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Are children’s perceptions of neighbourhood social environments associated with their walking and physical activity?
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Journal of Science and Medicine in Sport 12 (2009) 637–641
Original paper
Are children’s perceptions of neighbourhood social environments associated with their walking and physical activity? Clare Hume ∗ , Michelle Jorna, Lauren Arundell, Julie Saunders, David Crawford, Jo Salmon Centre for Physical Activity and Nutrition Research, Deakin University, Australia Received 5 December 2007; received in revised form 23 June 2008; accepted 18 July 2008
Abstract This study aimed to examine cross-sectional associations between neighbourhood social environmental factors and physical activity (PA) among Australian primary school children. Baseline data from a large-scale trial among 957 children (48% boys) aged 9–12 years were utilised. Children self-reported their perceptions of the neighbourhood social environment including social networks (e.g. there are lots of other children around to play with), and social capital (e.g. there are lots of people in my area I could go to if I need help). Children also self-reported their weekly walking frequency and PA from which average daily moderate to vigorous PA (MVPA) was calculated. Linear regression analyses examined these associations. Boys performed 17 min/day more MVPA than girls (p < 0.01), and girls performed one extra trip/week than boys (p < 0.001). Children’s perceptions of social capital (p < 0.0001) and social networks (p < 0.01) were both positively associated with MVPA and social capital was positively associated with walking frequency (p < 0.05). These associations were not moderated by the child’s sex. These findings suggest that children who had positive perceptions of neighbourhood social capital and social networks in the neighbourhood, tended to be more physically active. Longitudinal and experimental studies are required to further test the influence of these factors among children. © 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. Keywords: Walking; Health behaviour; Environment; Child; Residence characteristics; Motor activity
1. Introduction Physical activity is recognised to be important for youth health,1 and the promotion of physical activity is a key health priority in most developed countries. As a consequence there has been a large body of research that has been concerned with understanding the determinants of physical activity among youth. Much of this work has been informed by intra- and inter-personal models of health behaviour.2 This research initially focused on psychological (e.g. self-efficacy, intention) or individual-level influences (e.g. sex, age), and proximal social influences (e.g. modelling, social support). Many of these factors were shown to be associated with active behaviours3 and although important, they do not explain a large proportion of the variance in physical activity. Ecological models of behaviour posit that there are multiple levels of influence, including psychological and ∗
Corresponding author. E-mail address: [email protected] (C. Hume).
inter-personal factors, proximal and distal physical environments, as well as policy-level factors.4 The notion of ‘behaviour settings’, which can be defined as the social and physical situations in which behaviours take place,2 is a concept that may be useful in exploring environmental influences on physical activity. For children, key settings for physical activity are likely to include the local neighbourhood.5 Research into neighbourhood-level influences on children’s physical activity is novel. However, a recent review suggests that physical factors in the neighbourhood, such as access to facilities and the presence of sidewalks and controlled intersections are positively associated with children’s physical activity.5 The same review also reported that the number of roads to cross, traffic density and speed and local conditions such as crime and area deprivation were inversely associated with physical activity. While studies incorporating a behavioural settings approach have focused on the neighbourhood’s physical environment, few studies among children have attempted to assess the influence of the social environment on physical activ-
1440-2440/$ – see front matter © 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jsams.2008.07.006
638
C. Hume et al. / Journal of Science and Medicine in Sport 12 (2009) 637–641
ity. Additionally, few studies have investigated these issues from the perspective of the child. Two previous studies have used parent’s perceptions of the environment6,7 ; however, these measures may not accurately capture factors likely to be important to children, such as whether there are other children in their area to play with, or whether children know other people in their neighbourhood. Given differences in physical activity between boys and girls, it is plausible that there may be differences in perceptions of the environment, and this has not been widely investigated. One study among 280 Australian children aged between 9 and 12 years old showed that having friends in walking or cycling distance was positively associated with boys’ objectively measured physical activity, and knowing lots of people and having lots of friends in the area were associated with girls’ walking in bivariate analyses.8 A study among Australian adolescents also suggests that having peers to ‘hang out with’ locally was positively associated with walking and cycling among both boys and girls.9 Therefore, the aims of this study were to (1) examine associations between measures of children’s perceptions of the neighbourhood social environment and their walking and physical activity; (2) to examine whether these associations were moderated by the child’s sex.
