An Observational Study on Play and Physical Activity Associated with a Recreational Facility-Led Park-Based "Loose Parts" Play Intervention during the COVID-19 Pandemic.

Play is a human right, yet opportunities for unstructured play are declining. The COVID-19 pandemic further reduced children's play opportunities. We conducted an observational study of a novel community-based intervention (play hubs) that facilitated unstructured play by offering loose parts in parks (Calgary, Canada) during the pandemic. Our descriptive study included systematic observation using the System for Observing Children's Activity and Relationships During Play (SOCARP) and Tool for Observing Play Outdoors (TOPO) to capture physical activity, play, and social and environment interactions among children participating in the play hubs for 10-weeks in 2021 (n = 160) and 2022 (n = 147). Play hub attendance was low. Most children observed were aged 5 to 12 years (2021: 93% and 2022 98%), with boys and girls represented (2021: 58% male/42% female and 2022: 52% male/48% female). Standing, sitting, and moderate activity were common activities. Physical, exploratory, and expressive play were common, while digital, bio, and rule-based play were less common. Children typically played alone or in small groups and engaged with loose parts or played in the open spaces. The play hubs encouraged unstructured play and promoted positive social interactions among children, despite the challenges of implementing a community-based intervention under pandemic public health restrictions.

Effectiveness of an 8-Week Physical Activity Intervention Involving Wearable Activity Trackers and an eHealth App: Mixed Methods Study.

BACKGROUND: Health-promotion interventions incorporating wearable technology or eHealth apps can encourage participants to self-monitor and modify their physical activity and sedentary behavior. In 2020, a Calgary (Alberta, Canada) recreational facility developed and implemented a health-promotion intervention (Vivo Play Scientist program) that provided a commercially available wearable activity tracker and a customized eHealth dashboard to participants free of cost. OBJECTIVE: The aim of this study was to independently evaluate the effectiveness of the Vivo Play Scientist program for modifying physical activity and sedentary behavior during the initial 8 weeks of the piloted intervention. METHODS: Our concurrent mixed methods study included a single-arm repeated-measures quasiexperiment and semistructured interviews. Among the 318 eligible participants (≥18 years of age) registered for the program, 87 completed three self-administered online surveys (baseline, T0; 4 weeks, T1; and 8 weeks, T2). The survey captured physical activity, sedentary behavior, use of wearable technology and eHealth apps, and sociodemographic characteristics. Twenty-three participants were recruited using maximal-variation sampling and completed telephone-administered semistructured interviews regarding their program experiences. Self-reported physical activity and sedentary behavior outcomes were statistically compared among the three time points using Friedman tests. Thematic analysis was used to analyze the interview data. RESULTS: The mean age of participants was 39.8 (SD 7.4) years and 75% (65/87) were women. Approximately half of all participants had previously used wearable technology (40/87, 46%) or an eHealth app (43/87, 49%) prior to the intervention. On average, participants reported wearing the activity tracker (Garmin Vivofit4) for 6.4 (SD 1.7) days in the past week at T1 and for 6.0 (SD 2.2) days in the past week at T2. On average, participants reported using the dashboard for 1.6 (SD 2.1) days in the past week at T1 and for 1.0 (SD 1.8) day in the past week at T2. The mean time spent walking at 8 weeks was significantly higher compared with that at baseline (T0 180.34 vs T2 253.79 minutes/week, P=.005), with no significant differences for other physical activity outcomes. Compared to that at baseline, the mean time spent sitting was significantly lower at 4 weeks (T0 334.26 vs T1 260.46 minutes/day, P<.001) and 8 weeks (T0 334.26 vs T2 267.13 minutes/day, P<.001). Significant differences in physical activity and sitting between time points were found among subgroups based on the household composition, history of wearable technology use, and history of eHealth app use. Participants described how wearing the Vivofit4 device was beneficial in helping them to modify physical activity and sedentary behavior. The social support, as a result of multiple members of the same household participating in the program, motivated changes in physical activity. Participants experienced improvements in their mental, physical, and social health. CONCLUSIONS: Providing individuals with free-of-cost commercially available wearable technology and an eHealth app has the potential to support increases in physical activity and reduce sedentary behavior in the short term, even under COVID-19 public health restrictions.

Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults.

There are many health benefits of regular physical activity and improving physical fitness levels can reduce the risk of chronic disease. Accumulating evidence suggests the neighborhood built environment is important for supporting physical activity; however, few studies have investigated the contribution of the neighborhood built environment to fitness levels. We examined the associations between objectively-determined and self-reported neighborhood walkability and overall and specific components of perceived health-related fitness (cardiorespiratory, muscular strength, and flexibility) in a random sample of 592 adults from two areas of Calgary (Canada). Participants provided complete data to an online questionnaire capturing perceived cardiorespiratory fitness (CRF), muscular strength (MST), flexibility, moderate-to-vigorous intensity physical activity (MVPA), resistance training, and sociodemographic characteristics. The questionnaire also captured participant's perceptions of their neighborhood's walkability (Physical Activity Neighborhood Environment Scale; PANES) and the physical activity supportiveness of neighborhood parks (Park Perceptions Index; PPI). Objectively-measured neighborhood walkability was estimated using Walk Score®. The average (SD) age of participants was 46.6 (14.8) years and 67.2% were female. Participants, on average, participated in at least 30-minutes of MVPA on 3.4 (2.1) days/week and undertook resistance training 2.0 (1.8) days/week. Adjusting for covariates, Walk Score® was not associated with any fitness outcomes. Adjusting for covariates, the PANES index was positively associated (p < 0.05) with CRF, MST, flexibility, and overall fitness and the PPI was positively associated (p < 0.05) with all fitness outcomes except MST. Our findings provide novel preliminary evidence suggesting the neighborhood built environment may be important for supporting higher health-related fitness levels in adults.

Differences in transportation and leisure physical activity by neighborhood design controlling for residential choice.

BACKGROUND: Cross-sectional studies provide useful insight about the associations between the built environment and physical activity (PA), particularly when reasons for neighborhood choice are considered. Our study analyzed the relationship between levels of weekly transportation and leisure PA among 3 neighborhood designs, statistically adjusting for sociodemographic characteristics and reasons for neighborhood choice. METHODS: A stratified random sample of adults (age ≥20 years) living in Calgary (Canada) neighborhoods with different neighborhood designs (grid, warped-grid, and curvilinear) and socioeconomic status completed a self-administered questionnaire capturing PA, sociodemographic characteristics, and reasons for neighborhood choice (response rate = 10.1%; n = 1023). Generalized linear models estimated associations between neighborhood design and transportation and leisure PA outcomes (participation (any vs. none) and volume (metabolic equivalent: h/week)), adjusting for neighborhood socioeconomic status, sociodemographic characteristics (gender, age, ethnicity, education, household income, marital status, children, vehicle access, dog ownership, and injury), and reasons for neighborhood choice (e.g., proximity and quality of recreational and utilitarian destinations, proximity to work, highway access, aesthetics, and sense of community). RESULTS: Overall, 854 participants had resided in their neighborhood for at least 12 months and provided complete data. Compared with those living in curvilinear neighborhoods, grid neighborhood participants had greater odds (p < 0.05) of participating in any transportation walking (odds ratio (OR) = 2.17), transportation and leisure cycling (OR = 2.39 and OR = 1.70), active transportation (OR = 2.16), and high-intensity leisure PA (≥6 metabolic equivalent; OR = 1.74), respectively. There were no neighborhood differences in the volume of any transportation or leisure PA undertaken. Adjustment for neighborhood selection had minimal impact on the statistical or practical importance of model estimates. CONCLUSION: Neighborhood design is associated with PA patterns in adults, independent of reasons for neighborhood choice and sociodemographic factors.

Test-Retest Reliability and Walk Score® Neighbourhood Walkability Comparison of an Online Perceived Neighbourhood-Specific Adaptation of the International Physical Activity Questionnaire (IPAQ).

