Access to urban green spaces and use of social services and institutional long-term care among older people in Malmö, Sweden: a longitudinal register study.

BACKGROUND: Finding ways to prolong independence in daily life among older people would be beneficial for both individuals and society. Urban green spaces have been found to improve health, but only a few studies have evaluated the association between urban green spaces and independence in daily life. The aim of this study was to assess the long-term effect of urban green spaces on independence in daily life, using social services and support, mobility aids, and relocation to institutional long-term care as proxies, among community dwelling people 65 + years. METHODS: We identified 40 357 people 65 + years living in the city of Malmö, Sweden in 2010. Using geographical information systems (GIS), we determined the amount of urban green spaces (total, public, and quiet) within 300 m of each person's residence. All three measures were categorized based on their respective percentiles, so that the first quartile represented the 25% with the least access and the fourth quartile the 25% with the most access. In 2015 and 2019, we assessed the outcomes minor assistance (non-personal support), major assistance (personal support), and relocation into institutional long-term care. These three outcome measures were used as proxies for independence in daily life. The effect of amount of urban green spaces in 2010 on the three outcomes in 2015 and 2019, respectively, was assessed by pairwise comparing the three highest quartiles to the lowest. RESULTS: Compared to the lowest quartile, those in the highest quartile of quiet green spaces in 2010 were less likely to receive minor assistance in both 2015 and 2019. Besides this, there were no indications that any of the measures of urban green space affected independence in daily life at the five- and nine-year follow-up, respectively. CONCLUSION: Although urban green spaces are known to have positive impact on health, physical activity, and social cohesion among older people, we found no effect of total, public, or quiet green spaces on independence in daily life. This could possibly be a result of the choice of measures of urban green spaces, including spatial and temporal aspects, an inability to capture important qualitative aspects of the green spaces, or the proxy measures used to assess independence in daily life.

Shotgun metagenomic sequencing of swab samples from Japanese university campuses.

We obtained shotgun metagenome sequences from swab samples obtained through 3-minute swabbing of different surfaces and the air within buildings at three university campuses in part of the Greater Tokyo Area in Japan. These data aid in understanding built environment microbial communities and elucidate various microbial profiles across different locations.

Post-wildfire neighborhood change: evidence from the 2018 Camp Fire.

As the number of highly destructive wildfires grows, it is increasingly important to understand the long-term changes that occur to fire-affected places. Integrating approaches from social and biophysical science, we document two forms of neighborhood change following the 2018 Camp Fire in the United States, examining the more than 17,000 residential structures within the burn footprint. We found that mobile or motor homes, lower-value residences, and absentee owner residences had a significantly higher probability of being destroyed, providing evidence that housing stock filtering facilitated socially stratified patterns of physical damage. While the relationship between building value and destruction probability could be explained by measures of building density and distance to nearby roads, building type remained an independent predictor of structure loss that we could not fully explain by adding environmental covariates to our models. Using a geospatial machine learning technique, we then identified buildings that had been reconstructed within the burn footprint 20 months after the fire. We found that reconstructed buildings were more likely to have been owner-occupied prior to the fire and had higher average pre-fire property value, suggesting an emerging pattern of cost-burden gentrification. Our findings illustrate the importance of examining the built environment as a driver of socially uneven disaster impacts. Wildfire mitigation strategies are needed for mobile and motor home residents, renters, low-income residents, and dense neighborhoods.

The associations between neighborhood characteristics and childhood overweight and obesity in a national dataset.