2. Methods This study utilised data from the baseline evaluation of a ‘research to practise’ group randomised controlled trial (RCT) examining the effectiveness of a schoolbased physical activity and sedentary behaviour intervention among 9–12-year-old children (48% boys) from Melbourne, Australia. Schools were recruited through an unrelated complimentary fresh fruit school program organised by the local health centre in the western region of metropolitan Melbourne. Of the 35 schools participating in that program, 15 agreed to participate in the RCT. All schools were located in the western region of metropolitan Melbourne. All children in grades 5 and 6 at these schools were invited to participate (n = 1566). Approval to conduct the study was received by the Deakin University Human Research Ethics Committee and the Victorian Department of Education and Training. School principals and parents were also required to provide active consent for children’s participation in the assessment components of the study. Upon returning a signed parental consent form, children each received a physical activity item (a bouncy ball) as compensation. Children completed a self-report survey while at school in the presence of the classroom teacher. A script providing a detailed explanation of items in the survey and responses to possible questions was provided to each class teacher to ensure consistent administration across all schools and classes. Prior to administration, the questionnaire was pilot tested. One-week test re-test reliability of the remaining items was established in a separate sample of children aged 10–12
years (n = 54; 57% boys) to determine whether responses to the items showed significant agreement between test and re-test. 3. Perceptions of the neighbourhood environment In addition to reporting their age and sex, children were asked to respond to 13 items examining their perceptions of the neighbourhood environment that were either newly developed or adapted from existing measures of these factors among children or adults (item sources are described in Table 1). These items examined children’s perceptions of the aesthetics in their neighbourhood as well as their knowledge of the neighbourhood, and their perceptions of their neighbourhood social networks and social capital. Children responded to statements about their neighbourhood on a five-point Likert scale with response options ranging from strongly agree, agree, neither, disagree and strongly disagree, with an additional ‘don’t know’ response option. 4. Walking and physical activity Using a previously validated and reliability tested instrument known as ‘CLASS’10 children self-reported the frequency and duration of their participation in 30 different physical activities (e.g. basketball, dance, walking to school) in a usual week. As per the protocols outlined for that instrument, participation in activities defined as moderate-intensity (18 activities including walking) or vigorous-intensity (12 activities) were determined.10 The total duration of participation in these activities were summed and divided by seven to calculate average daily participation in moderate- and vigorous-intensity physical activity (MVPA). This instrument also contained items regarding walking to/from school, walking for exercise and walking the dog. Children reported the frequency for each of these which were then summed to indicate weekly walking frequency. For items examining perceptions of the environment, responses to each question were collapsed into binary variables to indicate whether children agreed with the statement or not (i.e. strongly agree or agree, compared to all other response options). One-week test re-test reliability was examined on the collapsed variables using the kappa statistic (κ). Results ranged from 0.51 to 0.73, although all items showed good to excellent percent agreement. The items examined children’s perceptions of their social networks (three items), their perceived neighbourhood social capital (six items), and neighbourhood physical environment (four items). Scales for each of these three factors were created by summing the positive (‘strongly agree or agree’) responses to each item. Cronbach’s α was calculated for each scale to determine the internal reliability, with the social capital and social networks scales demonstrating acceptable internal reliability (Cronbach’s α = 0.77 and 0.70, respectively). The scale examining children’s perceptions of the physical environment in their neighbourhood showed poor internal reliability (Cronbach’s
C. Hume et al. / Journal of Science and Medicine in Sport 12 (2009) 637–641
639
Table 1 One-week test re-test reliability of items examining children’s perceptions of the neighbourhood Source Physical environment scale [15] [15] [15] New item Social networks scale [16] [17] [17] Social capital scale [16] [16] [18] [18] [18] [18] a
Variable
κ
p
I know the area I live in very well My area has lots of good places to explore The area I live in has lots of good places to play and be active I like the area I live in
0.60 0.61
0.0001 0.0001
92 82
0.56
0.0001
85
N/A (cons)a
N/A
There are lots of children around to play with I often play in the street with other kids in my area I often visit other kids and families in my area
0.61
0.0001
82
0.64
0.0001
84
0.51
0.0001
76
0.55 0.73 0.61
0.0001 0.0001 0.0001
87 89 80
0.51
0.0001
82
0.54 0.72
0.0001 0.0001
80 89
I know many people in my area I know my neighbours quite well There are lots of people in my area I could go to if I needed help People in this neighbourhood can be trusted This is a close knit neighbourhood People around here are willing to help their neighbours
% agreement
100
Unable to be calculated as variable showed complete agreement between test and re-test.
α = 0.50); therefore this scale was dropped from further analyses. For the physical activity data, the walking variable was significantly skewed positively as a large number of participants reported no walking in a usual week. These data were then grouped into five categories according to the distribution of the data and treated as a continuous variable. The MVPA variable was also positively skewed; therefore a square root transformation was performed prior to analyses to ensure a normal distribution. Descriptive statistics examining the child’s age, the individual environment items and scales, and the physical activity variables (walking trips/day and MVPA min/day) were calculated. t-Tests examined any significant differences by sex for both the predictor and outcome variables. Regression analyses adjusting for clustering by school (the unit of recruitment), were performed to examine cross-sectional associations between children’s perceptions of the neighbourhood social environment and their walking and MVPA. Regression analyses also adjusting for clustering by school and including interaction terms were performed to examine the moderating effects of sex on associations between neighbourhood perceptions and children’s walking and MVPA. All analyses were performed in Stata Version 9.2.
