Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 181-212). Also available on the Internet.

Background: The Active Commuting Route Environment Scale (ACRES) was developed to study active commuters’ perceptions of their route environments. The overall aims were to assess the measuring properties of the ACRES and study active bicycle commuters’ perceptions of their commuting route environments. Methods: Advertisement- and street-recruited bicycle commuters from Greater Stockholm, Sweden, responded to the ACRES. Expected differences between inner urban and suburban route environments were used to assess criterion-related validity, together with ratings from an assembled expert panel as well as existing objective measures. Reliability was assessed as test-retest reproducibility. Comparisons of ratings between advertisement- and street-recruited participants were used for assessments of representativity. Ratings of inner urban and suburban route environments were used to evaluate commuting route environment profiles. Simultaneous multiple linear regression analyses were used to assess the relation between the outcome variable: whether the route environment hinders or stimulates bicycle-commuting and environmental predictors, such as levels of exhaust fumes, speeds of traffic and greenery, in inner urban areas. Results: The ACRES was characterized by considerable criterion-related validity and reasonable test-retest reproducibility. There was a good correspondence between the advertisement- and street-recruited participants’ ratings. Distinct differences in commuting route environment profiles between the inner urban and suburban areas were noted. Suburban route environments were rated as safer and more stimulating for bicycle-commuting. Beautiful, green and safe route environments seem to be, independently of each other, stimulating factors for bicycle-commuting in inner urban areas. On the other hand, high levels of exhaust fumes and traffic congestion, as well as low ‘directness’ of the route, seem to be hindering factors. Conclusions: The ACRES is useful for assessing bicyclists’ perceptions of their route environments. A number of environmental factors related to the route appear to be stimulating or hindering for bicycle commuting. The overall results demonstrate a complex research area at the beginning of exploration. / BAKGRUND: Färdvägsmiljöer kan tänkas påverka människors fysiskt aktiva arbetspendling och därmed bidra till bättre folkhälsa. Studier av färdvägsmiljöer är därför önskvärda för att öka förståelsen kring möjliga samband mellan fysiskt aktiv arbetspendling och färdvägsmiljöer. En enkät, ”The Active Commuting Route Environment Scale” (ACRES), har därför skapats i syfte att studera fysiskt aktiva arbetspendlares upplevelser av sina färdvägsmiljöer. Huvudsyftet med denna avhandling var dels att studera enkätens psykometriska egenskaper i form av validitet och reliabilitet, dels att studera arbetspendlande cyklisters upplevelser av sina färdvägsmiljöer. METODER: Arbetspendlande cyklister från Stor-Stockholm rekryterades via tidningsannonsering och via direkt kontakt i anslutning till färdvägen. Deltagarna besvarade enkäten ACRES. Tillsammans med skattningar från en grupp av experter och redan existerande objektiva mått användes förväntade skillnader mellan färdvägsmiljöer i inner- och ytterstaden för att studera kriterierelaterad validitet. Reliabiliteten studerades som reproducerbarhet via upprepade mätningar (test-retest). Jämförelser mellan skattningar av deltagare rekryterade via annonsering och via direkt kontakt i färdvägsmiljöer användes för att studera representativitet. Skattningar av färdvägsmiljöer i inner- och ytterstaden användes vidare för att studera färdvägsmiljöprofiler. Multipel linjär regressionsanalys användes även för att studera sambandet mellan utfallsvariabeln huruvida färdvägsmiljön motverkar eller stimulerar arbetspendling med cykel och miljöprediktorer, såsom avgasnivåer, trafikens hastighet och grönska, i innerstadsmiljöer. RESULTAT: Enkäten ACRES visade god kriterierelaterad validitet och rimlig reproducerbarhet. Det var en god överrensstämmelse mellan skattningar av deltagare rekryterade via annonsering och via direkt kontakt. Färdvägsmiljöprofilerna visade tydliga skillnader mellan inner- och ytterstadsmiljöer. Ytterstadens färdvägsmiljöer skattades som tryggare och mer stimulerande för arbetspendling med cykel än innerstadens färdvägsmiljöer. Vidare verkar vackra, gröna och trygga färdvägsmiljöer, oberoende av varandra, vara stimulerade faktorer för arbetspendling med cykel i innerstadsmiljöer. Däremot verkar höga avgasnivåer, höga trängselnivåer och färdvägar som kräver många riktningsändringar vara motverkande faktorer. SLUTSATSER: Enkäten ACRES är ett användbart instrument vid mätningar av cyklisters upplevelser av sina färdvägsmiljöer. Ett antal faktorer relaterade till färdvägsmiljön verkar vara stimulerande respektive motverkande för arbetspendling med cykel. Generellt sett på visar resultaten ett relativt outforskat och komplext forskningsområde. / Faap-projektet "Fysiskt aktiv arbetspendling i Stor-Stockholm"

