Background

In the Bronx, pedestrians comprise an estimated 55% of all traffic fatalities compared to nationwide (14%). At the rate of 1.91 fatalities per 100,000 residents, the pedestrian fatality rate is higher in the Bronx than in all New York City (1.88 per 100,000). Out of 25 priority corridors in the Bronx, the Grand Concourse is the third most dangerous with the rate of 13 pedestrians killed or severely injured (KSI) per mile. Such environmental injustice can be remediated. Complete Streets is a transportation policy and design approach that can be used to promote safe and convenient active transportation. Community coalitions can be integral to building support for Complete Streets policy and implementation changes.

Design

Since 2013, following the Complete Streets approach, the Bronx Health REACH coalition and Transportation Alternatives have collaborated to ensure that the NYC Department of Transportation re-design and re-engineer the Grand Concourse to guarantee pedestrian and cyclist safety. The Bronx Health REACH coalition includes faith-based organizations whose members are Bronx residents who understand the needs (i.e., safety and infrastructure) in their built environment and have a long history of successful community outreach and coordinated advocacy efforts. These members have been involved with Transportation Alternatives, an advocacy organization, in the Grand Concourse Great Street Phase I, II, III, IV and V projects by providing testimonies at community board meetings.

Results

The Grand Concourse was re-engineered during phase I (161st St to 166th St) and II (166th St to 171st St) (Phase 2) until completion in 2017. Major renovations included expanded sidewalks and new pedestrian islands at busy intersections, as well as relocated bicycle lanes to improve cycling and pedestrian safety. The Grand Concourse Great Street Project phases III, IV, and V are scheduled for completion in May 2020, September 2022 and November 2023, respectively.

Conclusions

Reducing traffic violence on the Grand Concourse can lead to increased active transportation among Bronx residents. The concerted effort of stakeholders including the Bronx Health REACH coalition and Transportation Alternatives has helped build sustainable support for complete streets policy approval by Bronx Community Boards and implementation by the NYC Department of Transportation.

Residents of southern rural areas within the United States (U.S.) have higher inactivity rates than any other region of the U.S. Individuals commonly report barriers that prevent them from exercising, such as lack of sidewalks and streetlights, no access to exercise or play facilities, lack of enjoyable scenery, and not seeing others exercise in their neighborhoods as reasons for inactivity. Many of these barriers represent factors of the built environment prevalent in rural communities, where there are long distances between everyday locations and residential areas, more dispersed populations, and lower local tax revenues to fund community active living projects. The purpose of this poster is to present the methods used to begin to address built environment challenges related to active living in Taliaferro County, Georgia, where 50% of adult residents reported no access to exercise opportunities.

In order to address these challenges, the University of Georgia College of Public Health faculty partnered with Cooperative Extension personnel to develop a coalition of community members under a Centers for Disease Control and Prevention cooperative agreement. Faculty then partnered with the University’s College of Environment and Design to develop active living plans for the community. This partnership facilitated three planning sessions with the coalition to gather input on the feasibility of different active living and built environment interventions with consideration to the culture, resources, and population of Taliaferro. Data gathered from these sessions were used to design initial plans for paths, physical activity hubs, and attractive outdoor areas to encourage active living. The coalition then voted on the plans that best fit Taliaferro’s resources. Plans with the most votes were re-designed in more detail.

Taliaferro County received five detailed architectural plans addressing active living in their community. The coalition used the plan to set their priorities for the next three years of grant funding and one of the finalized plans has been included in the county’s Joint Comprehensive Plan (2020-2025).

Changing the built environment in rural, low-resource communities requires a multisector approach. To ensure buy in from community members, all planning stages should take care to include residents of the target community.

Introduction: Recent research has identified crime and safety associations with physical activity (PA) declines in public parks. For example, it has been noted that gun violence is a significant predictor of PA reductions. However, extant research has relied on police records that (1) often do not account for community resident-level reports of crime and violence, and (2) as a result, may not report pertinent incidents that impact access to public parks and associated PA. Police calls for service (i.e., calls to 911 for emergency assistance) promisingly provide an accounting of community resident-level crime reporting. Thus, the current study leverages police calls for service data to examine crime and violence associations with PA. Methods: Working in a community-based participatory research (CBPR) context, we observed fifteen thousand, one hundred and fifteen park users in a random sample of 30 San José, CA public parks. Park user gender, age, ethnicity, and PA were recorded with the System for Observing Play and Recreation in Communities. Park conditions associated with crime and violence were documented with the Physical Activity Resource Assessment. To account for community-level social conditions that associate with crime and violence, social disorganization (i.e., poverty, resident turnover, racial heterogeneity) variables were collected from the 2010 U.S. Census. Crime and violence data were gleaned from San José Police Calls for Service records. Results: The largest number of park users included males, adults, and Latina/os. Significant PA differences were observed across gender, age, and ethnicity. Multiple linear regression controlling for gender, age, ethnicity, park conditions, and neighborhood-level social disorganization found that public drunkenness and shootings within ¼ mile buffers of public parks predicted PA reductions. Conclusions: Building on prior findings regarding the deleterious impact of crime and violence in public parks, the current study identified public drunkenness and shootings as pertinent resident-level concerns that associate with PA declines in public parks. Therefore, we contend that (a) working with community residents in a CBPR context may provide additional insights regarding crime and violence, and (b) help to identify social and environmental controls that reduce crime and violence and promote public park use and PA.