BACKGROUND: National child obesity rates continue to climb. While neighborhood factors are known to influence childhood weight, more work is needed to further our understanding of these relationships and inform intervention and policy approaches reflective of complex real-world contexts. METHODS: To evaluate the associations between neighborhood components and childhood overweight/obesity, we analyzed sequential, cross-sectional data from the National Survey of Children's Health collected annually between 2016 and 2021. To characterize the complexity of children's neighborhood environments, several interrelated neighborhood factors were examined: amenities, detractions, support, and safety. We used ordinal logistic regression models to evaluate the associations between these exposures of interest and childhood weight status, adjusting for potential confounders. RESULTS: Our analytic sample contained 96,858 children representing a weighted population of 28,228,799 children ages 10-17 years. Child weight status was healthy in 66.5%, overweight in 16.8%, and obese in 17.2%. All four neighborhood factors were associated with child weight status. The odds of overweight or obesity generally increased with a decreasing number of amenities and increasing number of detractions, with the highest adjusted odds ratio seen with no amenities and all three possible detractions (1.71; 95% confidence interval [1.31, 2.11]). CONCLUSIONS: Multiple factors within a child's neighborhood environment were associated with child weight status in this sample representative of the U.S. population aged 10-17 years. This suggests the need for future research into how policies and programs can support multiple components of a healthy neighborhood environment simultaneously to reduce rates of childhood overweight/obesity. WHAT'S NEW: In a national sample of 96,858 children ages 10-17 years, the odds of child overweight/obesity were highest in neighborhoods reported by parents as being unsafe, unsupportive, having multiple detractions (e.g. vandalism), and having no amenities (e.g. playgrounds).

Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults.

BACKGROUND/OBJECTIVES: Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults. METHODS: A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses. RESULTS: Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actually assess walkability (χ2 = 78.7, p < .001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents. CONCLUSION: When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.

Neighborhood Access to the Built Environment and Allostatic Load: A Systematic Review of the Use of Geographic Information Systems.

Objectives: This paper systematically reviews how spatial analysis has been used to measure relationships between access to the built environment and Allostatic Load (AL) or biomarkers relevant to the stress pathway. Geographic Information Systems (GIS) facilitate objective measurement of built environment access that may explain unequal health outcomes linked to living in stressful environments. Methods: Systematic review, search date 13 July 2022 with methods published a priori. Included studies that quantitatively assessed associations between GIS measures of neighborhood attributes and biomarkers of stress. Results: 23 studies from 14 countries were included having used GIS measures to assess relationships between access to the built environment and biomarkers relevant to AL, with 17 being cross-sectional and 6 longitudinal. Just 2 studies explicitly assessed associations between GIS measures and AL, but 21 explored biomarkers relevant to the stress pathway. GIS was used to calculate density (how much of x within y) and proximity (how far from a to b) measures. Conclusion: GIS measures of greenspace, the food environment, area-level demographics, and land-use measures were found to influence biomarkers relevant to the stress pathway, highlighting the utility of this approach. GIS use is extremely limited when measuring the built environment and its influence on AL but has been widely used to consider effects on individual biomarkers of stress. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=348355], identifier [CRD42022348355].

The relationship between neighbourhood built characteristics, physical activity, and health-related fitness in urban dwelling Canadian adults: A mediation analysis.

OBJECTIVE: Physical activity supportive environments have the potential to promote health-related fitness in adults. However, the extent to which neighbourhood built characteristics promote health-related fitness via physical activity has received little research attention. Therefore, our objective was to estimate the indirect and direct effects between neighbourhood built characteristics and health-related fitness mediated by physical activity. METHODS: Using cross-sectional data collected between 2014 and 2019, we merged neighbourhood built characteristics, physical activity, and health-related fitness variables, derived from two Canadian national databases. Using these data, we estimated sex-stratified covariate-adjusted path models (males: n = 983 to 2796 and females: n = 962 to 2835) to assess if accelerometer-measured light, moderate, and vigorous intensity physical activity mediated associations between objectively measured neighbourhood built characteristics (intersection density, dwelling density, points of interest, and transit density) and health-related fitness (grip strength, jump height, V̇O2max, and flexibility). Across 16 sex-specific models, we estimated 48 indirect and 16 direct effects. RESULTS: Concerning significant associations, for males we found that 16.6% of indirect and 18.8% of direct were negative and 4.2% of indirect and 0% of direct were positive. For females, we found that 12.5% of indirect and 0% of direct were negative and 0% of indirect and 25% of direct effects were positive. CONCLUSIONS: Individual Canadian Active Living Environment built characteristics are positively associated with moderate-intensity physical activity and negatively associated with light-intensity physical activity. Further, associations between activity friendly neighbourhood characteristics and health related-fitness may be distinct from physical activity.

