This study assesses environmental factors in the exercise and food environment, demographic factors, physical activity behavior, and fruit and vegetable consumption in 26 rural Georgia counties. The purpose of the study is to identify environmental indicators of physical activity and fruit and vegetable consumption; to see what agencies in Georgia, if any, are collecting these types of data systematically throughout the state; and, to analyze potential relationships between environmental factors and health behaviors. Physical activity and fruit and vegetable consumption were derived from the Georgia Behavioral Risk Factor Surveillance System (2001, 2002, 2003, and 2005). Demographic data were from the U.S. Census (2000). Environmental data were collected using Reference USA. Analysis was conducted using Pearson’s correlation (one-tailed). No statistically significant associations were found between the food environment and fruit and vegetable consumption nor the exercise environment and physical activity; suggesting associations found in urban areas may not exist in rural areas. Fruit and vegetable consumption was positively associated with travel time to work (P < .05). Physical activity was positively related to travel time to work (P < .01) and education (P < .05) and negatively related to federal spending per person (P < .05). Findings should improve understanding of the relationship between the environment and physical activity and fruit and vegetable consumption in rural GA. Recommendations for improved data collection and interdepartmental cooperation are made.

This research assessed correlations between funding for pedestrian facilities, presence of walkways, and daily and weekly walking trips in a sample of United States residents living in metropolitan areas. The purpose of the research was to identify factors at the policy and environmental level which are associated with a greater frequency of walking trips, and therefore may influence physical activity levels. Data from the U.S. Federal Highway Administration’s 2001 National Household Travel Survey and the Thunderhead Alliance’s 2007 Benchmarking Report: Bicycling and Walking in the U.S. were combined to provide variables for the number of daily and weekly walking trips, perceived lack of walkways, age, distance to work, housing unit density for each household, household income, and per capita federal and non-federal funding for pedestrian facilities for each metropolitan area. Correlation analysis and analysis of variance was conducted to test for associations with walking trip frequency and lack of walkways. The results suggested that increased walking trips were associated with increased non-federal funding but not with increased federal funding; and that increased federal funding was associated with reduced lack of walkways (but not increased non-federal funding), especially for lower-income respondents. These associations were statistically significant but not strong. Very little research has been conducted on the health effects of funding for pedestrian facilities; this research showed that more extensive study in this area is needed and that further integration of public health into transportation planning is in order.

ABSTRACT An Examination of Socio-demographic Characteristics and Perceptions of Cycling among Students at Georgia State University (Under the direction of Christine Stauber, Faculty Member) Background: Bicycling as a form of transportation is important to public health and the improvement of the environment by way of sustainable transportation. Active transportation is inversely related to all-cause mortality, obesity, and levels of ozone and greenhouse gases. University communities have been shown to bicycle more than big cities. However, downtown setting of the Georgia State University (GSU) campus poses unique barriers to bicycling. Methods: A cross-sectional study was conducted in fall, 2009 at GSU. To determine perceptions and barriers to bicycling, the sample was divided into cyclists and non-cyclists. Chi square analysis, odds ratios, and multivariate logistic regression were used to compare the socio-demographic characteristics and perceptions surrounding bicycling between the groups. Results: The survey included 314 students; 60% female, 11.1% bicyclists, and mean age of 23. Of the socio-demographic characteristics examined, gender was the only factor significantly associated with bicycling, with males being 6.82 times more likely to cycle. Independent t-tests found that bicyclists viewed the built environment, social support, and future bicycling support more favorably than non-cyclists. Of the built environment factors, distance was the most important barrier to bicycling (OR=2.156, 95% CI= 1.484-3.133). Cyclists and non-cyclists were in agreement that bicycling was unsafe due to motor vehicle traffic, roadway conditions, and theft risk Conclusions: Overall, the findings were consistent with current knowledge about bicycling. The findings show that distance appears to be the most significant barrier to bicycling. Although safety due to roadway conditions and motor vehicle traffic and risk of bicycle theft did not produce significant results, these factors should be addressed in future studies and/or programs. Further investigation into how to alter these perceptions and create safer environments for the community would be beneficial.

