Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data.

Farmers' market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets' physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (p = 0.11), bought fewer portions (p = 0.03) and a lesser FV variety (p < 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.

Promoting access to fresh fruits and vegetables through a local market intervention at a subway station.

OBJECTIVE: Alternative food sources (AFS) such as local markets in disadvantaged areas are promising strategies for preventing chronic disease and reducing health inequalities. The present study assessed how sociodemographic characteristics, physical access and fruit and vegetable (F&V) consumption are associated with market use in a newly opened F&V market next to a subway station in a disadvantaged neighbourhood. DESIGN: Two cross-sectional surveys were conducted among adults: (i) on-site, among shoppers who had just bought F&V and (ii) a telephone-based population survey among residents living within 1 km distance from the market. SETTING: One neighbourhood in Montreal (Canada) with previously limited F&V offerings. SUBJECTS: Respectively, 218 shoppers and 335 residents completed the on-site and telephone-based population surveys. RESULTS: Among shoppers, 23 % were low-income, 56 % did not consume enough F&V and 54 % did not have access to a car. Among all participants living 1 km from the market (n 472), market usage was associated (OR; 95 % CI) with adequate F&V consumption (1·86; 1·10, 3·16), living closer to the market (for distance: 0·86; 0·76, 0·97), having the market on the commute route (2·77; 1·61, 4·75) and not having access to a car (2·96; 1·67, 5·26). CONCLUSIONS: When implemented in strategic locations such as transport hubs, AFS like F&V markets offer a promising strategy to improve F&V access among populations that may be constrained in their food acquisition practices, including low-income populations and those relying on public transportation.

Estimating the health benefits of planned public transit investments in Montreal.

BACKGROUND: Since public transit infrastructure affects road traffic volumes and influences transportation mode choice, which in turn impacts health, it is important to estimate the alteration of the health burden linked with transit policies. OBJECTIVE: We quantified the variation in health benefits and burden between a business as usual (BAU) and a public transit (PT) scenarios in 2031 (with 8 and 19 new subway and train stations) for the greater Montreal region. METHOD: Using mode choice and traffic assignment models, we predicted the transportation mode choice and traffic assignment on the road network. Subsequently, we estimated the distance travelled in each municipality by mode, the minutes spent in active transportation, as well as traffic emissions. Thereafter we estimated the health burden attributed to air pollution and road traumas and the gains associated with active transportation for both the BAU and PT scenarios. RESULTS: We predicted a slight decrease of overall trips and kilometers travelled by car as well as an increase of active transportation for the PT in 2031 vs the BAU. Our analysis shows that new infrastructure will reduce the overall burden of transportation by 2.5 DALYs per 100,000 persons. This decrease is caused by the reduction of road traumas occurring in the inner suburbs and central Montreal region as well as gains in active transportation in the inner suburbs. CONCLUSION: Based on the results of our study, transportation planned public transit projects for Montreal are unlikely to reduce drastically the burden of disease attributable to road vehicles and infrastructures in the Montreal region. The impact of the planned transportation infrastructures seems to be very low and localized mainly in the areas where new public transit stations are planned.

Association of implementation of a public bicycle share program with intention and self-efficacy: The moderating role of socioeconomic status.

This natural experiment examines the effect of a public bicycle share program on cognitions and investigates the moderating influence of socioeconomic status on this effect. Two cross-sectional population-based surveys were conducted. Intention and self-efficacy to use the public bicycle share program were assessed by questionnaire. A difference-in-differences approach was adopted using logistic regression analyses. A significant effect of the public bicycle share program was observed on intention (exposure × time; odds ratio = 3.41; 95% confidence interval: 1.50-7.73) and self-efficacy (exposure; odds ratio = 1.61; 95% confidence interval: 1.28-2.01). A positive effect on intention was observed among individuals with low income (exposure × time; odds ratio = 27.85; 95% confidence interval: 2.51-309.25). Implementing a public bicycle share program is associated with increases in intention and self-efficacy for public bicycle share use, although some social inequalities persist.

Implementing a Public Bicycle Share Program: Impact on Perceptions and Support for Public Policies for Active Transportation.