Background

Research on physical activity among ethnic minority groups revealed that Asian Americans report lower physical activity levels than Non-Hispanic Whites. Individual psychosocial factors are believed to contribute to physical activity adoption and maintenance in Asian Americans, however, there is a knowledge gap in the built environment as a predictor of physical activity. The present study aimed to examine perceptions of neighborhood walkability and its association with active transportation, recreational, and overall physical activity among Asian American living in an urban environment.

Methods

Participants were recruited from July to December, 2019. A questionnaire that included socio-demographics, the Neighborhood Environment Walkability Scale (NEWS), and the Neighborhood Physical Activity Questionnaire (NPAQ) were administered in English and Asian languages. Zero-inflated negative binomial regression models were used while controlling for the clustered sample design and socio-demographic characteristics.

Results

A total of 240 Asian Americans (self-identified as Chinese, Korean, or Vietnamese) who resided in Philadelphia County participated in the study. With regards to overall physical activity, land use mix-diversity (β =0.2529, p=0.011) and access (β=0.4638, p=0.011) were positively associated with greater levels of physical activity, while residential density (β=-0.0016, p=0.036) and lack of cul de sacs (β=-0.5204, p<0.001) were linked to lower levels. Physical barriers to walking (β=-0.3206, p=0.01) and perceived lack of cul-de-sacs (β=-0.4819, p=0.003) were associated with a decreased likelihood of engaging in active transportation. Land use mix-diversity (β =0.5736, p<0.001) and access (β=0.4996, p=0.045) were positively associated with greater amount of walking and/or cycling for recreation, while higher perceived crime (β=-0.4435, p=0.008) and lack of cul de sacs (β=-0.3775, p<0.001) had negative associations. Overall neighborhood walkability was positively associated with greater overall physical activity and recreational walking and cycling within the neighborhood.

Conclusions

Results indicated that neighborhood characteristics such as land use mix, physical barriers, and connectivity can limit or promote the participation in various forms of physical activity in a predominantly Asian American immigrant population. Study findings can be utilized to develop strategies to increase physical activity behavior within neighborhoods to improve the overall health of the targeted populations.

Introduction and Objective: Evidence suggests that healthy behaviors initiated during childhood are likely to be sustained over time. The objective of this study was to determine whether active commuting to and from school (ACS) at baseline predicted 1) continued ACS, and 2) regular physical activity (PA) at follow-up two to five years later.

Methods: Data were drawn from the New Jersey Child Health Study. Two cohorts of households with 3-15 year-olds in four low-income New Jersey cities were randomly sampled and followed for two to five year periods between 2009 and 2017. Children who walked, bicycled, or skateboarded to or from school at least one day/week, as reported by their parent, were classified as active commuters. PA was measured as number of days per week the child engaged in PA for at least 60 minutes (PA60). Children with complete data at both time points were included in this analysis (n=570 for ACS; n=554 for PA60). Logistic regression was used to examine ACS (yes/no) at time 2; negative binomial regression was used to examine PA60 (0-7 days/week) at time 2. Models were adjusted for child age, sex, and race; parent’s education and nativity status (native-born vs foreign-born); household poverty level; and change in the transportation-related PA environment around the child’s home from time 1 to time 2. The focal predictor in both models was ACS at time 1. The PA60 model also adjusted for frequency of PA60 at time 1. Distance from home to school will be examined as a moderator in these associations.

Results: The mean age of the sample was 9.4 years. Approximately 59% of children were non-Hispanic black, 35% were Hispanic, 4% were non-Hispanic white, and 3% were another race/ethnicity. Half the children were female. Children who engaged in ACS at time 1, compared to children who did not, were 76% more likely to actively commute at time 2 (p<0.001). Similarly, time-1 active commuters engaged in PA for at least 60 minutes/day at time 2, on average, 13% more often than did time-1 non-active commuters (p<0.001).

Conclusions: Policies that encourage ACS may result in increased PA throughout childhood.

Introduction and Objective: Where people live has been shown to be associated with physical activity. The aim of this study is to examine the associations between after-school (AS) and weekend (WKND) physical activity and home neighborhood walkability, as measured with the Walk Score© (WS), among children participating in a childhood obesity prevention intervention.