A Future Growth Model for Building More Housing and Infrastructure with Less Embodied Greenhouse Gas.

Global demand for housing and the climate crisis have created a seemingly impossible choice between the need to build more and the need to emit less from construction materials. Here, we present the future infrastructure growth (FIG) model, a generalizable method for finding pathways to build enough housing and infrastructure while reducing material emissions, in line with climate commitments. FIG uses open data to quantify the emissions of existing neighborhoods as if they were built new; it then uses these quantifications to forecast future cradle-to-gate embodied emissions from new residential buildings and linear infrastructure construction. This novel approach allows for detailed analysis that scales to a city, region, and/or national level and captures variability in construction norms, designs, and codes. We demonstrate FIG on Canada, using the model to find neighborhood-level drivers of embodied emissions and the most effective reduction strategies through 2030 and 2050. Current construction practices will cause a 437% overshoot of Canada's climate commitments if housing growth targets are met. Avoiding this overshoot requires a near-total reliance on multiunit buildings and best-in-class design supported by improvements in material manufacturing, building within existing urban boundaries, and halving the use of new materials.

Designing movement space for elderly and disabled people in the construction law in selected countries.

BACKGROUND: Building law regulations determine designing the built environment recognising the needs of users of different ages and psychophysical abilities. Seniors and their spatial needs are covered there to a limited extent. The benchmark for design are wheelchair users. Their spatial requirements are greater in relation to independent walkers, including most older people. This makes it difficult to adapt the whole built environment to the needs of people with less mobility dysfunction. This can be considered in terms of spatial design and investment costs. MATERIAL AND METHODS: The paper analyses the building regulations of 3 countries in terms of legal conditions to shape the architectural movement space of older people and disabled people. Analytical and comparative methods are used. Such research is becoming relevant and necessary. The analyses are conducted in the context of ageing populations. They are justified by statistical data on the age groups of Polish society. This is followed by design analyses of the legal requirements in the wheelchair movement space and proposals for alternatives, e.g., people walking with canes (case study). Their aim is to indicate methods to limit excessive communication spaces in buildings while maintaining functional values for all users. RESULTS: Research may show the possibility of greater diversification of regulations and alternatives to current laws. They are dedicated to participants in investment processes to shape accessible buildings. They can also be used in legislative work on amendments to the construction law. CONCLUSIONS: Changes in building regulations and a detailed approach to the mobility needs of older and disabled people (walking independently) are proposed. These decisions can provide benefits (spatial and economic savings). They fall into the "design for all" trend and sustainability of the built environment. These demands are based on no longer valid normative regulations. Med Pr Work Health Saf. 2024;75(3).

Sources of Stress and Coping Strategies Among Urban African American Adolescents: A Qualitative Study of Child and Caregiver Perspectives.

Early adolescence is a critical point for intervention to protect against negative consequences of stress on the developing brain. This study aimed to gather perspectives on stress from adolescents and their caregivers living in under-resourced Baltimore City neighborhoods. Nine African American adolescents and their caregivers (n = 18 total) participated in qualitative interviews exploring neighborhood environments, sources of stress, and coping behaviors. Neighborhood social cohesion was described as a strength of participants' communities, despite concerns about neighborhood safety. Caregivers were highly aware of their child's stressors and coping behaviors. School-related pressure was a prevalent source of stress emphasized by adolescents, along with social stress due to disrupted routines during the COVID-19 pandemic. Adolescents described frequent use of electronics to cope with stress, as well as self-care and relaxation techniques. Themes identified from these data can be used to inform future adolescent stress-reduction interventions and stress-prevention efforts in this priority population.

Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review.

BACKGROUND: According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking. METHODS: We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results. RESULTS: Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting). CONCLUSIONS: Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults. TRIAL REGISTRATION: PROSPERO: CRD42021283508.

The Effects of the Built Environment on the Mental Health of Older Adults: A Case Study in Hangzhou, China.

