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“Walkable by Willpower”: Resident perceptions of neighbourhood environments
Health & Place 17 (2011) 895–901
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Health & Place journal homepage: www.elsevier.com/locate/healthplace
‘‘Walkable by Willpower’’: Resident perceptions of neighbourhood environments Genevieve R. Montemurro a, Tanya R. Berry a,n, John C. Spence a, Candace Nykiforuk b, Chris Blanchard c, Nicoleta Cutumisu a a
Faculty of Physical Education and Recreation, E-488 Van Vliet, University of Alberta, Edmonton, AB, Canada T6G 2H9 Centre for Health Promotion Studies, School of Public Health, 5-10 University Terrace, 8303-112 Street, University of Alberta, Edmonton, AB, Canada T6G 2T4 c Department of Medicine, QEII Health Sciences Centre, Centre for Clinical Research, 5790 University Avenue, Dalhousie University, Halifax, NS, Canada B3H 1V7 b
a r t i c l e i n f o
abstract
Article history: Received 21 October 2010 Received in revised form 15 March 2011 Accepted 25 April 2011 Available online 1 May 2011
Resident perceptions of neighbourhood walkability, physical activity opportunities, food choice and factors influencing choice of neighbourhood were examined through focus group discussion in higher and lower walkability neighbourhoods. Almost all participants perceived their neighbourhoods as very or reasonably walkable with high food choice. Walking was described as primarily leisure or exercise focused and less frequenly as destination or task-oriented. Factors influencing walking and physical activity included connectivity, path quality, weather and traffic. The ability to drive easily was a key factor in neighbourhood choice. Our findings identified important environmental factors perceived by residents as either positively or negatively influencing behaviour related to physical activity and food choice. Future research should examine the relationship between perceived and actual walkability features as well as residential selection. & 2011 Elsevier Ltd. All rights reserved.
Keywords: Built environment Environmental perceptions Walking Residential selection
1. Background There is evidence supporting the relationship between the built environment and health behaviours such as physical activity (Duncan et al., 2005; Humpel et al., 2002; Owen et al., 2004; Saelens et al., 2003; Sallis et al., 2004) and food choice (Li et al., 2009; Moore et al., 2009; Moreland et al., 2002a). As such attention is being given to the influence of neighbourhood design in promoting or inhibiting these health behaviours. Central to this discussion is the influence of neighbourhood walkability, that is, how pleasant and easy it is to walk in a neighbourhood. Walkability can be assessed both objectively and through perceptions of the environment. Objective walkability measurement involves quantifying built environment features into indices found to be associated with walking. A frequently used index of objective walkability assesses density, diversity, design and area in retail use (Frank et al., 2010). Objective walkability features are associated with walking and physical activity, body mass index (BMI), food choice and obesity (Frank et al., 2004; Gauvin et al., 2005; Lopez, 2004; Papas et al., 2007; Powell et al., 2007; Sallis et al., 2009; Smith et al., 2008; Spence et al., 2008, 2009; Vandegrift and Yoked, 2004; Wang et al., 2007).
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Corresponding author. Tel.: þ780 492 3280; fax: 780 492 2364. E-mail addresses: [email protected] (G.R. Montemurro), [email protected] (T.R. Berry), [email protected] (J.C. Spence), [email protected] (C. Nykiforuk), [email protected] (C. Blanchard), [email protected] (N. Cutumisu). 1353-8292/$ - see front matter & 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.healthplace.2011.04.010
Perceived walkability is typically measured through selfreport and includes questions related to built environment features such as residential density, proximity and access to stores and facilities (e.g., land-use mix diversity and access), street connectivity, aesthetics, facilities for walking and cycling and safety from traffic and crime (Cerin et al., 2005). Perceived residential density has been linked to physical activity (Atkinson et al., 2005) and perceived traffic linked to BMI (Berry et al., 2010a). Relationships between walking and other perceived environmental attributes such as aesthetics, weather and accessibility have also been demonstrated (Humpel et al., 2004). Studies indicate that different features may affect walking for particular purposes (e.g., exercise versus leisure or transport) in different ways, and among different population groups (Craig et al., 2002; Cerin et al., 2007; Humpel et al., 2004; Lovasi et al., 2008). Research examining agreement between perceived and objective walkability has been somewhat mixed. Australian research has found that residents rated attributes of residential density, land-use mix (access and diversity) and street connectivity consistently higher in high-walkability neighbourhoods than those in low-walkability neighbourhoods (Leslie et al., 2005). Other researchers, however, report poor agreement between perceived and objective walkability (McGinn et al., 2007) and non-concordance among adults based on individual and demographic characteristics (Gebel et al., 2009). A factor complicating the relationship between the built environment and health behaviour is the issue of self-selection, identified as a major limitation to existing research (Boone-Heinonen
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et al., 2011). Central to self-selection is the question of whether walkable environments influence individuals to be active or whether individuals choose neighbourhoods that facilitate existing (active) lifestyles. Research examining neighbourhood and travel preferences showed that those who preferred and lived in a walkable neighbourhood walked the most in comparison to those who preferred and lived in a car dependent neighbourhood (Frank et al., 2007). Recent longitudinal research found that participants who ranked ease of walking as an important neighbourhood choice factor were more likely to have maintained a stable BMI over time compared to those who did not (Berry et al., 2010b). While existing research has primarily examined walkability and related factors through the use of cross-sectional and longitudinal survey data (e.g., Frank et al., 2004; Lee et al., 2009; Sallis et al., 2009), there is an emerging body of research examining these topics qualitatively. Such research has identified important perceived barriers related to personal safety such as crime, dangerous people, traffic, animals, waste (garbage) and risk of falls (Burgoyne et al., 2007; Holt et al., 2009; Lockett et al., 2005). Qualitative researchers have also explored perceived purpose and value of walking and the development of walkable neighbourhoods. Research exploring resident experiences of a walkable community in Ontario, Canada found that residents valued and felt their behaviour was positively influenced by walkability features such as land use diversity (Kaczynski and Sharratt, 2010). Research in the United Kingdom has highlighted the importance of walking purpose and perceived value (Darker et al., 2007). Residents perceived walking as functional mode of transport and not a goal in and of itself or ‘‘proper’’ exercise, citing lack of time as a major barrier to walking for transportation. Research in Alberta, Canada examining key stakeholder perspectives on the development of walkable neighbourhoods revealed shared perception of barriers to health-focused development including economic constraints, existing social norms, attitudes and behaviours (Clark et al., 2010). There is relatively little qualitative research examining perceptions of walkability, physical activity, food choice and neighbourhood selection. Therefore, the purpose of this research was to examine neighbourhood resident’s definitions of walkability, how residents perceive their neighbourhoods for walking, physical activity and food choice, and what factors influence choice of neighbourhood. This examination was done through focus group discussion with residents living in objectively higher and lower walkable neighbourhoods.
2. Methods 2.1. Setting The setting of this study is the capital city of Edmonton in the Western Canadian province of Alberta, home to a growing population within its 684 km2, of over 730,372 inhabitants in 2006 (Statistics Canada, 2007). The median age of the population is 36.1 years, with 21.5% of the population over the age of 60 (Statistics Canada, 2007). The city is a central hub for many employed in Alberta’s oil and gas industry. Edmonton is divided by the North Saskatchewan River and is characterised by an expansive river valley. At 7400 ha, it is the largest stretch of urban parkland in North America, with 22 major parks and over 150 km of trails (City of Edmonton, 2010). A recent survey showed that 58.8% of adult Albertans (59.4% of women and 57.7% of men) are sufficiently active to experience health benefits (Alberta Centre for Active Living, 2009). Edmontonians are frequent car-users with an estimated 79% of the total employed labour force travelling to work by car or truck, 12.7% using transit, 9% walking
or biking and 1.4% using other modes (Statistics Canada, 2007). A 2008 report indicated that, of the people living in the 8 largest central metropolitan areas in Canada, individuals in Edmonton and Calgary were the most likely to have made all trips exclusively by automobile on the reference day (Turcotte, 2008). Seasonally, Edmonton is characterised by cold, snowy winters and warm summers, with average daily temperatures ranging from 11.7 1C in January to 17.5 1C in July (Environment Canada, 2010). 2.2. Participants Participants (N ¼63) were recruited based on participation in a cross-sectional survey in 2008. Those who agreed to future contact were clustered into geographic sampling groups based on objective neighbourhood walkability ranks (5 higher walkability and 6 lower walkability groups) established previously using participant postal codes (see Berry et al., 2010a for a full description of indices). Originally, it was hoped that sampling could be stratified to create four groups based on both neighbourhood walkability and neighbourhood SES (e.g., high walk/low SES, high walk/high SES, low walk/low SES, low walk/high SES); however, due to sampling constraints only neighbourhood walkability was used. As such, neighbourhood level SES ranged for each group. Of these 11 groups, six were comprised of participants from primarily lower to medium SES neighbourhoods, and five comprised of participants from primarily medium to high SES neighbourhoods. A maximum of 14 participants were recruited for each focus group, with final group sizes ranging from 4 to 9 participants. One group with low-turnout (n¼2) was excluded from analysis, leaving a total of 10 groups. 2.3. Data collection The focus group guide was developed through topics predetermined by the research team and during two pilot focus groups (one with graduate research assistants and university staff and the other with residents of Sherwood Park, a municipality sized hamlet 16 km east of Edmonton). Participants were provided with an information sheet in advance of the meeting along with the opportunity to discuss any questions with the researcher. All focus groups were conducted during the winter of 2010 by a researcher trained in qualitative methods and a research assistant. Focus groups were held in neighbourhood community leagues, typically lasting 90 min and were digitally recorded. Ethical clearance for the study was given by the institutional ethics board and all participants provided informed consent. Participants were asked to first define the term ‘walkability’, and were then given the objectively measured walkability rating for their area and asked to reflect on the relative walkability of their neighbourhood. They were asked how they felt their neighbourhood environment influenced physical activity (both personally and among others), and access to healthy, reasonably priced food close to home, as well as reasons for accessing food further away. They were also asked what factors influenced their choice of neighbourhood and for any suggestions concerning neighbourhood improvement related to physical activity and food choice. The focus group guide permitted structured exploration of these questions while remaining open to other related topics that arose. Probes were used where necessary to encourage discussion. 2.4. Data analysis Focus groups were transcribed verbatim and managed electronically using NVivo 2.0 software. Data were analysed using the
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constant comparison method (Strauss and Corbin, 1990). Systematic coding steps of open, axial and selective coding were used. In this strategy, a reciprocal relationship exists between data collection, analysis and theory. Westbrook (1994) suggests that together, these three types of coding follow the progression of a content analysis. Through open coding, conceptual labels were placed on discreet meaning units, which were then classified into categories of higher order. This involved line-by-line and paragraph analysis of focus group transcripts. During axial coding, connections were made between categories and sub-categories. Once axial coding was complete three randomly selected transcripts were coded a second time by the primary coder, and coded independently by the lead researcher to ensure inter- and intracoder reliability. Categories requiring further development or review were then discussed and appropriate coding revisions were made. Analyst triangulation of this kind is recognised as an important verification and validation method to test the consistency of conclusions in qualitative research, adding credibility and confidence (Patton, 2002). This activity was especially relevant as member checking (Lincoln and Guba, 1985) with focus group participants was not possible. The final selective coding stage involved the establishment of a description about the central theme of the study (Influence of the Neighbourhood Environment) and related categories followed by a final validation stage involving a full examination of categories and relationships. Data saturation was a critical principle under consideration. A category is considered at saturation when no new information about it develops out of the data (Westbrook, 1994); through analysis of 10 focus groups, saturation was achieved.
