Objectives. To examine the associations between domain-specific sedentary and active behaviours and workers’ presenteeism and absenteeism in a sample of company employees. Methods. This study recruited participants (n=2,466) from a nationwide online survey database (Japan,2019). Participants completed a questionnaire that captured data on relative and absolute presenteeism and absenteeism and domain-specific physical activity, and sedentary behaviours. Results. Daily minutes of work-related physical activity was negatively associated with relative absenteeism. Daily minutes of leisure-related physical activity was positively associated with absolute presenteeism (i.e., better productivity). Daily minutes of total physical activity were negatively and positively associated with relative absenteeism and absolute presenteeism (i.e., better productivity). There was also a positive association between car sitting time and absolute absenteeism. Conclusions. A change in work culture and practices that support active behaviours at work and outside of work may improve employee’s productivity indices.

A rapidly growing body of literature has explored associations between urban design attributes, which are conducive to walking, and social capital. The current study aimed to build on the limitations of previous research. Specifically, this study estimated the associations between traditional and novel walkable built environment metrics and social capital among a sample of adults in Japan. Data (n = 1010) from a randomly selected cross-section of residents (40–69 years old) from two areas in Japan were included. Social capital was assessed by questionnaires. Several objective and perceived walkable built environment attributes were calculated. Covariate-adjusted multivariable linear regression models were used to estimate associations between neighborhood built attributes and the three social capital scores. Street connectivity was negatively associated with activities with neighbors (b = -0.21, 95% CI -0.31, -0.11). Perceived population density was negatively associated with all three social capital scores, including social cohesion, activities with neighbors, and social participation (b = -0.21, 95% CI -0.30, -0.11, b = -0.15, 95% CI -0.24, -0.06, and b = -0.16, 95% CI -0.29, -0.02, respectively). Traditional walkability and Walk Score® were negatively associated with activities with neighbors (b = -0.04, 95% CI -0.07, -0.00 and b = -0.09, 95% CI -0.15, -0.04, respectively). No significant associations were observed between perceived walkability and social capital scores. Space syntax walkability was negatively associated with social cohesion and activities with neighbors (b = -0.12, 95% CI -0.23, -0.01 and b = -0.11, 95% CI -0.21, -0.01, respectively). This study provided unique findings demonstrating that walkable built environments may not necessarily support social capital in ultrahigh-density Asian cities.

Few longitudinal residential relocation studies have explored associations between urban form and physical activity, and none has used the Space Syntax theory. Using a Canadian longitudinal dataset (n=5944), we estimated: 1) differences in physical activity between non-movers, and those relocating to neighbourhoods with less or more integrated street layouts, and; 2) associations between changes in street layout integration exposure and differences in physical activity. Adjusting for covariates, we found relative to non-movers, those who moved to more integrated neighbourhoods undertook significantly (p<.05) more leisure walking (27.3 minutes/week), moderate-intensity (45.7 minutes/week), and moderate-to-vigorous intensity physical activity (54.4 minutes/week). Among movers, a one-unit increase in the relative change in street integration exposure ([Street integration at follow-up – street integration at baseline] / street integration at baseline) was associated with a 7.5 minutes/week increase in leisure walking. Our findings suggest that urban design policies that improve neighbourhood street integration might encourage more physical activity in adults.

Background: Sedentary behaviors and physical activity are likely to be affected by the COVID-19 outbreak, and sedentary lifestyles can increase subjective fatigue. The nonpharmaceutical policies imposed as a result of the COVID-19 pandemic may also have adverse effects on fatigue.

Objective: This study has two aims: to examine the changes in sedentary behaviors and physical activity of company workers in response to the COVID-19 pandemic in Japan and to examine relationships between changes in these sedentary behaviors and physical activity and changes in fatigue.

Methods: Data from a nationwide prospective online survey conducted in 2019 and 2020 were used. On February 22, 2019, an email with a link to participate in the study was sent to 45,659 workers, aged 20 to 59 years, who were randomly selected from a database of approximately 1 million individuals. A total of 2466 and 1318 participants, who self-reported their occupation as company workers, answered the baseline and follow-up surveys, respectively. Surveys captured fatigue, workday and daily domain-specific sedentary behaviors and physical activity, and total sedentary behaviors and physical activity. We used multivariable linear regression models to estimate associations of changes in sedentary behaviors and physical activity with changes in fatigue.

Results: Increases in public transportation sitting during workdays, other leisure sitting time during workdays, and other leisure sitting time were associated with an increase in the motivation aspect of fatigue (b=0.29, 95% CI 0-0.57, P=.048; b=0.40, 95% CI 0.18-0.62, P<.001; and b=0.26, 95% CI 0.07-0.45, P=.007, respectively). Increases in work-related sitting time during workdays, total sitting time during workdays, and total work-related sitting time were significantly associated with an increase in the physical activity aspect of fatigue (b=0.06, 95% CI 0-0.12, P=.03; b=0.05, 95% CI 0.01-0.09, P=.02; and b=0.07, 95% CI 0-0.14, P=.04, respectively). The motivation and physical activity aspects of fatigue increased by 0.06 for each 1-hour increase in total sitting time between baseline and follow-up (b=0.06, 95% CI 0-0.11, P=.045; and b=0.06, 95% CI 0.01-0.10, P=.009, respectively).

Conclusions: Our findings demonstrated that sedentary and active behaviors among company workers in Japan were negatively affected during the COVID-19 outbreak. Increases in several domain-specific sedentary behaviors also contributed to unfavorable changes in workers’ fatigue. Social distancing and teleworking amid a pandemic may contribute to the sedentary lifestyle of company workers. Public health interventions are needed to mitigate the negative effects of the COVID-19 pandemic or future pandemics on sedentary and physical activity behaviors and fatigue among company workers.

Accumulating evidence suggests that there is a socioeconomic status (SES) disparity in cardiovascular disease (CVD). We have identified key issues involved in the research on the supportive neighbourhood built environment and SES disparity in CVD and proposed future directions.

This study reviewed previous studies and discussed the relationship between sedentary behaviour and mental health in older adults. We also discussed the impact of the COVID-19 pandemic on sedentary behaviour and mental health in older people. The findings suggest that longer sedentary time may have a negative impact on mental health. Especially, previous studies consistently reported that mentally-passive sedentary behaviour, such as television viewing, is associated with poorer mental health in older adults. The COVID-19 pandemic has affected people of all ages, including the older population, by decreasing their physical activity and increasing their sedentary time. These changes in activity have led to deterioration in mental health. Therefore, it is essential to send public health messages to people encouraging them to reduce sedentary time in their daily lives and be physically active to maintain and improve their health, including their mental health, even in the COVID-19 pandemic. It is crucial to reduce mentally-passive sedentary behaviour, such as television viewing, to maintain mental health in older people.

Background - Several non-pharmaceutical policies, which include stay-at-home orders, mobility restrictions, and quarantine, have been implemented to reduce the spread of novel coronavirus disease 2019 (COVID-19). The present study examines work style changes among company workers after COVID-19 and analyses their effects on workers’ domain-specific sedentary and active behaviours. Methods - We analysed data from a nationwide prospective online survey in Japan. The data were obtained in February 2019 (n = 3200) and in July 2020 (n = 1709) from the registered individuals of a Japanese internet research service company. The participants reported work style patterns before and after the outbreak of COVID-19 in the follow-up survey. Domain-specific sedentary behaviours and physical activities were assessed by questionnaires. Paired t-tests were used to compare work styles before and after the outbreak of COVID-19. Multivariable linear regression models were used to assess the associations between changes in work style and changes in sedentary behaviours and physical activities. Results. Workers had more working from home days and fewer office-based working days after the outbreak of COVID-19 (p < 0.001 and p < 0.001, respectively). The increase in the number of working from home days per week was significantly associated with increases in work-related sitting time and total sitting time (b = 0.16, 95% CI 0.08, 0.24, p < 0.001 and b = 0.23, 95% CI 0.11, 0.36, p < 0.001, respectively). However, it was also associated with a decrease in car sitting time (b = −0.04, 95% CI −0.06, -0.01, p < 0.001). In addition, the increase in the number of working from home days was associated with a decrease in work-related moderate physical activity (b=−0.06, 95% CI −0.10, −0.02, p < 0.001). Conclusions. Our study provided preliminary evidence of an increase in working from home days in response to COVID-19 in Japan and of how this increase in the number of working from home days has affected workers’ sedentary behaviours and physical activities. These findings shed light on the effects of COVID-19 on work styles and workers’ sedentary behaviours and physical activity.

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 ).

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.

Background

There are spatial disparities in cardiovascular disease (CVD) mortality related to area‐level socioeconomic status (SES) disadvantage, but little is known about the spatial distribution of CVD mortality according to built environment factors. We examined joint associations of neighborhood walkability attributes and SES with CVD mortality rates through linkage of Japanese national data sets.
Methods and Results

National data were used from the 1824 municipalities (of the 1880 potentially eligible municipalities) across Japan. The outcome was mortality from CVD for a 5‐year period (2008–2012) for each municipality. A national index of neighborhood deprivation was used as an indicator of municipality‐level SES. A national walkability index (based on population density, road density, and access to commercial areas) was calculated. Compared with higher SES municipalities, relative rates for CVD mortality were significantly higher in medium SES municipalities (relative rate, 1.05; 95% CI, 1.02–1.07) and in lower SES municipalities (relative rate, 1.09; 95% CI, 1.07–1.12). There were walkability‐related gradients in CVD mortality within the high and medium SES areas, in which lower walkability was associated with higher rates of mortality; however, walkability‐related CVD mortality gradients were not apparent in lower SES municipalities.
Conclusions

CVD mortality rates varied not only by area‐level SES but also by walkability. Those living in areas of lower walkability were at higher risk of CVD mortality, even if the areas have a higher SES. Our findings provide a novel element of the evidence base needed to inform better allocation of services and resources for CVD prevention.

