From walkability to active living potential: an "ecometric" validation study.

BACKGROUND The purpose of this paper is to establish the reliability and validity of a neighborhood-level measure of active living potential by applying principles of ecometrics. METHODS Following a 3-day training session, observers (n =8) were provided with a map of a predetermined walking route constructed through the joining of ten randomly selected street blocks. Then, using an 18-item observation grid, pairs of observers performed ratings of 112 neighborhoods. Resulting observations produced a hierarchically structured data set including 4032 observations nested within observers, which in turn were nested within neighborhoods. Data from the 2001 Canadian census were linked to the neighborhood data. RESULTS Application of ecometric multilevel modeling analyses showed that once interitem and interobserver variability were statistically controlled, about one third of the variability in observations were at the between-neighborhood level. Reliability estimates were 0.78 for items measuring activity-friendliness, 0.76 for safety, and 0.83 for density of destinations. Assessment of the convergent validity of the instrument identified that safety of the environment was positively associated with neighborhood affluence. Density of destinations was negatively associated with affluence and positively associated with higher proportions of persons in the neighborhood walking to work. CONCLUSIONS The three dimensions of the neighborhood active-living potential measure have good reliability and convergent validity and are able to capture between neighborhood differences. Measurement characteristics would have been difficult to ascertain without the ecometrics methodology.

[1]  Richard Killingsworth,et al.  Supporting Health through Design: Challenges and Opportunities , 2003, American journal of health promotion : AJHP.

[2]  D. Stokols Establishing and maintaining healthy environments. Toward a social ecology of health promotion. , 1992, The American psychologist.

[3]  Michael Duncan,et al.  Walking, bicycling, and urban landscapes: evidence from the San Francisco Bay Area. , 2003, American journal of public health.

[4]  Reid Ewing,et al.  Urban sprawl as a risk factor in motor vehicle occupant and pedestrian fatalities. , 2003, American journal of public health.

[5]  A. Roux Investigating Neighborhood and Area Effects on Health , 2001 .

[6]  Anne Vernez Moudon,et al.  Walking and Bicycling: An Evaluation of Environmental Audit Instruments , 2003, American journal of health promotion : AJHP.

[7]  R. Brownson,et al.  Environmental and policy determinants of physical activity in the United States. , 2001, American journal of public health.

[8]  Yuk Fai Cheong,et al.  HLM 6: Hierarchical Linear and Nonlinear Modeling , 2000 .

[9]  D. Stokols Translating Social Ecological Theory into Guidelines for Community Health Promotion , 1996, American journal of health promotion : AJHP.

[10]  B. Giles-Corti,et al.  Relative influences of individual, social environmental, and physical environmental correlates of walking. , 2003, American journal of public health.

[11]  Billie Giles-Corti,et al.  Developing a reliable audit instrument to measure the physical environment for physical activity. , 2002, American journal of preventive medicine.

[12]  Fred Fridinger,et al.  Environmental and Policy Approaches to Cardiovascular Disease Prevention Through Physical Activity: Issues and Opportunities , 1995, Health education quarterly.

[13]  S. Syme,et al.  Promoting Health: Intervention Strategies from Social and Behavioral Research , 2001 .

[14]  B. Giles-Corti,et al.  Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment. , 2002, Preventive medicine.

[15]  J. Gill Hierarchical Linear Models , 2005 .

[16]  Richard J Jackson,et al.  The impact of the built environment on health: an emerging field. , 2003, American journal of public health.

[17]  John J. Chen Communicating complex information: the interpretation of statistical interaction in multiple logistic regression analysis. , 2003, American journal of public health.

[18]  P. Corso,et al.  The effectiveness of interventions to increase physical activity. A systematic review. , 2002, American journal of preventive medicine.

[19]  A. Bauman,et al.  Understanding environmental influences on walking; Review and research agenda. , 2004, American journal of preventive medicine.

[20]  Andrea L Dunn,et al.  Exploring the effect of the environment on physical activity: a study examining walking to work. , 2002, American journal of preventive medicine.

[21]  Allen Dearry,et al.  Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. , 2003, American journal of public health.