3. Results 3.1. Walkability, walking and physical activity Participants had little difficulty defining and appraising walkability. Proximity to amenities and services, safety, path availability (including sidewalks and crosswalks), as well as natural or green spaces were key features cited. Universal walkability, visibility, aesthetics and seasonal factors were also identified. Almost all participants (regardless of objective categorisation) felt their neighbourhoods were very or reasonably walkable. Only three participants felt their neighbourhoods were not walkable. Leisure, exercise, destination and dog walking were mentioned often across groups with most participants identifying walking as a primarily leisure or exercise focused activity. While access to amenities and services (e.g., grocery stores, physician) were viewed as important, the majority of walking was not destination focused. As one participant stated, ‘‘Well I just walk my dog every day so you know, that’s—I have to get out, I have to walk. But if I’m going to get a coffee or if I’m going to get groceries, I’m not walking.’’ The dominance of car-culture in Edmonton was identified by a number of participants. Discussion ranged from comments about large scale planning, ‘‘We geared ourselves for the car, there’s no doubt about it’’ to increases in multi-car families, ‘‘when I go to subdivisions. They remind me of used car lots’’ to the prevalence of car-use even for short trips, ‘‘but do you really find Edmontonians are walkers? I don’t. I’m embarrassed how much I see my neighbours at the Blockbuster and we’ve all driven and it’s only like a block away.’’ Despite this recognition of frequent car use, almost all participants regularly saw others in their neighbourhood walking or being active, with some stating that this triggered them to be active as well. As one participant explained, ‘‘I can’t help but notice all the people running and rollerblading, walking their dogs, and going into the park. And it’s in my peripheral vision all day, reminding me that I should get outside’’. Neighbourhood sidewalks and paths,
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river valley trails and dog-parks were frequently cited venues for leisure or exercise walking. Participants also mentioned a number of opportunities for physical activity in and outside their neighbourhoods. Health facilities such as the YMCA and City of Edmonton Leisure Centres were mentioned often with many indicating they accessed these venues by car. Vehicle transport meant distance to destinations was less of an issue, with many willing to travel further outside their neighbourhood to access their preferred health facility. As explained by one, ‘‘those are the ones we just choose to go to. They’re not closer because the Y(MCA) would be closer and Londonderry (Leisure Centre) would be closer to us. But I don’t really care for the facilities’’. While participants were quick to recognise the benefit of these venues, some indicated that cost was a prohibitive factor influencing use. As stated by one, ‘‘it’s a big incentive fory if you want to be active. If you have that in your community, it’s very good. But when it comes to payy’’ Community leagues and local playing fields, courts and rinks were also frequently cited as influencing physical activity, especially in relation to children’s sports. These diverse local venues were valued and used by many, as emphasised by one participant, ‘‘each one’s got a slightly different course and plus it’s not that far to gravitate to your next door neighbour, community hall, to take advantage there’’. Despite these benefits, challenges were also associated with these venues. Lack of community organisation to support community league programs (e.g., coordinating volunteers) and low participant turnout negatively influenced community programs for physical activity. Some also indicated that while they knew that programs and activities were likely available, they lacked specific information to get involved. It was also noted that although community venues may exist (e.g., a baseball diamond), they were sometimes unused or mismatched to community needs. This was illustrated by the comment, ‘‘there needs to be kind of an adaptation of the space ’cause there’s lots of opportunity. But if it doesn’t fit the people that are living there, then they’re not going to use it’’. The Edmonton river valley recurred often as a resource that positively influenced physical activity. Participants living in closer proximity were more likely to mention this resource and more frequently indicated accessing it by foot or on a bike. A participant in a group the furthest distance from the river stated, ‘‘I mean the river valley is beautiful but there’s no way to get there on a bikey I mean there is butyyou have to drive there with your bike’’. For many, the river valley provided a venue for activity that made them feel closer to nature and distanced from the undesirable factors associated with residential walking and busy roadways, ‘‘there’s no cars, you’re away from all the smog, all the sounds. And there’s this little hum of the traffic but it’s just a hum and it feels like it’s so far away.’’ Many cited the river valley trail networks as a valuable venue for walking, running and cycling with network connectivity making it easy to access other parts of the river valley and the city. As one described, ‘‘it’s connected north to south, east to west. And if you study it and follow it, it’s functional for that activity if you choose that activity.’’ This notion of individual choice was a recurring theme, with many expressing the belief that despite environmental features, enacting health behaviours was ultimately a matter of personal choice. One participant emphasised this stating her neighbourhood was, ‘‘walkable by willpower’’, while another summarised, ‘‘in terms of walkability—I think you can have a community that is quite walkable but that doesn’t necessarily mean that you’re going to spend a lot of time walking’’. 3.2. Influential factors: connectivity, quality, seasonal conditions and safety While the majority of participants engaged in some type of walking or physical activity in their neighbourhood, specific
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factors were cited repeatedly as influencing behaviour. These were path connectivity and quality, seasonal conditions and safety. In contrast to praise for the connectivity of the river valley trail systems, dissatisfaction with sidewalk connectivity was mentioned often. One participant described frustration with incomplete or poorly-planned sidewalks in her area, ‘‘the sidewalks on the right hand side while the park’s on the left. They have part sidewalks halfway down and it’s mudyIt’s like, did you guys run out of money?’’. Emphasising, ‘‘if you had more paths and made it accessible on both sides that more people would want to walk there’’. Sidewalk quality was also mentioned recurrently with a number of residents citing older cracking, uneven sidewalks, and those without curb cuts as a danger that inhibited walking, ‘‘It’s discouraging because of the heavingyThe sidewalks are seriously sloped, some of them are falling apart. So it’s not a very relaxing thing if you’re tripping or stepping over stuff all the time.’’ Many participants cited the drastic Edmonton winters as a barrier, put plainly by one as, ‘‘the major impediment to activity’’ characterised by summer activity increases, followed by decreases during the winter months, ‘‘I think that’s a big factor there—the numbers seem to drop in the wintertime, people you know, using the facilities or get involved’’. Seasonal influence was mentioned often in relation to sidewalk accessibility where snow and ice covered sidewalks (especially those in need of repair) presented a hazard in the winter months, particularly for those with mobility issues. One elderly woman stated, ‘‘I just reallyy don’t like to be threatening myself.’’ Interestingly a number of participants indicated city-cleared trails and stairways were often very well maintained in the winter months and this facilitated river valley access and use, contributing again to its positive appraisal. Because of the dramatic temperature lows, winter conditions may serve to reinforce car use over walking. Safety was also frequently mentioned, with many citing traffic-related safety as a concern. Key concerns were busy roadways (including main arterial roads through communities), excessive speed, and unsafe crossings. As one participant described, ‘‘you take your life in your hands to cross that streetytalking about walkability, I pretty much would avoid having to cross that. It’s a terrible intersection for speed and traffic and volume of trafficySo would I walk to that? Probably not. I’d drive there.’’ 3.3. Social capital and sense of community Social interaction with neighbours was mentioned repeatedly in connection to neighbourhood walking and local opportunities for physical activity, as one participant noted, ‘‘It’s just a way to get out and meet some of your neighbours ’cause you do get to meet familiar faces when you’re out there’’. A number of participants commented that they often met their neighbours on trails, at dog parks and through community activities, ‘‘if there isya vibrant kind of community activity, then it draws people back out and it gets them involved. And it’s not necessarily recreational but it kind of makes that connection for people’’. The importance of creating social gathering points was emphasised as a way to engage residents and strengthen the community. As one participant stated, ‘‘if everything that people want to go to is outside of their community, then it just becomes where they eat and they sleep and everything else is done outside.’’ 3.4. Planning and development: ideals and suggested improvements Sense of community and fostering opportunities for community interaction and physical activity was also identified in relation to community planning and development. Many valued ‘older neighbourhood’ planning and development features of connectivity and the integration of destinations, green space
and infrastructure for walking and cycling. This suggests that the majority of participants value neighbourhood features typically associated with objective walkability (e.g., diversity and design). One participant explained, ‘‘the concept is that they’re something that draws the people in, to gathering as a community and there’s a sense of community. And you know, when we get out here, like in the suburbs, we don’t have that sense.’’ Participants expressed frustration with ‘newer’ developments that lacked these features, commenting, ‘‘oh, it’s terrible. It’s just house, house, house, house, house all the way down the block and no green belts’’ though some indicated they felt developments were gradually improving with increased planning for walking trails within and between neighbourhoods. Transit planning was also mentioned, with some participants expressing frustration over infrequent buses, lack of service, and long trips. Although the light rail transit system was seen as improving, some noted it was well behind other cities and longer term planning was needed. As stated by one participant, ‘‘if you want people to be more active, if you want people to use public transportycreate the incentives but also the desire’’ emphasising, ‘‘we build all of these satellite communities, we put in roads but they never think about the public transit system as they’re developing these.’’ These same planning and development features were cited as suggestions to improve neighbourhoods with participants listing specific infrastructure features such as path and crosswalk availability and quality, increased venues for physical activity, and improved accessibility through decreased cost, increased information, and increased transit access.