Increasing population levels of physical activity is a key public health priority in combating chronic non-communicable diseases. Epidemiological evidence for the health benefits of moderate-intensity physical activity has aroused interest in active transport, particularly walking. Social ecological models, and specifically policy and environmental approaches to increasing active transport are core elements of public health goals. There is currently limited walking for transport data in Australia that can be analysed using public health criteria. There is some evidence that socio-demographic differentials may exist. Investigations of the correlates of walking for transport suggest that residents of neighbourhoods with greater population densities, more land use mix, greater street connectivity and better walking and cycling infrastructure, tend to walk and cycle more. The studies in this Thesis start to address some aspects of these knowledge gaps by focussing on the social, personal and environmental correlates of adults’ walking for transport. These studies aim to identify how active commuting and transport options might potentially be used to increase adult levels of health-enhancing physical activity, through increased walking. In doing so, it assists in increasing understanding about ways to link public health policy initiatives more strongly to the transport and urban-design fields, and to other sectors with an interest in active transport. The thesis begins with a literature review of the descriptive epidemiology and correlates of walking for transport. Chapter 2 is a secondary analysis of existing data from a statewide survey of adults. It reports socio-demographic variations in moderate to brisk paced walking for transport, and the contribution of walking for transport to health-enhancing physical activity, separately from walking for recreation. The results showed that rates of sufficient walking for transport using public health criteria (10% for men; 9% for women) were slightly less than those for walking for recreation or exercise (14% for both men and women). Few socio-demographic differences emerged in rates of walking for transport. Men aged over 60 years were significantly less likely to walk for transport. Walking contributed more toward meeting the current public-health guidelines among women (15% to 21%) than among men (6% to 8%). The Thesis then examines relevant issues associated with walking to two discrete destinations, within a defined local-community context. The first destination-type was primary schools (Chapter 3). In this study, the prevalence and duration of walking to and from school, together with perceived influences on doing so, were examined among parents of primary school children. Findings showed that, despite the overall low prevalence of walking to school by parents, health-enhancing benefits may be achieved, even when other modes of transport are used in conjunction with walking. Walking was a common (28%) mode of transport for journeys less than two kilometres. Eighteen percent of parents who travelled by modes other than walking also walked for at least 10 minutes. Significantly greater proportions of parents who walked for at least 10 minutes: had only one car in their household; had a child who attended a government school; did not have a driver’s licence; had 10 years or less of education; and, lived within two kilometres of the school. Factors perceived by parents as influencing walking to and from school were: being physically active; safety concerns for the child walking alone; not having to park; walking being the child’s preferred option; there being too much motor vehicle traffic; and, their child’s age and road sense. The second destination-type examined was tertiary education institutions (Chapter 4). In this study, associations of stages of motivational readiness for active transport with perceived barriers and incentives to walking to and from university among students were examined. Common barriers to walking were long travel distances, inconvenience and time constraints. Common incentives were shorter travel distance, having more time, supportive infrastructure and better security. Those not considering active commuting (pre-contemplators) were significantly more likely to report shorter travel distance as an incentive compared to those in the contemplation-preparation stage. Those in the contemplation-preparation stage were significantly more likely to report lack of motivation, inadequate infrastructure, shorter travel distance and inconvenience as barriers; and, having more time, supportive infrastructure, social support and incentive programs as enablers. Chapter 5 explores ways of linking public health policy initiatives with other sectors. Structured interviews with senior and middle level administrators from public, private and community groups were used to assess perceived barriers and enablers to active transport. Key themes emerged from the study relating to infrastructure delivery, public transport services, walk- and cycle-friendly community attributes, political leadership and government coordination, and societal travel norms and culture. There were also themes relating to limited resources and limited relevant technical expertise, institutional and practitioner cultures, and agencies not identifying with their roles in active transport. Broader intersectoral policies and cross-government initiatives were seen to hold promise, including economic incentives and built environment guidelines, campaigns targeting public attitudes and opinions, and community participation in policy-making. The findings from these studies and the implications for increasing physical activity through walking for transport are discussed in Chapter 6. These findings have potential to be used to inform intervention approaches, study initiatives and future research directions across key sectors for specific subgroups and particular destinations. Physical activity strategies and programs could feasibly be designed within community and organisational settings to increase adults’ rates of participation in walking for transport.