Methods: Elementary (n=14) and Middle (n=13) schools serving low-income communities in four districts (rural/urban/suburban) were recruited to participate in a trial examining approaches to support Local Wellness Policy implementation. Students in the 3^rd-4^th and 6^th-7^th grades wore an Actical ankle accelerometer for 7 days (non-removable). Accelerometer data were extracted by school end time and weekend day; validated thresholds applied by minute yielding minutes of total PA (TOTPA). WS was calculated from the participants’ home address, based on the accessibility of walking to nearby amenities, and grouped into three categories. Students self-reported demographics. Height/weight were measured (BMI-for-age calculated). ANOVA and multi-level regression models examined associations between WS and TOTPA, while controlling for type of school, sex, and weight status.

Results: 579 students were recruited, 540 had at least one 24-hr day of accelerometer data, a valid home address, and survey data (43% male, 43% overweight/obese, 52% in elementary school). Of the four counties, 21% were in an urban county (mean WS 74±16), 28% a suburban county (mean WS 38±20), and 51% from 2 rural counties (mean WS±14). Participants were 11±1.5 years old, AS-TOTPA of 228±60 min/day, and WKND-TOTPA of 451±114 min./day. Afterschool and weekend min. of TOTPA differed by WS (AS: F=15.2, p<0.0001; WKND: F=0.42, p=0.66), such that 52% lived in “Very Car-Dependent” neighborhoods (AS: 215±52 min/day; WKND: 456±119), 17% in “Car Dependent” (AS: 233±68 min/day; WKND: 447±110), and 31% in “Very Walkable” (AS: 247±65 min/day; WKND: 447±109). Students in “Walkable” and “Car-Dependent” neighborhoods participated in more minutes of AS-TOTPA than students in the “Very Car-Dependent” neighborhoods (p<0.01/p<0.01).

Conclusions: There was a positive association between walk score and minutes spent in total physical activity after school.

Context. Literature is inconclusive concerning the effects of commuting on obesity and overweight (OOW), especially in low- and middle-income countries (LMIC). This research provides an empirical evidence of the role of commuting, its duration, mode and history in OOW and body mass index (BMI).

Methods.Two rounds of demographic and health surveys were administered and most comprehensive measures of commuting were collected in Delhi Metropolitan in 2004 and 2009. Body mass index (BMI) was computed using height and weight 5,265 for all participants, and undernutrition (BMI < 18), normal (BMI = 18 to 24.9), overweight (BMI = 25 to 29.9) and obese (BMI > 30) groups were identified. Using travel and occupation modules, commuting measures were extracted. For this research, a commuter is defined as a person who travelled for at least 15 days in last 30 days for occupation and related activities. Lifelong history, mode, duration and distance of commuting, and individual and household level socio-demographic variables were also extracted for each participant. Passive commuting was defined as travel by motorbike/scooter/car and/or any other personal automobile, and the rest, including commuting by public transport, walking and bicycle, as active commuting. Regressions were employed to model BMI and BMI categories with respect to commuting measures.

Findings. Of 5,265 participants 667 (12.7%), 1,424 (27.1%) and 1,026 (19.3%) were obese, overweight and underweight respectively. Commuters were less likely to be obese OOW and more likely to be underweight. However, the risk of becoming OOW increases with the increase in commuting duration, commuting distance and history of commuting. Passive commuters and non-commuters were two times more likely to be oow as compared to active commuter and risk of becoming overweight/obese increases by 59% (27 % to 99%) with 15 years of commuting for men. Adjusting for age, gender and income, with every year of commuting BMI increases by 2.5%, and passive commuters had 2.7% higher BMI compared to active commuters.

Overall commuting is associated with lower BMI and lower risk of oow and higher risk of underweight. However, the risk of oow increase with the increase in the history of commuting and passive commuting.

Introduction and Objectives: Neighborhood environment influences physical activity (PA); perceived safety and limited access to PA locations may affect the decision to engage in PA, particularly in resource-limited communities. Qualitative data about a community’s PA preferences can direct the design of more effective community-based PA interventions. Our objective was to use qualitative data to account for individuals’ neighborhood environment when designing a community-based, mobile health technology-delivered PA intervention.

Methods: We created the mobile application (app) “Step It Up” to investigate how remote messaging tailored to one’s neighborhood environment can increase PA among African-American (AA) women living in resource-limited areas. A convenience sample of AA women (n=12, mean age =57 ±11 years, mean body mass index =36 ±6 kg/m²) living in Washington D.C. and neighboring Prince George’s County, Maryland was recruited via a community advisory board to test the Step It Up app. Prior to app use, each participant completed a semi-structured interview with two trained research team members to identify accessible PA locations and factors affecting use of these locations. Interviews were recorded and transcribed verbatim. Transcriptions were iteratively coded for final themes by three research team members. A qualitative expert reviewed interview transcripts and validated the finalized codebook. Remote messages sent through Step It Up were tailored to include PA locations identified by participants.