Increased sedentary behavior (SB) can adversely affect health. Understanding time-dependent patterns of SB and its correlates can inform targeted approaches for prevention. This study examined diurnal patterns of SB and its sociodemographic associations among Japanese workers. The proportion of sedentary time (% of wear time) and the number of breaks in SB (times/sedentary hour) of 405 workers (aged 40–64 years) were assessed using an accelerometer. SB patterns and sociodemographic associations between each time period (morning, afternoon, evening) on workdays and nonworkdays were examined in a series of multivariate regression analyses, adjusting for other sociodemographic associations. On both workdays and nonworkdays, the proportion of sedentary time was lowest in the morning and increased towards evening (b = 12.95, 95% CI: 11.28 to 14.62; b = 14.31, 95% CI: 12.73 to 15.88), with opposite trend for breaks. Being male was consistently correlated with SB. Other sociodemographic correlates differed depending on time-of-day and day-of-the-week. For instance, desk-based workstyles and urban residential area were associated with SB during workday mornings and afternoons, being single was related to mornings and evenings, workdays and nonworkdays. Initiatives to address SB should focus not only on work-related but time-of-day contexts, especially for at-risk subgroups during each period.

The potential of the neighbourhood built environment for reducing sedentary behaviour has been highlighted in the recent research building on the socio-ecological models. Nevertheless, few studies have investigated the associations between objectively-measured environmental attributes and domain-specific sedentary behaviours in different geographical locations. Notably, high-quality environmental measures that are less data-dependent and are replicable in and comparable across different contexts are needed to expand the evidence on urban design and public health. We examined associations of environmental attributes and Space Syntax Walkability (SSW) with leisure screen time and car driving in a sample of Canadian adults. A total of 2006 Calgarian adults completed a survey that captured their leisure screen time and car driving. Environmental attributes were population density, intersection density, availability of sidewalks, availability of destinations, and SSW using geographic information systems. Adjusting for covariates, a one standard deviation increase in SSW was associated with 0.43 (95% CI -0.85, -0.02) hours/week decrease in leisure screen time. No other environmental attributes were significantly associated with leisure screen time. All environmental attributes (except the availability of sidewalks) were negatively associated with car driving. The strongest association was observed between SSW with car driving – a one standard deviation increase in SSW was associated with 0.77 (95% CI -0.85, -0.02) hours/week decrease in the car driving. Those who lived in highly populated and more connected areas with a variety of destinations nearby spent less time driving their cars. Further, our findings highlight that the composite measure of SSW is associated with both leisure screen time and car driving. Focusing on a novel environmental aspect (SSW) and an emerging health risk factor (sedentary behaviour) among a relatively large sample of Canadian adults, our study provides unique insights into environmental health research.

Awareness of the effect of the neighbourhood built environment on cardiovascular diseases is growing. In this Comment, we identify major conceptual, methodological and policy-relevant issues in research related to the built environment and describe potential future directions to improve the scientific rigour of research in this field.

Background

Few studies have examined the associations between urban design attributes and older adults’ physical function. Especially, it is less known how built environment attributes may influence physical function in Asian cities. The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults.
Methods

Cross-sectional data collected in 2013 from 314 older residents (aged 65–84 years) living in Japan were used. Physical function was estimated from objectively measured upper and lower body function, mobility, and balance by a trained research team member. A comprehensive list of built environment attributes, including population density, availability of destinations, intersection density, and distance to the nearest public transport station, were objectively calculated. Walk Score as a composite measure of neighbourhood walkability was also obtained.
Results

Among men, higher population density, availability of destinations, and intersection density were significantly associated with better physical function performance (one-legged stance with eyes open). Higher Walk Score was also marginally associated with better physical function performance (one-legged stance with eyes open). None of the environmental attributes were associated with physical function in elderly women.
Conclusions

Our findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia. Walking-friendly neighbourhoods can not only promote older adults’ active behaviors but can also support their physical function.

Studies have shown the potential effects of sedentary behavior and physical activity on not only physical and mental health but also academic performance in children. Nevertheless, studies have only focused on either sedentary behavior or physical activity. Examining the joint effects of both behaviors on academic performance provides detailed insights into the patterns of these behaviors in relation to children's academic achievement. The present study investigated the joint longitudinal associations of physical activity and screen time with academic performance among Japanese children. The screen time and physical activity of 261 children aged 7-10 years were assessed, and their academic performance was evaluated one year later. Multivariate logistic regression analysis was used to examine the joint associations of screen time and physical activity with academic performance adjusted for demographic characteristics. Children with low screen time and physical activity had 2.04 (95% confidence interval: 1.11-3.78) times greater odds of having high academic performance compared to children with high screen time and low physical activity, while children with low screen time and high physical activity had 2.75 (1.17-6.43) times greater odds (boys; 4.12 (1.19-14.24)). Low screen time was related to high academic performance after one year, regardless of the physical activity level.

There is a dearth of evidence about how high-density living may influence dog-walking behaviour. We examined associations between neighbourhood built environment attributes and dog-ownership and dog-walking behaviour in Japan. Data from 1058 participants were used. The dog-ownership was 18.8%. All neighbourhood built attributes (excluding availability of parks) were negatively associated with dog-ownership. Among dog-owners, these same attributes were positively associated with any dog-walking in a usual week and with achieving 150-min per week of physical activity through dog-walking alone. These findings provided evidence on the importance of neighbourhood built environment attributes on dog-ownership and dog-walking behaviour in dense and compact areas. The urban design and public health implication of these findings is that the built environment attributes in high-density living areas may have different impacts on dog-ownership and dog-walking: while living in a walkable neighbourhood may not be conducive to dog-ownership, it may support dog-walking in such areas. Programs targeting dog-owners in high-density areas might be needed to encourage them to walk their dogs more. If successful, these programs could contribute to higher physical activity levels among dog-owners.

Background<br />
<br />
Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers.<br />
Methods<br />
<br />
Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors.<br />
Results<br />
<br />
A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, “typically seeing work colleagues take sedentary breaks” was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = −7.08 [−13.75 to −0.40]). “I am motivated to take sedentary breaks” had an unfavorable association with less sedentary breaks (B [95% CI] = −1.36 [−2.61 to −0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, “Too stressed to take sedentary breaks” was significantly associated with less sedentary breaks (B [95% CI] = −5.6 [−9.17 to −2.02]).<br />
Conclusions<br />
<br />
Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.

There is little evidence on how perceptions of the built environment may influence physical activity among post-stroke patients. This study aimed to explore the associations between perceived built environment attributes and objectively measured physical activity outcomes in community-dwelling ambulatory patients with stroke. This cross-sectional study recruited patients who could walk outside without assistance. We assessed both objectively measured physical activity outcomes such as number of steps and duration of moderate-to-vigorous physical activity (MVPA) with an accelerometer and the patients' perceived surrounding built environment with the International Physical Activity Questionnaire Environmental Module. Sixty-one patients (67.0 years old) were included. The multiple linear regression analysis showed significant associations of the presence of sidewalks (β = 0.274, p = 0.016) and access to recreational facilities (β = 0.284, p = 0.010) with the number of steps taken (adjusted R2 = 0.33). In contrast, no significant associations were found between perceived built environment attributes and MVPA. These findings may help to suggest an approach to promote appropriate physical activity in patients with stroke depending on their surrounding built environment.

OBJECTIVES: The aims of this study were to examine (a) associations of two metric and space syntax measures of street layout with the cognitive function of Japanese older adults and (b) the extent to which objectively assessed physical activity mediated such associations. METHODS: Cross-sectional data from 277 older adults who lived in Japan were used. Street layout attributes were objectively calculated for each participant's geocoded home location. The Mini-Mental State Examination was used to evaluate cognitive function. Physical activity was objectively assessed with accelerometers. RESULTS: There was a statistically significant negative association between street integration and the odds of having cognitive impairment. Objectively assessed physical activity did not attenuate this relationship. CONCLUSIONS: Our findings provide unique evidence regarding the importance of the topological aspects of street layouts in (re)designing neighborhoods to support mental illness.

Different models of accelerometer have the potential to provide a different estimate of the same physical activity or sedentary behavior. Our study compared the outputs of the Active Style Pro (ASP) and ActiGraph (AG) devices in assessing predicted metabolic equivalents (METs) for specific activities under laboratory conditions. Thirty healthy young adults wore two hip accelerometers (ASP and AG), simultaneously while performing twenty-two activities (eight sedentary, eight household, and six ambulatory activities) in a controlled laboratory setting. For the AG, predicted METs for each activity was calculated using four equations based on vertical-axis and vector magnitude data. Separate paired t-tests and Bland–Altman analysis examined the difference and agreement in METs between AG using four commonly used equations and ASP measurements for each activity. AG devices using different equations calculated significantly different outcomes for most activities compared with ASP devices. The smallest differences in predicted METs estimates between ASP and AG were observed for ambulatory activities. Ambulatory activities demonstrated the best agreement between ASP and AG regardless of which AG equation was used. Our findings can be used to assist researchers in their selection of accelerometer and output estimation equations for measuring physical activity and sedentary behavior in adults.

Various accelerometers have been used in research measuring physical activity (PA) and sedentary behavior (SB). This study compared two triaxial accelerometers—Active style Pro (ASP) and ActiGraph (AG)—in measuring PA and SB during work and nonwork days in free-living conditions. A total of 50 working participants simultaneously wore these two accelerometers on one work day and one nonwork day. The difference and agreement between the ASP and AG were analyzed using paired t-tests, Bland–Altman plots, and intraclass coefficients, respectively. Correction factors were provided by linear regression analysis. The agreement in intraclass coefficients was high among all PA intensities between ASP and AG. SB in the AG vertical axis was approximately 103 min greater than ASP. Regarding moderate-to-vigorous-intensity PA (MVPA), ASP had the greatest amount, followed by AG. There were significant differences in all variables among these devices across all day classifications, except for SB between ASP and AG vector magnitude. The correction factors decreased the differences of SB and MVPA. PA time differed significantly between ASP and AG. However, SB and MVPA differences between these two devices can be decreased using correction factors, which are useful methods for public health researchers.

PURPOSE: The purposes of this study were to examine associations between objectively measured walkable urban design attributes with Japanese older adults' body mass index (BMI) and to test whether objectively assessed physical activity and sedentary behavior mediated such associations. DESIGN: Cross-sectional. SETTING: Matsudo City, Chiba Prefecture, Japan. PARTICIPANTS: Participants were 297 older residents (aged 65-84 years) randomly selected from the registry of residential addresses. MEASURES: Walkable urban design attributes, including population density, availability of physical activity facilities, intersection density, and access to public transportation stations, were calculated using geographic information systems. Physical activity, sedentary behavior, and BMI were measured objectively. ANALYSIS: The relationships of walkable urban design attributes, Walk Score®, and BMI were examined by multiple linear regression with adjustment for covariates in all models. Mediation effects of the physical activity and sedentary behavior variables in these relationships were tested using a product-of-coefficients test. RESULTS: Higher population density and Walk Score® were associated with lower BMI. Light and moderate-to-vigorous physical activities partially mediated the relationships between these walkable urban design attributes and BMI. CONCLUSIONS: Developing active-friendly environmental policies to (re)design neighborhoods may not only promote active transport behaviors but also help in improving residents' health status in non-Western contexts.