There is a growing public health interest in the contributions of the built environment in enabling and supporting physical activity. However, few tools measuring neighbourhood-specific physical activity exist. This study assessed the reliability of an established physical activity tool (International Physical Activity Questionnaire: IPAQ) adapted to capture perceived neighbourhood-specific physical activity (N-IPAQ) administered via the internet and compared N-IPAQ outcomes to differences in neighbourhood Walk Score®. A sample of n = 261 adults completed an online questionnaire on two occasions at least seven days apart. Questionnaire items captured walking, cycling, moderate-intensity, and vigorous-intensity physical activity, undertaken inside the participant's perceived neighbourhood in the past week. Intraclass correlations, Spearman's rank correlation, and Cohen's Kappa coefficients estimated item test-retest reliability. Regression estimated the associations between self-reported perceived neighbourhood-specific physical activity and Walk Score®. With the exception of moderate physical activity duration, participation and duration for all physical activities demonstrated moderate reliability. Transportation walking participation and duration was higher (p < 0.05) in more walkable neighbourhoods. The N-IPAQ administered online found differences in neighbourhoods that vary in their walkability. Future studies investigating built environments and self-reported physical activity may consider using the online version of the N-IPAQ.

A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence. / Examen de la portée sur les associations entre aménagement urbain et santé : les données quantitatives canadiennes.

INTRODUCTION: Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and quality of life, and injuries in the Canadian adult population. METHODS: From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectively-measured built environment and health conditions in Canadian adults. Studies under-taken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features. RESULTS: Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic condi-tions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for associations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found. CONCLUSION: Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limitations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice.

The Independent Associations between Walk Score® and Neighborhood Socioeconomic Status, Waist Circumference, Waist-To-Hip Ratio and Body Mass Index Among Urban Adults.

Background: Environmental and policy factors can influence weight status via facilitating or discouraging physical activity and healthy diet. Despite mixed evidence, some findings suggest that the neighborhood built environment, including “walkability”, is associated with overweight and obesity. Most of these findings have measured body mass index (BMI), yet other weight status measures including waist circumference (WC) and waist-to-hip (W-H) ratio are also predictive of health outcomes, independent of BMI. Our study aim was to estimate the associations between walkability, measured using Walk Score®, and each of WC, W-H ratio, and BMI among urban Canadian adults. Methods: In 2014, n = 851 adults recruited from 12 structurally and socioeconomic diverse neighborhoods (Calgary, Alberta, Canada) provided complete data on a physical activity, health and demographic questionnaire and self-reported anthropometric measures (i.e., height and weight, WC and hip circumference). Anthropometric data were used to estimate WC, W-H ratio, and BMI which were categorized into low and high risk in relation to their potential adverse effect on health. WC and BMI were also combined to provide a proxy measure of both overall and abdominal adiposity. Multivariable logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between each weight status outcome and Walk Score®. Results: A one-unit increase in Walk Score® was associated with lower odds of being high-risk based on WC (OR = 0.99; 95%CI 0.97⁻0.99). Notably, those residing in socioeconomically disadvantage neighborhoods had significantly higher odds of being high risk based on WC, BMI, and WC-BMI combined compared with advantaged neighborhoods. Conclusions: Interventions that promote healthy weight through the design of neighborhoods that support and enhance the effect of physical activity and diet-related interventions could have a significant population health impact.

Changes in Objectively-Determined Walkability and Physical Activity in Adults: A Quasi-Longitudinal Residential Relocation Study.