Findings: Of the finalized themes about use of preferred PA locations, the three most cited were Caregiving, Safety, and Social Support. Remaining themes included: Injury Risk, Health History, Financial Concerns, Activity Type, Schedule Constraints, Proximity to Home/Work, and Accountability. Participants mentioned how caregiving of children sometimes increased PA, while other caregiving took time away from PA-based self-care. Safety was a determining factor for PA locations. Participants were enthusiastic about group activities that offered social support, including water aerobics or hand dancing.

Conclusions: This community-based approach to building Step It Up suggests that remote messaging should focus on PA locations that are safe, convenient, and social. Future iterations of the app can consider increased promotion of existing group-based PA resources or adding a participant-driven safety rating feature for each suggested PA location.

Purpose: Designing effective, sustainable and scalable interventions to reach low-income Mexican Americans to improve physical activity is challenging. This evaluation study used the RE-AIM Framework to examine expanded implementation of Tu Salud, ¡Si Cuenta!, a Community Wide Campaign (CWC) that promotes physical activity and lifestyle behaviors in 11 municipalities on the U.S.-Mexico border. Intervention components include policy and environmental changes, media, free exercise offerings in more than 50 community locations, community health worker outreach using motivational interviewing strategies, and community-based screenings.

Methods: For the RE-AIM evaluation to measure Reach, we examined data on the program participants’ demographics derived from the enrollment database. We examined Effectiveness of the program to improve physical activity based on a modified Godin Leisure-Time Exercise Physical Activity Questionnaire activity (Godin and Shephard, 1997) obtained at baseline enrollment and 3 to 6 months later. Qualitative interviews were conducted with city leaders, staff implementing the program, and participants from each municipality regarding Adoption, Implementation and Maintenance.

Results: Reach – over 80% of the participants were low income and nearly all were Mexican American.

Effectiveness - among 3651 participants who did not meet MVPA guidelines at baseline enrollment, those individuals who were highly engaged in the program were more likely than low engaged (adjusted odds ratio=1.46; p=0.0002) to meet MVPA guidelines at posttest.

Adoption - Despite a history of little collaboration, the program provided cross-community dialogue that enhanced program fidelity. Successful adoption was facilitated by community health workers and community leader participation in monthly training and meetings.

Implementation – There was an overall increase in implementation audit scores from the previous year across all but one municipality. Facilitators included programmatic factors like new resource connections, use of social media, and mission alignment. Participants’ sense of community and self-confidence also were discussed as facilitators.

Maintenance –Complex factors impacted maintenance related to sustaining and institutionalizing a health intervention in municipalities.

Conclusions: This evaluation of 11 municipalities allows for examinations across settings and organizational culture. While participant data across the program shows positive outcomes with regard to physical activity, the RE-AIM Framework provides insight into the factors contributing to program adoption, implementation and maintenance.

introduction and objective: Fewer than one in five Latinx children in Texas are reaching recommended physical activity levels. High outdoor temperatures may be hindering physical activity, and previous studies have not explored the relations between physical activity and trees—a proven heat management strategy—during different temperature conditions. The purpose of this study was to measure how low-income, Latinx children interact with trees in school parks during high and moderate temperatures.

methods: This descriptive cross-sectional study included three joint-use, elementary school parks in Austin, Texas, serving populations greater than 85% low-income Latinx. The study spanned 12 September days (i.e., high temperature) and six November days (i.e., moderate temperature), in 2019. Air temperature data originated from the official NOAA weather station at Austin-Bergstrom International Airport. On study days at 07:00, 12:00, 16:00, and 18:00, researcher pairs used the System for Observing Play and Recreation in Communities (SOPARC) to observe the number and physical activity levels (i.e., sedentary, walking, and vigorous) of children aged 0–12 years at multiple target areas per park, selected based on land use. We adapted SOPARC to observe children’s interaction with trees (i.e., under or touching a tree). Lastly, we summed observed counts of physical activity and tree interactions by sex.

results: Study days averaged 83.5°F in September and 61.8°F in November. Overall, we observed 2,004 children (male = 56.2%; female = 43.8%). Most trees resided in playgrounds and grass fields, whereas soccer fields, basketball courts, and tracks had little to no trees. Although children were present in target areas only 7.2% of the time, 80% of children present were physically active. Approximately 40% of physical activity occurred on playgrounds. Males constituted over 80% of those engaging in physical activity on soccer fields and basketball courts. More children interacted with trees in September (male = 64.5%; female = 63.2%) than in November (male = 39.1%; female = 52.4%).

conclusions: School parks are underutilized, active spaces. More children interact with trees during high temperatures, potentially for thermal comfort. In the face of climate change, health practitioners should consider how park programming may be influenced by seasonal interactions with trees.