Despite associations found between physical activity and depression, and the built environment and physical activity, there appears to be inconclusive evidence regarding the role of built environment attributes with preventing depression among the elderly. This is mainly because few studies exist on this topic. In addition, the majority of existing studies have been conducted in Western countries; and there is a dearth of studies in other regions, where the built, social, and cultural environment is different than Western countries. Using data from Japanese older adults, this study examined the associations between objectively-assessed built environment attributes and depressive symptoms. We examined these associations stratified by gender, since research has well-documented gender differences in depression. Data were from 328 older adults living in Japan. Built environment attributes were objectively calculated and Walk Score ratings were obtained from the website. Depressive symptoms were assessed using the GDS-15. Gender-stratified regression models were used to estimate the associations. We found that a walkable environment characterized by a high population density and proximate local destinations to be supportive for a better mental health among older adults, in particular for women. These findings suggest that walkable built environment attributes may influence depression among older women in an Asian urban context. This study contributed to the literature by examining how walkable urban design may influence elderly's depression in a setting with extreme level of environmental attributes. Investing in urban design to promote walkability may help in reducing the observed gender gap in depression in the Japanese population.

Background. Comparability of accelerometers in epidemiological studies is important for public health researchers. This study aimed to compare physical activity (light, LPA; moderate, MPA; and moderate-to-vigorous, MVPA) and sedentary behavior (SB) data collected using two Omron triaxial accelerometer generations (Active style Pro, ASP) among a sample of Japanese workers in a free-living environment. Methods. Thirty active and sedentary workers (24–62 years) wore two types of ASP accelerometers, the HJA-350IT (350IT) and the HJA-750C (750C), simultaneously for seven consecutive days to represent a typical week. The accelerometers estimated daily average step counts and time spent per day in LPA, MPA, and MVPA. If a participant had data for ≥4 days (&gt;10 h/day) it was considered valid. The difference and agreement between the two ASPs were analyzed using a paired t-test, intra-class correlation coefficients (ICC), and a Bland–Altman analysis in total and for each type of worker. Results. Among all workers, the 750C measured significantly (p &lt; 0.05) less SB, MPA, MVPA, and more LPA compared with the 350IT. The agreements in ICC were high (ICC ≥ 0.94). Conclusions. Compared with the 350IT, the newer generation 750C ASP accelerometer may not provide equivalent estimates of activity time, regardless of the type of physical activity.

Background<br />
<br />
Cross-sectional studies provide useful insight about the associations between the built environment and physical activity (PA), particularly when reasons for neighborhood choice are considered. Our study analyzed the relationship between levels of weekly transportation and leisure PA among three neighborhood designs, statistically adjusting for sociodemographic characteristics and reasons for neighborhood choice.<br />
Methods<br />
<br />
A stratified random sample of adults (age ≥20 years) living in Calgary (Canada) neighborhoods with different neighborhood designs (grid, warped-grid, curvilinear) and socioeconomic status completed a self-administered questionnaire capturing PA, sociodemographic characteristics, and reasons for neighborhood choice (response rate = 10.1%; n = 1023). Generalized linear models estimated associations between neighborhood design and transportation and leisure PA outcomes (participation [any vs. none] and volume [metabolic equivalent: h/week]), adjusting for neighborhood socioeconomic status, sociodemographic characteristics (gender, age, ethnicity, education, household income, marital status, children, vehicle access, dog ownership, and injury), and reasons for neighborhood choice (e.g., proximity and quality of recreational and utilitarian destinations, proximity to work, highway access, aesthetics, and sense of community).<br />
Results<br />
<br />
Overall, 854 participants had resided in their neighborhood for at least 12 months and provided complete data. Compared with those living in curvilinear neighborhoods, grid neighborhood participants had greater odds (p &lt; 0.05) of participating in any transportation walking (odds ratio [OR] = 2.17), transportation and leisure cycling (OR = 2.39 and OR = 1.70), active transportation (OR = 2.16), and high-intensity leisure PA (≥6 METs; OR = 1.74), respectively. There were no neighborhood differences in the volume of any transportation or leisure PA undertaken. Adjustment for neighborhood selection had minimal impact on the statistical or practical importance of model estimates.<br />
Conclusion<br />
<br />
Neighborhood design is associated with PA patterns in adults, independent of reasons for neighborhood choice and sociodemographic factors.

Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes—dwelling density, street connectivity, and neighbourhood destination accessibility—using seven different neighbourhood definitions (three administrative unit boundaries, and 500, 800, 1000- and 1500-m road network buffers). The associations between the three built environment measures and five measures of physical activity (mean accelerometer counts per hour, percentage time in moderate–vigorous physical activity, self-reported walking for transport, self-reported walking for recreation and self-reported walking for all purposes) were modelled for each neighbourhood definition. The combination of the choice of neighbourhood definition, built environment measure, and physical activity measure determined whether evidence of an association was detected or not. Results demonstrated that, while there was no single ideal neighbourhood definition, the built environment was most consistently associated with a range of physical activity measures when the 800-m and 1000-m road network buffers were used. For the street connectivity and destination accessibility measures, associations with physical activity were less likely to be detected at smaller scales (less than 800 m). In line with some previous research, this study demonstrated that the choice of neighbourhood definition can influence whether or not an association between the built environment and adults’ physical activity is detected or not. This study additionally highlighted the importance of the choice of built environment attribute and physical activity measures. While we identified the 800-m and 1000-m road network buffers as the neighbourhood definitions most consistently associated with a range of physical activity measures, it is important that researchers carefully consider the most appropriate type of neighbourhood definition and scale for the particular aim and participants, especially at smaller scales.

We examined associations of neighborhood population density with 12-year changes in diabetes risk (post-challenge plasma glucose), and potential moderation by neighborhood socio-economic status (SES) among 4,816 Australians. In lower SES neighborhoods, post-challenge plasma glucose increased by 6% in low-density, remained stable in medium-density and decreased by 3% in high-density neighborhoods. In medium SES neighborhoods, glucose remained stable in high-density, but increased by 2% and 3% in medium- and low-density neighborhoods, respectively. In higher SES neighborhoods, no significant interaction effect between time and density was observed. Densification may make protective contributions for diabetes risk in lower and medium SES neighborhoods.

Objectives To examine patterns of sedentary behaviour and physical activity, among Japanese workers with differing occupational activity types.<br />
<br />
Design A cross-sectional observational study in 2013–2015.<br />
<br />
Setting Two local communities in Japan.<br />
<br />
Participants Full-time workers aged 40–64 years (n=345; 55% men) and who lived in two cities.<br />
<br />
Main outcome measures From accelerometer data for 7 days, mean overall sedentary time, prolonged bouts of sedentary time and light-and moderate-to vigorous-intensity of physical activity (LPA and MVPA) as a proportion of accelerometer wear time and number of breaks per sedentary hour were identified for four time periods: working hours, workdays, non-work hours and non-workdays. These sedentary behaviour and physical activity measures in the four time periods were examined among workers with four self-attributed occupational activity types (mainly sitting, standing, walking, and physical labour), adjusting for sociodemographic attributes. Diurnal patterns of sedentary behaviour, LPA, and MVPA were examined.<br />
<br />
Results In working hours, those with a sitting job had significantly more total and prolonged sedentary time (total: p&lt;0.001; prolonged: p&lt;0.01) along with less LPA (p&lt;0.001) and MVPA (p&lt;0.001) and less frequent breaks (p&lt;0.01), compared with those with the three more active job type. Similar differences by job type were found for the whole working day, but not for prolonged sedentary time and breaks. On non-working hours and days, differences in sedentary and physically active patterns by job type were not apparent.<br />
<br />
Conclusions Occupational activity type is related to overall sedentary time and patterns on working days, but not to leisure-time sitting and activity patterns, which were similar across the sitting, standing, walking, and physical labour occupational activity types.

© The Author(s) 2019. An increasing number of studies have examined neighbourhood built environment attributes associated with cycling. Some of them suggest non-linear relationships between built environment attributes and cycling. This study examined the strength and shape of associations of cycling for transport with objectively measured built environment attributes. Data were from 9146 Australian adults who took part in the 2009 South-East Queensland Travel Survey. Participants (aged 18–64 years) completed a 24-hour travel survey, in which they reported modes of travel. Residential density, Walk Score and a Space Syntax measure of street integration were calculated at a neighbourhood level using geographic information systems. Multilevel logistic regression analyses examined associations of bicycle use with each built environment attribute, which was modelled continuously and categorically. All continuous measures of the built environment attributes were associated with bicycle use. Each one-decile increment in residential density, Walk Score, and street integration was associated with 13%, 16%, and 10% higher odds of bicycle use, respectively. However, the associations appeared to be non-linear, with significant odds ratios observed only for the higher categories of each built environment attribute relative to the middle category. This study found that adults living in high-density neighbourhoods with more destinations nearby and well-connected streets were more likely to cycle for transport. However, medium-level density, access to destinations and street connectivity may not be enough to facilitate bicycle use. Further studies are needed to investigate urban design threshold values above which cycling can be promoted.

Research has examined spatial distribution of physical activity, mostly focusing on between-area differences by examining associations of area-level walkability measures with physical activity. Within-area distribution is also relevant, since larger disparities in physical activity within an area can contribute to greater inequalities in health. However, associations of within-area disparity in walking and walkability have been examined only at a large geographical scale (city level). This cross-sectional study examined associations of local-area walkability measures with within-area disparities in residents&#039; walking and car use, using data collected in the 2009 South-East Queensland Travel Survey in Australia. For each Statistical Area 2 (SA2), we calculated disparity indices of the duration of walking and car use among participants aged 18–84 years, using Gini coefficients. Linear regression examined associations of the disparity measures with population density, street connectivity, and Walk Score. Analyses were conducted for 196 SA2s, which contained 15,895 participants. Higher walkability was associated with lower levels of disparity in walking and higher levels of disparity in car use, regardless of the measures used. Each one-SD increment in Walk Score was associated with a 0.64 lower SD in walking disparity and a 0.50 higher SD in car-use disparity, after adjusting for covariates. The associations remained significant after further adjusting for car ownership. Higher walkability is known to be associated with more walking and less car use. This study extends previous knowledge by showing that higher local-area walkability can be associated with less inequality in residents&#039; walking and higher diversity in their car use.