[22]  M. Raeini-Sarjaz,et al.  Plant sterols and their derivatives: the current spread of results. , 2009, Nutrition reviews.

[23]  A. Kriska,et al.  The Relationship between Convenience of Destinations and Walking Levels in Older Women , 2003, American journal of health promotion : AJHP.

[24]  Susan L Handy,et al.  How the built environment affects physical activity: views from urban planning. , 2002, American journal of preventive medicine.

[25]  R. Hambleton,et al.  Fundamentals of Item Response Theory , 1991 .

[26]  B. Giles-Corti,et al.  Environmental and Lifestyle Factors Associated with Overweight and Obesity in Perth, Australia , 2003, American journal of health promotion : AJHP.

[27]  L. Dijkstra,et al.  Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany. , 2003, American journal of public health.

[28]  P. O’Campo,et al.  A brief observational measure for urban neighborhoods. , 2001, Health & place.

[29]  J. Prochaska,et al.  Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools. , 2003, American journal of preventive medicine.

[30]  J. Sallis,et al.  Environmental and societal factors affect food choice and physical activity: rationale, influences, and leverage points. , 2009, Nutrition reviews.

[31]  J. Sallis,et al.  Neighborhood-based differences in physical activity: an environment scale evaluation. , 2003, American journal of public health.

[32]  B. Giles-Corti,et al.  The relative influence of individual, social and physical environment determinants of physical activity. , 2002, Social science & medicine.

[33]  F. Bull,et al.  Developing a framework for assessment of the environmental determinants of walking and cycling. , 2003, Social science & medicine.

[34]  A. Bauman,et al.  Environmental and policy interventions to promote physical activity. , 1998, American journal of preventive medicine.

[35]  Anthony S. Bryk,et al.  Hierarchical Linear Models: Applications and Data Analysis Methods , 1992 .

[36]  Pranesh P. Chowdhury,et al.  Places to walk: convenience and regular physical activity. , 2003, American journal of public health.

[37]  J. McGinnis,et al.  Why are some neighborhoods active and others not?Charting a new course for research on the policy and environmental determinants of physical activity , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[38]  ROBERT W. Johnson,et al.  Promoting the maintenance of health behavior change: recommendations for the next generation of research and practice. , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[39]  M. O'Donnell Health Promoting Community Design , 2003, American journal of health promotion : AJHP.

[40]  B Erens,et al.  Measuring the built environment: validity of a site survey instrument for use in urban settings. , 2001, Health & place.

[41]  H. Frumkin Healthy places: exploring the evidence. , 2003, American journal of public health.

[42]  Stephen W. Raudenbush,et al.  1. Ecometrics: Toward a Science of Assessing Ecological Settings, with Application to the Systematic Social Observation of Neighborhoods , 1999 .

[43]  K. Leyden Social capital and the built environment: the importance of walkable neighborhoods. , 2003, American journal of public health.

[44]  G. Galster On the Nature of Neighbourhood , 2001 .

[45]  Shari McMahan,et al.  Increasing the Health Promotive Capacity of Human Environments , 2003, American journal of health promotion : AJHP.

[46]  J. McGinnis,et al.  Making the case for active living communities. , 2003, American journal of public health.

[47]  J. Sallis,et al.  Environmental correlates of walking and cycling: Findings from the transportation, urban design, and planning literatures , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[48]  A. Bandura Social cognitive theory: an agentic perspective. , 1999, Annual review of psychology.

[49]  Lawrence O Gostin,et al.  The built environment and its relationship to the public's health: the legal framework. , 2003, American journal of public health.

[50]  Stephen W. Raudenbush,et al.  The Quantitative Assessment of Neighborhood Social Environments , 2003 .

[51]  Philip Bors,et al.  Reliability and Validity of Two Instruments Designed to Assess the Walking and Bicycling Suitability of Sidewalks and Roads , 2003, American journal of health promotion : AJHP.

[52]  Patricia O'Campo,et al.  Invited commentary: Advancing theory and methods for multilevel models of residential neighborhoods and health. , 2003, American journal of epidemiology.