3.5. Food choice Participants listed many inter- and intra-personal as well as macro-level factors influencing food choice strategies and venue choice. Inter- and intra-personal factors included perceived quality, price, time, convenience, specialty tastes and the influence of children. Macro-level, or upstream, factors included economic competition between larger box stores, supermarkets and smaller corner stores, and provincial and national food system industrialisation. As one participant described, ‘‘most of these little stores that specialized in butchers like an actual grocery store, produce store, they’re all disappearing and the big stores are taking over. Because they’ve got the buying power’’. These factors served to drive specific food strategies and venues (e.g., bulk buying at box stores; buying local at farmers markets; buying fast food when time constrained). These findings fit well within the ecological framework developed by Story et al. (2008) who identify four broad levels of influence (individual, social environment, physical environment and macro-level environments), which interact directly and indirectly to influence eating behaviour. The majority of participants perceived they had high food choice, identifying multiple venues nearby, although few accessed these on foot. Although they could reasonably walk to get groceries, carrying purchases home was not feasible for many, as stated by one mother, ‘‘for me to walk to get groceries would be impractical because I have a family of five. I could never carry it all back anyways so it just wouldn’t happen’’. Many indicated that they accessed foods away from home when they were buying bulk, seeking specialty foods or restaurants, or looking for the lowest price. Food choice was rarely a factor that influenced neighbourhood choice, likely because most perceived they had numerous local options within their own and surrounding neighbourhoods, and vehicle use made it easy to access foods further from home. This is congruent with findings by Clark et al. (2010) who reported car dependency in Edmonton was associated with a tendency for people to shop at large grocery stores irrespective of distance from their own neighbourhood, and a perception that
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adding neighbourhood corner stores may not translate into increased use. 3.6. Neighbourhood choice Primary neighbourhood choice factors were location, school proximity, recreation opportunities (including river valley access and walkability features), house or lot itself and affordability. While discussion of school and recreation factors focused primarily on proximity, it is possible the quality of these neighbourhood features was also an important factor (e.g., school quality as an important factor among individuals with school age children). A dominant location related theme was a value on ‘drivability’; the ability to drive easily to multiple destinations outside the neighbourhood. Many participants indicated that vehicle access from their house was an important factor in their decision. As one participant explained, ‘‘the main reason why we moved there is driveability, you know? When we started looking for a house we basically drew a circle around they downtown and it was like, well we can’t be any further west than this, we can’t be any further north than this, we can’t be any further southy’’. Another explained that his neighbourhood choice was a philosophy to live on the periphery of the city centre because, ‘‘you generally are halfway to everywhereyYou’re halfway out, you’re halfway iny and if you’re lucky enoughyyou might be even going against traffic patterns.’’ Other notable factors were green space, sense of community, transit access, family, proximity to work, safety and access to amenities and services.
4. Discussion Regardless of objective neighbourhood walkability classification, almost all participants indicated they perceived their neighbourhoods as very or reasonably walkable. The majority of participants reported engaging in some type of walking, though primarily for leisure or exercise and less often for destination or task-oriented trips. It may be that how residents perceive their neighbourhoods for walking may be as or more important than walkability features themselves. However, it also may be that participants ‘‘adjusted’’ their attitudes regarding walkability features and their own walking behaviour. This is in keeping with cognitive dissonance theory, which argues that people look for consistency among their beliefs and when there is a discrepancy, may alter their attitudes to reconcile the difference (Festinger, 1957; Crano and Prislin, 2006). Others have argued that people may not hold accurate cognitive representations of their environments (Gebel et al., 2009). Thus, participants in our study may have adjusted their beliefs regarding the walkability of their neighbourhoods to match study objectives (i.e., they knew the research was about neighbourhood walkability) or to reconcile with their reasons for living in a given neighbourhood. However, Gebel et al. (2009) reported greater walking, self-efficacy and enjoyment for exercise in participants who lived in objectively low walkable neighbourhoods that were perceived to be highly walkable. These authors also found that low SES participants were more likely to report their environments as low walkable when objectively classified as high walkable. In the current study, focus group participants were recruited by neighbourhood walkability and there were participants from different SES in each group. We were thus unable to examine the finding of Gebel et al. in this study. However, the idea of adjusting beliefs is an intriguing area for future research and should be examined with SES as a possible moderator. Other research has emphasised the complex interplay of both objective and perceived environments. Giles-Corti and Donovan
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(2002) found that while residents in low SES neighbourhoods had better spatial access to recreational facilities, they perceived their neighbourhoods as less conducive to physical activity than those in high SES neighbourhoods. They suggest that environmental features alone may be necessary but insufficient to influence activity, emphasising that individual and social environmental factors must also be addressed. This could be due in part to the ‘urban–suburban paradox’ described by Lopez and Hynes (2006) whereby despite objective features promoting activity, physical inactivity, obesity and related diseases are more prevalent among inner-city than suburban residents. They suggest that factors in the built, physical and social environment in inner-city areas (e.g., infrastructure maintenance, neighbourhood crime) can create environments where outdoor exercise and recreation become unappealing or risky (see also Holt et al., 2009). Decreased destination walking could be due to in part to cultural values of ‘automobility’ (Urry, 2004) where motorised movement, perceived as convenient and fast, favours automobile over active or alternate transport for such trips. Perceived traffic safety may act to discourage destination walking trips along or across busy roadways where stores or services are often located. In these cases, automobility values may prevail, increasing the likelihood of car travel. Recent longitudinal research in Edmonton found the more participants agreed that traffic in their neighbourhood made it unpleasant to walk, the more likely their BMI had increased over 6 years (Berry et al., 2010a). Other safety concerns cited by focus group participants were crime-related, including youth ‘gangs’, drunks and drug activity; however, participants were far more likely to cite traffic over crime safety as influencing activity. Though a recent review found insufficient evidence to conclude that crime-related safety influences physical activity (Foster and Giles-Corti, 2008), it has been suggested that perception of safety may mediate the formation of social capital, where people who are more fearful are less likely to venture into the neighbourhood and socially interact, for recreation or otherwise (Wood et al., 2008). Resident perceptions of community opportunity structures or ‘third’ spaces as important venues for social interaction and social capital were identified in this study and have been reported in other qualitative research (Baum and Palmer, 2002). It is likely that incorporation of multiple destinations (e.g., amenities, services, schools and parks) with adequate connectivity provides a neighbourhood environment favourable to multiple types of walking, with cultural values promoting vehicle use for task-oriented trips. Many participants described walking and physical activity as an intentional behaviour for exercise or leisure, as opposed to activity incorporating daily transportation or tasks (e.g., walking to work or going to the store). These findings are contrary to other qualitative research on walking (Darker et al., 2007) indicating walking was primarily perceived as a functional mode of transport and not for exercise or leisure. While planning and development incorporating traditional features associated with diversity and design were valued by participants, many emphasised individual choice as the ultimate factor deciding whether health behaviours were enacted. This finding echoes other qualitative research in which developers believed the creation of walkable neighbourhoods would not influence walking behaviour among those not already inclined to walk (Clark et al., 2010). However, objective neighbourhood walkability may have influenced participant’s decisions to walk, whether they were aware of it or not. Thus, neighbourhoods with increased destinations and density may have influenced walking, but people who think of walking as a leisure-activity may not perceive having destinations as influencing their behaviour. Clearly, this is an important question that needs further examination.
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It may be that access to places by car (as reflected in the notion of automobility) is a key factor influencing neighbourhood choice for many regardless of activity level, but that those most inclined to walk are those most likely to also include walkability as a consideration when choosing where to live. Frank et al. (2007) reported that individuals who lived and preferred a walkable neighbourhood walked the most, but still drove an average of 26 miles per day. In comparison, those who lived and preferred a cardependent neighbourhood drove the most and walked the least. Those preferring high walkability neighbourhoods were less also likely to be obese than those preferring low walkability neighbourhoods. Canadian research found that participants who moved and did not rate ‘ease of walking’ as an important reason for neighbourhood choice had greater increases in BMI compared to those who moved and rated ease of walking as important (Berry et al., 2010b). These findings suggest that residential selection is an important factor influencing health behaviour and health outcomes. Further, there are additional neighbourhood choice factors, such as quality of schools for those parents who can afford it, that did not emerge in our data but have been reported by others (e.g., Carnoske et al., 2010) that should be further explored. It should be noted that many participants cited winter temperatures and conditions as a barrier to activity, suggesting seasonal factors may also influence behaviour, regardless of neighbourhood features. Seasonal variation in physical activity is well documented for children and adults (Carson and Spence, 2010; Tucker and Gilliland, 2007). Perception of weather has been linked to walking behaviour in Australia, where women who did not perceive the weather as inhibiting walking were more likely to be high neighbourhood walkers, and men more likely to be exercise walkers (Humpel et al., 2004). A Canadian study examining individual and socio-environmental determinants of obesity and overweight found significant differences in potential contribution of built environment variables related to walkability between Vancouver and Toronto (Pouliou and Elliot, 2010). Land-use mix, residential density and street connectivity were significant predictors of BMI in Vancouver, but only residential density was predictive in Toronto. The authors suggest that in addition to potential differences in neighbourhood design for density and walkability, the substantial climatic variation between these cities (Vancouver being notably more moderate year-round) may be responsible for these results. Thus, it is important to take into account the location of the study when considering the influence of the built environment and this research adds data from a northern perspective.
5. Conclusions Almost all participants perceived their neighbourhoods as reasonably or highly walkable, regardless of objective walkability classification. Why this is so remains to be determined. Interesting avenues to investigate include following up on the research of Gebel et al. (2009) or further qualitative research that explores specifically discrepancies between objective and perceived walkability. Our findings identified important environmental factors perceived by residents as either positively or negatively influencing behaviour related to physical activity and food choice. While path connectivity and quality (e.g., neighbourhood walking paths), land-use mix and social-capital benefits are key features that serve to encourage leisure and exercise walking and physical activity, ‘automobility’, traffic safety and seasonal conditions may negatively influence behaviour. Future research should examine the relationship between perceived and actual walkability features and activity as well as neighbourhood choice as suggested by others (Saelens et al., 2003).
