km) was calculated using satellite data. RESULTS More agricultural green was associated with less time spent on bicycling (β1km=-0.15, 95%CL -0.13; -0.04) and sports (β1km=-0.04, 95%CL -0.07; -0.01) and more time spent on gardening (β1km=0.16, 95%CL 0.12; 0.19) and odd jobs (β1km=0.10, 95%CL 0.05; 0.15), and this was in the other direction for urban green. For only a few of the many health indicators a positive association with green was found, and mainly for total green within 1km radius. Longstanding green or a transition to more green did not show more pronounced associations with health. CONCLUSIONS For the green space range of the Doetinchem area the findings do not strongly support the hypothesis that the percentage of green in the living environment affects health positively. The distinction by type of green may, however, be relevant for physical activity.

Cross-Sectional Associations of Objectively Measured Physical Activity, Cardiorespiratory Fitness and Anthropometry in European Adults

To quantify the independent associations between objectively measured physical activity (PA), cardiorespiratory fitness (CRF), and anthropometry in European men and women.

Living Close to Natural Outdoor Environments in Four European Cities: Adults' Contact with the Environments and Physical Activity.

This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent (United Kingdom); Doetinchem (The Netherlands); and Kaunas (Lithuania). Smartphones were used to collect information on the location and physical activity (overall and NOE) of around 100 residents of each city over seven days. We used Geographic Information Systems (GIS) to determine residential NOE availability (presence/absence of NOE within 300 m buffer from residence), contact with NOE (time spent in NOE), overall PA (total physical activity), NOE PA (total physical activity in NOE). Potential effect modifiers were investigated. Participants spent around 40 min in NOE and 80 min doing overall PA daily, of which 11% was in NOE. Having residential NOE availability was consistently linked with higher NOE contact during weekdays, but not to overall PA. Having residential NOE availability was related to NOE PA, especially for our Barcelona participants, people that lived in a city with low NOE availability.

Transport choice when travelling to a sports facility: the role of perceived route features - Results from a cross-sectional study in the Netherlands

BackgroundPhysical activity and sedentary behaviour are independently associated with health outcomes, where physical activity (PA) is associated with health benefits and sedentary behaviour is associated with health risks. One possible strategy to counteract sedentary behaviour is to stimulate active transport use. As monitoring studies in the Netherlands have shown that among sedentary people the proportion of adults who engage in sports (hereafter: sports practitioners) is 62.3%, sports practitioners seem a feasible target group for this strategy. Previous studies have generally reported associations between neighbourhood characteristics and active transport use. However, the neighbourhood covers only part of the route to a certain destination. Therefore, we examined the association between perceived route features and transport choice when travelling up to 7.5 kilometres to a sports facility among sports practitioners.MethodsFor 1118 Dutch sports practitioners – who indicated that they practice a sport and travel to a sports facility – age 18 and older, data on transport choice and perceived features of the route to a sports facility were gathered. Participants were classified into one of three transport groups based on their transport choice: car users, cyclists and walkers. Participants were asked whether perceived route features influenced their transport choice. Logistic regression was used to model the odds of cycling versus car use and walking versus car use in the association with perceived route features, adjusted for potential confounders.ResultsPerceived traffic safety was associated with lower odds of cycling (OR: 0.36, 95% CI: 0.15-0.86). Perceived route duration was associated with lower odds of both cycling (OR: 0.54, 95%CI: 0.39-0.75) and walking (OR: 0.60, 95%CI: 0.36-1.00). Perceived distance to a sports facility and having to make a detour when using other transport modes than the chosen transport mode were associated with higher odds of both cycling and walking (ORrange: 1.82-5.21). What and who people encountered during their trip (i.e. visual aspects) was associated with higher odds of both cycling and walking (ORrange: 2.40-3.69).ConclusionsPerceived traffic safety, duration, distance, detour, and visual aspects, when travelling to a sports facility were associated with transport choice. Therefore, the perception of route features should be considered when stimulating active transport use among sports practitioners.