Introduction and Objective: Physical activity (PA) is associated with positive health outcomes throughout life. Many community-based interventions promoting PA focus on implementing incremental changes to existing facilities and improvements of existing infrastructure (e.g., improved bike lanes, renovated sidewalks). While prominent among existing interventions and less costly than building new facilities, rigorous assessment of their impact on PA outcomes is lacking. The objective of this study was to determine if upgrades to existing PA facilities/infrastructure are associated with increased children’s PA.

Methods: Two randomly sampled cohorts of 3- to 15-year-old children (n=599) living in four low-income New Jersey cities were followed during 2- to 5-year periods from 2009 through 2017. Data were collected on children’s PA at two time points (T1 and T2) from each cohort using telephone surveys of parents; data on changes to PA facilities were collected yearly from 2009-2017 using Open Public Records Act requests, publicly available data sources, and interviews with stakeholders. PA changes were categorized into six domains (PA facility, park, trail, complete street, sidewalk, bike lane), and changes coded as new opportunity, renovated opportunity, or amenity. A scale variable capturing all street-related upgrades (complete street, sidewalk, and bike lane) was constructed. PA was measured as the number of days per week the child engaged in at least 60 minutes of PA. The association between change in PA between T1 and T2 and changes to the PA environment was modeled using weighted linear regression controlling for PA at T1, child age, sex, race, as well as household and neighborhood demographic and socioeconomic characteristics.

Results: Response rates were 49% and 36% for T1 and T2, respectively. Street-related upgrades were positively associated with PA change. For each additional street upgrade within a 1-mile radius of their homes, children’s PA increased, on average, 0.42 (95% CI: 0.02, 0.82; p=0.039) days between T1 and T2. This corresponds to an 11% increase over the mean baseline value (3.8 days).

Conclusions: The current study supports funding projects aimed at improving streets and sidewalks in cities; incremental improvements to the PA environment near children’s homes may result in increased daily PA among children.