5. Results The characteristics of the sample are shown in Table 2. Nine hundred and fifty-seven participants were recruited to the study (61% response rate); however the final number of participants included in these analyses after accounting for missing data, was 764. On average participants were aged 10.6 (±0.61) years and a similar proportion of boys and girls participated (48% boys). Table 2 shows the weekly walking frequency (trips/week) and participation in MVPA (min/day) among boys and girls. Girls performed significantly more trips/week than boys (1.2 extra trips/week, p < 0.001) and boys participated in significantly more MVPA than girls (23.9 more min/day, p = 0.009). Table 3 shows the associations between children’s perceptions of the social environment in the neighbourhood, and their walking frequency. There were no significant associations between children’s perceptions of social networks and their walking frequency. Perceptions of neighbourhood social capital was significantly associated with walking frequency, with those children reporting a higher perception of social capital, walking more frequently (0.28 trips/week, p = 0.04).
Table 2 Age and descriptive characteristics of children’s physical activity
Age (years) Walking frequency (trips/week) MVPA (min/day) **p ≤ 001, *p ≤ .01.
Boys (n = 368)
Girls (n = 496)
Total (n = 764)
10.7 (±0.62) 4.2 (±4.54)** 136.9 (±100.95)*
10.6 (±0.59) 5.4 (±5.13) 119.8 (±98.19)
10.6 (±0.61) 4.8 (±4.89) 128.1 (±99.83)
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Table 3 Bivariate and multivariable regression analyses examining cross-sectional associations between perceptions of the social environment and children’s walking frequency and MVPA Adjusteda
Unadjusted
Walking frequency (trips/week) Social networks scale Social capital scale MVPA (log min/day) Social networks scale (untransformed min/day) Social capital scale (untransformed min/day) a
Standardised β (95% CI)
Robust standard error
0.04 (−0.11, 0.19) 0.07 (0.01, 0.13) (∼0.3 trips/week)
0.07 0.03
0.58 0.04
– –
– –
– –
0.50 (0.15, 0.85) (∼13 min/day)
0.16
0.009
0.20 (−0.14, 0.54)
0.16
0.22
0.41 (0.25, 0.57) (∼10 min/day)
0.08
0.0001
0.35 (0.23, 0.47) (∼8 min/day)
0.05
0.0001
p
Standardised β (95% CI)
Robust standard error
p
Analyses adjusted for all other significant associations and clustering by school.
Children’s perceptions of the social capital and social networks in their neighbourhood were both positively associated with their MVPA (Table 3). Children who reported a more positive perception of social capital performed approximately 10 min/week extra MVPA (p ≤ 0.0001) and those children who perceived better neighbourhood social networks performed an extra 13 min/day MVPA (p = 0.009). In multiple regression analyses, perceptions of neighbourhood social capital remained significant after adjusting significant predictors from bivariate analyses (approximately 8 extra min/day, p = 0.0001). Sex was not a significant moderator of the associations between children’s perceptions of the social capital or social networks in their neighbourhood and physical activity. 6. Discussion This study aimed to examine associations between the measures of children’s perceptions of their neighbourhood social environment, and their walking and physical activity. This study also examined whether these associations were moderated by the child’s sex. Children’s perceptions of neighbourhood social capital were positively associated with their walking frequency, and their MVPA. The child’s sex did not moderate these associations suggesting these findings are consistent between boys and girls. There are currently very few published scales available to measure children’s perceptions of the neighbourhood social environment, as it relates to physical activity. By taking a child-centred perspective, factors that are firstly, important to them in their neighbourhood environment, and secondly, that may influence their behaviour, can be examined. Previous qualitative research using map drawing techniques highlighted the importance of social interaction as well as factors in the neighbourhood such as green space among children.11,12 The present study is one of the first to incorporate quantitative measures of the neighbourhood social environment to examine associations with children’s physical activity.