Walking to get to and from local destinations including shops, services, and transit stops is a major source of adults’ health-related physical activity. Research has been using space syntax measures in examining how urban form is related to such routine walking for transport. This paper proposes to apply a theory of space syntax, natural movement, which posits street layout as a primary factor influencing pedestrian movement. Discussing how this theory can link urban form (street layout) and function (land use) with walking for transport, we propose a research agenda to produce new insights and advance methods in active living research.

© 2019 Most walkability indices do not capture the topological structure of urban forms. Space syntax models these topological relationships. We estimated associations between the space syntax measure of street integration and walkability (SSW) and neighborhood-specific leisure (LW) and transportation (TW) walking among 4422 Canadian adults. Street integration and SSW were found to be positively associated with TW and LW participation in a usual week. A one-unit increase in SSW was associated with a 6-min increase in usual weekly minutes of TW. Street integration and SSW were also positively associated with TW participation in the last week. Higher street integration and walkability conceptualized using space syntax support neighborhood walking.

Although greater sedentary time has been found to be associated with negative health impacts, little is known whether the specific pattern of sedentary behavior (i.e. sedentary bouts, breaks and durations) are associated with physical function among older adults. The present study examined the associations between objectively measured sedentary behavior and physical function among older Japanese adults. A total of 174 male and 107 female community-dwelling older Japanese adults aged 65–84 years (mean age: 74.5 ± 5.2 years) were recruited. Sedentary behavior and physical activity were assessed using a triaxial accelerometer. Physical function was measured through hand grip strength, eye-open one leg standing, 5-m walking, and timed up and go tests. Forced-entry multiple linear regression models adjusted for potential confounders were performed. After adjustment, total daily sedentary time and duration of prolonged sedentary bouts (both ≥ 30 min) were positively associated with time spent on the 5-m walking stage and timed up and go tests in older women; however, no significant associations were observed in older men or the whole sample. This paper highlights the importance of developing sedentary behavior change strategies for interventions aiming to improve mobility in in older women. Further evidence from a prospective study is required to establish directions of causality between sedentary behavior and mobility.

Neighborhood environmental attributes have been found to be associated with residents&#039; time spent walking and in physical activity, in studies from single countries and in multiple-country investigations. There are, however, mixed findings on such environmental relationships with sedentary (sitting) time, which primarily have used evidence derived from single-country investigations with self-reported behavioral outcome measures. We examined potential relationships of neighborhood environmental attributes with objectively-assessed sedentary time using data from 5712 adults recruited from higher and lower socio-economic status neighborhoods in 12 sites in 10 countries, between 2002 and 2011. Ten perceived neighborhood attributes, derived from an internationally-validated scale, were assessed by questionnaire. Sedentary time was derived from hip-worn accelerometer data. Associations of individual environmental attributes and a composite environmental index with sedentary time were estimated using generalized additive mixed models. In fully adjusted models, higher street connectivity was significantly related to lower sedentary time. Residential density, pedestrian infrastructure and safety, and lack of barriers to walking were related to higher sedentary time. Aesthetics and safety from crime were related to less sedentary time in women only. The predicted difference in sedentary time between those with the minimum versus maximum composite environmental index values was 71 min/day. Overall, certain built environment attributes, including street connectivity, land use mix and aesthetics were found to be related to sedentary behavior in both expected and unexpected directions. Further research using context-specific measures of sedentary time is required to improve understanding of the potential role of built environment characteristics as influences on adults&#039; sedentary behavior.

Since the burden of chronic diseases is rising globally, there is an urgent need to develop population-level approaches to reducing the risk of chronic diseases. Neighborhood environments, where people spend much of their time, are relevant in this context because they can influence residents’ daily behaviors related to health. In particular, public green spaces (PGS) can confer health benefits through facilitating physical activity, contact with nature, and social interaction. PGS may also mitigate socio-economic inequalities in health. However, despite growing evidence, PGS are generally not fully utilized as a resource for physical activity. Thus, there is substantial scope for enhancing population health through increased visits and active use of PGS. This essay argues that PGS are not only health-enhancing but also practical and workable environmental resources to promote population health. We discuss three “advantages” of using PGS as health promotion initiatives: PGS are easier to modify (than are other structural environmental features)
PGS can involve programs to help residents initiate physical activity
and PGS are valued by residents. The essay concludes with a discussion of future research topics, the result of which can be used to convince and assist local authorities and other key stakeholders to use PGS as readily available resources for health promotion.

Objective<br />
<br />
We examined (1) cross-sectional and prospective associations of perceived and objectively-measured neighborhood attributes with purpose-specific walking; (2) the differences between cross-sectional and prospective associations in the sample of Japanese middle-to-older-aged adults.<br />
Methods<br />
<br />
We conducted a prospective cohort study to collect data from 544 adults aged 40 to 69 years living in two cities in Japan in 2011 and again in 2013. Generalized linear modelling was employed to examine associations of perceived and GIS-measured built environment attributes (population density, access to destinations, access to public transportation, sidewalk, and street connectivity) with four types of self-reported purpose-specific walking, namely walking for commuting (to and from work), walking during work, walking for errands (shopping, to the bank or post office), and walking for exercise.<br />
Results<br />
<br />
After adjusting for potential confounders, GIS-measured higher population density and better street connectivity were associated with increased time spent walking for commuting and exercise. Furthermore, GIS-measured better access to public transportation was related to increased time spent walking for commuting, and perceived better access to destinations was also associated with increased time spent walking for commuting and daily errands. Unexpectedly, GIS-measured better access to destinations, and perceived sidewalk presence were related to decreased time spent in work-related walking.<br />
Conclusion<br />
<br />
Living in high-density neighborhoods with well-connected streets and convenient public transportation systems, and having a higher awareness of destinations are supportive of the long-term engagement in walking for various purposes. Further studies using a prospective design with longer follow-up period to confirm these results are warranted.

OBJECTIVES: Reducing sedentary behaviour (SB) and increasing physical activity (PA) have been shown to be associated with decreased depression. However, there are yet few studies examining the potential benefits on older adults' depression, when SB is replaced with PA. This study aimed to examine the associations of objectively assessed SB, light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA) with depression among a sample of Japanese older adults, and to explore impacts of substituting SB with PA on older adults' depression. DESIGN: Cross-sectional analysis. SETTING: General community. PARTICIPANTS: A total of 276 older adults aged 65-85 years living in Japan. MAIN OUTCOME MEASURES: Three behaviours including the average daily time spent in SB (≤1.5 METs); LPA (>1.5 to <3.0 METs) and MVPA (≥3.0 METs) per day were calculated by accelerometers. Depression was assessed using the Japanese version of the 15-item Geriatric Depression Scale (GDS-15). RESULTS: Less SB (β=0.129, 95% CI 0.015 to 0.243) and more LPA (β=-0.138, 95% CI -0.265 to -0.011) were found to be significantly and negatively associated with the GDS-15 score in the single-activity model. The isotemporal substitution model found that replacing only 30 min per day of SB with the same amount of LPA to be significantly and negatively associated with the GDS-15 score (β=-0.131, 95% CI -0.260 to -0.002). CONCLUSIONS: These findings indicated that substituting even small amounts of SB with LPA may contribute to less depression in older adults. Potential favourable effects can be observed for replacing only 30 min per day of SB with LPA.

There is a growing recognition of the role of built environment attributes, such as streets, shops, greenways, parks, and public transportation stations, in supporting people’s active behaviors. In particular, surrounding built environments may have an important role in supporting healthy active aging. Nevertheless, little is known about how built environments may influence active lifestyles in “super-aged societies”. More robust evidence-based research is needed to identify how where people live influences their active behaviors, and how to build beneficial space in the context of super-aged societies. This evidence will also be informative for the broader international context, where having an aging society will be the inevitable future. This commentary sought to move this research agenda forward by identifying key research issues and challenges in examining the role of built environment attributes on active behaviors in Japan, which is experiencing the longest healthy life expectancy, but rapid “super-aging”, with the highest proportion of old adults among its population in the world.

Older adults are often considered more vulnerable to environmental factors than are younger adults. We examined whether the associations of objectively-measured environmental attributes (Walk Score; street connectivity) with walking for transport differed between younger- (25-44 years), middle- (45-64 years), and older-aged (65-84 years) adults, using a large of Australian sample of 14,656. Walk Score and street connectivity were similarly associated with walking (any; 30+ min/day) in all age groups. Contrary to commonly held views, the study did not find any evidence suggesting that older adults may be more sensitive to their environment to get out and walk than are younger adults, at least for the environmental attributes examined in this study. Further research is needed to investigate if there are particular environmental factors that hinder older adults from being active.

More than half the world’s population now live in urban settlements. Worldwide, cities are expanding at their fringe to accommodate population growth. Low-density residential development, urban sprawl, and car dependency are common, contributing to physical inactivity and obesity. However, urban design and planning can modify urban form and enhance health by improving access to healthy food, public transport, and services. This study used a sequential mixed methods approach to investigate associations between food outlet access and body mass index (BMI) across urban-growth and established areas of Melbourne, Australia, and identify factors that influence local food environments. Population survey data for 3141 adults were analyzed to examine associations, and 27 interviews with government, non-government, and private sector stakeholders were conducted to contextualize results. Fast food density was positively associated with BMI in established areas and negatively associated in urban-growth areas. Interrelated challenges of car dependency, poor public transport, and low-density development hampered healthy food access. This study showed how patterns of suburban development influence local food environments and health outcomes in an urbanized city context and provides insights for other rapidly growing cities. More nuanced understandings of the differential effect of food environments within cities have potential to guide intra-city planning for improving health and reducing inequities.

