Perceived built environment characteristics associated with walking and cycling across 355 communities in 21 countries
Boakye K. Bovbjerg M. Schuna J., Jr Branscum A. Mat-Nasir N. Bahonar A. Barbarash O. Yusuf R. Lopez-Jaramillo P. Seron P. Rosengren A. Yeates K. Chifamba J. Alhabib K.F. Davletov K. Keskinler M.V. Diaz M. Kruger L. Li Y. Zhiguang L. Tse L.A. Wielgosz A. Teo K. Erkin M. Rangarajan S. Lear S. Yusuf S. Hystad P.
January 2023Elsevier Ltd
Cities
2023#132
Research examining built environment (BE) characteristics and walking/cycling behaviors has been conducted primarily in high-income countries and conclusions cannot be applied directly to low- and middle-income countries. We evaluated perceived BE characteristics and walking/cycling behaviors across 355 urban communities in 21 low-, middle-, and high- income countries using individual data for 39,908 adults in the Prospective Urban and Rural Epidemiology study. The 1-week long-form International Physical Activity Questionnaire was used to measure walking/cycling behaviors. Perceived BE characteristics were measured using the Neighborhood Environment Walkability Scale. Mixed effects logistic regression models examined associations between BE measures and walking for transport (≥150 min/wk), walking for leisure (≥150 min/wk), and any cycling for transport, controlling for individual, household, and community factors. Land-use mix diversity, land-use mix access, and street connectivity were associated with higher odds of walking for transport. Land-use mix diversity, land-use mix access, safety from traffic and safety from crime were associated with higher odds of walking for leisure. Land-use mix diversity, land-use mix access, and aesthetics were associated with higher odds of cycling. Differences in associations were observed by country-income status. Our findings can help guide policy makers globally to implement BE design to encourage walking and cycling behaviors.
Active transport , Built environment , Global , Leisure , Physical activity
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Department of Public Health & Health Services Administration, California State University, Chico, CA, United States
College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Sungai Buloh, 47000, Malaysia
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” (NII KPSSZ), Russian Federation
School of Life Sciences, Independent University, Dhaka, Bangladesh
Masira Research Institute, Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia
Facultad de Medicina, Universidad de La Frontera, Claro Solar 115, Temuco, Chile
Sahlgrenska Academy, University of Gothenburg, Sweden
Sahlgrenska University Hospital, VGR Region, Sweden
Department of Medicine, Queens University, ON, Canada
Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud Medical City, King Saud University, Saudi Arabia
Al-Farabi Kazakh National University, Health Research Institute, 71 Al-Farabi Avenu, Almaty, Kazakhstan
Istanbul Medeniyet University, Department of Internal Medicine, Kadikoy, Istanbul, 34722, Turkey
Instituto Cardiovascular de Rosario, Oroño 450, Rosario, Argentina
Africa Unit for Transdisciplinary Health Research, North-West University, North-West Province, Potchefstroom, South Africa
Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, China
Drug Clinical Trial Institution, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
Department of Medicine, University of Ottawa, Ottawa, ON, Canada
Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
Kyrgyz State Medical Academy, 92 Akhunbaev street, Bishkek, 720020, Kyrgyzstan
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Department of Public Health & Health Services Administration
College of Public Health and Human Sciences
Primary Care Medicine Discipline
Isfahan Cardiovascular Research Center
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” (NII KPSSZ)
School of Life Sciences
Masira Research Institute
Facultad de Medicina
Sahlgrenska Academy
Sahlgrenska University Hospital
Department of Medicine
Department of Biomedical Sciences
Department of Cardiac Sciences
Al-Farabi Kazakh National University
Istanbul Medeniyet University
Instituto Cardiovascular de Rosario
Africa Unit for Transdisciplinary Health Research
Medical Research & Biometrics Center
Drug Clinical Trial Institution
JC School of Public Health and Primary Care
Department of Medicine
Population Health Research Institute
Kyrgyz State Medical Academy
Faculty of Health Sciences
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