Acknowledgement This research was supported by grants from the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research. Tanya Berry is supported by a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research and the Canada Research Chairs Program. Chris Blanchard is supported by the Canada Research Chairs Program. References Alberta Centre for Active Living, 2009 Alberta Survey on Physical Activity. Available: /http://www.centre4activeliving.ca/publications/ab-survey-physi cal-activity/2009-report.pdfS (accessed July 7 2010). Atkinson, J.L., Sallis, J.F., Saelens, E., Cain, K.L., Black, J.B., 2005. The association of neighborhood design and recreational environments with physical activity. American Journal of Health Promotion 19, 304–309. Baum, F., Palmer, C., 2002. ‘Opportunity structures’: urban landscape, social capital and health promotion in Australia. Health Promotion International 17, 351–361. Berry, T.R., Spence, J.C., Blanchard, C.M., Cutumisu, N., Edwards, J., Nykiforuk, C., 2010a. Changes in BMI over 6 years: the role of demographic and neighbourhood characteristics. International Journal of Obesity 34, 1275–1283. Berry, T.R., Spence, J.C., Blanchard, C.M., Cutumisu, N., Edwards, J., Selfridge, G., 2010b. A longitudinal and cross-sectional examination of the relationship between reasons for choosing a neighbourhood, physical activity and body mass index. International Journal of Behavioral Nutrition and Physical Activity, 7. doi:10.1186/1479-5868-7-57. Boone-Heinonen, J., Gordon-Larsen, G., Guilkey, D.K., Jacobs, D.R., Popkin, B.M., 2011. Environment and physical activity dynamics: the role of residential selfselection. Psychology of Sport and Exercise 12, 54–60. Burgoyne, L.N., Coleman, R., Perry, I.J., 2007. Walking in a city neighbourhood, paving the way. Journal of Public Health 29, 222–229. Carnoske, C., Hoehner, C., Ruthmann, N., Frank, L., Handy, S., Hill, J., et al., 2010. Developer and realtor perspectives on factors that influence development, sale, and perceived demand for activity-friendly communities. Journal of Physical Activity and Health 7 (suppl1), S48–S59. Carson, V., Spence, J.C., 2010. Seasonal variation in physical activity among children and adolescents: a review. Pediatric Exercise Science 22, 81–92. Cerin, E., Leslie, E., du Toit, L., Owen, N., Frank, L.D., 2007. Destinations that matter: associations with walking for transport. Health and Place 13, 713–724. Cerin, E., Saelens, B.F., Sallis, J.F., Frank, L., 2005. Neighborhood environment walkability scale: validity and development of a short form. Medicine Science Sports and Exercise 38, 1682–1691. City of Edmonton, 2010. Attractions and Recreation, Parks and River Valley. Available: /http://www.edmonton.ca/attractions_recreation/parks_rivervalley/river-valley. aspxS (accessed June 25, 2010). Clark, M.I., Berry, T.R., Spence, J.C., Nykiforuk, C., Carlson, M., Blanchard, C., 2010. Key stakeholder perspectives on the development of walkable neighborhoods. Health and Place 16, 43–50. Craig, C., Brownson, R.C., Cragg, S.E., Dunn, A.L., 2002. Exploring the effect of the environment on physical activity: a study examining walking to work. American Journal of Preventative Medicine 23 (2S), 36–43. Crano, W.D., Prislin, R., 2006. Attitudes and persuasion. Annual Review of Psychology 57, 345–374. Darker, C.D., Larkin, M., French., D.P., 2007. An exploration of walking behaviour— an interpretative phenomenological approach. Social Science and Medicine 65, 2172–2183. Duncan, M.J., Spence, J.C., Mummery, W.K., 2005. Perceived environment and physical activity: a meta-analysis of selected environmental characteristics. International Journal of Behavioural Nutrition and Physical Activity 2, 11–19. Environment Canada, 2010. Canadian Climate Normals 1971–2000, Edmonton City Centre. Available: /http://climate.weatheroffice.gc.ca/climate_normals/results_ e.html?Province=ALTA&StationName=&SearchType=&LocateBy=Province& Proximity=25&ProximityFrom=City&StationNumber=&IDType=MSC&CityName= &ParkName=&LatitudeDegrees=&LatitudeMinutes=&LongitudeDegrees=&Longitu deMinutes=&NormalsClass=A&SelNormals=&StnId=1867S(accessed July 7 2010). Festinger, L.A., 1957. Theory of Cognitive Dissonance. Stanford University Press, Stanford, CA. Foster, S., Giles-Corti, B., 2008. The built environment, neighbourhood crime and constrained physical activity: an exploration of inconsistent findings. Preventative Medicine 47, 241–251. Frank, L.D., Sallis, J.F., Saelens, B., Leary, L., Cain, K., Conway, T., Hess, P.M., 2010. The development of a walkability index: application to the neighbourhood quality of life study. British Journal of Sports Medicine 44, 924–933. Frank, L.D., Saelens, B.E., Powell, K.E., Chapman, J.E., 2007. Stepping toward causation: do built environments or neighbourhood and travel preferences explain physical activity, driving, and obesity? Social Science and Medicine 65, 1898–1914. Frank, L.D., Andresen, M.A., Schmid, T.L., 2004. Obesity relationships with community design, physical activity, and time spent in cars. American Journal of Preventative Medicine 27, 87–96.
G.R. Montemurro et al. / Health & Place 17 (2011) 895–901
Gauvin, L., Craig, R.C., Spivock, M., Riva, M., Foster, M., Laforest, S., Laberge, S., Fournel, M.-C., Gagnon, H., Gagne, S., 2005. From walkability to active living potential: an ‘‘ecometric’’ validation study. American Journal of Preventative Medicine 28, 126–133. Gebel, K., Bauman, A., Owen, N., 2009. Correlated of non-concordance between perceived and objective measures of walkability. Annals of Behavioral Medicine 37, 228–238. Giles-Corti, B., Donovan, R.J., 2002. The relative influence of individual, social and physical environment determinants of physical activity. Social Science and Medicine 54, 1793–1812. Holt, N.L., Cunningham, C.T., Sehn, Z.L., Spence, J.C., Newton, A.S., Ball, G.D., 2009. Neighborhood physical activity opportunities for inner-city children and youth. Health Place 15, 1022–1028. Humpel, N., Owen, N., Iverson, D., Leslie, E., Bauman, A., 2004. Perceived environment attributes, residential location and walking for particular purposes. American Journal of Preventative Medicine 26, 119–125. Humpel, N., Owen, N., Leslie, E., 2002. Environmental factors associated with adults’ participation in physical activity: a review. American Journal of Preventative Medicine 22, 188–199. Kaczynski, A.T., Sharratt, M.T., 2010. Deconstructing Williamsburg: using focus groups to examine residents’ perceptions of the building of a walkable community. International Journal of Behavioral Nutrition and Physical Activity 7, 50–62. Lee, I.-M., Ewing, R., Sesso, H.D., 2009. The built environment and physical activity levels: the Harvard alumni health study. American Journal of Preventative Medicine 37, 293–298. Leslie, E., Saelens, B., Frank, L., Owen, N., Bauman, A., Coffee, N., Hugo, G., 2005. Residents’ perceptions of walkability attributes in objectively different neighborhoods: a pilot study. Health and Place 11, 227–236. Li, F., Harmer, P., Cardinal, B.J., Bosworth, M., Johnson-Shelton, D., 2009. Obesity and the built environment: does the density of neighbourhood fast-food outlets matter? American Journal of Health Promotion 23, 203–209. Lincoln, Yvonna S., Guba, Egon G., 1985. Naturalistic Inquiry. Sage, Beverly Hills, CA. Lockett, D., Willis, A., Edwards, N., 2005. Through seniors’ eyes: an exploratory qualitative study to identify environmental barriers to and facilitators of walking. Canadian Journal of Nursing Research 37, 48–65. Lopez, R.P., 2004. Urban sprawl and risk for being overweight or obese. American Journal of Public Health 94, 1574–1579. Lopez, R.P., Hynes, H.P., 2006. Obesity, physical activity, and the urban environment: public health research needs. Environmental Health 5, 25–35. Lovasi, G.S., Moudon, A.V., Pearson, A.L., Hurvitz, P.M., Larson, E.B., Siscovick, D.S., Berke, E.M., Lumley, T., Psaty, B.M., 2008. Using built environment characteristics to predict walking for exercise. International Journal of Health Geographics 7, 10–23. McGinn, A.P., Evenson, K.R., Herring, A.H., Huston, S.L., Rodriguez, D.A., 2007. Exploring associations between physical activity and perceived and objective measures of the built environment. Journal of Urban Health 84, 162–184. Moore, L.V., Diez Roux, A.V., Nettleton, J.A., Jacobs, D.R., Franco, M., 2009. Fast-food consumption, diet quality, and neighbourhood exposure to fast food: the multiethnic study of atherosclerosis. American Journal of Epidemiology 170, 29–36. Moreland, K., Wing, S., Diez Roux, A., 2002a. The contextual effect of the local environment on residents’ diets: atherosclerosis risk in communities study. American Journal of Public Health 92, 1761–1767. Owen, N., Humpel, N., Leslie, E., Bauman, A., Sallis, J.F., 2004. Understanding environmental influences on walking: review and research agenda. Americal Journal of Preventive medicine 27 (1).
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Papas, M.A., Alberg, A.J., Ewing, R., Helzlsouer, K.J., Gary, T.L., Klassen, A.C., 2007. The built environment and obesity. Epidemiological Reviews 29, 129–143. Patton, M.Q., 2002. Qualitative Research and Evaluation Methods. Sage, Thousand Oaks, CA. Pouliou, T., Elliot, S.J., 2010. Individual and socio-environmental determinants of overweight and obesity in Urban Canada. Health and Place 16, 389–398. Powell, L.M., Auld, C., Chaloupka, F.J., O’Malley, P.M., Johnston, L.D., 2007. Associations between access to food stores and adolescent body mass index. American Journal of Preventative Medicine 33, S301–S307. Saelens, B.E., Sallis, J.F., Frank, L.D., 2003. Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures. Annals of Behavioral Medicine 25, 80–91. Sallis, J.F., Frank, L.D., Saelens, B.E., Kraft, K.M., 2004. Active transportation and physical activity: opportunities for collaboration on transportation and public health research. Transportation Research Part A 38, 249–268. Sallis, J.F., Saelens, B.E., Frank, L.D., Conway, T.L., Slymen, D.J., Cain, K.L., Chapman, J.E., Kerr, J., 2009. Neighborhood built environment and income: examining multiple health outcomes. Social Science and Medicine 68, 1285–1293. Smith, K.R., Brown, B.B., Yamada, I., Kowaleski-Jones, L., Zick, C.D., Fan, J.X., 2008. Walkability and body mass index: density, design and new diversity measures. American Journal of Preventative Medicine 35, 237–244. Spence, J.C., Cutumisu, N., Edwards, J., Evans, J., 2008. Influence of neighbourhood design and access to facilities on overweight among preschool children. International Journal of Pediatric Obesity 3, 109–116. Spence, J.C., Cutumisu, N., Edwards, J., Raine, K.D., Smoyer-Tomic., K., 2009. Relation between local food environments and obesity among adults. BMC Public Health 9, 192–197. Statistics Canada, 2007. Edmonton, Alberta (table). 2006 Community Profiles. 2006 Census. Statistics Canada Catalogue no. 92-591-XWE. Ottawa. Released March 13, 2007. Available: /http://www12.statcan.ca/census-recensement/2006/ dp-pd/prof/92-591/index.cfm?Lang=ES (accessed June 23, 2010). Story, M., Kaphingst, K.M., Robinson-O’Brien, R., Glanz, K., 2008. Creating healthy food and eating environments: policy and environmental approaches. Annual Reviews of Public Health 29, 253–271. Strauss, A., Corbin, J., 1990. Basics of Qualitative Research: Grounded Theory Procedure and Techniques. Sage, Newbury Park. Tucker, P., Gilliland, J., 2007. The effect of season and weather on physical activity: a systematic review. Journal of Public Health 121, 909–922. Turcotte, M., 2008. Dependence on Cars in Urban Neighbourhoods. Canadian Social Trends. Available: /http://www.statcan.gc.ca/pub/11-008-x/11-008-x2008001eng.htmS (accessed June 23, 2010). Urry, J., 2004. The ‘system’ of automobility. Theory, Culture, and Society 21, 25–39. Vandegrift, D., Yoked, T., 2004. Obesity rates, income, and suburban sprawl: an analysis of U.S. states. Health and Place 10, 221–229. Wang, M.C., Kim, S., Gonzalez, A.A., MacLeod, K.E., Winkleby, M.A., 2007. Socioeconomic and food-related physical characteristics of the neighbourhood environment are associated with body mass index. Journal of Epidemiology and Community Health 61, 491–498. Westbrook, L., 1994. Qualitative research methods: a review of major stages, data analysis techniques, and quality controls. Library and Information Science Research 16, 241–254. Wood, L., Shannon, T., Bulsara, M., Pikora, T., McCormack, G., Giles-Corti, B., 2008. The anatomy of the safe and social suburb: an exploratory study of the built environment, social capital and residents’ perceptions of safety. Health and Place 14, 15–31.
