Effects of built environment on walking among Hong Kong older adults

 Key Messages
1. Reliable and valid intervieweradministered questionnaires were developed to investigate associations of perceived neighbourhood attributes of Hong Kong older adults with their walking for transportation and recreation.
2. Access to and availability of different types of services and destinations, provision of
facilities for resting/sitting in the neighbourhood, and easy access to/from residential
buildings may help maintain an active lifestyle by facilitating walking for transport in the neighbourhood.
3. Access to services, indoor places for walking, environmental aesthetics, low traffic, and absence of physical barriers may promote recreational walking.

Measuring walking within and outside the neighborhood in Chinese elders : reliability and validity

Background : Walking is a preferred, prevalent and recommended activity for aging populations and is influenced by the neighborhood built environment. To study this influence it is necessary to differentiate whether walking occurs within or outside of the neighborhood. The Neighborhood Physical Activity Questionnaire (NPAQ) collects information on setting-specific physical activity, including walking, inside and outside one's neighborhood. While the NPAQ has shown to be a reliable measure in adults, its reliability in older adults is unknown. Additionally its validity and the influence of type of neighborhood on reliability and validity have yet to be explored. Methods : The NPAQ walking component was adapted for Chinese speaking elders (NWQ-CS). Ninety-six Chinese elders, stratified by social economic status and neighborhood walkability, wore an accelerometer and completed a log of walks for 7 days. Following the collection of valid data the NWQ-CS was interviewer-administered. Fourteen to 20 days (average of 17 days) later the NWQ-CS was re-administered. Test-retest reliability and validity of the NWQ-CS were assessed. Results : Reliability and validity estimates did not differ with type of neighborhood. NWQ-CS measures of walking showed moderate to excellent reliability. Reliability was generally higher for estimates of weekly frequency than minutes of walking. Total weekly minutes of walking were moderately related to all accelerometry measures. Moderate-to-strong associations were found between the NWQ-CS and log-of-walks variables. The NWQ-CS yielded statistically significantly lower mean values of total walking, weekly minutes of walking for transportation and weekly frequency of walking for transportation outside the neighborhood than the log-of-walks. Conclusions : The NWQ-CS showed measurement invariance across types of neighborhoods. It is a valid measure of walking for recreation and frequency of walking for transport. However, it may systematically underestimate the duration of walking for transport in samples that engage in high levels of this type of walking.

Environmental perceptions as mediators of the relationship between the objective built environment and walking among socioeconomically disadvantaged women

Background
Women living in socio-economically disadvantaged neighbourhoods are at increased risk for physical inactivity and associated health outcomes and are difficult to reach through personally tailored interventions. Targeting the built environment may be an effective strategy in this population subgroup. The aim of this study was to examine the mediating role of environmental perceptions in the relationship between the objective environment and walking for transportation/recreation among women from socio-economically disadvantaged neighbourhoods.

Methods
Baseline data of the Resilience for Eating and Activity Despite Inequality (READI) study were used. In total, 4139 women (18–46 years) completed a postal survey assessing physical environmental perceptions (aesthetics, neighbourhood physical activity environment, personal safety, neighbourhood social cohesion), physical activity, and socio-demographics. Objectively-assessed data on street connectivity and density of destinations were collected using a Geographic Information System database and based on the objective z-scores, an objective destinations/connectivity score was calculated. This index was positively scored, with higher scores representing a more favourable environment. Two-level mixed models regression analyses were conducted and the MacKinnon product-of-coefficients test was used to examine the mediating effects.

Results
The destinations/connectivity score was positively associated with transport-related walking. The perceived physical activity environment mediated 6.1% of this positive association. The destinations/connectivity score was negatively associated with leisure-time walking. Negative perceptions of aesthetics, personal safety and social cohesion of the neighbourhood jointly mediated 24.1% of this negative association.

Conclusion
For women living in socio-economically disadvantaged neighbourhoods, environmental perceptions were important mediators of the relationship between the objective built environment and walking. To increase both transport-related and leisure-time walking, it is necessary to improve both objective walkability-related characteristics (street connectivity and proximity of destinations), and perceptions of personal safety, favourable aesthetics and neighbourhood social cohesion.

Ageing in an ultra-dense metropolis: perceived neighbourhood characteristics and utilitarian walking in Hong Kong elders

Objective
The neighbourhood built environment may affect walking behaviour of elders. However, such effects remain underexplored, especially in an Asian context. We examined associations of perceived environmental attributes with overall and neighbourhood-specific walking for transport in a sample of Chinese elders residing in Hong Kong, an ultra-dense Chinese metropolis.

Design
Cross-sectional observational study using a two-stage stratified sampling strategy.

Setting
Hong Kong, China.

Subjects
Chinese-speaking elders (n 484), with no cognitive impairment and able to walk without assistance, residing in thirty-two selected communities stratified by socio-economic status and walkability, were interviewer-administered validated measures of perceived neighbourhood environment and walking for transport.

Results
Much higher levels of transport-related walking (mean 569 (sd 452) min/week) than found in Western samples were reported. The degree of perceived access to shops, crowdedness, presence of sitting facilities and easy access of residential entrance were independently positively related to both frequency of overall and within-neighbourhood walking for transportation. Infrastructure for walking and access to public transport were predictive of higher frequency of transport-related walking irrespective of location, while the perceived degree of land-use mix was predictive of higher levels of within-neighbourhood walking.