In the present study, the two aspects of neighbourhood social environment measured were associated with children’s walking and physical activity. Social capital, a component of the neighbourhood social environment, is often defined as civic engagement or engagement within the community and trust in others, and is therefore termed a communitylevel or ecologic variable.13 Social capital has been widely examined in studies among adults and several positive associations have been shown with health.13 Carver et al.9 found that adolescents who waved to or talked to neighbours, tended to walk more often than other adolescents; however the concept of social capital has not been well defined for children, particularly as questions examining perceptions of trust in neighbours have previously been developed for use in studies among adults. Although the current study found positive associations between social capital and children’s MVPA, further research is needed to better conceptualise and operationalise social capital among children. For example, items used in the current study such as ‘this is a close-knit neighbourhood’ may have been challenging for children conceptually; therefore a better understanding of how children operationalise these terms is required. Children’s perceptions of neighbourhood social networks were also associated with their physical activity in bivariate analyses. Consistent with the present study, Carver and colleagues found that having more peers to hang out with locally was positively associated with adolescents’ walking and cycling.9 Hume et al. reported similar positive associations; for example, having many friends living within walking or cycling distance was associated with increased physical activity among boys.8 Interestingly, the association with social networks found in the present study was only significant for children’s MVPA and not walking. This is in contrast to the associations seen for social capital in this sample and suggests that having a strong social network in the neighbourhood is important for children’s MVPA but may be less important for walking. It may be that children with friends living nearby are more likely to do physical activity with
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them, than to walk to destinations on their own or with family members. Overall, these findings do suggest that targeting neighbourhood social environments may be an important intervention approach, and that programs that encourage children to play with and or visit neighbours, or that promote trust in neighbours, may also promote children’s physical activity. Associations between environmental factors and children’s walking and physical activity were not moderated by the child’s sex in the current study, that is, they were consistent between boys and girls. Interestingly, previous research has typically found different factors are associated with boys and girls’ walking and physical activity,8,14 although moderating analyses were not performed in those studies. It is possible that the differences in perceptions of the neighbourhood are due to differing levels of participation in physical activity typically seen between boys and girls3 ; however further research is needed to better understand these differences. The present study has some limitations which should be acknowledged. Children’s physical activity and walking was self-reported and the error and bias associated with using self-report data, particularly among children, are well documented. Additionally, the instrument used in the present study, like many other self-report instruments, did not show a strong correlation when validated against an objective measure. Future research should consider using objective measures of physical activity to more accurately capture these associations. Participating schools were all recruited from the Western suburbs of metropolitan Melbourne and the generalisability of these findings may be limited to this area. Additionally, the measure of walking in the present study only included walking for three purposes, and as such, may not have been sensitive enough to capture associations with the neighbourhood social environment. 7. Conclusions Findings from this study highlight the importance of the neighbourhood environment for children’s physical activity and they add some weight to the evidence that neighbourhood social environments are associated with children’s walking and physical activity. Future programs focusing on increasing children’s physical activity or preventing declines in activity should incorporate aspects of the neighbourhood social environment. Practical implications • Children who have a positive perception of neighbourhood social capital and social networks in the neighbourhood, tend to be more physically active. • Programs focusing on increasing children’s physical activity or preventing declines in activity should incorporate aspects of the neighbourhood social environment.
641
Acknowledgements The authors would like to thank the schools and participants in the study. David Crawford is funded by the Victorian Health Promotion Foundation and Jo Salmon is funded by the National Heart Foundation of Australia and sanofi-aventis. References 1. Biddle S, Gorely T, Stensel D. Health-enhancing physical activity and sedentary behaviour in children and adolescents. J Sports Sci 2004;22(8):679–701. 2. Sallis JF, Owen N. Physical activity and behavioural medicine. Thousand Oaks: Sage Publications; 1999. 3. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc 2000;32(5):963–75. 4. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q 1988;15(4):351–77. 5. Davison KK, Lawson CT. Do attributes in the physical environment influence children’s physical activity? A review of the literature. Int J Behav Nutr Phys Activity 2006;3:19. 6. Timperio A, Ball K, Salmon J, Roberts R, Giles-Corti B, Simmons D, et al. Personal, family, social, and environmental correlates of active commuting to school. Am J Prev Med 2006;30(1):45–51. 7. Prezza M, Pilloni S, Morabito C, Sersante C, Alparone F, Giuliani M. The influence of psychosocial and environmental factors on children’s independent mobility and relationship to peer frequentation. J Community Appl Soc Psychol 2001;11:435–50. 8. Hume C, Salmon J, Ball K. Associations of children’s perceived neighborhood environments with walking and physical activity. Am J Health Promot 2007;21(3):201–7. 9. Carver A, Salmon J, Campbell K, Baur L, Garnett S, Crawford D. How do perceptions of local neighborhood relate to adolescents’ walking and cycling? Am J Health Promot 2005;20(2):139–47. 10. Telford A, Salmon J, Jolley D, Crawford D. Reliability and validity of a self-report and proxy-report physical activity questionnaire for children: the Children’s Leisure Activities Study Survey (CLASS). Pediat Exerc Sci 2004;16(1):64–78. 11. Hume C, Salmon J, Ball K. Children’s perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: a qualitative and quantitative study. Health Educ Res 2005;20(1):1–13. 12. Veitch J, Bagley S, Ball K, Salmon J. Where do children usually play? A qualitative study of parents’ perceptions of influences on children’s active free-play. Health Place 2006;12(4):383–93. 13. Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health 1997;87(9):1491–8. 14. Timperio A, Crawford D, Telford A, Salmon J. Perceptions about the local neighborhood and walking and cycling among children. Prev Med 2004;38(1):39–47. 15. Rudestam K, Brown P, Zarcadoolas C, Mansell C. Children’s asthma experience and the importance of place. Health (London) 2004;8(4):423–44. 16. Hume C, Ball K, Salmon J. Development and reliability of a self-report questionnaire to examine children’s perceptions of the physical activity environment at home and in the neighbourhood. International Journal of Behavioural Nutrition and Physical Activity 2006;3(16):1–6. 17. Karsten L. It all used to be better? Different generations on continuity and change in urban children’s daily use of space. Children’s Geographies 2005;3(3):275–90. 18. Australian Bureau of Statistics. Measuring Social Capital: Current Collections and Future Directions. Canberra: Australian Bureau of Statistics; 2000.