With the increase in Canada’s seniors population (age 65 and over), there is a need to understand the residential requirements of this population. Almost 90 percent of seniors in Ontario reside in urban areas (Hodge 2008) and the majority live in the Greater Toronto Area. Of particular concern is the decrease in availability of informal care for aging and weakening individuals due to changes in economy and family relations. These changes are likely to result in a large influx of seniors into residential care facilities (RCFs) because not everyone is able to stay at home or is eligible to live in a long term care (LTC) facility. Seniors’ reasons for relocating as well as an analysis of their experiences after the move are required as the need for RCFs increases. Cultural and/or religious groups have become important providers of RCFs in Canada by offering necessary services for an aging population. The goal of this thesis is to analyse the importance of culture and the built environment within a push-pull framework associated with the decision to move to an RCF through a case study. The guiding question of the research is: Why do seniors choose facilities with cultural affiliations? In 2013, interviews were conducted with 15 residents, who were currently residing in a Ukrainian RCF called Ivan Franko. The results show that seniors move because of certain limitations (e.g., health, difficulty doing housework, family events, etc.). When an older person decides that they want or need to move, they will move to a facility that provides a physical and social environment while reinforcing cultural values (i.e., built environment), assuming a place is available. Acknowledging the limitations of a qualitative case study approach, the findings are important to consider as the multicultural population of the GTA and other large Canadian cities continue to age. The growing demand for places in RCFs reflects social, cultural and religious needs of a diverse older population. A challenge will exist for cultural and religious not-for-profit voluntary organizations, the for-profit sector, and governments at all levels to seek new ways to develop facilities in the future. / Thesis (Master, Geography) -- Queen's University, 2014-06-19 00:28:54.511

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Background: The high prevalence of children and adolescents not meeting the recommended 60 minutes of physical activity (PA) per day and the associated negative health consequences make it critical to increase PA. Ecological models suggest that the school environment may influence student health behaviour. However, few studies have examined the school environment in relation to student PA. Purpose: To examine between-school variability in students’ time spent in PA, and identify factors of the school built environment that account for the between-school variability in students’ time spent in PA overall as well as by gender and school location, while also considering school physical education (PE) and PA programming and controlling for student-level characteristics and potential environment-level confounders. Methods: This thesis consisted of a secondary data analysis of the School Health Action, Planning and Evaluation System (SHAPES) Ontario project, which included self-report data from administrators and 25,416 students in 76 secondary schools across Ontario. The student- and school-level survey data were supplemented with GIS-derived measures of the built environment within 1-km buffers of the 76 schools. Multilevel modeling was used to examine between-school variability in students’ time spent in PA, as well as environment-level factors associated with PA. Results: There was significant between-school variability in students’ time spent in PA overall as well as by gender and school location, respectively. Schools having another room for PA and schools offering daily PE were positively associated with students’ PA. Schools located in areas with higher land-use mix diversity and walkability were negatively associated with students’ PA. Results of the gender-specific multilevel analyses indicated schools should consider providing another room for PA, especially for offering flexibility activities directed at female students. Schools should also consider offering daily PE to male students in senior grades. Students attending schools in urban and suburban areas that provided another room for PA or were located within close proximity to a shopping mall or fast food outlet spent more time in PA. Conclusions: These findings support the ecological notion that the school environment can influence student PA behaviour. A better understanding of the relationship between the school environment and PA will assist in the development of effective school-based policies, programs and interventions to increase PA.