Increasing population levels of physical activity is a key public health priority in combating chronic non-communicable diseases. Epidemiological evidence for the health benefits of moderate-intensity physical activity has aroused interest in active transport, particularly walking. Social ecological models, and specifically policy and environmental approaches to increasing active transport are core elements of public health goals. There is currently limited walking for transport data in Australia that can be analysed using public health criteria. There is some evidence that socio-demographic differentials may exist. Investigations of the correlates of walking for transport suggest that residents of neighbourhoods with greater population densities, more land use mix, greater street connectivity and better walking and cycling infrastructure, tend to walk and cycle more. The studies in this Thesis start to address some aspects of these knowledge gaps by focussing on the social, personal and environmental correlates of adults’ walking for transport. These studies aim to identify how active commuting and transport options might potentially be used to increase adult levels of health-enhancing physical activity, through increased walking. In doing so, it assists in increasing understanding about ways to link public health policy initiatives more strongly to the transport and urban-design fields, and to other sectors with an interest in active transport. The thesis begins with a literature review of the descriptive epidemiology and correlates of walking for transport. Chapter 2 is a secondary analysis of existing data from a statewide survey of adults. It reports socio-demographic variations in moderate to brisk paced walking for transport, and the contribution of walking for transport to health-enhancing physical activity, separately from walking for recreation. The results showed that rates of sufficient walking for transport using public health criteria (10% for men; 9% for women) were slightly less than those for walking for recreation or exercise (14% for both men and women). Few socio-demographic differences emerged in rates of walking for transport. Men aged over 60 years were significantly less likely to walk for transport. Walking contributed more toward meeting the current public-health guidelines among women (15% to 21%) than among men (6% to 8%). The Thesis then examines relevant issues associated with walking to two discrete destinations, within a defined local-community context. The first destination-type was primary schools (Chapter 3). In this study, the prevalence and duration of walking to and from school, together with perceived influences on doing so, were examined among parents of primary school children. Findings showed that, despite the overall low prevalence of walking to school by parents, health-enhancing benefits may be achieved, even when other modes of transport are used in conjunction with walking. Walking was a common (28%) mode of transport for journeys less than two kilometres. Eighteen percent of parents who travelled by modes other than walking also walked for at least 10 minutes. Significantly greater proportions of parents who walked for at least 10 minutes: had only one car in their household; had a child who attended a government school; did not have a driver’s licence; had 10 years or less of education; and, lived within two kilometres of the school. Factors perceived by parents as influencing walking to and from school were: being physically active; safety concerns for the child walking alone; not having to park; walking being the child’s preferred option; there being too much motor vehicle traffic; and, their child’s age and road sense. The second destination-type examined was tertiary education institutions (Chapter 4). In this study, associations of stages of motivational readiness for active transport with perceived barriers and incentives to walking to and from university among students were examined. Common barriers to walking were long travel distances, inconvenience and time constraints. Common incentives were shorter travel distance, having more time, supportive infrastructure and better security. Those not considering active commuting (pre-contemplators) were significantly more likely to report shorter travel distance as an incentive compared to those in the contemplation-preparation stage. Those in the contemplation-preparation stage were significantly more likely to report lack of motivation, inadequate infrastructure, shorter travel distance and inconvenience as barriers; and, having more time, supportive infrastructure, social support and incentive programs as enablers. Chapter 5 explores ways of linking public health policy initiatives with other sectors. Structured interviews with senior and middle level administrators from public, private and community groups were used to assess perceived barriers and enablers to active transport. Key themes emerged from the study relating to infrastructure delivery, public transport services, walk- and cycle-friendly community attributes, political leadership and government coordination, and societal travel norms and culture. There were also themes relating to limited resources and limited relevant technical expertise, institutional and practitioner cultures, and agencies not identifying with their roles in active transport. Broader intersectoral policies and cross-government initiatives were seen to hold promise, including economic incentives and built environment guidelines, campaigns targeting public attitudes and opinions, and community participation in policy-making. The findings from these studies and the implications for increasing physical activity through walking for transport are discussed in Chapter 6. These findings have potential to be used to inform intervention approaches, study initiatives and future research directions across key sectors for specific subgroups and particular destinations. Physical activity strategies and programs could feasibly be designed within community and organisational settings to increase adults’ rates of participation in walking for transport.

