ABSTRACT
Living in urban environments affects individuals' mental health through different pathways. For instance, physical activity and social participation are seen as mediators. However, aiming to understand underlying mechanisms, it is necessary to consider that the individual is interacting with its environment. In this regard, this viewpoint discusses how urban health research benefits from integration of socioecological and interdisciplinary perspectives, combined with innovative ambulatory data assessments that enable researchers to integrate different data sources. It is stated that neither focusing on the objective and accurate assessment of the environment (from the perspective of spatial sciences) nor focusing on subjectively measured individual variables (from the public health as well as a psychosocial perspective) alone is suitable to further develop the field. Addressing person-place interactions requires an interdisciplinary view on the level of theory (eg, which variables should be focused on?), assessment methods (eg, combination of time-varying objective and subjective measures), as well as data analysis and interpretation. Firstly, this viewpoint gives an overview on previous findings addressing the relationship of environmental characteristics to physical activity and mental health outcomes. We emphasize the need for approaches that allow us to appropriately assess the real-time interaction between a person and a specific environment and examine within-subject associations. This requires the assessment of environmental features, the spatial-temporal behavior of the individual, and the subjective experiences of the situation together with other individual factors, such as momentary affective states. Therefore, we finally focused on triggered study designs as an innovative ambulatory data assessment approach that allows us to capture real-time data in predefined situations (eg, while walking through a specific urban area).
Subject(s)
Exercise , Mental Health , Humans , WalkingABSTRACT
BACKGROUND: Walking behavior is positively associated with physiological and mental health as much evidence has already shown. Walking is also becoming a critical issue for health promotion in urban environments as it is the most often used form of active mobility and helps to replace carbon dioxide emissions from motorized forms of transport. It therefore contributes to mitigate the negative effects of climate change and heat islands within cities. However, to promote walking among urban dwellers and to utilize its health-enhancing potential, we need to know more about the way in which physical and social environments shape individual experiences during walking episodes. Such person-place interactions could not adequately be analyzed in former studies owing to methodological constraints. OBJECTIVE: This study introduces walking-triggered e-diaries as an innovative ambulatory assessment approach for time-varying associations, and investigates its accuracy with 2 different validation strategies. METHODS: The walking trigger consists of a combination of movement acceleration via an accelerometer and mobile positioning of the cellphone via GPS and transmission towers to track walking activities. The trigger starts an e-diary whenever a movement acceleration exceeds a predetermined threshold and participants' locations are identified as nonstationary outside a predefined place of residence. Every 420 (±300) seconds, repeated e-diaries were prompted as long as the trigger conditions were met. Data were assessed on 10 consecutive days. First, to investigate accuracy, we reconstructed walking routes and calculated a percentage score for all triggered prompts in relation to all walking routes where a prompt could have been triggered. Then, to provide data about its specificity, we used momentary self-reports and objectively assessed movement behavior to describe activity levels before the trigger prompted an e-diary. RESULTS: Data of 67 participants could be analyzed and the walking trigger led to 3283 e-diary prompts, from which 2258 (68.8%) were answered. Regarding accuracy, the walking trigger prompted an e-diary on 732 of 842 (86.9%) reconstructed walking routes. Further, in 838 of 1206 (69.5%) triggered e-diaries, participants self-reported that they were currently walking outdoors. Steps and acceleration movement was higher during these self-reported walking episodes than when participants denied walking outdoors (steps: 106 vs 32; acceleration>0.2 g in 58.4% vs 19% of these situations). CONCLUSIONS: Accuracy analysis revealed that walking-triggered e-diaries are suitable to collect different data of individuals' current experiences in situations in which a person walks outdoors. Combined with environmental data, such an approach increases knowledge about person-place interactions and provides the possibility to gain knowledge about user preferences for health-enhancing urban environments. From a methodological viewpoint, however, specificity analysis showed how changes in trigger conditions (eg, increasing the threshold for movement acceleration) lead to changes in accuracy.
ABSTRACT
In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation-the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future.