Cardiovascular disease is the leading cause of premature death in the United States today, and vulnerable populations may be more susceptible to this disease risk. Relocating into a new neighborhood may affect one’s cardiovascular disease risk. Through a socio-ecological framework, this study sought to determine whether changes in one’s interior and exterior built environment had a significant effect on cardiovascular disease risk in Atlanta’s relocated public housing population. Using pre- and post-relocation data from a questionnaire delivered to public housing residents, and built environment assessments from before and after demolition neighborhoods, the results showed residents were significantly more satisfied with their new neighborhoods and residences. However, while the interior built environment improved significantly after relocation, the exterior built environment declined significantly. Further, neither overall health nor cardiovascular disease risk improved significantly after relocation. These results corroborate findings in other public housing research that shows that many former public housing residents do not perceive an improvement in their health after relocation.

Using data from the prospective Black Women's Health Study (BWHS; n=18,525), the impact of neighborhood walkability on incident diabetes and depressive symptomology was assessed. Neighborhood walkability was assessed for BWHS participants residing in Chicago, IL, Los Angeles, CA or New York, New York in 1995, 1997 or 1999 by factor-analyzing 14 components (e.g., sidewalk coverage, number/type of intersections, population/housing density) into a single continuous measure ("neighborhood walkability"), divided into four categories (least walkable, 2nd least walkable, 2nd most walkable, most walkable). Compared to women living in a most walkable neighborhood in 1995, women living in a least walkable neighborhood had a modestly higher hazard of incident diabetes over 16 years of follow-up (IRR=1.06; 95% CI=0.90-1.24) and a higher risk of depressive symptomology, using 1999 and 2005 Center for Epidemiologic Studies (CES-D) scores (CES-D≥16: RR=1.02, 95% CI=0.94-1.11; CES-D≥25: RR=1.18, 95% CI=1.02-1.37). Associations with incident diabetes were strongest among women who resided in a higher SES neighborhood, among the healthiest women (lowest body mass index, most frequent vigorous exercise), and when follow-up was lagged four or 10 years, while associations with depressive symptomology were strongest among women who resided in Los Angeles, who engaged in no vigorous activity at baseline, or who averaged less than one per hour travelling in a car or bus. Neighborhood walkability and neighborhood socioeconomic status (SES) were strongly inversely related; disentangling these two aspects is a methodological challenge to assessing the health impact of the built environment. In a subset of 3,000 addresses, neighborhood walkability in 1999 was highly positively correlated (r=0.70) with WalkScore® (a free, publicly-available measure relying upon walking distances to specified amenities) in 2012-13. Neighborhood walkability and WalkScore® were both valid measures of neighborhood walkability, best gauged using total length of bus routes, number of intersections, and total sidewalk length. WalkScore® has the potential to serve as a "standard" neighborhood walkability measure, allowing easier comparison of the health impact of the built environment across many studies.

Society is at an energy crossroads today. How will our global economy become sustainable for future generations? For today's global organizations can the right thing and the profitable thing be the same thing? Can (or should) successful organizations improve the human condition? Worldwide, buildings account for 17 per cent of fresh water withdrawals, 25 per cent of wood harvest, 33 per cent of CO2 emissions and 40 per cent of material and energy use. Integrated 'green' and sustainable building design is being heralded as the fastest route to ecological modern buildings in Europe, North America and Asia (United States Green Building Council, 2008). On average North Americans spend 90 per cent (United States Environmental Protection Agency, 2009) of their time indoors, a large portion of this time in commercial buildings. Furthermore, salaries and wages account for approximately 90 per cent (Romm and Browning, 1994) of an organization's building-related expenses. However, in our rush to create 'green' and sustainable North American commercial buildings and a laser-like focus on reducing carbon footprints and reducing energy costs have we lost sight of the purpose of the commercial building which is the generation of wealth through the productivity of the commercial building occupant and by extension the occupant's organization. For if any slight increase or if any slight decrease in occupant and organizational productivity can be proven this would easily justify or (un)justify respectively most if not all North American commercial building sustainability initiatives as 'productivity is the fundamental economic measure of a technology's contribution' (Brynjolfsson, 1994). In other words have we increased or at a minimum maintained occupant and organizational productivity as we move our North American commercial building occupants and organizations into these newly created enhanced 'green' and sustainable structures with their new or enhanced 'green' and sustainable systems, processes and designs. The originality of the research will be in the linking of these two distinct areas namely; organizational productivity to North American commercial building 'green' and sustainability initiatives. Furthermore, through the mixed-methods research methodology approach we will attempt to develop new knowledge and findings as we implement measureable 'green' and sustainable strategies into comparative North American commercial building research settings.