Background and Objectives: This study examines the association between the built environment and mental health among older adults by exploring the potential pathways through the perceived built environment, social interaction, and environmental pollution. Research Design and Methods: Research data were collected from 1 405 older adults aged 60 years and older in 30 residential neighborhoods of Hangzhou, China, in 2022. The participants' evaluation of the perceived built environment, social interaction, and environmental pollution were assessed. Mental health was measured by the 12-item Short-Form Health Survey. The built environment was measured through an evaluation of density, diversity, design, destination accessibility, distance to transit, and the age-friendly environment. Structural equation models were established based on 300-m, 500-m, and 800-m buffers from the entrance of residential neighborhoods. The propensity score method was employed for sensitivity analysis. Results: With regard to older adult's mental health, there were significant direct effects of the accessibility of health services, shopping services, and bus stops. A robust mediating effect of perceived built environment was displayed on the relationship between land use mix and mental health of older adults. Social interaction exhibited robust mediating effects between the age-friendly environment, the number of bus stops, and mental health of older adults. Discussion and Implications: This study provides empirical experience for related research on the built environment and mental health as well as policy implications for urban planners focusing on community planning.

Neighborhood built environment, obesity, and diabetes: A Utah siblings study.

Background: This study utilizes innovative computer vision methods alongside Google Street View images to characterize neighborhood built environments across Utah. Methods: Convolutional Neural Networks were used to create indicators of street greenness, crosswalks, and building type on 1.4 million Google Street View images. The demographic and medical profiles of Utah residents came from the Utah Population Database (UPDB). We implemented hierarchical linear models with individuals nested within zip codes to estimate associations between neighborhood built environment features and individual-level obesity and diabetes, controlling for individual- and zip code-level characteristics (n = 1,899,175 adults living in Utah in 2015). Sibling random effects models were implemented to account for shared family attributes among siblings (n = 972,150) and twins (n = 14,122). Results: Consistent with prior neighborhood research, the variance partition coefficients (VPC) of our unadjusted models nesting individuals within zip codes were relatively small (0.5%-5.3%), except for HbA1c (VPC = 23%), suggesting a small percentage of the outcome variance is at the zip code-level. However, proportional change in variance (PCV) attributable to zip codes after the inclusion of neighborhood built environment variables and covariates ranged between 11% and 67%, suggesting that these characteristics account for a substantial portion of the zip code-level effects. Non-single-family homes (indicator of mixed land use), sidewalks (indicator of walkability), and green streets (indicator of neighborhood aesthetics) were associated with reduced diabetes and obesity. Zip codes in the third tertile for non-single-family homes were associated with a 15% reduction (PR: 0.85; 95% CI: 0.79, 0.91) in obesity and a 20% reduction (PR: 0.80; 95% CI: 0.70, 0.91) in diabetes. This tertile was also associated with a BMI reduction of -0.68 kg/m2 (95% CI: -0.95, -0.40). Conclusion: We observe associations between neighborhood characteristics and chronic diseases, accounting for biological, social, and cultural factors shared among siblings in this large population-based study.

Manganese dioxide-coated biocarbon for integrated adsorption-photocatalytic degradation of formaldehyde in indoor conditions.

Formaldehyde is a common indoor air pollutant with hazardous effects on human health. This study investigated the efficiency of biocarbon (BC) functionalized with variable contents of MnO2 for formaldehyde removal in ambient conditions via integrated adsorption-photocatalytic degradation technology. The sample with the highest formaldehyde removal potential was used to prepare a functional coating made of acrylic binder mixed with 20 wt% of the particles and applied on beech (Fagus sylvatica L) substrate. SEM images showed that MnO2 was deposited around and inside the pores of the BC. EDX spectra indicated the presence of Mn peaks and increased content of oxygen in the doped BC compared to pure BC, which indicated the successful formation of MnO2. Raman spectra revealed that the disorder in the BC's structure increased with increasing MnO2 loadings. FTIR spectra of BC-MnO2 samples displayed additional peaks compared to the BC spectrum, which were attributed to MnO vibrations. Moreover, the deposition of increased MnO2 loadings decreased the porosity of the BC due to pores blockage. The BC sample containing 8 % Mn exhibited the highest formaldehyde removal efficiency in 8 h, which was 91 %. A synergetic effect between BC and MnO2 was observed. The formaldehyde removal efficiency and capacity of the coating reached 43 % and 6.1 mg/m2, respectively, suggesting that the developed coating can be potentially used to improve air quality in the built environment.