Background: Inconsistent associations of neighbourhood walkability with adults' body weight have been reported. Most studies examining the relationships of walkability and adiposity are cross-sectional in design. We examined the longitudinal relationships of two walkability indices - conventional walkability and space syntax walkability, and their individual components, with weight change among adults over four years. Methods: Data were from the Physical Activity in Localities and Community study in Adelaide, Australia. In 2003-2004, 2650 adults living in 154 Census Collection Districts (CCDs) returned baseline questionnaires
in 2007-2008, the follow-up survey was completed by 1098. Participants reported their weight at baseline and at follow-up. Neighbourhood walkability indices were calculated using geographic information systems and space syntax software. Linear marginal models using generalized estimating equations with robust standard errors were fitted to examine associations of the two walkability indices and their individual components with the weight at follow-up, adjusting for baseline weight, socio-demographic variables, and spatial clustering at the level of CCD. Results: The overall mean weight gain over four years was 1.5 kg. The two walkability indices were closely correlated (r = 0.76, p &lt
0.01). No significant associations were found between the overall neighbourhood walkability indices and weight change. Among walkability components, there was a marginally significant negative association between space syntax measure of street integration and weight change: one standard deviation increment in street integration was associated with 0.31 kg less weight gain (p = 0.09). Conclusions: Using a prospective study design and a novel space-syntax based measure of walkability, we were not able to identify relationships between neighbourhood walkability with weight gain. This is consistent with other inconclusive findings on the built environment and obesity. Research on the built environment and adults' weight gain may need to consider not just local environments but also a larger scale environment within a city or workplace environment in order to capture multiple behaviours relevant to weight gain.

Evidence about the impacts of the physical activity environment on adults' weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score
®
-a free online walkability tool-is related to obesity. This study aimed to examine associations between multiple physical activity environment measures and Walk Score
®
ratings with Japanese adults' body mass index (BMI). Data from 1073 adults in the Healthy Built Environment in Japan study were used. In 2011, participants reported their height and weight. Environmental attributes, including population density, intersection density, density of physical activity facilities, access to public transportation, and availability of sidewalks, were calculated using Geographic Information Systems. Walk Scores
®
ratings were obtained from the website. Multiple linear regression analysis was conducted to examine the association between each environmental attribute and BMI. Adjusting for covariates, all physical activity environmental attributes were negatively associated with BMI. Similarly, an increase of one standard deviation of Walk Score
®
was associated with a 0.29 (95% confidence interval (CI) of -0.49--0.09) decrease in BMI. An activity-friendly built environment was associated with lower adults' BMI in Japan. Investing in healthy community design may positively impact weight status in non-Western contexts.

Objectives This study examined cross-sectional and 2-year prospective associations of perceived and objectively measured environmental attributes with screen time among middle-Aged Japanese adults. Design Prospective cohort study. Setting Nerima and Kanuma cities of Japan. Participants Data were collected from adults aged 40-69 years living in two cities of Japan in 2011 (baseline: n=1011
55.3±8.4 years) and again in 2013 (follow-up: n=533
52.7% of baseline sample). Measures The exposure variables were five geographic information system-based and perceived attributes of neighbourhood environments (residential density, access to shops and public transport, footpaths, street connectivity), respectively. The outcome variables were baseline screen time (television viewing time and leisure-time internet use) and its change over 2 years. Multilevel generalised linear modelling was used. Results On average, participants' screen time was not statistically different over 2 years (2.3 hours/day at baseline and 2.2 hours/day at follow-up
P=0.24). There were cross-sectional associations of objective (exp(β): 1.11
95% CI 1.01 to 1.22) and perceived (1.12
1.02 to 1.23) good access to public transport, perceived good access to shop (1.18
1.04 to 1.36) and perceived good street connectivity (1.11
1.01 to 1.23) with higher time spent in screen time at baseline. No objective and perceived environmental attributes were significantly associated with change in screen time. Conclusions Activity-supportive neighbourhood environmental attributes appear to be related to higher levels of screen time cross-sectionally. Pattern of screen time might be maintained rather than changed over time under the same neighbourhood environments. Environmental interventions that promote physical activity may need to consider the potential negative health impact of screen time in Japan.

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan. Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017). Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density (r = 0.82) and with the number of local destinations (r = 0.77). Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data.

Public open spaces (POS) are key neighbourhood destinations shown to confer numerous physical and mental health benefits. The amount and spatial distribution of POS throughout cities are guided by urban planning policies and standards. However, empirical evidence is not generally used to create POS standards. Developing and testing POS indices associated with positive health outcomes, can inform evidence-based POS urban design and planning standards that support the creation of healthier cities. This study examined associations of urban design policy-derived and empirical measures of POS proximity and density with walking and depression. The 2011–12 Australian Diabetes, Obesity and Lifestyle study (AusDiab) wave data were used. Adults living in metropolitan Melbourne, Australia were included (n = 319). Participants reported walking for recreation and any walking within their neighbourhood during the last week. Depression was calculated using the Center for Epidemiologic Studies Short Depression Scale (CESD-10). Informed by Australian urban design policies and empirical evidence, various POS measures were calculated at different street network distances around residential addresses using geographic information systems software. Measures tested included: distance to nearest POS, size of nearest POS, total number of POS, and area of POS at scales of 400, 800, 1000, and 1600 m. Associations of these POS measures with walking and depression were examined using adjusted multilevel logistic regression models. Overall 68% and 77% of participants reported walking for recreation and any walking in the past week, respectively; and about 13% were categorized as depressed. Living within 400 m of POS was not associated with either type of walking, but those whose nearest POS was &gt; 1.5 ha had 1.90 and 2.66 times greater odds of walking for recreation and any walking during the last week, respectively. In Melbourne, the urban design policy standard is that POS be available within 400 m of homes. In our study, this standard was not associated with walking or depression; however having a larger POS nearby supported residents&#039; walking. This study highlights the importance of assessing such standards for their potential health impact, and warrants further investigation.

Background and Objectives: To examine prospective associations of perceived attributes of local destinations and routes with middle-to-older aged adults' 4-year changes in walking for transport (WT) and walking for recreation (WR). Research Design and Methods: Data were collected from adults aged 50-64 years old, living in Adelaide, Australia. Participants (N = 454) reported weekly frequency of WT and WR at baseline (2003-2004) and follow-up (2007-2008). Attributes of local destinations and routes were based on self-reported measures at baseline and included: proximity to utilitarian and recreational destinations, the number of such destinations within 10 and 11-20 min walk from home, street connectivity, and walking paths. Generalized additive mixed models were used to examine the associations of perceived destination and route attributes with changes in frequency of WT and WR. Results: Higher levels of perceived proximity to utilitarian destinations, reporting a larger number of utilitarian destinations within 10 min walk from home and higher street connectivity were associated with more positive changes in frequency of WT. Higher levels of perceived proximity to recreational destinations and better walking paths were associated with more positive changes in frequency of WR. No curvilinear relationships were observed and baseline frequency of walking did not moderate the associations. Discussion and Implications: Proximity of utilitarian and recreational destinations, well-connected streets, and better walking paths can be supportive of long-term participation in walking among middle-to-older aged adults. Environmental and policy initiatives focusing on such destination and route attributes have the potential to support residents' aging in place.

身体活動が健康増進に対して有益なことはこれまでの研究から明らかになっているが，非活動的な人が多いのが現状である。日本においても、身体活動を行う人の割合は低く、特に長時間の座位行動が顕著である。人々の活動的な生活を推進するにあたり、最近では身体活動に従事することを容易にするような周辺環境に着目した研究が行われている。そのようなアプローチは多くの人が身体活動を習慣的に行うことを可能にすると考えられている。本稿は近隣環境と活動的な生活との関連についてのこれまでの研究についてまとめたものであり、既往研究において用いられている概念、環境要因の計測方法、これまでの研究例とともに、日本における今後の研究の必要性と方向について記述している。

キーワード：公衆衛生、歩行、アーバンデザイン、都市計画

BACKGROUNDS: The purpose of this study was to examine, in a sample of Japanese older adults, the associations of objectively-assessed sedentary behavior (SB) and physical activity (PA) with performance-based physical function. The isotemporal substitution (IS) approach was used to model simultaneously the effects of the specific activity being performed and the activity being displaced, in an equal time-exchange manner. METHODS: Among 287 older adults (65-84 years), we used accelerometers to identify the daily average time spent on SB (≤1.5 METs); light-intensity PA (LIPA) (>1.5 to <3.0 METs); and moderate- to vigorous-intensity PA (MVPA) (≥3.0 METs). Physical function was assessed using five performance-based measures: hand grip strength, usual and maximum gait speeds, timed up and go, and one-legged stance with eyes open. We employed three linear regression models - a single-activity model, a partition model, and an IS model - to assess the associations of SB, LIPA, and MVPA with each of the five measures of physical function. RESULTS: There were significant positive associations in the single-activity and partition models between MVPA and the measures of physical function (with the exception of hand grip strength). The IS models found that replacing SB or LIPA with MVPA was significantly and favorably associated with physical function measures. CONCLUSIONS: These findings indicate that replacing small amounts of SB and LIPA with MVPA (such as 10 min) may contribute to improvements in older adults' physical function.

Walk Score® is a free publicly-available tool that evaluates how a particular location is supportive of residents&#039; walking, based on the distance to various local destinations. Several studies have shown associations of Walk Score with walking behaviors. However, these studies have been conducted only in Western countries, such as the U.S.A., Australia, Canada, and France. In addition, the role of Walk Score in sedentary behaviors has not yet been explored. The current study examined associations of Walk Score with physically-active and sedentary behaviors in Japan.<br />
<br />
This study used cross-sectional survey data from the Healthy Built Environment in Japan (HEBEJ) project. In 2011, adults living in urban and rural areas in Japan (n = 1072) reported their walking and sedentary behaviors. Participants reported their walking in the past week for three specific purposes: for commuting; for errands; and for exercise. They also reported two sedentary behaviors in the past week: TV viewing and car driving. Walk Score was obtained manually for each participant&#039;s residential address. Logistic regression models (adjusted for covariates) were used to examine the associations of Walk Score with specific walking and sedentary behaviors.<br />
<br />
There were significant positive associations of Walk Score with two types of walking and car driving. Each 10-point increment in Walk Score (range: 0–97) was associated with a 34% (95%CI: 1.25, 1.42) higher odds of any walking for commuting; a 6% (95%CI: 1.01, 1.11) higher odds of any walking for errands; a 36% (95%CI: 1.23, 1.50) higher odds of sufficient walking for commuting; and, a 10% (95%CI: 0.83, 0.97) lower odds of driving a car for more than one hour per day.<br />
<br />
This study found for the first time that Walk Score was related to travel behaviors in a non-Western country. Walk Score can be useful to transport and urban designers in identifying local areas that support (or do not support) residents&#039; active travel, and can help to inform broader environmental and urban design policy initiatives to promote active living.