Contents lists available at ScienceDirect
Health & Place journal homepage: www.elsevier.com/locate/healthplace
‘‘Walkable by Willpower’’: Resident perceptions of neighbourhood environments Genevieve R. Montemurro a, Tanya R. Berry a,n, John C. Spence a, Candace Nykiforuk b, Chris Blanchard c, Nicoleta Cutumisu a a
Faculty of Physical Education and Recreation, E-488 Van Vliet, University of Alberta, Edmonton, AB, Canada T6G 2H9 Centre for Health Promotion Studies, School of Public Health, 5-10 University Terrace, 8303-112 Street, University of Alberta, Edmonton, AB, Canada T6G 2T4 c Department of Medicine, QEII Health Sciences Centre, Centre for Clinical Research, 5790 University Avenue, Dalhousie University, Halifax, NS, Canada B3H 1V7 b
a r t i c l e i n f o
abstract
Article history: Received 21 October 2010 Received in revised form 15 March 2011 Accepted 25 April 2011 Available online 1 May 2011
Resident perceptions of neighbourhood walkability, physical activity opportunities, food choice and factors influencing choice of neighbourhood were examined through focus group discussion in higher and lower walkability neighbourhoods. Almost all participants perceived their neighbourhoods as very or reasonably walkable with high food choice. Walking was described as primarily leisure or exercise focused and less frequenly as destination or task-oriented. Factors influencing walking and physical activity included connectivity, path quality, weather and traffic. The ability to drive easily was a key factor in neighbourhood choice. Our findings identified important environmental factors perceived by residents as either positively or negatively influencing behaviour related to physical activity and food choice. Future research should examine the relationship between perceived and actual walkability features as well as residential selection. & 2011 Elsevier Ltd. All rights reserved.
Keywords: Built environment Environmental perceptions Walking Residential selection
1. Background There is evidence supporting the relationship between the built environment and health behaviours such as physical activity (Duncan et al., 2005; Humpel et al., 2002; Owen et al., 2004; Saelens et al., 2003; Sallis et al., 2004) and food choice (Li et al., 2009; Moore et al., 2009; Moreland et al., 2002a). As such attention is being given to the influence of neighbourhood design in promoting or inhibiting these health behaviours. Central to this discussion is the influence of neighbourhood walkability, that is, how pleasant and easy it is to walk in a neighbourhood. Walkability can be assessed both objectively and through perceptions of the environment. Objective walkability measurement involves quantifying built environment features into indices found to be associated with walking. A frequently used index of objective walkability assesses density, diversity, design and area in retail use (Frank et al., 2010). Objective walkability features are associated with walking and physical activity, body mass index (BMI), food choice and obesity (Frank et al., 2004; Gauvin et al., 2005; Lopez, 2004; Papas et al., 2007; Powell et al., 2007; Sallis et al., 2009; Smith et al., 2008; Spence et al., 2008, 2009; Vandegrift and Yoked, 2004; Wang et al., 2007).
n
Corresponding author. Tel.: þ780 492 3280; fax: 780 492 2364. E-mail addresses: [email protected] (G.R. Montemurro), [email protected] (T.R. Berry), [email protected] (J.C. Spence), [email protected] (C. Nykiforuk), [email protected] (C. Blanchard), [email protected] (N. Cutumisu). 1353-8292/$ - see front matter & 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.healthplace.2011.04.010
Perceived walkability is typically measured through selfreport and includes questions related to built environment features such as residential density, proximity and access to stores and facilities (e.g., land-use mix diversity and access), street connectivity, aesthetics, facilities for walking and cycling and safety from traffic and crime (Cerin et al., 2005). Perceived residential density has been linked to physical activity (Atkinson et al., 2005) and perceived traffic linked to BMI (Berry et al., 2010a). Relationships between walking and other perceived environmental attributes such as aesthetics, weather and accessibility have also been demonstrated (Humpel et al., 2004). Studies indicate that different features may affect walking for particular purposes (e.g., exercise versus leisure or transport) in different ways, and among different population groups (Craig et al., 2002; Cerin et al., 2007; Humpel et al., 2004; Lovasi et al., 2008). Research examining agreement between perceived and objective walkability has been somewhat mixed. Australian research has found that residents rated attributes of residential density, land-use mix (access and diversity) and street connectivity consistently higher in high-walkability neighbourhoods than those in low-walkability neighbourhoods (Leslie et al., 2005). Other researchers, however, report poor agreement between perceived and objective walkability (McGinn et al., 2007) and non-concordance among adults based on individual and demographic characteristics (Gebel et al., 2009). A factor complicating the relationship between the built environment and health behaviour is the issue of self-selection, identified as a major limitation to existing research (Boone-Heinonen
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et al., 2011). Central to self-selection is the question of whether walkable environments influence individuals to be active or whether individuals choose neighbourhoods that facilitate existing (active) lifestyles. Research examining neighbourhood and travel preferences showed that those who preferred and lived in a walkable neighbourhood walked the most in comparison to those who preferred and lived in a car dependent neighbourhood (Frank et al., 2007). Recent longitudinal research found that participants who ranked ease of walking as an important neighbourhood choice factor were more likely to have maintained a stable BMI over time compared to those who did not (Berry et al., 2010b). While existing research has primarily examined walkability and related factors through the use of cross-sectional and longitudinal survey data (e.g., Frank et al., 2004; Lee et al., 2009; Sallis et al., 2009), there is an emerging body of research examining these topics qualitatively. Such research has identified important perceived barriers related to personal safety such as crime, dangerous people, traffic, animals, waste (garbage) and risk of falls (Burgoyne et al., 2007; Holt et al., 2009; Lockett et al., 2005). Qualitative researchers have also explored perceived purpose and value of walking and the development of walkable neighbourhoods. Research exploring resident experiences of a walkable community in Ontario, Canada found that residents valued and felt their behaviour was positively influenced by walkability features such as land use diversity (Kaczynski and Sharratt, 2010). Research in the United Kingdom has highlighted the importance of walking purpose and perceived value (Darker et al., 2007). Residents perceived walking as functional mode of transport and not a goal in and of itself or ‘‘proper’’ exercise, citing lack of time as a major barrier to walking for transportation. Research in Alberta, Canada examining key stakeholder perspectives on the development of walkable neighbourhoods revealed shared perception of barriers to health-focused development including economic constraints, existing social norms, attitudes and behaviours (Clark et al., 2010). There is relatively little qualitative research examining perceptions of walkability, physical activity, food choice and neighbourhood selection. Therefore, the purpose of this research was to examine neighbourhood resident’s definitions of walkability, how residents perceive their neighbourhoods for walking, physical activity and food choice, and what factors influence choice of neighbourhood. This examination was done through focus group discussion with residents living in objectively higher and lower walkable neighbourhoods.
2. Methods 2.1. Setting The setting of this study is the capital city of Edmonton in the Western Canadian province of Alberta, home to a growing population within its 684 km2, of over 730,372 inhabitants in 2006 (Statistics Canada, 2007). The median age of the population is 36.1 years, with 21.5% of the population over the age of 60 (Statistics Canada, 2007). The city is a central hub for many employed in Alberta’s oil and gas industry. Edmonton is divided by the North Saskatchewan River and is characterised by an expansive river valley. At 7400 ha, it is the largest stretch of urban parkland in North America, with 22 major parks and over 150 km of trails (City of Edmonton, 2010). A recent survey showed that 58.8% of adult Albertans (59.4% of women and 57.7% of men) are sufficiently active to experience health benefits (Alberta Centre for Active Living, 2009). Edmontonians are frequent car-users with an estimated 79% of the total employed labour force travelling to work by car or truck, 12.7% using transit, 9% walking
or biking and 1.4% using other modes (Statistics Canada, 2007). A 2008 report indicated that, of the people living in the 8 largest central metropolitan areas in Canada, individuals in Edmonton and Calgary were the most likely to have made all trips exclusively by automobile on the reference day (Turcotte, 2008). Seasonally, Edmonton is characterised by cold, snowy winters and warm summers, with average daily temperatures ranging from 11.7 1C in January to 17.5 1C in July (Environment Canada, 2010). 2.2. Participants Participants (N ¼63) were recruited based on participation in a cross-sectional survey in 2008. Those who agreed to future contact were clustered into geographic sampling groups based on objective neighbourhood walkability ranks (5 higher walkability and 6 lower walkability groups) established previously using participant postal codes (see Berry et al., 2010a for a full description of indices). Originally, it was hoped that sampling could be stratified to create four groups based on both neighbourhood walkability and neighbourhood SES (e.g., high walk/low SES, high walk/high SES, low walk/low SES, low walk/high SES); however, due to sampling constraints only neighbourhood walkability was used. As such, neighbourhood level SES ranged for each group. Of these 11 groups, six were comprised of participants from primarily lower to medium SES neighbourhoods, and five comprised of participants from primarily medium to high SES neighbourhoods. A maximum of 14 participants were recruited for each focus group, with final group sizes ranging from 4 to 9 participants. One group with low-turnout (n¼2) was excluded from analysis, leaving a total of 10 groups. 2.3. Data collection The focus group guide was developed through topics predetermined by the research team and during two pilot focus groups (one with graduate research assistants and university staff and the other with residents of Sherwood Park, a municipality sized hamlet 16 km east of Edmonton). Participants were provided with an information sheet in advance of the meeting along with the opportunity to discuss any questions with the researcher. All focus groups were conducted during the winter of 2010 by a researcher trained in qualitative methods and a research assistant. Focus groups were held in neighbourhood community leagues, typically lasting 90 min and were digitally recorded. Ethical clearance for the study was given by the institutional ethics board and all participants provided informed consent. Participants were asked to first define the term ‘walkability’, and were then given the objectively measured walkability rating for their area and asked to reflect on the relative walkability of their neighbourhood. They were asked how they felt their neighbourhood environment influenced physical activity (both personally and among others), and access to healthy, reasonably priced food close to home, as well as reasons for accessing food further away. They were also asked what factors influenced their choice of neighbourhood and for any suggestions concerning neighbourhood improvement related to physical activity and food choice. The focus group guide permitted structured exploration of these questions while remaining open to other related topics that arose. Probes were used where necessary to encourage discussion. 2.4. Data analysis Focus groups were transcribed verbatim and managed electronically using NVivo 2.0 software. Data were analysed using the
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constant comparison method (Strauss and Corbin, 1990). Systematic coding steps of open, axial and selective coding were used. In this strategy, a reciprocal relationship exists between data collection, analysis and theory. Westbrook (1994) suggests that together, these three types of coding follow the progression of a content analysis. Through open coding, conceptual labels were placed on discreet meaning units, which were then classified into categories of higher order. This involved line-by-line and paragraph analysis of focus group transcripts. During axial coding, connections were made between categories and sub-categories. Once axial coding was complete three randomly selected transcripts were coded a second time by the primary coder, and coded independently by the lead researcher to ensure inter- and intracoder reliability. Categories requiring further development or review were then discussed and appropriate coding revisions were made. Analyst triangulation of this kind is recognised as an important verification and validation method to test the consistency of conclusions in qualitative research, adding credibility and confidence (Patton, 2002). This activity was especially relevant as member checking (Lincoln and Guba, 1985) with focus group participants was not possible. The final selective coding stage involved the establishment of a description about the central theme of the study (Influence of the Neighbourhood Environment) and related categories followed by a final validation stage involving a full examination of categories and relationships. Data saturation was a critical principle under consideration. A category is considered at saturation when no new information about it develops out of the data (Westbrook, 1994); through analysis of 10 focus groups, saturation was achieved.