Journal of Science and Medicine in Sport 12 (2009) 637–641
Original paper
Are children’s perceptions of neighbourhood social environments associated with their walking and physical activity? Clare Hume ∗ , Michelle Jorna, Lauren Arundell, Julie Saunders, David Crawford, Jo Salmon Centre for Physical Activity and Nutrition Research, Deakin University, Australia Received 5 December 2007; received in revised form 23 June 2008; accepted 18 July 2008
Abstract This study aimed to examine cross-sectional associations between neighbourhood social environmental factors and physical activity (PA) among Australian primary school children. Baseline data from a large-scale trial among 957 children (48% boys) aged 9–12 years were utilised. Children self-reported their perceptions of the neighbourhood social environment including social networks (e.g. there are lots of other children around to play with), and social capital (e.g. there are lots of people in my area I could go to if I need help). Children also self-reported their weekly walking frequency and PA from which average daily moderate to vigorous PA (MVPA) was calculated. Linear regression analyses examined these associations. Boys performed 17 min/day more MVPA than girls (p < 0.01), and girls performed one extra trip/week than boys (p < 0.001). Children’s perceptions of social capital (p < 0.0001) and social networks (p < 0.01) were both positively associated with MVPA and social capital was positively associated with walking frequency (p < 0.05). These associations were not moderated by the child’s sex. These findings suggest that children who had positive perceptions of neighbourhood social capital and social networks in the neighbourhood, tended to be more physically active. Longitudinal and experimental studies are required to further test the influence of these factors among children. © 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. Keywords: Walking; Health behaviour; Environment; Child; Residence characteristics; Motor activity
1. Introduction Physical activity is recognised to be important for youth health,1 and the promotion of physical activity is a key health priority in most developed countries. As a consequence there has been a large body of research that has been concerned with understanding the determinants of physical activity among youth. Much of this work has been informed by intra- and inter-personal models of health behaviour.2 This research initially focused on psychological (e.g. self-efficacy, intention) or individual-level influences (e.g. sex, age), and proximal social influences (e.g. modelling, social support). Many of these factors were shown to be associated with active behaviours3 and although important, they do not explain a large proportion of the variance in physical activity. Ecological models of behaviour posit that there are multiple levels of influence, including psychological and ∗
Corresponding author. E-mail address: [email protected] (C. Hume).
inter-personal factors, proximal and distal physical environments, as well as policy-level factors.4 The notion of ‘behaviour settings’, which can be defined as the social and physical situations in which behaviours take place,2 is a concept that may be useful in exploring environmental influences on physical activity. For children, key settings for physical activity are likely to include the local neighbourhood.5 Research into neighbourhood-level influences on children’s physical activity is novel. However, a recent review suggests that physical factors in the neighbourhood, such as access to facilities and the presence of sidewalks and controlled intersections are positively associated with children’s physical activity.5 The same review also reported that the number of roads to cross, traffic density and speed and local conditions such as crime and area deprivation were inversely associated with physical activity. While studies incorporating a behavioural settings approach have focused on the neighbourhood’s physical environment, few studies among children have attempted to assess the influence of the social environment on physical activ-
1440-2440/$ – see front matter © 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jsams.2008.07.006
638
C. Hume et al. / Journal of Science and Medicine in Sport 12 (2009) 637–641
ity. Additionally, few studies have investigated these issues from the perspective of the child. Two previous studies have used parent’s perceptions of the environment6,7 ; however, these measures may not accurately capture factors likely to be important to children, such as whether there are other children in their area to play with, or whether children know other people in their neighbourhood. Given differences in physical activity between boys and girls, it is plausible that there may be differences in perceptions of the environment, and this has not been widely investigated. One study among 280 Australian children aged between 9 and 12 years old showed that having friends in walking or cycling distance was positively associated with boys’ objectively measured physical activity, and knowing lots of people and having lots of friends in the area were associated with girls’ walking in bivariate analyses.8 A study among Australian adolescents also suggests that having peers to ‘hang out with’ locally was positively associated with walking and cycling among both boys and girls.9 Therefore, the aims of this study were to (1) examine associations between measures of children’s perceptions of the neighbourhood social environment and their walking and physical activity; (2) to examine whether these associations were moderated by the child’s sex.