This research aims to define and develop a methodology to assist an individual traveller to select healthier and more sustainable transport routes and modes among admissible transport options and highlight the trade-offs among multiple objectives in terms of health, economic, social and environmental benefits. It aims to assist an individual traveller with multi-objectives to make more informed decisions in route and mode planning. The objectives in the case study were identified as personal energy expenditure, travel time, travel cost, CO2 emissions and energy resource consumption concerning sustainability. / This research presents procedures for estimating a range of costs and benefits for journeys; procedures for determining the optimal route for an individual’s trip in an urban area based on cost and benefit estimates and preference weights for specific objectives; procedures for undertaking sensitivity analysis for the optimal route; and uses of the cost and benefit estimation and optimal route generation procedures to conduct a case study for a realistic journey in Melbourne. / An active transport journey planner model was developed in MS Excel to allow users to set constraints for most objectives and give their corresponding weightings, respectively. The recommended transport solution (the least total disutility one) and ranking of other options along with their detailed objective-related information are derived. A case study shows that the methodology developed could be applied in selecting more informed transport solutions based on the user’s multi-objective preferences. In addition, transport options incorporating more cycling and walking have the higher probability to deliver healthier and more sustainable solution to users if social, environmental concerns were considered beyond economic issues. Meanwhile, in sensitivity analysis, the tornado diagrams and spiderplots diagrams are used for demonstrating how sensitive each transport option’s disutility is to the weightings of objectives.

Thesis (Ph. D.)--University of Virginia, 2007. / Includes bibliographical references. Also available online through Digital Dissertations.

Thesis (Ph. D.)--University of Virginia, 2008. / Includes bibliographical references. Also available online through Digital Dissertations.

Thesis (Ph. D.)--University of Virginia, 2007. / Title from title page. Includes bibliographical references. Also available online through Digital Dissertations.

Thesis (Ph. D.)--University of Virginia, 2007. / Includes bibliographical references. Also available online through Digital Dissertations.

abstract: This dissertation was guided by the Ecological Model of Physical Activity and Ecological Model of Obesity and sought to determine the relationship between active transportation (AT), physical activity, and cardiometabolic health among adults and ethnic minority women. Chapter 2 presents an investigation into the relationship between walking for AT and cardiometabolic health among adults through systematic review. Chapter 3 presents an exploration of the cross-sectional relationships of AT and moderate-to-vigorous physical activity (MVPA) with cardiometabolic health among African American (AA) and Hispanic/Latina (HL) women from Texas. Chapter 4 presents an investigation into the cross-sectional relationship of AT on cardiometabolic health and physical activity among primarily HL women. In Chapter 2, walking for AT was found to be related to smaller waist circumference, lower blood pressure, and lower prevalence of abdominal obesity and hypertension, and that differences may exist based on sex. Walking for AT was not clearly defined, and criteria used to determine the presence of cardiometabolic outcomes were inconsistent. No significant relationships between AT and cardiometabolic health were found in Chapter 3 or 4; however, AT users had slightly better cardiometabolic health. AT users had significantly higher levels of self-reported total physical activity compared to those who did not use AT in Chapter 3. Furthermore, a significant relationship was found between MVPA and diastolic blood pressure. Associations differed by ethnicity, with MVPA being inversely related to body fat in both AA and HL women, but to body mass index only in AA women. AT users were found to be seven times more likely to meet 2018 national MVPA recommendations than non-AT users in Chapter 4. Across all studies, measures of AT were subjective and of low quality, potentially limiting the ability to detect significant findings. High quality randomized controlled studies should be conducted using clearly defined, objective measures of AT, and analyzed based on sex and race/ethnicity. Clinicians should recommend AT use to promote meeting MVPA recommendations where appropriate, potentially resulting in improved cardiometabolic health. Policymakers should advocate for changes to the built environment to encourage AT use and MVPA to improve public health. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2019