3. Results 3.1. Walkability, walking and physical activity Participants had little difficulty defining and appraising walkability. Proximity to amenities and services, safety, path availability (including sidewalks and crosswalks), as well as natural or green spaces were key features cited. Universal walkability, visibility, aesthetics and seasonal factors were also identified. Almost all participants (regardless of objective categorisation) felt their neighbourhoods were very or reasonably walkable. Only three participants felt their neighbourhoods were not walkable. Leisure, exercise, destination and dog walking were mentioned often across groups with most participants identifying walking as a primarily leisure or exercise focused activity. While access to amenities and services (e.g., grocery stores, physician) were viewed as important, the majority of walking was not destination focused. As one participant stated, ‘‘Well I just walk my dog every day so you know, that’s—I have to get out, I have to walk. But if I’m going to get a coffee or if I’m going to get groceries, I’m not walking.’’ The dominance of car-culture in Edmonton was identified by a number of participants. Discussion ranged from comments about large scale planning, ‘‘We geared ourselves for the car, there’s no doubt about it’’ to increases in multi-car families, ‘‘when I go to subdivisions. They remind me of used car lots’’ to the prevalence of car-use even for short trips, ‘‘but do you really find Edmontonians are walkers? I don’t. I’m embarrassed how much I see my neighbours at the Blockbuster and we’ve all driven and it’s only like a block away.’’ Despite this recognition of frequent car use, almost all participants regularly saw others in their neighbourhood walking or being active, with some stating that this triggered them to be active as well. As one participant explained, ‘‘I can’t help but notice all the people running and rollerblading, walking their dogs, and going into the park. And it’s in my peripheral vision all day, reminding me that I should get outside’’. Neighbourhood sidewalks and paths,
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river valley trails and dog-parks were frequently cited venues for leisure or exercise walking. Participants also mentioned a number of opportunities for physical activity in and outside their neighbourhoods. Health facilities such as the YMCA and City of Edmonton Leisure Centres were mentioned often with many indicating they accessed these venues by car. Vehicle transport meant distance to destinations was less of an issue, with many willing to travel further outside their neighbourhood to access their preferred health facility. As explained by one, ‘‘those are the ones we just choose to go to. They’re not closer because the Y(MCA) would be closer and Londonderry (Leisure Centre) would be closer to us. But I don’t really care for the facilities’’. While participants were quick to recognise the benefit of these venues, some indicated that cost was a prohibitive factor influencing use. As stated by one, ‘‘it’s a big incentive fory if you want to be active. If you have that in your community, it’s very good. But when it comes to payy’’ Community leagues and local playing fields, courts and rinks were also frequently cited as influencing physical activity, especially in relation to children’s sports. These diverse local venues were valued and used by many, as emphasised by one participant, ‘‘each one’s got a slightly different course and plus it’s not that far to gravitate to your next door neighbour, community hall, to take advantage there’’. Despite these benefits, challenges were also associated with these venues. Lack of community organisation to support community league programs (e.g., coordinating volunteers) and low participant turnout negatively influenced community programs for physical activity. Some also indicated that while they knew that programs and activities were likely available, they lacked specific information to get involved. It was also noted that although community venues may exist (e.g., a baseball diamond), they were sometimes unused or mismatched to community needs. This was illustrated by the comment, ‘‘there needs to be kind of an adaptation of the space ’cause there’s lots of opportunity. But if it doesn’t fit the people that are living there, then they’re not going to use it’’. The Edmonton river valley recurred often as a resource that positively influenced physical activity. Participants living in closer proximity were more likely to mention this resource and more frequently indicated accessing it by foot or on a bike. A participant in a group the furthest distance from the river stated, ‘‘I mean the river valley is beautiful but there’s no way to get there on a bikey I mean there is butyyou have to drive there with your bike’’. For many, the river valley provided a venue for activity that made them feel closer to nature and distanced from the undesirable factors associated with residential walking and busy roadways, ‘‘there’s no cars, you’re away from all the smog, all the sounds. And there’s this little hum of the traffic but it’s just a hum and it feels like it’s so far away.’’ Many cited the river valley trail networks as a valuable venue for walking, running and cycling with network connectivity making it easy to access other parts of the river valley and the city. As one described, ‘‘it’s connected north to south, east to west. And if you study it and follow it, it’s functional for that activity if you choose that activity.’’ This notion of individual choice was a recurring theme, with many expressing the belief that despite environmental features, enacting health behaviours was ultimately a matter of personal choice. One participant emphasised this stating her neighbourhood was, ‘‘walkable by willpower’’, while another summarised, ‘‘in terms of walkability—I think you can have a community that is quite walkable but that doesn’t necessarily mean that you’re going to spend a lot of time walking’’. 3.2. Influential factors: connectivity, quality, seasonal conditions and safety While the majority of participants engaged in some type of walking or physical activity in their neighbourhood, specific
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factors were cited repeatedly as influencing behaviour. These were path connectivity and quality, seasonal conditions and safety. In contrast to praise for the connectivity of the river valley trail systems, dissatisfaction with sidewalk connectivity was mentioned often. One participant described frustration with incomplete or poorly-planned sidewalks in her area, ‘‘the sidewalks on the right hand side while the park’s on the left. They have part sidewalks halfway down and it’s mudyIt’s like, did you guys run out of money?’’. Emphasising, ‘‘if you had more paths and made it accessible on both sides that more people would want to walk there’’. Sidewalk quality was also mentioned recurrently with a number of residents citing older cracking, uneven sidewalks, and those without curb cuts as a danger that inhibited walking, ‘‘It’s discouraging because of the heavingyThe sidewalks are seriously sloped, some of them are falling apart. So it’s not a very relaxing thing if you’re tripping or stepping over stuff all the time.’’ Many participants cited the drastic Edmonton winters as a barrier, put plainly by one as, ‘‘the major impediment to activity’’ characterised by summer activity increases, followed by decreases during the winter months, ‘‘I think that’s a big factor there—the numbers seem to drop in the wintertime, people you know, using the facilities or get involved’’. Seasonal influence was mentioned often in relation to sidewalk accessibility where snow and ice covered sidewalks (especially those in need of repair) presented a hazard in the winter months, particularly for those with mobility issues. One elderly woman stated, ‘‘I just reallyy don’t like to be threatening myself.’’ Interestingly a number of participants indicated city-cleared trails and stairways were often very well maintained in the winter months and this facilitated river valley access and use, contributing again to its positive appraisal. Because of the dramatic temperature lows, winter conditions may serve to reinforce car use over walking. Safety was also frequently mentioned, with many citing traffic-related safety as a concern. Key concerns were busy roadways (including main arterial roads through communities), excessive speed, and unsafe crossings. As one participant described, ‘‘you take your life in your hands to cross that streetytalking about walkability, I pretty much would avoid having to cross that. It’s a terrible intersection for speed and traffic and volume of trafficySo would I walk to that? Probably not. I’d drive there.’’ 3.3. Social capital and sense of community Social interaction with neighbours was mentioned repeatedly in connection to neighbourhood walking and local opportunities for physical activity, as one participant noted, ‘‘It’s just a way to get out and meet some of your neighbours ’cause you do get to meet familiar faces when you’re out there’’. A number of participants commented that they often met their neighbours on trails, at dog parks and through community activities, ‘‘if there isya vibrant kind of community activity, then it draws people back out and it gets them involved. And it’s not necessarily recreational but it kind of makes that connection for people’’. The importance of creating social gathering points was emphasised as a way to engage residents and strengthen the community. As one participant stated, ‘‘if everything that people want to go to is outside of their community, then it just becomes where they eat and they sleep and everything else is done outside.’’ 3.4. Planning and development: ideals and suggested improvements Sense of community and fostering opportunities for community interaction and physical activity was also identified in relation to community planning and development. Many valued ‘older neighbourhood’ planning and development features of connectivity and the integration of destinations, green space
and infrastructure for walking and cycling. This suggests that the majority of participants value neighbourhood features typically associated with objective walkability (e.g., diversity and design). One participant explained, ‘‘the concept is that they’re something that draws the people in, to gathering as a community and there’s a sense of community. And you know, when we get out here, like in the suburbs, we don’t have that sense.’’ Participants expressed frustration with ‘newer’ developments that lacked these features, commenting, ‘‘oh, it’s terrible. It’s just house, house, house, house, house all the way down the block and no green belts’’ though some indicated they felt developments were gradually improving with increased planning for walking trails within and between neighbourhoods. Transit planning was also mentioned, with some participants expressing frustration over infrequent buses, lack of service, and long trips. Although the light rail transit system was seen as improving, some noted it was well behind other cities and longer term planning was needed. As stated by one participant, ‘‘if you want people to be more active, if you want people to use public transportycreate the incentives but also the desire’’ emphasising, ‘‘we build all of these satellite communities, we put in roads but they never think about the public transit system as they’re developing these.’’ These same planning and development features were cited as suggestions to improve neighbourhoods with participants listing specific infrastructure features such as path and crosswalk availability and quality, increased venues for physical activity, and improved accessibility through decreased cost, increased information, and increased transit access.