Imagining and implementing healthy city interventions: Combined results from parallel concept mapping exercises in Montreal with community members and stakeholders.

OBJECTIVE: Built environment interventions provide structural solutions to complex urban challenges. Though community voices are part of municipal decision-making, planners and public health professionals need tools to better integrate their perspectives for desired changes (what) when implementing built environment interventions (how). We present two simultaneous concept mapping exercises conducted in Montréal, Canada, to facilitate the consideration of these dimensions. METHODS: Community members were prompted about neighbourhood changes that could improve their quality of life; stakeholders were prompted about factors that contribute to successful implementation of interventions. Through each exercise, items were generated, grouped, and rated on importance and feasibility. Concept maps were produced using multidimensional scaling and hierarchical cluster analysis. The clusters identified by community members and stakeholders were combined into a Community × Stakeholder Matrix, which supported discussions on interventions with the research's Advisory Committee. RESULTS: Thirty-two community members generated 41 responses, which resulted in 6 clusters: (1) strengthen public transportation, (2) reduce space dedicated to cars, (3) foster local social connections, (4) develop quality cycling infrastructure, (5) improve pedestrian accessibility, and (6) green the city. Thirty-seven stakeholders generated 40 items, which resulted in 5 clusters: (1) collaboration with stakeholders and citizens, (2) planning and evaluation, (3) common vision for the future, (4) regulatory framework and funding, and (5) context-informed approach. CONCLUSION: Capturing the collective vision of our urban environments and the processes underlying change through concept mapping can lead to more successful changes. We propose combining understandings of the what and how into a matrix to support evaluation and strategic planning of interventions and better integrate community voices into operational planning.

RéSUMé: OBJECTIF: Les interventions sur le cadre bâti peuvent offrir des solutions structurelles aux défis urbains complexes. Bien que les communautés fassent partie du processus décisionnel municipal, les urbanistes et les professionnels de la santé publique ont besoin d'outils pour mieux intégrer leurs perspectives sur les changements souhaités (le quoi) dans la mise en œuvre réussie des programmes et des interventions sur l'environnement bâti (le comment). Nous présentons deux exercices simultanés de cartographie conceptuelle menés à Montréal, Canada, visant à capter ces dimensions de mise en œuvre. MéTHODES: Les membres de la communauté ont été sondés sur les changements dans leur quartier qui seraient susceptibles d'améliorer leur qualité de vie, tandis que des acteurs municipaux ont été sondés sur les facteurs qui contribuent à la réussite de la mise en œuvre des interventions urbaines. Pour chaque exercice, des items ont été générés, regroupés et notés en fonction de leur importance et de leur faisabilité. Des cartes conceptuelles ont été produites à l'aide d'analyse multivariée d'étalonnage multidimensionnel et d'une analyse hiérarchique ascendante. Les regroupements identifiés par les membres de la communauté et les acteurs municipaux ont été combinés dans une matrice communauté × acteurs municipaux, qui a encadré une discussion sur les interventions sur le cadre bâti avec le comité consultatif du programme de recherche. RéSULTATS: Trente-deux membres de la communauté ont généré 41 réponses uniques, qui ont formé 6 regroupements : (1) renforcer les transports en commun, (2) réduire l'espace dédié aux voitures, (3) favoriser le lien social local, (4) développer des infrastructures cyclables de qualité, (5) améliorer l'accessibilité piétonne, et (6) verdir la ville. Trente-sept acteurs municipaux ont généré 40 éléments uniques, qui ont mené à 5 regroupements : (1) collaboration avec les parties prenantes et les citoyens, (2) planification et évaluation, (3) vision commune pour l'avenir, (4) cadre réglementaire et financement, et (5) approche contextuelle. CONCLUSION: En captant la vision collective sur nos environnements urbains et la compréhension des processus sous-jacents au changement avec la cartographie conceptuelle, les transformations urbaines peuvent être plus réussies et plus inclusives. Nous proposons de combiner les perspectives sur le quoi et le comment dans une matrice pour soutenir l'évaluation et la planification stratégique d'interventions, tout en promouvant l'intégration des voix de la communauté dans la planification opérationnelle de l'aménagement urbain.