BACKGROUND: Favorable public opinion and support for policies are essential to favor the sustainability of environmental interventions. This study examined public perceptions and support for active living policies associated with implementing a public bicycle share program (PBSP). METHODS: Two cross-sectional population-based telephone surveys were conducted in 2009 and 2010 among 5011 adults in Montréal, Canada. Difference-in-differences analyses tested the impact of the PBSP on negative perceptions of the impact of the PBSP on the image of the city, road safety, ease of traveling, active transportation, health, and resistance to policies. RESULTS: People living closer to docking stations were less likely to have negative perceptions of the effect of the PBSP on the image of the city (OR = 0.5; 95% CI, 0.4-0.8) and to be resistant to policies (OR = 0.8; 95% CI, 0.6-1.0). The likelihood of perceiving negative effects on road safety increased across time (OR = 1.4; 95% CI, 1.2-1.8). Significant interactions were observed for perceptions of ease of traveling (OR = 0.5; 95% CI, 0.4-0.8), active transportation (OR = 0.6; 95% CI, 0.4-1.0), and health (OR = 0.6; 95% CI, 0.4-0.8): likelihood of negative perceptions decreased across time among people exposed. CONCLUSION: Findings indicate that negative perceptions were more likely to abate among those living closer to the PBSP.

Grassroots projects aimed at the built environment: Association with neighbourhood deprivation, land-use mix and injury risk to road users.

OBJECTIVES: 1) To describe grassroots projects aimed at the built environment and associated with active transportation on the Island of Montreal; and 2) to examine associations between the number of projects and indicators of neighbourhood material and social deprivation and the built environment. METHOD: We identified funding agencies and community groups conducting projects on built environments throughout the Island of Montreal. Through website consultation and a snowballing procedure, we inventoried projects that aimed at transforming built environments and that were carried out by community organizations between January 1, 2006, and November 1, 2010. We coded and validated information about project activities and created an interactive map using Geoclip software. Correlational analyses quantified associations between number of projects, neighbourhood characteristics and deprivation. RESULTS: A total of 134 community organizations were identified, and 183 grassroots projects were inventoried. A large number of projects were aimed at increasing awareness of/improving active or public transportation (n=95), improving road safety (n=84) and enhancing neighbourhood beautification and greening (n=69). The correlation between the presence of projects and the extent of neighbourhood material deprivation was small (Kendall's t=0.26, p<0.001), but in areas with greater social deprivation there were more projects (Kendall's t=0.38, p<0.001). Larger numbers of projects were also associated with the presence of more extensive land-use mix (Kendall's t=0.23, p<0.001) and a greater proportion of road intersections with injured pedestrians, cyclists and motor vehicle users (Kendall's t=0.43, p<0.001). CONCLUSION: There is significant community mobilization around built environments and active transportation. Investigations of the implementation processes and impacts are warranted.

The impact of implementing a public bicycle share program on the likelihood of collisions and near misses in Montreal, Canada.

OBJECTIVE: This study aimed to estimate the impact of implementing a public bicycle share program (PBSP) on the likelihood of self-reported collisions and near misses between cyclists and motor vehicles among cyclists living in Montreal. METHODS: A repeated cross sectional design was used. Surveys were conducted at the launch of the PBSP, at the end of the first and second seasons of implementation. Logistic regression estimated changes in the likelihood of reporting collisions or near misses. RESULTS: There was no evidence of a change in likelihood of reporting a collision or near miss after implementing the PBSP. PBSP users were not at a greater risk of reporting a collision (OR=1.53, 95% CI: 0.77-3.02) or near miss (OR=1.37, 95% CI: 0.94-1.98), although confidence intervals were wide. The number of days of cycling per week was associated with collisions (OR=1.27, 95% CI: 1.17-1.39) and near misses (OR=1.34, 95% CI: 1.26-1.42). CONCLUSIONS: There was no evidence of a change in the likelihood of reporting collisions or near misses in Montreal between the implementation of the PBSP and the end of the second season. Time spent cycling was associated with reporting a collision or near miss.

The potential modal shift and health benefits of implementing a public bicycle share program in Montreal, Canada.

BACKGROUND: This study estimated the modal shift associated with the implementation of a public bicycle share program in Montreal, Canada. METHODS: A population-based sample of adults participated in two cross sectional telephone surveys. Self-reported travel behaviors were collected at the end of the first (fall 2009) and second (fall 2010) season of implementation. The sample included 2502 (Mean age=47.8 years, 61.8% female), and 2509 (Mean age=48.9 years, 59.0% female) adult respondents in each survey. RESULTS: The estimated modal shift associated with the implementation of the PBSP from motor vehicle use to walking, cycling, and public transportation was 6483 and 8023 trips in 2009 and 2010. This change represents 0.34% and 0.43% of all motor vehicle trips in Montreal. CONCLUSIONS: The implementation of a PBSP was associated with a shift toward active transportation. The modal shift was complex and not simply the result of a discrete shift from one mode to another. Promotion of active transportation should encourage integration of multiple active transportation modes to better reflect people's actual transportation behaviors.