3.5. Food choice Participants listed many inter- and intra-personal as well as macro-level factors influencing food choice strategies and venue choice. Inter- and intra-personal factors included perceived quality, price, time, convenience, specialty tastes and the influence of children. Macro-level, or upstream, factors included economic competition between larger box stores, supermarkets and smaller corner stores, and provincial and national food system industrialisation. As one participant described, ‘‘most of these little stores that specialized in butchers like an actual grocery store, produce store, they’re all disappearing and the big stores are taking over. Because they’ve got the buying power’’. These factors served to drive specific food strategies and venues (e.g., bulk buying at box stores; buying local at farmers markets; buying fast food when time constrained). These findings fit well within the ecological framework developed by Story et al. (2008) who identify four broad levels of influence (individual, social environment, physical environment and macro-level environments), which interact directly and indirectly to influence eating behaviour. The majority of participants perceived they had high food choice, identifying multiple venues nearby, although few accessed these on foot. Although they could reasonably walk to get groceries, carrying purchases home was not feasible for many, as stated by one mother, ‘‘for me to walk to get groceries would be impractical because I have a family of five. I could never carry it all back anyways so it just wouldn’t happen’’. Many indicated that they accessed foods away from home when they were buying bulk, seeking specialty foods or restaurants, or looking for the lowest price. Food choice was rarely a factor that influenced neighbourhood choice, likely because most perceived they had numerous local options within their own and surrounding neighbourhoods, and vehicle use made it easy to access foods further from home. This is congruent with findings by Clark et al. (2010) who reported car dependency in Edmonton was associated with a tendency for people to shop at large grocery stores irrespective of distance from their own neighbourhood, and a perception that
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adding neighbourhood corner stores may not translate into increased use. 3.6. Neighbourhood choice Primary neighbourhood choice factors were location, school proximity, recreation opportunities (including river valley access and walkability features), house or lot itself and affordability. While discussion of school and recreation factors focused primarily on proximity, it is possible the quality of these neighbourhood features was also an important factor (e.g., school quality as an important factor among individuals with school age children). A dominant location related theme was a value on ‘drivability’; the ability to drive easily to multiple destinations outside the neighbourhood. Many participants indicated that vehicle access from their house was an important factor in their decision. As one participant explained, ‘‘the main reason why we moved there is driveability, you know? When we started looking for a house we basically drew a circle around they downtown and it was like, well we can’t be any further west than this, we can’t be any further north than this, we can’t be any further southy’’. Another explained that his neighbourhood choice was a philosophy to live on the periphery of the city centre because, ‘‘you generally are halfway to everywhereyYou’re halfway out, you’re halfway iny and if you’re lucky enoughyyou might be even going against traffic patterns.’’ Other notable factors were green space, sense of community, transit access, family, proximity to work, safety and access to amenities and services.
4. Discussion Regardless of objective neighbourhood walkability classification, almost all participants indicated they perceived their neighbourhoods as very or reasonably walkable. The majority of participants reported engaging in some type of walking, though primarily for leisure or exercise and less often for destination or task-oriented trips. It may be that how residents perceive their neighbourhoods for walking may be as or more important than walkability features themselves. However, it also may be that participants ‘‘adjusted’’ their attitudes regarding walkability features and their own walking behaviour. This is in keeping with cognitive dissonance theory, which argues that people look for consistency among their beliefs and when there is a discrepancy, may alter their attitudes to reconcile the difference (Festinger, 1957; Crano and Prislin, 2006). Others have argued that people may not hold accurate cognitive representations of their environments (Gebel et al., 2009). Thus, participants in our study may have adjusted their beliefs regarding the walkability of their neighbourhoods to match study objectives (i.e., they knew the research was about neighbourhood walkability) or to reconcile with their reasons for living in a given neighbourhood. However, Gebel et al. (2009) reported greater walking, self-efficacy and enjoyment for exercise in participants who lived in objectively low walkable neighbourhoods that were perceived to be highly walkable. These authors also found that low SES participants were more likely to report their environments as low walkable when objectively classified as high walkable. In the current study, focus group participants were recruited by neighbourhood walkability and there were participants from different SES in each group. We were thus unable to examine the finding of Gebel et al. in this study. However, the idea of adjusting beliefs is an intriguing area for future research and should be examined with SES as a possible moderator. Other research has emphasised the complex interplay of both objective and perceived environments. Giles-Corti and Donovan
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(2002) found that while residents in low SES neighbourhoods had better spatial access to recreational facilities, they perceived their neighbourhoods as less conducive to physical activity than those in high SES neighbourhoods. They suggest that environmental features alone may be necessary but insufficient to influence activity, emphasising that individual and social environmental factors must also be addressed. This could be due in part to the ‘urban–suburban paradox’ described by Lopez and Hynes (2006) whereby despite objective features promoting activity, physical inactivity, obesity and related diseases are more prevalent among inner-city than suburban residents. They suggest that factors in the built, physical and social environment in inner-city areas (e.g., infrastructure maintenance, neighbourhood crime) can create environments where outdoor exercise and recreation become unappealing or risky (see also Holt et al., 2009). Decreased destination walking could be due to in part to cultural values of ‘automobility’ (Urry, 2004) where motorised movement, perceived as convenient and fast, favours automobile over active or alternate transport for such trips. Perceived traffic safety may act to discourage destination walking trips along or across busy roadways where stores or services are often located. In these cases, automobility values may prevail, increasing the likelihood of car travel. Recent longitudinal research in Edmonton found the more participants agreed that traffic in their neighbourhood made it unpleasant to walk, the more likely their BMI had increased over 6 years (Berry et al., 2010a). Other safety concerns cited by focus group participants were crime-related, including youth ‘gangs’, drunks and drug activity; however, participants were far more likely to cite traffic over crime safety as influencing activity. Though a recent review found insufficient evidence to conclude that crime-related safety influences physical activity (Foster and Giles-Corti, 2008), it has been suggested that perception of safety may mediate the formation of social capital, where people who are more fearful are less likely to venture into the neighbourhood and socially interact, for recreation or otherwise (Wood et al., 2008). Resident perceptions of community opportunity structures or ‘third’ spaces as important venues for social interaction and social capital were identified in this study and have been reported in other qualitative research (Baum and Palmer, 2002). It is likely that incorporation of multiple destinations (e.g., amenities, services, schools and parks) with adequate connectivity provides a neighbourhood environment favourable to multiple types of walking, with cultural values promoting vehicle use for task-oriented trips. Many participants described walking and physical activity as an intentional behaviour for exercise or leisure, as opposed to activity incorporating daily transportation or tasks (e.g., walking to work or going to the store). These findings are contrary to other qualitative research on walking (Darker et al., 2007) indicating walking was primarily perceived as a functional mode of transport and not for exercise or leisure. While planning and development incorporating traditional features associated with diversity and design were valued by participants, many emphasised individual choice as the ultimate factor deciding whether health behaviours were enacted. This finding echoes other qualitative research in which developers believed the creation of walkable neighbourhoods would not influence walking behaviour among those not already inclined to walk (Clark et al., 2010). However, objective neighbourhood walkability may have influenced participant’s decisions to walk, whether they were aware of it or not. Thus, neighbourhoods with increased destinations and density may have influenced walking, but people who think of walking as a leisure-activity may not perceive having destinations as influencing their behaviour. Clearly, this is an important question that needs further examination.
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It may be that access to places by car (as reflected in the notion of automobility) is a key factor influencing neighbourhood choice for many regardless of activity level, but that those most inclined to walk are those most likely to also include walkability as a consideration when choosing where to live. Frank et al. (2007) reported that individuals who lived and preferred a walkable neighbourhood walked the most, but still drove an average of 26 miles per day. In comparison, those who lived and preferred a cardependent neighbourhood drove the most and walked the least. Those preferring high walkability neighbourhoods were less also likely to be obese than those preferring low walkability neighbourhoods. Canadian research found that participants who moved and did not rate ‘ease of walking’ as an important reason for neighbourhood choice had greater increases in BMI compared to those who moved and rated ease of walking as important (Berry et al., 2010b). These findings suggest that residential selection is an important factor influencing health behaviour and health outcomes. Further, there are additional neighbourhood choice factors, such as quality of schools for those parents who can afford it, that did not emerge in our data but have been reported by others (e.g., Carnoske et al., 2010) that should be further explored. It should be noted that many participants cited winter temperatures and conditions as a barrier to activity, suggesting seasonal factors may also influence behaviour, regardless of neighbourhood features. Seasonal variation in physical activity is well documented for children and adults (Carson and Spence, 2010; Tucker and Gilliland, 2007). Perception of weather has been linked to walking behaviour in Australia, where women who did not perceive the weather as inhibiting walking were more likely to be high neighbourhood walkers, and men more likely to be exercise walkers (Humpel et al., 2004). A Canadian study examining individual and socio-environmental determinants of obesity and overweight found significant differences in potential contribution of built environment variables related to walkability between Vancouver and Toronto (Pouliou and Elliot, 2010). Land-use mix, residential density and street connectivity were significant predictors of BMI in Vancouver, but only residential density was predictive in Toronto. The authors suggest that in addition to potential differences in neighbourhood design for density and walkability, the substantial climatic variation between these cities (Vancouver being notably more moderate year-round) may be responsible for these results. Thus, it is important to take into account the location of the study when considering the influence of the built environment and this research adds data from a northern perspective.
5. Conclusions Almost all participants perceived their neighbourhoods as reasonably or highly walkable, regardless of objective walkability classification. Why this is so remains to be determined. Interesting avenues to investigate include following up on the research of Gebel et al. (2009) or further qualitative research that explores specifically discrepancies between objective and perceived walkability. Our findings identified important environmental factors perceived by residents as either positively or negatively influencing behaviour related to physical activity and food choice. While path connectivity and quality (e.g., neighbourhood walking paths), land-use mix and social-capital benefits are key features that serve to encourage leisure and exercise walking and physical activity, ‘automobility’, traffic safety and seasonal conditions may negatively influence behaviour. Future research should examine the relationship between perceived and actual walkability features and activity as well as neighbourhood choice as suggested by others (Saelens et al., 2003).