Utilizing Agent-Based Modeling for Optimization of Wayfinding in Hospital: A Case Study.

OBJECTIVES: This research aims to propose a novel methodology for analyzing and optimizing wayfinding in complex environments by examining their spatial configurations. BACKGROUND: Wayfinding difficulties often lead to disorientation and hinder users' ability to locate destinations. Although architectural design can aid in simplifying user access, existing approaches lack a specific focus on wayfinding optimization despite its significant impact on users' navigational abilities. METHODS: In this study, an agent-based model was employed to assess the efficacy of wayfinding in a multistory hospital. Subsequently, the layouts were optimized, leading to the creation of a new space distribution diagram. The simulation was then repeated to examine the potential improvement in wayfinding. Data collection encompassed user types, workflow scenarios, population distribution, and user speed. RESULTS: Comparative analysis of the agent-based simulation findings before and after layout optimization revealed a decrease in total distance and time spent on the modified floor plans for all users when compared to the existing layout. This suggests that the optimized layout holds significant potential for enhancing wayfinding performance. Given the positive outcomes observed for users, this approach is particularly well suited for preliminary design stages of complex environments, where designations among user groups are less crucial or flexibility is desired. Additional advantages include the ability to generate a comprehensive simulation of users' daily workflow, which is integrated into the optimization process and considers specific requirements regarding spatial adjacency.

Multi-Family Housing Environment and Physical Activity: A Systematic Review of the Literature.

OBJECTIVE: To identify environmental features of multi-family housing (MFH) and their surrounding neighborhoods that influence residents' physical activity (PA). DATA SOURCE: Articles published between January 2000 and September 2023 were identified from major social science, medical, health, behavioral science, and urban studies databases. STUDY INCLUSION AND EXCLUSION CRITERIA: Studies were included if they (a) were empirical studies published in peer-reviewed journals and written in English; (b) focused on the MFH environment or the surrounding neighborhood; and (c) had at least one PA outcome. DATA EXTRACTION: Data was extracted regarding the study objective, location, study sample, research design, results related to MFH and neighborhood environment, and limitations. DATA SYNTHESIS: Descriptive summary of study characteristics and analysis to identify emerging themes at three spatial scales (i.e., building, site, and neighborhood). RESULTS: Findings from 35 identified articles revealed factors influencing MFH residents' PA. On the building level, typology (apartment, townhouse) and tenure (public, market rent) showed contrasting correlations with PA in different age groups. On the site level, the presence of PA facilities and safe, walking-friendly environments promoted PA. On the neighborhood level, safety, quality of PA and pedestrian infrastructure, upkeep, air quality, aesthetics, neighborhood satisfaction, street connectivity, walkability, land use mix, density, and public transport promoted PA. CONCLUSION: Study findings highlight the importance of the MFH environments in promoting PA, especially in older adults and young children. With increasing housing demand, understanding diverse MFH typologies and the impact of interventions on multi-spatial scales can help promote healthy and activity-friendly communities.

Advancing Health Equity through 15-min Cities and Chrono-urbanism.