Objective To investigate dietary intake, BMI and supermarket access at varying geographic scales and transport modes across areas of socio-economic disadvantage, and to evaluate the implementation of an urban planning policy that provides guidance on spatial access to supermarkets. Design Cross-sectional study used generalised estimating equations to investigate associations between supermarket density and proximity, vegetable and fruit intake and BMI at five geographic scales representing distances people travel to purchase food by varying transport modes. A stratified analysis by area-level disadvantage was conducted to detect optimal distances to supermarkets across socio-economic areas. Spatial distribution of supermarket and transport access was analysed using a geographic information system. Setting Melbourne, Australia. Subjects Adults (n 3128) from twelve local government areas (LGA) across Melbourne. Results Supermarket access was protective of BMI for participants in high disadvantaged areas within 800 m (P=0·040) and 1000 m (P=0·032) road network buffers around the household but not for participants in less disadvantaged areas. In urban growth area LGA, only 26 % of dwellings were within 1 km of a supermarket, far less than 80-90 % of dwellings suggested in the local urban planning policy. Low public transport access compounded disadvantage. Conclusions Rapid urbanisation is a global health challenge linked to increases in dietary risk factors and BMI. Our findings highlight the importance of identifying the most appropriate geographic scale to inform urban planning policy for optimal health outcomes across socio-economic strata. Urban planning policy implementation in disadvantaged areas within cities has potential for reducing health inequities.

Several studies have examined how the associations of built environment attributes with walking behaviors may be moderated by socioeconomic status (SES). Such understanding is important to address socioeconomic inequalities in health through urban design initiatives. However, to date, there is no study examining the moderation effects of SES in the relationships of environmental attributes and walking in non-Western countries. The current study aims to examine associations of environmental attributes with walking behaviors among Japanese adults, and to test whether these associations were moderated by area-level SES. Data on walking were collected from Japanese adults using a nationwide Internet survey (N = 4605). Built environment measures including population density, street density, distance to the nearest public open space, and distance to the nearest commercial destination were calculated using geographic information systems software. An index of neighborhood deprivation was used as an area-level indicator of SES. Logistic regression models adjusted for clustering and sociodemographic variables were used. It was found that more residents in high SES areas walked for commuting, for errands, and for exercise compared with those who lived in low SES areas. When the whole sample was examined, all environmental attributes were associated with walking behaviors (except for street density not being associated with walking for exercise). Associations of environmental attributes with walking behaviors were moderated by area-level SES only in walking for exercise. Walking for exercise was associated with higher population density, higher street density (marginally significant), and shorter distance to the nearest commercial destination only in high SES areas. Our findings showed that the associations of these environmental attributes and walking behaviors were largely consistent across different SES levels. Therefore, urban design interventions focusing on low SES areas may help to reduce socioeconomic disparities in walking.

We examined whether street layout a key urban design element is associated with walking and sedentary behaviors in the context of a non-Western country; and, whether such associations differ between an urban and a rural area. In 2011, 1076 middle-to-older aged adults living in an urban and a rural area of Japan reported their walking and sedentary (sitting) behaviors. Two objective measures of street layout (intersection density and street integration) were calculated. Participants exposed to more-connected street layouts were more likely to walk for commuting and for errands, to meet physical activity recommendations through walking for commuting, and less likely to drive. These relationships differed between the urban and the rural area. This shows that previous findings from Western countries on associations of street connectivity with travel behaviors may also be applicable to Japan.

Street layout is consistently associated with adults' travel behaviors, however factors influencing this association are unclear.
We examined associations of street layout with travel behaviors: walking for transport (WT) and car use; and, the extent to which these relationships may be accounted for by availability of local destinations. A 24-h travel diary was completed in 2009 by 16,345 adult participants of the South-East Queensland Household Travel Survey, Australia. Three travel-behavior outcomes were derived: any home-based WT; over 30 min of home-based WT; and, over 60 min of car use. For street layout, a space syntax measure of street integration was calculated for each Statistical Area 1 (SA1, the smallest geographic unit in Australia). An objective measure of availability of destinations - Walk Score - was also derived for each SA1. Logistic regression examined associations of street layout with travel behaviors. Mediation analyses examined to what extent availability of destinations explained the associations.
Street integration was significantly associated with travel behaviors. Each one-decile increment in street integration was associated with an 18% (95% CI: 1.15, 1.21) higher odds of any home-based WT; a10% (95% CI: 1.06, 1.15) higher odds of over 30 min of home-basedWT; and a 5% (95% CI: 0.94, 0.96) lower odds of using a car over 60min. Local destinations partially mediated the effects of street layout on travel behaviors. Well-connected street layout contributes to active travel partially through availability of more local destinations. Urban design strategies need to address street layout and destinations to promote active travel among residents. (C) 2016 Elsevier Inc. All rights reserved.

Many short trips are made by car, and replacing them with walking is a potential strategy to increase physical activity at the population level. The prevalence and correlates of walkable short car trips were examined among adults aged 18-84 years living in the state of Queensland, Australia. Participants (N=14,481) reported their travel behaviors using a 24-h travel diary in the 2009 South East Queensland Travel Survey (SEQTS). A threshold distance within which adults can walk was first identified using the SEQTS data. Consistent with previous studies, we used the 80th percentile distance in walking trips, determined for specific age groups (18-34, 35-49, 50-64, and 65-84 years) and gender, as the distance threshold. This ranged from 1.6 to 2.0 km for a single trip, and 3.4 to 4.7 km for a trip chain. Car trips that did not exceed the distance threshold were regarded as short trips. The study found that 7% of all car trips were short enough to be walked, and 11% of participants reported at least one short trip on the survey day either as a driver or passenger. Short car trips were more likely to be made by middle-to-older aged adults, women, those who were unemployed, those who had children in the household, those living in the middle-to-most disadvantaged areas, and those living in higher population density areas. The findings suggest a potential for some car trips to be converted into walking among some population groups in Australia. Initiatives to replace short car trips with walking may be particularly effective in higher density areas where local destinations are within a walking distance. Barriers that discourage walking will need to be addressed to facilitate walking trips among middle-to-older adults and in disadvantaged areas.

Background: This study examined associations of perceived and objectively measured neighborhood environmental attributes with leisure-time sitting for transport among middle-to-older aged Japanese adults. Method: Data were collected using a postal survey of 998 adults aged 40 to 69 years. Generalized linear modeling with a gamma distribution and a log link was used to examine associations of perceived (International Physical Activity Questionnaire-Environmental module) and Geographic Information Systems (GIS)-derived built environment attributes with self-reported leisure-time sitting for transport. Results: Mean leisure-time sitting time for transport was 20.4 min/day. After adjusting for potential confounders, perceived higher residential density, GIS-measured higher population density, better access to destinations, better access to public transport, longer sidewalk length, and higher street connectivity, were associated significantly with lower sitting time for transport. Conclusion: Residents living in neighborhoods with attributes previously found to be associated with more walking tended to spend less time sitting for transport during leisure-time. The health benefits of walkability-related attributes may accrue not only through increased physical activity, but also through less sedentary time.

Background: Neighborhood walkability has been shown to be associated with walking behavior. However, the availability of geographical data necessary to construct it remains a limitation. Building on the concept of space syntax, we propose an alternative walkability index, space syntax walkability (SSW). This study examined associations of the full walkability index and SSW with walking for transport (WT).
Methods: Data were collected in 2003-2004 from 2544 adults living in 154 Census Collection Districts (CCD) in Adelaide, Australia. Participants reported past week WT frequency. Full walkability (consisting of net residential density, intersection density, land use mix, and net retail area ratio) and SSW (consisting of gross population density and a space syntax measure of street integration) were calculated for each CCD using geographic information systems and space syntax software. Generalized linear models with negative binomial variance and logarithmic link functions were employed to examine the associations of each walkability index with WT frequency, adjusting for socio-demographic variables.
Results: Two walkability indices were closely correlated (rho = 0.76, p &lt; 0.01). The associations of full walkability and SSW with WT frequency were positive, with regression coefficients of 1.12 (95% CI: 1.08, 1.17) and 1.14 (95% CI: 1.10, 1.19), respectively.
Conclusions: SSW employs readily-available geographic data, yet is comparable to full walkability in its association with WT. The concept and methods of space syntax provide a novel approach to further understanding how urban design influences walking behaviors.

Background: The dramatic rise in Noncommunicable Diseases (NCD) in the oil-producing countries of the Arabian Peninsula is driven in part by insufficient physical activity, one of the five main contributors to health risk in the region. The aim of this paper is to review the available evidence on physical activity and sedentary behaviour for this region. Based on the findings, we prioritize an agenda for research that could inform policy initiatives with regional relevance.
Methods: We reviewed regional evidence on physical activity and sedentary behaviour to identify the needs for prevention and policy-related research. A literature search of peer-reviewed publications in the English language was conducted in May 2016 using PubMed, Web of Science and Google Scholar. 100 studies were identified and classified using the Behavioural Epidemiology Framework.
Results: Review findings demonstrate that research relevant to NCD prevention is underdeveloped in the region. A majority of the studies were epidemiological in approach with few being large-scale population-based studies using standardised measures. Correlates demonstrated expected associations with health outcomes, low levels of physical activity (particularly among young people), high levels of sedentary behaviour (particularly among men and young people) and expected associations of known correlates (e.g. gender, age, education, time, self-motivation, social support, and access). Very few studies offered recommendations for translating research findings into practice.
Conclusions: Further research on the determinants of physical activity and sedentary behaviour in the Arabian Peninsula using standard assessment tools is urgently needed. Priority research includes examining these behaviours across the four domains (household, work, transport and leisure). Intervention research focusing on the sectors of education, health and sports sectors is recommended. Furthermore, adapting and testing international examples to the local context would help identify culturally relevant policy and programmatic interventions for the region.

