Associations between neighbourhood walkability, active school transport and physical activity levels in primary and secondary school students: A pilot-study

Objectives: This longitudinal pilot-study examined the associations of neighbourhood walkability with active school transport (AST) and pedometer-determined physical activity (PA) immediately before and after the transition from primary to secondary school. Methods: Fifty-five grade 6 students were recruited from 4 primary schools in Ottawa in May/June 2012. They were asked to complete a diary indicating their mode of transport to/from school for 1 week and wear a SC-StepMX pedometer for 8 consecutive days. 48 study packages were returned at baseline and 29 at follow-up (September/October 2012). The Walk Score® application was used as a proxy for walkability around the home and around the school. The associations of walkability with AST and average daily step counts at both time points were respectively examined with binary logistic regression and linear regression models adjusted for gender. Results: At baseline, only walkability around the school was positively associated with AST (OR = 1.04). At follow-up, higher Walk Score ratings around the home and the school were both associated with greater odds of AST (OR = 1.12 and 1.29 respectively). Furthermore, walkability around the home was associated with higher step counts with a large effect size (η2 = 0.19). Conclusions: There was a negative association between having a regular medical doctor and high self-perceived health, modified by age. The findings suggest that individual access to care does not predict health in the same way as physician density. INTRODUCTION Recent survey findings indicate that the majority of children and youth do not meet current physical activity (PA) guidelines, which recommend 60 minutes of moderate-to-vigorous physical activity per day [1,2]. Even in the pediatric population, insufficient PA levels are associated with detrimental health parameters such as cardiovascular disease risk factors [3,4], underscoring the need for interventions that promote PA. Since children and youth must travel to and from school on a regular basis, active school transport (AST; e.g. using non-motorized travel modes such as walking and cycling to travel to/from school) is regarded as a promising strategy to increase PA at the population level [5,6]. During the last two decades, there has been a rapid in R E S U M E Objectifs: Cette etude pilote longitudinale verifiait l’association entre les quartiers favorables a la marche, le transport actif scolaire (TAS) et le niveau d’activite physique (AP) determine a l’aide d’un podometre, immediatement avant et apres la transition de l’ecole primaire a l’ecole secondaire. Methodes: En mai et juin 2012, 55 eleves de la sixieme annee ont ete recrutes dans 4 ecoles primaires d’Ottawa. On leur a demande de remplir quotidiennement un journal de bord dans lequel ils devaient indiquer leur mode de transport pour se rendre a l’ecole et en revenir durant une semaine. Ils devaient egalement porter un podometre SC-StepMX durant huit jours consecutifs. A la premiere etape, 48 trousses d’etude ont ete retournees a la premiere etape et 29 lors du suivi en septembre et octobre 2012. L’application Walk Score® a ete utilisee comme temoin pour determiner si le milieu environnant le domicile et l’ecole etait favorable a la marche. L’association entre les quartiers favorables a la marche, le TAS et le nombre moyen de pas faits dans une journee a ete examinee respectivement aux deux etapes de l’etude a l’aide d’une regression logistique binaire et d’un modele de regression lineaire ajuste selon le sexe. Resultats: A l’etape initiale, seul un milieu favorable a la marche autour de l’ecole etait associe positivement au TAS (RC = 1,04). Lors du suivi, un indice Walk Score eleve aux alentours de la maison et de l’ecole etait associe a une probabilite superieure de TAS (RC = 1,12 et 1,29 respectivement). De plus, un quartier favorable a la marche autour du domicile etait associe a un nombre plus eleve de pas avec une taille d’effet elevee (η2 = 0,19). Conclusion: Ces observations preliminaires suggerent qu’il peut s’averer plus important pour les etudiants de l’ecole secondaire que leur milieu soit favorable a la marche. Puisqu’aucune autre etude longitudinale n’a ete menee pour evaluer si l’association entre les quartiers favorables a la marche, le TAS et le niveau d’AP varie au fil du temps, il serait justifie de proceder a de grandes etudes prospectives.