Impact evaluation of a public bicycle share program on cycling: a case example of BIXI in Montreal, Quebec.

OBJECTIVES: We examined associations between residential exposure to BIXI (BIcycle-taXI)-a public bicycle share program implemented in Montreal, Quebec, in 2009, which increases accessibility to cycling by making available 5050 bicycles at 405 bicycle docking stations-and likelihood of cycling (BIXI and non-BIXI) in Montreal over the first 2 years of implementation. METHODS: Three population-based samples of adults participated in telephone surveys. Data collection occurred at the launch of the program (spring 2009), and at the end of the first (fall 2009) and second (fall 2010) seasons of implementation. Difference in differences models assessed whether greater cycling was observed for those exposed to BIXI compared with those not exposed at each time point. RESULTS: We observed a greater likelihood of cycling for those exposed to the public bicycle share program after the second season of implementation (odds ratio = 2.86; 95% confidence interval = 1.85, 4.42) after we controlled for weather, built environment, and individual variables. CONCLUSIONS: The implementation of a public bicycle share program can lead to greater likelihood of cycling among persons living in areas where bicycles are made available.

Internal consistency, concurrent validity, and discriminant validity of a measure of public support for policies for active living in transportation (PAL-T) in a population-based sample of adults.

Active living is a broad conceptualization of physical activity that incorporates domains of exercise; recreational, household, and occupational activities; and active transportation. Policy makers develop and implement a variety of transportation policies that can influence choices about how to travel from one location to another. In making such decisions, policy makers act in part in response to public opinion or support for proposed policies. Measures of the public's support for policies aimed at promoting active transportation can inform researchers and policy makers. This study examined the internal consistency, and concurrent and discriminant validity of a newly developed measure of the public's support for policies for active living in transportation (PAL-T). A series of 17 items representing potential policies for promoting active transportation was generated. Two samples of participants (n = 2,001 and n = 2,502) from Montreal, Canada, were recruited via random digit dialling. Analyses were conducted on the combined data set (n = 4,503). Participants were aged 18 through 94 years (58% female). The concurrent and discriminant validity of the PAL-T was assessed by examining relationships with physical activity and smoking. To explore the usability of the PAL-T, predicted scale scores were compared to the summed values of responses. Results showed that the internal consistency of the PAL-T was 0.70. Multilevel regression demonstrated no relationship between the PAL-T and smoking status (p > 0.05) but significant relationships with utilitarian walking (p < 0.05) and cycling (p < 0.01) for at least 30 minutes on 5 days/week. The PAL-T has acceptable internal consistency and good concurrent and discriminant validity. Measuring public opinion can inform policy makers and support advocacy efforts aimed at making built environments more suitable for active transportation while allowing researchers to examine the antecedents and consequences of public support for policies.

Use of a new public bicycle share program in Montreal, Canada.

BACKGROUND: Cycling contributes to physical activity and health. Public bicycle share programs (PBSPs) increase population access to bicycles by deploying bicycles at docking stations throughout a city. Minimal research has systematically examined the prevalence and correlates of PBSP use. PURPOSE: To determine the prevalence and correlates of use of a new public bicycle share program called BIXI (name merges the word BIcycle and taXI) implemented in May 2009 in Montreal, Canada. METHODS: A total of 2502 adults were recruited to a telephone survey in autumn 2009 via random-digit dialing according to a stratified random sampling design. The prevalence of BIXI bicycle use was estimated. Multivariate logistic regression allowed for identification of correlates of use. Data analysis was conducted in spring and summer 2010. RESULTS: The unweighted mean age of respondents was 47.4 (SD=16.8) years and 61.4% were female. The weighted prevalence for use of BIXI bicycles at least once was 8.2%. Significant correlates of BIXI bicycle use were having a BIXI docking station within 250 m of home, being aged 18-24 years, being university educated, being on work leave, and using cycling as the primary mode of transportation to work. CONCLUSIONS: A newly implemented public bicycle share program attracts a substantial fraction of the population and is more likely to attract younger and more educated people who currently use cycling as a primary transportation mode.

Making the narrative walk-in-real-time methodology relevant for public health intervention: towards an integrative approach.

The purpose of this article is to describe a novel approach for understanding the subjective experience of being a pedestrian in urban settings. In so doing, we take into account the "experience of the body in movement" as described in different theories and according to different methods, and develop a tool to allow citizens and urban planners to exchange ideas about how to make cities more walkable. Finally, we present the adaptation of the approach for use in public health and provide a rationale for its more widespread use in place and health research.