The street network underpins the walkability of local neighborhoods. We examined whether two street network measures (intersection density and street integration from space syntax) were independently associated with walking for transport (WT); and, to what extent the relationship of street integration with WT may be explained by the presence of destinations. In 2003-2004, adults living in Adelaide, Australia (n=2544) reported their past-week WT frequency and perceived distances to 16 destination types. Marginal models via generalized estimating equations tested mediation effects. Both intersection density and street integration were significantly associated with WT, after adjusting for each other. Perceived destination availability explained 42% of the association of street integration with WT; this may be because of an association between street integration and local destination availability - an important element of neighborhood walkability. The use of space syntax concepts and methods has the potential to provide novel insights into built-environment influences on walking. (C) 2016 Elsevier Ltd. All rights reserved.

Objective. To examine associations of time spent sitting in cars with markers of cardio-metabolic risk in Australian adults.
Method. Data were from 2800 participants (age range: 34-65) in the 2011-12 Australian Diabetes, Obesity and Lifestyle Study. Self-reported time spent in cars was categorized into four groups: = 15 min/day; &gt;15 to = 30 min/day; &gt;30 to = 60 min/day; and &lt;= 60 min/day. Markers of cardio-metabolic risk were body mass index (BMI), waist circumference, systolic and diastolic blood pressure, triglycerides, HDL (high-density lipoprotein)-cholesterol, fasting plasma glucose, 2-h plasma glucose, a clustered cardio-metabolic risk score, and having the metabolic syndrome or not. Multilevel linear and logistic regression analyses examined associations of car time with each cardio-metabolic risk outcome, adjusting for socio-demographic and behavioral variables and medication use for blood pressure and cholesterol/triglycerides.
Results. Compared to spending 15 min/day or less in cars, spending more than 1 h/day in cars was significantly associated with higher BMI, waist circumference, fasting plasma glucose, and clustered cardio-metabolic risk, after adjusting for socio-demographic attributes and potentially relevant behaviors including leisure-time physical activity and dietary intake. Gender interactions showed car time to be associated with higher BMI in men only.
Conclusions. Prolonged time spent sitting in cars, in particular over 1 h/day, was associated with higher total and central adiposity and a more-adverse cardio-metabolic risk profile. Further studies, ideally using objective measures of sitting time in cars and prospective designs, are needed to confirm the impact of car use on cardio-metabolic disease risk. (C) 2015 The Authors. Published by Elsevier Inc.

Objective. Physical activity recommendations are beginning to address sedentary behaviors - time spent sitting. Environmental and policy initiatives for physical activity might assist in addressing sedentary behaviors, but sedentary-specific innovations may be required. This review synthesizes current evidence on associations of neighborhood environmental attributes with adults' sedentary behaviors.
Methods. A search was conducted using three electronic databases (PubMed, Web of Science, and Transport Research Information Services). Relevant articles were assessed for their eligibility for inclusion (English-language articles with a quantitative examination of associations of neighborhood environmental attributes with adults' sedentary behaviors).
Results. Within 17 studies meeting inclusion criteria, associations of environmental attributes with sedentary behaviors were examined in 89 instances. Significant associations were found in 28% (n = 25) of them; however, non-significant associations were found in 56% (n = 50) of these instances. The most consistent association was for lower levels of sedentary behavior among residents of urban compared to regional areas.
Conclusions. There is a modest but mixed initial evidence in associations of neighborhood environmental attributes with adults' sedentary behaviors. A research agenda required for this emerging field should include the development of more relevant conceptual models, measuring domain-specific sedentary behavior objectively, examining environments in close vicinity of and a larger area around home, and the use of prospective designs. (C) 2015 Elsevier Inc. All rights reserved.

This article examines differences in proximity to, and size of, four types of public open space for different levels of socio-economic disadvantage in metropolitan Melbourne. Since the provision of public open space in Melbourne is guided by the Victoria Planning Provisions (VPP), this article also demonstrates the use of Geographic Information Systems (GIS) as a tool to compare the current distribution of public open space with policy. Measures of distance to, and size of, the closest public open space were derived using GIS and analysed according to area-level socio-economic disadvantage. A novel method of estimating public open space access points is introduced.Over one-third of dwellings in metropolitan Melbourne were located in areas that did not align with the VPP public open space proximity standard; however, we found no evidence of a socio-economic gradient in terms of compliance. There were statistically significant differences between disadvantaged and advantaged areas with respect to proximity to, and size of, public open space. However, while the differences were statistically significant the magnitudes of the differences were small. Future research needs to investigate how different measures (e.g. quality, size) can be included in planning regulations to support equitable provision of public open space.

Purpose: Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance. Methods: Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments. Results: Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working. Conclusions: Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.

Public open spaces such as parks and green spaces are key built environment elements within neighbourhoods for encouraging a variety of physical activity behaviours. Over the past decade, there has been a burgeoning number of active living research studies examining the influence of public open space on physical activity. However, the evidence shows mixed associations between different aspects of public open space (e.g., proximity, size, quality) and physical activity. These inconsistencies hinder the development of specific evidence-based guidelines for urban designers and policy-makers for (re) designing public open space to encourage physical activity. This paper aims to move this research agenda forward, by identifying key conceptual and methodological issues that may contribute to inconsistencies in research examining relations between public open space and physical activity. (C) 2015 Elsevier Ltd. All rights reserved,

Studies on the mismatch between objective and perceived measures of walkability and walking provide insights into targeting interventions. These studies focused on those living in more walkable environments, but perceiving them as less walkable. However, it is equally important to understand how the other mismatch (living in less walkable areas, but perceiving them as walkable) is related to walking. This study examined how the mismatch between perceived and objective walkability measures (i.e., living in less walkable areas, but perceiving them as walkable, and living in more walkable areas, but perceiving them as less walkable) was associated with walking. Baseline data from adult participants (n = 1466) of the RESIDential Environment Project (Perth, Australia in 2004-06) collected self-report neighborhood walking for recreation and transport in a usual week and participants' perceptions of street connectivity and land use mix in their neighborhood. The exposure was the mismatch between objective and perceived measures of these. Multilevel logistic regression examined associations of walking with the mismatch between perceived and objective walkability measures. Perceiving high walkable attributes as low walkable was associated with lower levels of walking, while perceiving a low walkable attribute as walkable was associated with higher levels of walking. Walking interventions must create more pedestrian-friendly environments as well as target residents' perceptions.

There is growing interest from policy-makers, practitioners, and academics alike in creating indicators of the built environment to measure progress towards achieving a wide range of policy outcomes, including enhanced health and wellbeing. Public open space (POS) is a built environment feature that is important for health and wellbeing across the life course, and contributes to the liveability of a region. To optimise health and community wellbeing outcomes, there is a need to test different policy standards and metrics to understand which measures are impactful. Identifying the best POS indicators would be useful tools to measure and monitor progress towards achieving a range of policy and health and wellbeing outcomes. Thus, we propose a method to develop POS indicators from a health and wellbeing lens through: 1) developing a framework conceptualising the pathways in which POS influences health and wellbeing outcomes; and 2) using this conceptual framework as a guide to identify upstream policy-relevant indicators of POS that are evidence-based, specific, quantifiable, and measurable across regions. We also highlight methodological issues and challenges in developing these indicators. In doing so, we have identified eleven potential POS spatial measures to test with population health and wellbeing datasets in Australia. However, these methods may be relevant and applicable to other developed countries, and could be modified for use in developing countries. Together, spatial indicators are analytic tools in the policy environment to benchmark and measure neighbourhoods in terms of POS provision, thereby helping to improve neighbourhood liveability and wellbeing, and people's health. Crown Copyright (C) 2014 Published by Elsevier Ltd. All rights reserved.

Background: Parks are valuable resources for physical activity (PA) given their widespread availability and low cost to maintain and use. Both proximity to parks and the availability of particular features are important correlates of PA. However, few studies have explored multiple measures of proximity simultaneously or the specific facilities associated with park use and park-based PA among adults, let alone differences across socio-demographic characteristics. The purpose of this study was to examine associations between park proximity and park facilities and adults' park use and park-based PA, while also exploring differences by gender, age, race, and income.
Methods: Data on monthly park use and weekly amount of PA undertaken in parks were collected via a mail survey of adults from randomly-selected households (n = 893) in Kansas City, Missouri (KCMO) in 2010-2011. Three measures of park proximity were calculated within 1 mile of participating households: distance to the closest park, number of parks, and total park area. All parks in KCMO were audited using the Community Park Audit Tool to determine the availability of 14 park facilities within 1 mile of each participant (e.g., trail, playground, tennis court). Multilevel logistic regression was used to examine the relationship between each of park use and park-based PA and 1) three measures of park proximity, and 2) the availability of 14 park facilities within 1 mile of participants. Separate analyses were conducted by gender, age, race, and income, while controlling for all socio-demographic characteristics and BMI.
Results: Across all sub-samples, distance to the closest park was not significantly related to either park use or park-based PA. However, numerous significant associations were found for the relationship of number of parks and amount of park space within 1 mile with both outcomes. As well, diverse facilities were associated with park use and park-based PA. For both park proximity and facilities, the significant relationships varied widely across gender, age, race, and income groups.
Conclusions: Both park proximity and park facilities are related to park use and park-based PA. Understanding how such associations vary across demographic groups is important in planning for activity-friendly parks that are responsive to the needs of neighborhood residents.

Objective: Built environment attributes may be important determinants of physical activity. Greater street connectivity has been shown in several studies to be associated with adults' walking for transport (WFT). We examined the extent to which this association can be explained by the availability of utilitarian destinations.
Methods: Adults (n = 2544) participating in the Physical Activity in Localities and Community Environments (PLACE) study in Adelaide, Australia during 2003-2004, reported their WFT and perceived distances to 16 utilitarian destinations. Connectivity was calculated as the ratio of the number of intersections to Census Collection District land area. Marginal models via generalized estimating equations were used and the product-of-coefficients test was used to test mediation effects.
Results: Connectivity was significantly associated with destination availability and with WFT frequency. The connectivity-WFT relationship was attenuated after taking availability of destinations into account, but remained significant. Availability of destinations accounted for 16% of the total effect of connectivity on WFT.
Conclusions: Higher connectivity can be associated with more frequent WFT, partly because more utilitarian destinations are available in areas with well-connected street networks. Further clarification of these relationships and other pathways through which connectivity influences residents' walking can inform urban design initiatives to promote physical activity. (C) 2014 Elsevier Inc. All rights reserved.