2. Methods This study utilised data from the baseline evaluation of a ‘research to practise’ group randomised controlled trial (RCT) examining the effectiveness of a schoolbased physical activity and sedentary behaviour intervention among 9–12-year-old children (48% boys) from Melbourne, Australia. Schools were recruited through an unrelated complimentary fresh fruit school program organised by the local health centre in the western region of metropolitan Melbourne. Of the 35 schools participating in that program, 15 agreed to participate in the RCT. All schools were located in the western region of metropolitan Melbourne. All children in grades 5 and 6 at these schools were invited to participate (n = 1566). Approval to conduct the study was received by the Deakin University Human Research Ethics Committee and the Victorian Department of Education and Training. School principals and parents were also required to provide active consent for children’s participation in the assessment components of the study. Upon returning a signed parental consent form, children each received a physical activity item (a bouncy ball) as compensation. Children completed a self-report survey while at school in the presence of the classroom teacher. A script providing a detailed explanation of items in the survey and responses to possible questions was provided to each class teacher to ensure consistent administration across all schools and classes. Prior to administration, the questionnaire was pilot tested. One-week test re-test reliability of the remaining items was established in a separate sample of children aged 10–12
years (n = 54; 57% boys) to determine whether responses to the items showed significant agreement between test and re-test. 3. Perceptions of the neighbourhood environment In addition to reporting their age and sex, children were asked to respond to 13 items examining their perceptions of the neighbourhood environment that were either newly developed or adapted from existing measures of these factors among children or adults (item sources are described in Table 1). These items examined children’s perceptions of the aesthetics in their neighbourhood as well as their knowledge of the neighbourhood, and their perceptions of their neighbourhood social networks and social capital. Children responded to statements about their neighbourhood on a five-point Likert scale with response options ranging from strongly agree, agree, neither, disagree and strongly disagree, with an additional ‘don’t know’ response option. 4. Walking and physical activity Using a previously validated and reliability tested instrument known as ‘CLASS’10 children self-reported the frequency and duration of their participation in 30 different physical activities (e.g. basketball, dance, walking to school) in a usual week. As per the protocols outlined for that instrument, participation in activities defined as moderate-intensity (18 activities including walking) or vigorous-intensity (12 activities) were determined.10 The total duration of participation in these activities were summed and divided by seven to calculate average daily participation in moderate- and vigorous-intensity physical activity (MVPA). This instrument also contained items regarding walking to/from school, walking for exercise and walking the dog. Children reported the frequency for each of these which were then summed to indicate weekly walking frequency. For items examining perceptions of the environment, responses to each question were collapsed into binary variables to indicate whether children agreed with the statement or not (i.e. strongly agree or agree, compared to all other response options). One-week test re-test reliability was examined on the collapsed variables using the kappa statistic (κ). Results ranged from 0.51 to 0.73, although all items showed good to excellent percent agreement. The items examined children’s perceptions of their social networks (three items), their perceived neighbourhood social capital (six items), and neighbourhood physical environment (four items). Scales for each of these three factors were created by summing the positive (‘strongly agree or agree’) responses to each item. Cronbach’s α was calculated for each scale to determine the internal reliability, with the social capital and social networks scales demonstrating acceptable internal reliability (Cronbach’s α = 0.77 and 0.70, respectively). The scale examining children’s perceptions of the physical environment in their neighbourhood showed poor internal reliability (Cronbach’s
C. Hume et al. / Journal of Science and Medicine in Sport 12 (2009) 637–641
639
Table 1 One-week test re-test reliability of items examining children’s perceptions of the neighbourhood Source Physical environment scale [15] [15] [15] New item Social networks scale [16] [17] [17] Social capital scale [16] [16] [18] [18] [18] [18] a
Variable
κ
p
I know the area I live in very well My area has lots of good places to explore The area I live in has lots of good places to play and be active I like the area I live in
0.60 0.61
0.0001 0.0001
92 82
0.56
0.0001
85
N/A (cons)a
N/A
There are lots of children around to play with I often play in the street with other kids in my area I often visit other kids and families in my area
0.61
0.0001
82
0.64
0.0001
84
0.51
0.0001
76
0.55 0.73 0.61
0.0001 0.0001 0.0001
87 89 80
0.51
0.0001
82
0.54 0.72
0.0001 0.0001
80 89
I know many people in my area I know my neighbours quite well There are lots of people in my area I could go to if I needed help People in this neighbourhood can be trusted This is a close knit neighbourhood People around here are willing to help their neighbours
% agreement
100
Unable to be calculated as variable showed complete agreement between test and re-test.
α = 0.50); therefore this scale was dropped from further analyses. For the physical activity data, the walking variable was significantly skewed positively as a large number of participants reported no walking in a usual week. These data were then grouped into five categories according to the distribution of the data and treated as a continuous variable. The MVPA variable was also positively skewed; therefore a square root transformation was performed prior to analyses to ensure a normal distribution. Descriptive statistics examining the child’s age, the individual environment items and scales, and the physical activity variables (walking trips/day and MVPA min/day) were calculated. t-Tests examined any significant differences by sex for both the predictor and outcome variables. Regression analyses adjusting for clustering by school (the unit of recruitment), were performed to examine cross-sectional associations between children’s perceptions of the neighbourhood social environment and their walking and MVPA. Regression analyses also adjusting for clustering by school and including interaction terms were performed to examine the moderating effects of sex on associations between neighbourhood perceptions and children’s walking and MVPA. All analyses were performed in Stata Version 9.2.
