COVID-19 and working from home-related changes in physical activity in Sydney, Australia.

ISSUES ADDRESSED: Evidence on how COVID-19 lockdowns impacted physical activity (PA) is mixed. This study explores changes in PA following initial mobility restrictions, and their subsequent relaxation, in a sample of Sydney (Australia) residents using a natural experiment methodology. METHODS: Participants' health and travel behaviours were collected pre-pandemic in late 2019 (n = 1937), with follow-up waves during the pandemic in 2020 (n = 1706) and 2021 (n = 1514). Linear mixed-effects models were used to analyse changes in weekly duration of PA between the three waves. RESULTS: Compared with pre-pandemic, average weekly PA increased in 2021 by 42.6 min total PA (p = .001), 16 min walking PA (p = .02), and 26.4 min moderate-vigorous PA (MVPA) (p = .003). However, average weekly sessions of PA decreased in 2020 and remained lower in 2021. For participants who were sufficiently active in 2019, weekly total PA (-66.3 min) MVPA (-43.8 min) decreased in 2020 compared to pre-pandemic. Conversely, among participants who were insufficiently active in 2019, average weekly PA increased in both 2020 (total PA, +99.1 min; walking PA, +46.4 min; MVPA +52.8 min) and 2021 (total PA, +117.8 min; walking PA, +58.4 min; MVPA +59.2 min), compared to 2019. Participants who did more work from home increased their average weekly total PA in 2021 compared to pre-pandemic (+45.3 min). CONCLUSION: These findings reveal the complex variability in PA behaviour brought about by the pandemic. SO WHAT?: Strategies to support the population in achieving sufficient PA must focus on maintaining an appetite for PA as we move out of the pandemic and on promoting more frequent PA sessions.

Assessing tenant health amid social housing redevelopment: lessons from a pilot project.

OBJECTIVES: To trial methods for a future longitudinal study to: a) assess how the redevelopment of a large social housing estate affects the health of tenants; and b) act on health needs identified throughout the redevelopment. Type of program or service: Self-reported health assessment with referral to community-based link worker. METHODS: Participants recruited from the tenant population completed (online or face-to-face) a health questionnaire covering self-reported health status and behaviours, housing conditions, sense of community, and demographics. Those identified as being at moderate/high risk of psychological distress and/or alcohol use disorder were contacted by a community-based link worker, who connected them with health/human services as appropriate. RESULTS: A total of 24 tenants were recruited for the pilot study against a target sample size of 50. The health questionnaire and referral process worked as expected, with no issues reported. LESSONS LEARNT: This pilot study successfully trialled methods for: a) assessing tenants' health; and b) referring those identified as being likely to have unmet health service needs to a community-based link worker, leveraging existing collaborations between academics, the local health district and community groups. Fewer tenants than expected, and none aged younger than 35 years, participated in the survey. Furthermore, the substantial number of suspicious/fraudulent responses was not anticipated. Recruitment and data collection approaches must be reviewed to address these issues if this study is to be scaled up. Although only a pilot project, we connected several tenants who had unmet health needs with a health service. While it is impossible to generalise from our small sample, the number of referrals (one-quarter of participants) indicates a potentially large unmet need for health services in the community. It highlights the importance of link workers or other person-centred integrated care interventions in social housing populations.

Interventions Designed to Support Physical Activity and Disease Prevention for Working from Home: A Scoping Review.

Working from home (WfH) has public health implications including changes to physical activity (PA) and sedentary behavior (SB). We reviewed published and grey literature for interventions designed to support PA or reduce SB in WfH contexts. From 1355 published and grey literature documents since 2010, we screened 136 eligible documents and extracted ten intervention studies. Interventions designed specifically for WfH were limited and included structured exercise programs, infrastructure (e.g., sit-stand workstations), online behavioral and educational programs, health professional advice and peer support, activity trackers and reminder prompts. Evidence of interventions to improve PA and reduce SB in WfH contexts is emergent but lacking in variety and in utilization of local environments to promote good health. Evidence is needed on the adaptation of existing workplace interventions for home environments and exploration of opportunities to support PA through alternative interventions, such as urban planning and recreational strategies.

How equitable are the distributions of the physical activity and accessibility benefits of bicycle infrastructure?

BACKGROUND: Cycling for transport provides many health and social benefits - including physical activity and independent access to jobs, education, social opportunities, health care and other services (accessibility). However, some population groups have less opportunity to reach everyday destinations, and public transport stops, by bicycle - owing in part to their greater aversion to riding amongst motor vehicle traffic. Health equity can therefore be improved by providing separated cycleway networks that give more people the opportunity to access places by bicycle using traffic-free routes. The aim of this study was to assess the health equity benefits of two bicycle infrastructure development scenarios - a single cycleway, and a complete network of cycleways - by examining the distributions of physical activity and accessibility benefits across gender, age and income groups. METHODS: Travel survey data collected from residents in Sydney (Australia) were used to train a predictive transport mode choice model, which was then used to forecast the impact of the two intervention scenarios on transport mode choice, physical activity and accessibility. The latter was measured using a utility-based measure derived from the mode choice model. The distributions of the forecast physical activity and accessibility benefits were then calculated across gender, age and income groups. RESULTS: The modelled physical activity and accessibility measures improve in both intervention scenarios. However, in the single cycleway scenario, the benefits are greatest for the male, high-income and older age groups. In the complete network scenario, the benefits are more equally distributed. Forecast increases in cycling time are largely offset by decreases in walking time - though the latter is typically low-intensity physical activity, which confers a lesser health benefit than moderate-intensity cycling. CONCLUSIONS: Separated cycleway infrastructure can be used to improve health equity by providing greater opportunities for transport cycling in population groups more averse to riding amongst motor vehicle traffic. Disparities in the opportunity to access services and economic/social activities by bicycle - and incorporate more physical activity into everyday travel - could be addressed with connected, traffic-free cycleway networks that cater to people of all genders, ages and incomes.

Associations between the frequency of cycling and domains of quality of life.

ISSUE ADDRESSED: This study examined the association between domains of quality of life (QoL) and the frequency of cycling by men and women. METHOD: A cross-sectional survey of 846 healthy adults in Sydney, Australia measured cycling behaviour and self-reported QoL. Participants were aged 18-55 years and were living within 5km of the centre. Cycling frequency for all purposes was recorded as weekly, less than weekly or never cycling. QoL was measured using the four QoL domains of the WHOQOL-BREF: physical psychological, social and environment. Linear regression was used to assess the association between cycling and QoL. RESULTS: Among men, at least weekly cycling was associated with physical QoL (P=0.002) and any cycling was positively associated with psychological wellbeing (at least weekly P=0.01, less than weekly P=0.01) after adjusting for age, education and income. No significant associations were observed for women. CONCLUSION: Frequent cycling was associated with higher physical and psychological QoL in men, but not among women in this sample. No relationship was observed between cycling and the environment and social QoL domains. SO WHAT?: These findings suggest that cycling offers physical and psychological QoL benefits for men.