Background: Too much sitting, including time spent sitting in cars, is associated with poor health outcomes. Identifying the built-environment attributes that may reduce vehicular sitting time can inform future initiatives linking the public health, urban design, and transportation sectors. Methods: Data collected in 2003-2004 from adult residents (n = 2521) of Adelaide, Australia were used. Logistic regression analyses examined associations of prolonged time spent sitting in cars during leisure time (30 min/day or more) with neighborhood walkability and its components (dwelling density; intersection density; land use mix; net retail area ratio). Results: Lower overall walkability was significantly associated with a higher odds (OR = 1.43, 95% CI: 1.21-1.70) of spending prolonged time in cars. For analyses with walkability components, lower net retail area ratio, lower residential density, and lower intersection density were significantly associated with prolonged sitting in cars. Conclusion: This study found that residents of high walkable neighborhoods tended to spend less time sitting in cars. In particular, higher net retail area ratio, an indicator of tightly spaced commercial areas, was strongly associated with less time in cars. Policy and planning initiatives to reduce car use require further evidence, particularly on the influence of neighborhood retail areas.

The application of space syntax as a method for examining the role of spatial configuration on people's behavior has been widespread in several disciplines, such as urban design and architecture. However, the ideas and procedures of space syntax have rarely been applied in studies within the field of public health or leisure studies. This article briefly introduces the principles of space syntax and describes how space syntax can extend previous knowledge regarding associations between the built environment and physical activity with specific applications to research on parks and public open spaces.

The time that children and adults spend sedentary-put simply, doing too much sitting as distinct from doing too little physical activity-has recently been proposed as a population-wide, ubiquitous influence on health outcomes. It has been argued that sedentary time is likely to be additional to the risks associated with insufficient moderate-to-vigorous physical activity. New evidence identifies relationships of too much sitting with overweight and obesity, type 2 diabetes, cardiovascular disease, some cancers and other adverse health outcomes. There is a need for a broader base of evidence on the likely health benefits of changing the relevant sedentary behaviours, particularly gathering evidence on underlying mechanisms and dose-response relationships. However, as remains the case for physical activity, there is a research agenda to be pursued in order to identify the potentially modifiable environmental and social determinants of sedentary behaviour. Such evidence is required so as to understand what might need to be changed in order to influence sedentary behaviours and to work towards population-wide impacts on prolonged sitting time. In this context, the research agenda needs to focus particularly on what can inform broad, evidence-based environmental and policy initiatives. We consider what has been learned from research on relationships of environmental and social attributes and physical activity; provide an overview of recent-emerging evidence on relationships of environmental attributes with sedentary behaviour; argue for the importance of conducting international comparative studies and addressing life-stage issues and socioeconomic inequalities and we propose a conceptual model within which this research agenda may be addressed.

Purpose. The purpose of this study was to examine associations between street connectivity and road traffic speed and neighborhood residents' use of parks and park-based physical activity.
esign. Cross-sectional. Setting. Kansas City, Missouri.
Subjects. Participants were 893 adults from randomly selected households. Measures. Both self-reported park use and park-based physical activity were dichotomized as some versus none. Intersection density was calculated around each participant, and network analysis was used to determine whether participants had to travel on or cross a road with traffic speed greater than 35 miles per hour (mph) to reach the closest park. Analysis. Multilevel logistic regression examined the association between intersection density and traffic speed wit park use and park-based physical activity.
Results. Compared to those in the lowest intersection density quartile, participants in the third and fourth quartiles were more likely to use parks and to engage in physical activity in parks (odds ratio [OR] 1.76-2.34; all p &lt; .05). Likewise, compared to those who had a high-speed road on their way to the closest park, participants with slower traffic routes to parks were more likely to use the parks (OR 1.47; 95% confidence interval [CI] 1.05-1.92).
Conclusion. In addition to park proximity and the design of park features, ensuring direct and safe access to parks through street network design and traffic speed reduction strategies may be key to facilitating park-related physical activity.

While public health and urban planning fields worked closely to tackle communicable disease outbreaks in the 19th century, this collaboration faded during the 20th century. Over the last few decades, engagement in physical activity - even walking - has declined substantially, with serious impacts on population health. Recently there has been an emerging body of literature and guidance illustrating the role the built environment has in shaping health outcomes; much of this has focussed on physical activity behaviours. Associations between built environment attributes and physical activity have been reported by many studies, however the geographic scales at which these built environment attributes need to be measured and the magnitude of the built environment attributes required to support physical activity are not clear. Further studying these geographical scales and thresholds will facilitate development of specific guidance to urban designers and planners to create supportive built environments to facilitate physical activity engagement. This is an important addition for re-connecting the fields of public health and urban design and planning. (C) 2013 Elsevier Ltd. All rights reserved.

Background: Variations in 'slope' (how steep or flat the ground is) may be good for health. As walking up hills is a physiologically vigorous physical activity and can contribute to weight control, greater neighbourhood slopes may provide a protective barrier to weight gain, and help prevent Type 2 diabetes onset. We explored whether living in 'hilly' neighbourhoods was associated with diabetes prevalence among the Australian adult population.
Methods: Participants (&gt;= 25 years; n = 11,406) who completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) were asked whether or not they had medically-diagnosed diabetes. Geographic Information Systems (GIS) software was used to calculate a neighbourhood mean slope score, and other built environment measures at 1600 m around each participant's home. Logistic regression models were used to predict the odds of self-reported diabetes after progressive adjustment for individual measures (i.e., age, sex), socioeconomic status (i.e., education, income), built environment, destinations, nutrition, and amount of walking.
Results: After full adjustment, the odds of self-reported diabetes was 0.72 (95% CI 0.55-0.95) and 0.52 (95% CI 0.39-0.69) for adults living in neighbourhoods with moderate and higher levels of slope, respectively, compared with adults living in neighbourhoods with the lowest levels of slope. The odds of having diabetes was 13% lower (odds ratio 0.87; 95% CI 0.80-0.94) for each increase of one percent in mean slope.
Conclusions: Living in a hilly neighbourhood may be protective of diabetes onset or this finding is spurious. Nevertheless, the results are promising and have implications for future research and the practice of flattening land in new housing developments.

Public open spaces (POSs) are important destinations and settings for walking in neighborhoods and different aspects of POSs can influence walking. Proximity to POSs is a key urban design issue that should be considered in distributing such resources within neighborhoods and it is worthwhile to examine how PUS proximity may influence residents' walking. However, little research has explored how different measures of proximity to POSs might influence PUS-related walking.
This study examined both metric and topological proximity measures to examine associations with amount of walking to and within POSs. Residents (n = 320) of three neighborhoods in Melbourne, Australia completed a questionnaire reporting their level of walking to and within PUS and perceptions of their neighborhoods. GIS and space syntax were used to extract four proximity measures: distance to the closest PUS, number of POSs, total area of POSs within 1 km, and PUS integration.
None of the proximity measures were associated with walking (versus not walking) to or within POSs. Distance to the nearest POS and the number of POSs within 1 km was negatively associated with the absolute amount of walking to POSs. Residents who lived in areas in which POSs were located on less integrated streets reported more walking to and within POSs. Future landscape and urban design research should consider not only proximity to POSs, but also how factors such as characteristics of the routes that people traverse to reach PUS influence use of, and the likelihood of walking to and within, these important neighborhood destinations. (C) 2013 Elsevier B.V. All rights reserved.

This study examined how proximity and attractiveness of public open spaces (POSs), perceptions of the surrounding built environment, and street configuration were associated with walking to and within POSs. Residents from three neighborhoods in Melbourne (N = 335) completed a questionnaire about walking and perceptions of their neighborhood, and geographic information systems and space syntax measures were used to assess proximity of POSs and street configuration. Proximity and attractiveness of POSs were not associated with POS-related walking. However, several perceptual qualities of the built environment, including safety from crime and traffic and aesthetics, were associated with greater walking. As well, persons living in areas with the most integrated street configurations reported less POS-related walking. Neighborhood perceptions and street configuration are key urban design issues to consider in promoting residents' use of POS for walking.

Walking has an important role in improving public health. In the last decade, there has been a growing body of literature in public health, transportation, and urban design, which has analyzed the role of the built environment on physical activity, typically walking. Although these issues have received considerable attention in developed countries, few studies exist in developing countries such as Iran. The present study is the first study in the capital city of Iran: Tehran. This paper aims to analyze the objective measuring of the built environment in relation to walking in some neighborhoods of Tehran city. The results are then compared with the level of self-reported walking among elderly people in the study area. The results revealed that elderly people who live in high-walkable neighborhoods walk more frequently than those who live in low-walkable neighborhoods regardless of their socioeconomic status. DOI: 10.1061/(ASCE)UP.1943-5444.0000085. (C) 2011 American Society of Civil Engineers.

The subject of urban quality of life and the promotion of its concept in particular, has always been the central focus of urban designers. This term is a multi-conceptual and dimensions. However most of the scholars have agreed that the concept consisted from two main dimensions; objective and subjective which these two approaches are used for its measuring. One of the important goals of urban designers is to create urban environment that all citizens have easy access to urban services, as accessibility reflects the quality of an urban environment. The present research intends to measure the public space accessibility by using objective approach in first and then by using the subjective approach for measuring in the study area to compare the results. The results revealed that there are considerable differences between objective and subjective measuring of urban quality of life in a urban space, therefore urban designers can not rely only on the results of objective measuring to understand such spaces for planning, if so, their attitudes towards urban spaces could not be an appropriate guide for explaining the quality of life for urban residents.

Access to public spaces could be one of the important factors in their use. Whilst measuring accessibility to public spaces has received considerable attention, there are few studies outside the Anglophone world, especially in developing countries such as Iran. The present research targets two important goals. First it attempts to create a new methodology for measuring objective accessibility to public spaces (such as parks, schools and shops) at the neighborhood scale and second it investigates the distribution of such spaces by examining the socio-economic status of citizens. The goal is achieved by applying a new and straightforward method of GIS and fuzzy logic. This methodology was applied in the study area and the results presented in the form of tables and maps. The results revealed that there are spatial disparities in some parts of the area with lower accessibility to such spaces. The study indicates that the general understanding of people with high level deprivation having less access to public space is incorrect. (C) 2009 Published by Elsevier Ltd.

This interdisciplinary course provides an evidence-based review of physical environmental geography and how it influences human life. As an example, this course discusses the ways through which physical environmental geography can impact human behaviour and population health. By the end-of-this intensive course students will be familiar with a brief introduction of physical environmental geography, its components, and how it impacts human life.