5. Results The characteristics of the sample are shown in Table 2. Nine hundred and fifty-seven participants were recruited to the study (61% response rate); however the final number of participants included in these analyses after accounting for missing data, was 764. On average participants were aged 10.6 (±0.61) years and a similar proportion of boys and girls participated (48% boys). Table 2 shows the weekly walking frequency (trips/week) and participation in MVPA (min/day) among boys and girls. Girls performed significantly more trips/week than boys (1.2 extra trips/week, p < 0.001) and boys participated in significantly more MVPA than girls (23.9 more min/day, p = 0.009). Table 3 shows the associations between children’s perceptions of the social environment in the neighbourhood, and their walking frequency. There were no significant associations between children’s perceptions of social networks and their walking frequency. Perceptions of neighbourhood social capital was significantly associated with walking frequency, with those children reporting a higher perception of social capital, walking more frequently (0.28 trips/week, p = 0.04).
Table 2 Age and descriptive characteristics of children’s physical activity
Age (years) Walking frequency (trips/week) MVPA (min/day) **p ≤ 001, *p ≤ .01.
Boys (n = 368)
Girls (n = 496)
Total (n = 764)
10.7 (±0.62) 4.2 (±4.54)** 136.9 (±100.95)*
10.6 (±0.59) 5.4 (±5.13) 119.8 (±98.19)
10.6 (±0.61) 4.8 (±4.89) 128.1 (±99.83)
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Table 3 Bivariate and multivariable regression analyses examining cross-sectional associations between perceptions of the social environment and children’s walking frequency and MVPA Adjusteda
Unadjusted
Walking frequency (trips/week) Social networks scale Social capital scale MVPA (log min/day) Social networks scale (untransformed min/day) Social capital scale (untransformed min/day) a
Standardised β (95% CI)
Robust standard error
0.04 (−0.11, 0.19) 0.07 (0.01, 0.13) (∼0.3 trips/week)
0.07 0.03
0.58 0.04
– –
– –
– –
0.50 (0.15, 0.85) (∼13 min/day)
0.16
0.009
0.20 (−0.14, 0.54)
0.16
0.22
0.41 (0.25, 0.57) (∼10 min/day)
0.08
0.0001
0.35 (0.23, 0.47) (∼8 min/day)
0.05
0.0001
p
Standardised β (95% CI)
Robust standard error
p
Analyses adjusted for all other significant associations and clustering by school.
Children’s perceptions of the social capital and social networks in their neighbourhood were both positively associated with their MVPA (Table 3). Children who reported a more positive perception of social capital performed approximately 10 min/week extra MVPA (p ≤ 0.0001) and those children who perceived better neighbourhood social networks performed an extra 13 min/day MVPA (p = 0.009). In multiple regression analyses, perceptions of neighbourhood social capital remained significant after adjusting significant predictors from bivariate analyses (approximately 8 extra min/day, p = 0.0001). Sex was not a significant moderator of the associations between children’s perceptions of the social capital or social networks in their neighbourhood and physical activity. 6. Discussion This study aimed to examine associations between the measures of children’s perceptions of their neighbourhood social environment, and their walking and physical activity. This study also examined whether these associations were moderated by the child’s sex. Children’s perceptions of neighbourhood social capital were positively associated with their walking frequency, and their MVPA. The child’s sex did not moderate these associations suggesting these findings are consistent between boys and girls. There are currently very few published scales available to measure children’s perceptions of the neighbourhood social environment, as it relates to physical activity. By taking a child-centred perspective, factors that are firstly, important to them in their neighbourhood environment, and secondly, that may influence their behaviour, can be examined. Previous qualitative research using map drawing techniques highlighted the importance of social interaction as well as factors in the neighbourhood such as green space among children.11,12 The present study is one of the first to incorporate quantitative measures of the neighbourhood social environment to examine associations with children’s physical activity.