Conclusions
The provision of easy access to shops, residential entrances and sitting facilities in the neighbourhood may promote overall transport-related walking, while a good public transport network and pedestrian infrastructure linking destination-poor with destination-rich locations may compensate for the detrimental effects of living in less walkable neighbourhoods. Governmental investment in these micro- and macro-environmental features would help the promotion of an active lifestyle in elders.

Physical environmental factors that invite older adults to walk for transportation

Knowledge on the physical environmental factors that invite older adults to walk for transportation is limited. The current study aimed to investigate the relationships between environmental factors and invitingness to walk for transportation and the potential moderating effects of gender, functional limitations and current walking for transportation behavior. Sixty older participants evaluated 40 panoramic photographs on their invitingness in two ways: a forced choice (first impressions) and a rating task (more deliberate evaluation). Presence of vegetation, benches, and surveillance significantly positively related to both invitingness-measures. Upkeep and presence of historic elements significantly positively related to the assigned invitingness-ratings. For the forced choice task, significant positive relationships emerged for land use and separation between sidewalk and cycling path, but only in functionally limited participants. Environments offering comfort, safety from crime, and pleasantness may attract older adults to walk for transportation. Experimental and on-site studies are needed to elaborate on current findings.

Percepção do ambiente comunitário e a prática de atividade física em adultos residentes em Rio Claro - SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Associação entre indicadores do ambiente construído e variáveis individuais com atividade física no lazer e no transporte em adultos do município de Rio Claro - SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Integrating bicycle and pedestrian considerations into state and local transportation planning, design, and operations. National Bicycling and Walking Study. Case study no. 21.

Federal Highway Administration, Washington, D.C.

Street characteristics preferred for transportation walking among older adults: a choice-based conjoint analysis with manipulated photographs

BACKGROUND: Knowledge about the relationships between micro-scale environmental factors and older adults' walking for transport is limited and inconsistent. This is probably due to methodological limitations, such as absence of an accurate neighborhood definition, lack of environmental heterogeneity, environmental co-variation, and recall bias. Furthermore, most previous studies are observational in nature. We aimed to address these limitations by investigating the effects of manipulating photographs on micro-scale environmental factors on the appeal of a street for older adults' transportation walking. Secondly, we used latent class analysis to examine whether subgroups could be identified that have different environmental preferences for transportation walking. Thirdly, we investigated whether these subgroups differed in socio-demographic, functional and psychosocial characteristics, current level of walking and environmental perceptions of their own street.

METHODS: Data were collected among 1131 Flemish older adults through an online (n = 940) or an interview version of the questionnaire (n = 191). This questionnaire included a choice-based conjoint exercise with manipulated photographs of a street. These manipulated photographs originated from one panoramic photograph of an existing street that was manipulated on nine environmental attributes. Participants chose which of two presented streets they would prefer to walk for transport.

RESULTS: In the total sample, sidewalk evenness had by far the greatest appeal for transportation walking. The other environmental attributes were less important. Four subgroups that differed in their environmental preferences for transportation walking were identified. In the two largest subgroups (representing 86% of the sample) sidewalk evenness was the most important environmental attribute. In the two smaller subgroups (each comprising 7% of the sample), traffic volume and speed limit were the most important environmental attributes for one, and the presence of vegetation and a bench were the most important environmental attributes for the other. This latter subgroup included a higher percentage of service flat residents than the other subgroups.

CONCLUSIONS: Our results suggest that the provision of even sidewalks should be considered a priority when developing environmental interventions aiming to stimulate older adults' transportation walking. Natural experiments are needed to confirm whether our findings can be translated to real environments and actual transportation walking behavior.

The influence of platform walking on BRT station bus dwell time estimation

The common approach to estimate bus dwell time at a BRT station platform is to apply the traditional dwell time methodology derived for suburban bus stops. Current dwell time models are sensitive towards bus type, fare collection policy along with the number of boarding and alighting passengers. However, they fall short in accounting for the effects of passenger/s walking on a relatively longer BRT station platform. Analysis presented in this paper shows that the average walking time of a passenger at BRT platform is 10 times more than that of bus stop. The requirement of walking to the bus entry door at the BRT station platform may lead to the bus experiencing a higher dwell time. This paper presents a theory for a BRT network which explains the loss of station capacity during peak period operation. It also highlights shortcomings of present available bus dwell time models suggested for the analysis of BRT operation.

Transportation : implications for accessibility for older people

Objective: This research investigates older people’s use of transportation to develop strategies for age-friendly transportation within the community. Methods: Data for this study was derived from Global Positioning System (GPS) tracking of thirteen people aged 55 years and older, together with self-report information recorded in travel diaries about daily activities undertaken outside the home over a period of seven days. Semi-structured interviews were aided by individual maps to investigate engagement in out-of-home activities and verify the recorded GPS data. Results: Overall, participants were highly reliant on the car for daily commuting. Walking, biking and public transport options were unattractive due to environmental conditions, accessibility and usability. Conclusion: Participation within the community and access to services is facilitated by private and public transportation. It is therefore critical to address accessibility and usability issues faced by older people to enable them to maintain their mobility, and ensure access to services, especially when driving ceases.