Causal evidence for the built environment's role in supporting physical activity is needed to inform land use and transportation policies. This quasi-longitudinal residential relocation study compared within-person changes in self-reported transportation walking, transportation cycling, and overall physical activity during the past 12 months among adults who did and did not move to a different neighbourhood. In 2014, a random sample of adults from 12 neighbourhoods (Calgary, AB, Canada) with varying urban form and socioeconomic status provided complete self-administered questionnaire data (n = 915). Participants, some of whom moved neighbourhood during the past 12 months (n = 95), reported their perceived change in transportation walking and cycling, and overall physical activity during that period. The questionnaire also captured residential self-selection, and sociodemographic and health characteristics. Walk Scores® were linked to each participant's current and previous neighbourhood and three groups identified: walkability "improvers" (n = 48); "decliners" (n = 47), and; "maintainers" (n = 820). Perceived change in physical activity was compared between the three groups using propensity score covariate-adjusted Firth logistic regression (odds ratios: OR). Compared with walkability maintainers, walkability decliners (OR 4.37) and improvers (OR 4.14) were more likely (p < 0.05) to report an increase in their transportation walking since moving neighbourhood, while walkability decliners were also more likely (OR 3.17) to report decreasing their transportation walking since moving. Walkability improvers were more likely than maintainers to increase their transportation cycling since moving neighbourhood (OR 4.22). Temporal changes in neighbourhood walkability resulting from residential relocation appear to be associated with reported temporal changes in transportation walking and cycling in adults.

Associations between aspects of friendship networks, physical activity, and sedentary behaviour among adolescents.

BACKGROUND: Adolescent friendships have been linked to physical activity levels; however, network characteristics have not been broadly examined. METHOD: In a cross-sectional analysis of 1061 adolescents (11-15 years), achieving 60 minutes/day of moderate-to-vigorous physical activity (MVPA) and participating in over 2 hours/day of sedentary behaviour were determined based on friendship network characteristics (density; proportion of active/sedentary friends; betweenness centrality; popularity; clique membership) and perceived social support. RESULTS: Adolescents with no friendship nominations participated in less MVPA. For boys and girls, a ten percent point increase in active friends was positively associated with achievement of 60 minutes/day of MVPA (OR 1.11; 95% CI 1.02-1.21, OR 1.14; 95% CI 1.02-1.27, resp.). For boys, higher social support from friends was negatively associated with achieving 60 minutes/day of MVPA (OR 0.63; 95% CI 0.42-0.96). Compared with low density networks, boys in higher density networks were more likely to participate in over 2 hours/day of sedentary behaviour (OR 2.93; 95% CI 1.32-6.49). Social support from friends also modified associations between network characteristics and MVPA and sedentary behaviour. CONCLUSION: Different network characteristics appeared to have different consequences. The proportion of active close friends was associated with MVPA, while network density was associated with sedentary behaviour. This poses challenges for intervention design.

Associations between familial affluence and obesity risk behaviours among children.

BACKGROUND: Results of studies examining associations between socioeconomic status and obesity among children are mixed. OBJECTIVE: To examine whether physical activity, television viewing, computer use, and fruit, vegetable, soft drink and sweet consumption differed according to familial affluence of children attending schools in disadvantaged communities. METHOD: A total of 218 children (seven to 11 years of age) recruited from three Calgary (Alberta) schools located in two adjacent socioeconomically disadvantaged neighbourhoods completed online surveys during the spring of 2005/2006. The number of days per week participating in vigorous physical activity for more than 20 min, and weekly frequency of fruit, vegetable, sweet and soft drink consumption were collected. Time spent watching television and using a computer during a normal school day was also captured. A family affluence scale was used to assess socioeconomic status (number of family holidays in the past year, ownership of motor vehicles and computers, and bedroom sharing). Associations between familial affluence and obesity risk behaviours were estimated using Pearson's correlation and demographic-adjusted logistic regression ORs. RESULTS: Higher family affluence scale scores were significantly associated with weekly fruit consumption (r=0.14). Children with lower affluence were less likely to participate in vigorous physical activity five days/week or more (OR=0.39), and to use a computer for more than 2 h/day (OR=0.41) than children with higher affluence. Linear trends between familial affluence and the likelihood of participating in physical activity and using a computer were also found. However, no other behaviours were related to affluence. CONCLUSIONS: Increasing opportunities for physical activity and accessibility to healthy food may be important for reducing obesity risk among less affluent children.