Master of Public Health / Department of Kinesiology / Katie M. Heinrich / Introduction: Transportation-related physical activity can help adults can meet moderate physical activity guidelines. Only 52% of United States adults meet the physical activity guidelines on a regular basis. Active transportation (AT) is a healthier alternative to motorized transport and incorporates more physical activity into one’s day. Universities with supportive built environment features, such as pedestrian and bicycling infrastructure and amenities, can support AT choices. This study was conducted to (1) examine differences in the overall physical activity and AT behaviors of university students, faculty and staff in 2008 and 2016; and (2) explore influential factors for transportation choice and perceptions of the campus built environment in 2016. Physical activity and AT behaviors were hypothesized to be greater in 2016 than 2008 due to changes in supportive built environment features on campus. Methods: All students, faculty and staff members at Kansas State University’s Manhattan campus were eligible to participate in this repeated cross-sectional study by completing a survey in 2008 and 2016. Similar survey questions were asked both years to allow for comparisons. Questions asked about physical activity levels, transportation modes, factors influencing mode choice, and (in 2016) written feedback regarding built environment changes on campus and additional changes needed. After dichotomizing responses by role (students or faculty/staff), independent samples t-tests were used to assess differences in physical activity and transportation modes between survey years. The most influential reasons for transportation mode in 2016 were identified and compared by role. Multiple linear regression models were used to predict variance within each transportation mode. Themes were identified within the written feedback. Results: In spring 2016, 1006 participants (815 students, 80 faculty, and 111 staff members) completed the survey. This compared to 800 participants in spring 2008 (368 students, 256 faculty, and 176 staff members). There was a significant difference for greater moderate but not vigorous physical activity for both students and faculty/staff in 2016 than 2008. Days per week of driving, biking, and other transportation were significantly greater for students, while driving, walking, and biking were significantly greater for faculty/staff in 2016 than 2008. For students, linear regression predicted 21.4% of the variance for driving, 14.7% of walking, and 5.4% of biking for transport. Strongest predictors for students were: health benefits (β = -0.27) and time constraints (β = 0.21) for driving, traffic congestion (β = 0.19) and length of time frequenting campus (β = -0.17) for walking, and safety concerns for crime (β = -0.26) for biking. For faculty/staff, linear regression predicted 23.5% of the variance for driving, 70.3% of walking, 29.8% of biking, and 14.0% of other transport. Strongest predictors for faculty/staff were: time constraints (β = 0.34) and health benefits (β = -0.30) for driving, health benefits (β = 0.28) and time constraints (β = -0.55) for walking, environmental concerns (e.g., pollution; β = 0.35) and safety concerns for crime (β = -0.43) for biking, and weather (β = -0.37) for other transportation. From 436 written responses, main themes for AT influences were: construction (n = 174), parking (n = 128), walking (n = 99), and biking (n = 64). From 403 responses for suggestions for improvements on the commute to campus main themes were: bike lanes (n = 85), sidewalks (n = 29), limits of construction (n = 28), and KSU master plan (n = 26). Conclusions: Time constraints was a key factor for both students and faculty/staff that positively predicted driving and negatively predicted walking behaviors. Few campus built environment features emerged as key predictive factors. Understanding key influences for transportation-related physical activity and commuting behaviors in a university population are useful for health behavior promotion as well as campus planning. Future research should further study the relationship between mode of transportation and other health behaviors in students, faculty, and staff.