In the present study, the two aspects of neighbourhood social environment measured were associated with children’s walking and physical activity. Social capital, a component of the neighbourhood social environment, is often defined as civic engagement or engagement within the community and trust in others, and is therefore termed a communitylevel or ecologic variable.13 Social capital has been widely examined in studies among adults and several positive associations have been shown with health.13 Carver et al.9 found that adolescents who waved to or talked to neighbours, tended to walk more often than other adolescents; however the concept of social capital has not been well defined for children, particularly as questions examining perceptions of trust in neighbours have previously been developed for use in studies among adults. Although the current study found positive associations between social capital and children’s MVPA, further research is needed to better conceptualise and operationalise social capital among children. For example, items used in the current study such as ‘this is a close-knit neighbourhood’ may have been challenging for children conceptually; therefore a better understanding of how children operationalise these terms is required. Children’s perceptions of neighbourhood social networks were also associated with their physical activity in bivariate analyses. Consistent with the present study, Carver and colleagues found that having more peers to hang out with locally was positively associated with adolescents’ walking and cycling.9 Hume et al. reported similar positive associations; for example, having many friends living within walking or cycling distance was associated with increased physical activity among boys.8 Interestingly, the association with social networks found in the present study was only significant for children’s MVPA and not walking. This is in contrast to the associations seen for social capital in this sample and suggests that having a strong social network in the neighbourhood is important for children’s MVPA but may be less important for walking. It may be that children with friends living nearby are more likely to do physical activity with
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them, than to walk to destinations on their own or with family members. Overall, these findings do suggest that targeting neighbourhood social environments may be an important intervention approach, and that programs that encourage children to play with and or visit neighbours, or that promote trust in neighbours, may also promote children’s physical activity. Associations between environmental factors and children’s walking and physical activity were not moderated by the child’s sex in the current study, that is, they were consistent between boys and girls. Interestingly, previous research has typically found different factors are associated with boys and girls’ walking and physical activity,8,14 although moderating analyses were not performed in those studies. It is possible that the differences in perceptions of the neighbourhood are due to differing levels of participation in physical activity typically seen between boys and girls3 ; however further research is needed to better understand these differences. The present study has some limitations which should be acknowledged. Children’s physical activity and walking was self-reported and the error and bias associated with using self-report data, particularly among children, are well documented. Additionally, the instrument used in the present study, like many other self-report instruments, did not show a strong correlation when validated against an objective measure. Future research should consider using objective measures of physical activity to more accurately capture these associations. Participating schools were all recruited from the Western suburbs of metropolitan Melbourne and the generalisability of these findings may be limited to this area. Additionally, the measure of walking in the present study only included walking for three purposes, and as such, may not have been sensitive enough to capture associations with the neighbourhood social environment. 7. Conclusions Findings from this study highlight the importance of the neighbourhood environment for children’s physical activity and they add some weight to the evidence that neighbourhood social environments are associated with children’s walking and physical activity. Future programs focusing on increasing children’s physical activity or preventing declines in activity should incorporate aspects of the neighbourhood social environment. Practical implications • Children who have a positive perception of neighbourhood social capital and social networks in the neighbourhood, tend to be more physically active. • Programs focusing on increasing children’s physical activity or preventing declines in activity should incorporate aspects of the neighbourhood social environment.
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Acknowledgements The authors would like to thank the schools and participants in the study. David Crawford is funded by the Victorian Health Promotion Foundation and Jo Salmon is funded by the National Heart Foundation of Australia and sanofi-aventis. References 1. Biddle S, Gorely T, Stensel D. Health-enhancing physical activity and sedentary behaviour in children and adolescents. J Sports Sci 2004;22(8):679–701. 2. Sallis JF, Owen N. Physical activity and behavioural medicine. Thousand Oaks: Sage Publications; 1999. 3. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc 2000;32(5):963–75. 4. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q 1988;15(4):351–77. 5. Davison KK, Lawson CT. Do attributes in the physical environment influence children’s physical activity? A review of the literature. Int J Behav Nutr Phys Activity 2006;3:19. 6. Timperio A, Ball K, Salmon J, Roberts R, Giles-Corti B, Simmons D, et al. Personal, family, social, and environmental correlates of active commuting to school. Am J Prev Med 2006;30(1):45–51. 7. Prezza M, Pilloni S, Morabito C, Sersante C, Alparone F, Giuliani M. The influence of psychosocial and environmental factors on children’s independent mobility and relationship to peer frequentation. J Community Appl Soc Psychol 2001;11:435–50. 8. Hume C, Salmon J, Ball K. Associations of children’s perceived neighborhood environments with walking and physical activity. Am J Health Promot 2007;21(3):201–7. 9. Carver A, Salmon J, Campbell K, Baur L, Garnett S, Crawford D. How do perceptions of local neighborhood relate to adolescents’ walking and cycling? Am J Health Promot 2005;20(2):139–47. 10. Telford A, Salmon J, Jolley D, Crawford D. Reliability and validity of a self-report and proxy-report physical activity questionnaire for children: the Children’s Leisure Activities Study Survey (CLASS). Pediat Exerc Sci 2004;16(1):64–78. 11. Hume C, Salmon J, Ball K. Children’s perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: a qualitative and quantitative study. Health Educ Res 2005;20(1):1–13. 12. Veitch J, Bagley S, Ball K, Salmon J. Where do children usually play? A qualitative study of parents’ perceptions of influences on children’s active free-play. Health Place 2006;12(4):383–93. 13. Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health 1997;87(9):1491–8. 14. Timperio A, Crawford D, Telford A, Salmon J. Perceptions about the local neighborhood and walking and cycling among children. Prev Med 2004;38(1):39–47. 15. Rudestam K, Brown P, Zarcadoolas C, Mansell C. Children’s asthma experience and the importance of place. Health (London) 2004;8(4):423–44. 16. Hume C, Ball K, Salmon J. Development and reliability of a self-report questionnaire to examine children’s perceptions of the physical activity environment at home and in the neighbourhood. International Journal of Behavioural Nutrition and Physical Activity 2006;3(16):1–6. 17. Karsten L. It all used to be better? Different generations on continuity and change in urban children’s daily use of space. Children’s Geographies 2005;3(3):275–90. 18. Australian Bureau of Statistics. Measuring Social Capital: Current Collections and Future Directions. Canberra: Australian Bureau of Statistics; 2000.