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Physical activity in relation to urban environments in 14 cities worldwide : a cross-sectional study

(2016) LANCET. 387(10034). p.2207-2217
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Abstract
Background: Physical inactivity is a global pandemic responsible for over 5 million deaths annually through its effects on multiple non-communicable diseases. We aimed to document how objectively measured attributes of the urban environment are related to objectively measured physical activity, in an international sample of adults. Methods: We based our analyses on the International Physical activity and Environment Network (IPEN) adult study, which was a coordinated, international, cross-sectional study. Participants were sampled from neighbourhoods with varied levels of walkability and socioeconomic status. The present analyses of data from the IPEN adult study included 6822 adults aged 18-66 years from 14 cities in ten countries on five continents. Indicators of walkability, public transport access, and park access were assessed in 1.0 km and 0.5 km street network buffers around each participant's residential address with geographic information systems. Mean daily minutes of moderate-to-vigorous-intensity physical activity were measured with 4-7 days of accelerometer monitoring. Associations between environmental attributes and physical activity were estimated using generalised additive mixed models with gamma variance and logarithmic link functions. Results: Four of six environmental attributes were significantly, positively, and linearly related to physical activity in the single variable models: net residential density (exp[b] 1.006 [95% CI 1.003-1.009]; p=0.001), intersection density (1.069 [1.011-1.130]; p=0.019), public transport density (1.037 [1.018-1.056]; p=0.0007), and number of parks (1.146 [1.033-1.272]; p=0.010). Mixed land use and distance to nearest public transport point were not related to physical activity. The difference in physical activity between participants living in the most and least activity-friendly neighbourhoods ranged from 68 min/week to 89 min/week, which represents 45-59% of the 150 min/week recommended by guidelines. Interpretation: Design of urban environments has the potential to contribute substantially to physical activity. Similarity of findings across cities suggests the promise of engaging urban planning, transportation, and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic.
Keywords
PUBLIC-HEALTH, IPEN ADULT, ACCELEROMETER, COMMUNITIES, INACTIVITY, SCIENCE, DISEASE, LIFE

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MLA
Sallis, James F et al. “Physical Activity in Relation to Urban Environments in 14 Cities Worldwide : a Cross-sectional Study.” LANCET 387.10034 (2016): 2207–2217. Print.
APA
Sallis, J. F., Cerin, E., Conway, T. L., Adams, M. A., Frank, L. D., Pratt, M., Salvo, D., et al. (2016). Physical activity in relation to urban environments in 14 cities worldwide : a cross-sectional study. LANCET, 387(10034), 2207–2217.
Chicago author-date
Sallis, James F, Ester Cerin, Terry L Conway, Marc A Adams, Lawrence D Frank, Michael Pratt, Deborah Salvo, et al. 2016. “Physical Activity in Relation to Urban Environments in 14 Cities Worldwide : a Cross-sectional Study.” Lancet 387 (10034): 2207–2217.
Chicago author-date (all authors)
Sallis, James F, Ester Cerin, Terry L Conway, Marc A Adams, Lawrence D Frank, Michael Pratt, Deborah Salvo, Jasper Schipperijn, Graham Smith, Kelli L Cain, Rachel Davey, Jacqueline Kerr, Poh-Chin Lai, Josef Mitáš, Rodrígo Reis, Olga L Sarmiento, Grant Schofield, Jens Troelsen, Delfien Van Dyck, Ilse De Bourdeaudhuij, and Neville Owen. 2016. “Physical Activity in Relation to Urban Environments in 14 Cities Worldwide : a Cross-sectional Study.” Lancet 387 (10034): 2207–2217.
Vancouver
1.
Sallis JF, Cerin E, Conway TL, Adams MA, Frank LD, Pratt M, et al. Physical activity in relation to urban environments in 14 cities worldwide : a cross-sectional study. LANCET. 2016;387(10034):2207–17.
IEEE
[1]
J. F. Sallis et al., “Physical activity in relation to urban environments in 14 cities worldwide : a cross-sectional study,” LANCET, vol. 387, no. 10034, pp. 2207–2217, 2016.
@article{7253417,
  abstract     = {Background: Physical inactivity is a global pandemic responsible for over 5 million deaths annually through its effects on multiple non-communicable diseases. We aimed to document how objectively measured attributes of the urban environment are related to objectively measured physical activity, in an international sample of adults. 
Methods: We based our analyses on the International Physical activity and Environment Network (IPEN) adult study, which was a coordinated, international, cross-sectional study. Participants were sampled from neighbourhoods with varied levels of walkability and socioeconomic status. The present analyses of data from the IPEN adult study included 6822 adults aged 18-66 years from 14 cities in ten countries on five continents. Indicators of walkability, public transport access, and park access were assessed in 1.0 km and 0.5 km street network buffers around each participant's residential address with geographic information systems. Mean daily minutes of moderate-to-vigorous-intensity physical activity were measured with 4-7 days of accelerometer monitoring. Associations between environmental attributes and physical activity were estimated using generalised additive mixed models with gamma variance and logarithmic link functions. 
Results: Four of six environmental attributes were significantly, positively, and linearly related to physical activity in the single variable models: net residential density (exp[b] 1.006 [95% CI 1.003-1.009]; p=0.001), intersection density (1.069 [1.011-1.130]; p=0.019), public transport density (1.037 [1.018-1.056]; p=0.0007), and number of parks (1.146 [1.033-1.272]; p=0.010). Mixed land use and distance to nearest public transport point were not related to physical activity. The difference in physical activity between participants living in the most and least activity-friendly neighbourhoods ranged from 68 min/week to 89 min/week, which represents 45-59% of the 150 min/week recommended by guidelines. 
Interpretation: Design of urban environments has the potential to contribute substantially to physical activity. Similarity of findings across cities suggests the promise of engaging urban planning, transportation, and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic.},
  author       = {Sallis, James F and Cerin, Ester and Conway, Terry L and Adams, Marc A and Frank, Lawrence D and Pratt, Michael and Salvo, Deborah and Schipperijn, Jasper and Smith, Graham and Cain, Kelli L and Davey, Rachel and Kerr, Jacqueline and Lai, Poh-Chin and Mitáš, Josef and Reis, Rodrígo and Sarmiento, Olga L and Schofield, Grant and Troelsen, Jens and Van Dyck, Delfien and De Bourdeaudhuij, Ilse and Owen, Neville},
  issn         = {0140-6736},
  journal      = {LANCET},
  keywords     = {PUBLIC-HEALTH,IPEN ADULT,ACCELEROMETER,COMMUNITIES,INACTIVITY,SCIENCE,DISEASE,LIFE},
  language     = {eng},
  number       = {10034},
  pages        = {2207--2217},
  title        = {Physical activity in relation to urban environments in 14 cities worldwide : a cross-sectional study},
  url          = {http://dx.doi.org/10.1016/S0140-6736(15)01284-2},
  volume       = {387},
  year         = {2016},
}

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