Implementing the 15-min city and chrono-urbanism aims to improve sustainability and quality of life by ensuring residents' proximity to essential services. The 15-min city model is gaining global traction, with localized adaptations to suit communities' needs. Beyond environmental motivations, 15-min cities can benefit public health through enhanced walkability, social cohesion, and universal accessibility. However, research examining the intersection of health and equity among chrono-urbanism and the 15-min city remains limited. This study aims to develop a framework to integrate health and equity into chrono-urbanism and 15-min city plans. We describe the potential benefits and risks of the 15-min approach for urban planning, daily behaviors, and health outcomes. Potential benefits of 15-min cities for health equity include proximity to destinations, increased physical activity, strengthened social capital, reduced emissions, and traffic calming. Risks that must be mitigated include gentrification, variable proximity definitions, infrastructure upgrades, and inadequate cultural sensitivity. Recommendations to integrate 15-min cities into planning activities include conducting comprehensive baseline assessments, aligning goals with sustainability, economic development, flexible zoning, inclusive public spaces, and diverse community engagement tactics. We recommend interventions targeting marginalized communities and developing standardized measurement tools for comparison, monitoring, and evaluation. A nuanced, equitable approach to implementing 15-min cities can help urban plans support health equity across diverse populations.

Characteristics of built food environments associated with alternative protein food choices: a systematic review.

BACKGROUND: This systematic review contributes to the understanding of the characteristics of built food environments that may be associated with choices of alternative protein foods (APF). Using the built food environment typology proposed by Downs et al., we investigated various environmental structures (e.g., supermarkets, other retailers, farmers' markets, restaurants, schools, and online vendors) and the characteristics that may facilitate or hinder consumers' choices. For example, facilitators and barriers may refer to the physical characteristics of environmental structures, food presentation practices, the organizational strategies or policies operating in the setting, or the actions that retailers or consumers engage in while selling, serving, choosing, trying, or purchasing APF in these environmental structures. METHODS: A systematic review (PROSPERO database preregistration; no. CRD42023388700) was conducted by searching 13 databases for peer-reviewed journals focusing on the fields of economics and business, agriculture, medical sciences, and social sciences. Data searches, coding, and quality evaluations were conducted by at least 2 researchers. A total of 31 papers (36 original studies) were included. The risk of bias was evaluated with the Joanna Briggs Institute quality evaluation tool, with 24 publications presenting low risk of bias. RESULTS: The findings indicate that perceived and actual availability facilitate consumers' APF choices across a built food environment. Several barriers/facilitators were associated with APF choices in specific types of built food environments: the way food is presented in produce sections (supermarkets), consumer habits in terms of green and specialty shopping (grocery stores), and mismatches among retailer actions in regard to making APF available in one type of food environment structure (e-commerce) and consumers' preferences for APF being available in other food environment structures (supermarkets, grocery stores). The effect of a barrier/facilitator may depend on the APF type; for example, social norms regarding masculinity were a barrier affecting plant-based APF choices in restaurants, but these norms were not a barrier affecting the choice of insect-based APF in restaurants. CONCLUSIONS: Addressing barriers/facilitators identified in this review will help in developing environment-matching interventions that aim to make alternative proteins mainstream. TRIAL REGISTRATION: PROSPERO database registration: #CRD42023388700.

Sacred space: a qualitative interpretive meta-synthesis of women's experiences of supportive birthing environments.

BACKGROUND: In the United States there are roughly three million births a year, ranging from cesarean to natural births. A major aspect of the birthing process is related to the healing environment, and how that helps or harms healing for the mother and child. Using the theoretical framework, Theory of Supportive Care Settings (TSCS), this study aimed to explore what is necessary to have a safe and sacred healing environment for mothers. METHOD: This study utilized an updated Qualitative Interpretive Meta-synthesis (QIMS) design called QIMS-DTT [deductive theory testing] to answer the research question, What are mother's experiences of environmental factors contributing to a supportive birthing environment within healthcare settings? RESULTS: Key terms were run through multiple databases, which resulted in 5,688 articles. After title and abstract screening, 43 were left for full-text, 12 were excluded, leaving 31 to be included in the final QIMS. Five main themes emerged from analysis: 1) Service in the environment, 2) Recognizing oneself within the birthing space, 3) Creating connections with support systems, 4) Being welcomed into the birthing space, and 5) Feeling safe within the birthing environment. CONCLUSIONS: Providing a warm and welcoming birth space is crucial for people who give birth to have positive experiences. Providing spaces where the person can feel safe and supported allows them to find empowerment in the situation where they have limited control.