Acknowledgement This research was supported by grants from the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research. Tanya Berry is supported by a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research and the Canada Research Chairs Program. Chris Blanchard is supported by the Canada Research Chairs Program. References Alberta Centre for Active Living, 2009 Alberta Survey on Physical Activity. Available: /http://www.centre4activeliving.ca/publications/ab-survey-physi cal-activity/2009-report.pdfS (accessed July 7 2010). Atkinson, J.L., Sallis, J.F., Saelens, E., Cain, K.L., Black, J.B., 2005. The association of neighborhood design and recreational environments with physical activity. American Journal of Health Promotion 19, 304–309. Baum, F., Palmer, C., 2002. ‘Opportunity structures’: urban landscape, social capital and health promotion in Australia. Health Promotion International 17, 351–361. Berry, T.R., Spence, J.C., Blanchard, C.M., Cutumisu, N., Edwards, J., Nykiforuk, C., 2010a. Changes in BMI over 6 years: the role of demographic and neighbourhood characteristics. International Journal of Obesity 34, 1275–1283. Berry, T.R., Spence, J.C., Blanchard, C.M., Cutumisu, N., Edwards, J., Selfridge, G., 2010b. A longitudinal and cross-sectional examination of the relationship between reasons for choosing a neighbourhood, physical activity and body mass index. International Journal of Behavioral Nutrition and Physical Activity, 7. doi:10.1186/1479-5868-7-57. Boone-Heinonen, J., Gordon-Larsen, G., Guilkey, D.K., Jacobs, D.R., Popkin, B.M., 2011. Environment and physical activity dynamics: the role of residential selfselection. Psychology of Sport and Exercise 12, 54–60. Burgoyne, L.N., Coleman, R., Perry, I.J., 2007. Walking in a city neighbourhood, paving the way. Journal of Public Health 29, 222–229. Carnoske, C., Hoehner, C., Ruthmann, N., Frank, L., Handy, S., Hill, J., et al., 2010. Developer and realtor perspectives on factors that influence development, sale, and perceived demand for activity-friendly communities. Journal of Physical Activity and Health 7 (suppl1), S48–S59. Carson, V., Spence, J.C., 2010. Seasonal variation in physical activity among children and adolescents: a review. Pediatric Exercise Science 22, 81–92. Cerin, E., Leslie, E., du Toit, L., Owen, N., Frank, L.D., 2007. Destinations that matter: associations with walking for transport. Health and Place 13, 713–724. Cerin, E., Saelens, B.F., Sallis, J.F., Frank, L., 2005. Neighborhood environment walkability scale: validity and development of a short form. Medicine Science Sports and Exercise 38, 1682–1691. City of Edmonton, 2010. Attractions and Recreation, Parks and River Valley. Available: /http://www.edmonton.ca/attractions_recreation/parks_rivervalley/river-valley. aspxS (accessed June 25, 2010). Clark, M.I., Berry, T.R., Spence, J.C., Nykiforuk, C., Carlson, M., Blanchard, C., 2010. Key stakeholder perspectives on the development of walkable neighborhoods. Health and Place 16, 43–50. Craig, C., Brownson, R.C., Cragg, S.E., Dunn, A.L., 2002. Exploring the effect of the environment on physical activity: a study examining walking to work. American Journal of Preventative Medicine 23 (2S), 36–43. Crano, W.D., Prislin, R., 2006. Attitudes and persuasion. Annual Review of Psychology 57, 345–374. Darker, C.D., Larkin, M., French., D.P., 2007. An exploration of walking behaviour— an interpretative phenomenological approach. Social Science and Medicine 65, 2172–2183. Duncan, M.J., Spence, J.C., Mummery, W.K., 2005. Perceived environment and physical activity: a meta-analysis of selected environmental characteristics. International Journal of Behavioural Nutrition and Physical Activity 2, 11–19. Environment Canada, 2010. Canadian Climate Normals 1971–2000, Edmonton City Centre. Available: /http://climate.weatheroffice.gc.ca/climate_normals/results_ e.html?Province=ALTA&StationName=&SearchType=&LocateBy=Province& Proximity=25&ProximityFrom=City&StationNumber=&IDType=MSC&CityName= &ParkName=&LatitudeDegrees=&LatitudeMinutes=&LongitudeDegrees=&Longitu deMinutes=&NormalsClass=A&SelNormals=&StnId=1867S(accessed July 7 2010). Festinger, L.A., 1957. Theory of Cognitive Dissonance. Stanford University Press, Stanford, CA. Foster, S., Giles-Corti, B., 2008. The built environment, neighbourhood crime and constrained physical activity: an exploration of inconsistent findings. Preventative Medicine 47, 241–251. Frank, L.D., Sallis, J.F., Saelens, B., Leary, L., Cain, K., Conway, T., Hess, P.M., 2010. The development of a walkability index: application to the neighbourhood quality of life study. British Journal of Sports Medicine 44, 924–933. Frank, L.D., Saelens, B.E., Powell, K.E., Chapman, J.E., 2007. Stepping toward causation: do built environments or neighbourhood and travel preferences explain physical activity, driving, and obesity? Social Science and Medicine 65, 1898–1914. Frank, L.D., Andresen, M.A., Schmid, T.L., 2004. Obesity relationships with community design, physical activity, and time spent in cars. American Journal of Preventative Medicine 27, 87–96.
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Gauvin, L., Craig, R.C., Spivock, M., Riva, M., Foster, M., Laforest, S., Laberge, S., Fournel, M.-C., Gagnon, H., Gagne, S., 2005. From walkability to active living potential: an ‘‘ecometric’’ validation study. American Journal of Preventative Medicine 28, 126–133. Gebel, K., Bauman, A., Owen, N., 2009. Correlated of non-concordance between perceived and objective measures of walkability. Annals of Behavioral Medicine 37, 228–238. Giles-Corti, B., Donovan, R.J., 2002. The relative influence of individual, social and physical environment determinants of physical activity. Social Science and Medicine 54, 1793–1812. Holt, N.L., Cunningham, C.T., Sehn, Z.L., Spence, J.C., Newton, A.S., Ball, G.D., 2009. Neighborhood physical activity opportunities for inner-city children and youth. Health Place 15, 1022–1028. Humpel, N., Owen, N., Iverson, D., Leslie, E., Bauman, A., 2004. Perceived environment attributes, residential location and walking for particular purposes. American Journal of Preventative Medicine 26, 119–125. Humpel, N., Owen, N., Leslie, E., 2002. Environmental factors associated with adults’ participation in physical activity: a review. American Journal of Preventative Medicine 22, 188–199. Kaczynski, A.T., Sharratt, M.T., 2010. Deconstructing Williamsburg: using focus groups to examine residents’ perceptions of the building of a walkable community. International Journal of Behavioral Nutrition and Physical Activity 7, 50–62. Lee, I.-M., Ewing, R., Sesso, H.D., 2009. The built environment and physical activity levels: the Harvard alumni health study. American Journal of Preventative Medicine 37, 293–298. Leslie, E., Saelens, B., Frank, L., Owen, N., Bauman, A., Coffee, N., Hugo, G., 2005. Residents’ perceptions of walkability attributes in objectively different neighborhoods: a pilot study. Health and Place 11, 227–236. Li, F., Harmer, P., Cardinal, B.J., Bosworth, M., Johnson-Shelton, D., 2009. Obesity and the built environment: does the density of neighbourhood fast-food outlets matter? American Journal of Health Promotion 23, 203–209. Lincoln, Yvonna S., Guba, Egon G., 1985. Naturalistic Inquiry. Sage, Beverly Hills, CA. Lockett, D., Willis, A., Edwards, N., 2005. Through seniors’ eyes: an exploratory qualitative study to identify environmental barriers to and facilitators of walking. Canadian Journal of Nursing Research 37, 48–65. Lopez, R.P., 2004. Urban sprawl and risk for being overweight or obese. American Journal of Public Health 94, 1574–1579. Lopez, R.P., Hynes, H.P., 2006. Obesity, physical activity, and the urban environment: public health research needs. Environmental Health 5, 25–35. Lovasi, G.S., Moudon, A.V., Pearson, A.L., Hurvitz, P.M., Larson, E.B., Siscovick, D.S., Berke, E.M., Lumley, T., Psaty, B.M., 2008. Using built environment characteristics to predict walking for exercise. International Journal of Health Geographics 7, 10–23. McGinn, A.P., Evenson, K.R., Herring, A.H., Huston, S.L., Rodriguez, D.A., 2007. Exploring associations between physical activity and perceived and objective measures of the built environment. Journal of Urban Health 84, 162–184. Moore, L.V., Diez Roux, A.V., Nettleton, J.A., Jacobs, D.R., Franco, M., 2009. Fast-food consumption, diet quality, and neighbourhood exposure to fast food: the multiethnic study of atherosclerosis. American Journal of Epidemiology 170, 29–36. Moreland, K., Wing, S., Diez Roux, A., 2002a. The contextual effect of the local environment on residents’ diets: atherosclerosis risk in communities study. American Journal of Public Health 92, 1761–1767. Owen, N., Humpel, N., Leslie, E., Bauman, A., Sallis, J.F., 2004. Understanding environmental influences on walking: review and research agenda. Americal Journal of Preventive medicine 27 (1).
901
Papas, M.A., Alberg, A.J., Ewing, R., Helzlsouer, K.J., Gary, T.L., Klassen, A.C., 2007. The built environment and obesity. Epidemiological Reviews 29, 129–143. Patton, M.Q., 2002. Qualitative Research and Evaluation Methods. Sage, Thousand Oaks, CA. Pouliou, T., Elliot, S.J., 2010. Individual and socio-environmental determinants of overweight and obesity in Urban Canada. Health and Place 16, 389–398. Powell, L.M., Auld, C., Chaloupka, F.J., O’Malley, P.M., Johnston, L.D., 2007. Associations between access to food stores and adolescent body mass index. American Journal of Preventative Medicine 33, S301–S307. Saelens, B.E., Sallis, J.F., Frank, L.D., 2003. Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures. Annals of Behavioral Medicine 25, 80–91. Sallis, J.F., Frank, L.D., Saelens, B.E., Kraft, K.M., 2004. Active transportation and physical activity: opportunities for collaboration on transportation and public health research. Transportation Research Part A 38, 249–268. Sallis, J.F., Saelens, B.E., Frank, L.D., Conway, T.L., Slymen, D.J., Cain, K.L., Chapman, J.E., Kerr, J., 2009. Neighborhood built environment and income: examining multiple health outcomes. Social Science and Medicine 68, 1285–1293. Smith, K.R., Brown, B.B., Yamada, I., Kowaleski-Jones, L., Zick, C.D., Fan, J.X., 2008. Walkability and body mass index: density, design and new diversity measures. American Journal of Preventative Medicine 35, 237–244. Spence, J.C., Cutumisu, N., Edwards, J., Evans, J., 2008. Influence of neighbourhood design and access to facilities on overweight among preschool children. International Journal of Pediatric Obesity 3, 109–116. Spence, J.C., Cutumisu, N., Edwards, J., Raine, K.D., Smoyer-Tomic., K., 2009. Relation between local food environments and obesity among adults. BMC Public Health 9, 192–197. Statistics Canada, 2007. Edmonton, Alberta (table). 2006 Community Profiles. 2006 Census. Statistics Canada Catalogue no. 92-591-XWE. Ottawa. Released March 13, 2007. Available: /http://www12.statcan.ca/census-recensement/2006/ dp-pd/prof/92-591/index.cfm?Lang=ES (accessed June 23, 2010). Story, M., Kaphingst, K.M., Robinson-O’Brien, R., Glanz, K., 2008. Creating healthy food and eating environments: policy and environmental approaches. Annual Reviews of Public Health 29, 253–271. Strauss, A., Corbin, J., 1990. Basics of Qualitative Research: Grounded Theory Procedure and Techniques. Sage, Newbury Park. Tucker, P., Gilliland, J., 2007. The effect of season and weather on physical activity: a systematic review. Journal of Public Health 121, 909–922. Turcotte, M., 2008. Dependence on Cars in Urban Neighbourhoods. Canadian Social Trends. Available: /http://www.statcan.gc.ca/pub/11-008-x/11-008-x2008001eng.htmS (accessed June 23, 2010). Urry, J., 2004. The ‘system’ of automobility. Theory, Culture, and Society 21, 25–39. Vandegrift, D., Yoked, T., 2004. Obesity rates, income, and suburban sprawl: an analysis of U.S. states. Health and Place 10, 221–229. Wang, M.C., Kim, S., Gonzalez, A.A., MacLeod, K.E., Winkleby, M.A., 2007. Socioeconomic and food-related physical characteristics of the neighbourhood environment are associated with body mass index. Journal of Epidemiology and Community Health 61, 491–498. Westbrook, L., 1994. Qualitative research methods: a review of major stages, data analysis techniques, and quality controls. Library and Information Science Research 16, 241–254. Wood, L., Shannon, T., Bulsara, M., Pikora, T., McCormack, G., Giles-Corti, B., 2008. The anatomy of the safe and social suburb: an exploratory study of the built environment, social capital and residents’ perceptions of safety. Health and Place 14, 15–31.