Physical Activity and the Built Environment: Difference between revisions

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== Introduction ==
== Introduction ==
The environment is integral to encouraging physical activity.<ref>Goldstein B. The environment and health:a conversation with CDC chief Jeffrey Koplan; tracing intersections between behaviour and environment fascinates this top health officer. Health Affairs 2002;21:179-184  [Pub Med]</ref>  The built environment is an aspect of the environment that is increasingly receiving research attention.<ref>Sallis JF, Floyd MF, Rodriguez DA, Saelens BE. Role of built environments in physical activity, obesity, and cardiovascular disease. Circulation. 2012;125(5):729-37</ref>  Recommended levels of physical activity can be achieved by including activities such as walking, cycling as part of everyday life. This can be encouraged with a supportive built environment. Even though individual and social factors affect physical activity,<ref>Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of Physical Activity: Why are some physically active and others are not? Lancet 2012;380(9838):258-271.</ref> research has shown that a well-designed environment matters.<ref>Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF. Measuring the built environment for physical activity: State of Science. ''Am J Prev Med''.2009;36(4 Supplement):S99-S123.e12.</ref><ref name=":1">Ding D, Sallis JF, Kerr J, Lee S, Rosenburg DE. Neighborhood environment and physical activity among youth: A Review. ''Am J Prev Med.''2011;41(4):442-455.</ref><ref>Sugiyama T, Leslie E, Giles-Corti B, Owen N. Physical activity for recreation or exercise on neighborhod streets: Associations with perceived environmental attributes. Health Place 2009;15(4):1058-1063.</ref> Public health professionals can advocate for policies to help shape the design of cities and suburbs in ways to encourage physical activity.
The environment is integral to encouraging physical activity.<ref>Goldstein B. The environment and health:a conversation with CDC chief Jeffrey Koplan; tracing intersections between behaviour and environment fascinates this top health officer. Health Affairs 2002;21:179-184  [Pub Med]</ref>  The built environment is an aspect of the environment that is increasingly receiving research attention.<ref name=":2">Sallis JF, Floyd MF, Rodriguez DA, Saelens BE. Role of built environments in physical activity, obesity, and cardiovascular disease. Circulation. 2012;125(5):729-37</ref>  Recommended levels of physical activity can be achieved by including activities such as walking, cycling as part of everyday life. This can be encouraged with a supportive built environment. Even though individual and social factors affect physical activity,<ref>Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of Physical Activity: Why are some physically active and others are not? Lancet 2012;380(9838):258-271.</ref> research has shown that a well-designed environment matters.<ref>Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF. Measuring the built environment for physical activity: State of Science. ''Am J Prev Med''.2009;36(4 Supplement):S99-S123.e12.</ref><ref name=":1">Ding D, Sallis JF, Kerr J, Lee S, Rosenburg DE. Neighborhood environment and physical activity among youth: A Review. ''Am J Prev Med.''2011;41(4):442-455.</ref><ref name=":3">Sugiyama T, Leslie E, Giles-Corti B, Owen N. Physical activity for recreation or exercise on neighborhod streets: Associations with perceived environmental attributes. Health Place 2009;15(4):1058-1063.</ref> Public health professionals can advocate for policies to help shape the design of cities and suburbs in ways to encourage physical activity.


The built environment is defined as the part of the physical environment that is constructed or modified by human activity.<ref name=":0">Saelens BE, Handy SL. Built environment correlates of walking: a review. Med Sci Sport Exer. 2008;40(7 Suppl):S550-66.</ref> It includes homes, schools, workplaces, parks or recreation areas, green-ways, business areas and transportation systems.<ref>National Institute of Environmental Health Sciences 2004 p 2</ref> In public health, a built environment refers to physical environments that are designed with health and wellness as integral parts of communities and it includes open spaces, footpaths, cycle lanes, parks, trails.<ref>Renalds, A; Smith T; Hale, P (2010). "A Systematic Review of Built Environment And Health". Family and Community Health.'''33:''' 68-78.</ref> The emphasis on the role of built environment is necessary as encouraging people to be more physically active in an environment that is not supportive is less likely to be effective.  
The built environment is defined as the part of the physical environment that is constructed or modified by human activity.<ref name=":0">Saelens BE, Handy SL. Built environment correlates of walking: a review. Med Sci Sport Exer. 2008;40(7 Suppl):S550-66.</ref> It includes homes, schools, workplaces, parks or recreation areas, green-ways, business areas and transportation systems.<ref>National Institute of Environmental Health Sciences 2004 p 2</ref> In public health, a built environment refers to physical environments that are designed with health and wellness as integral parts of communities and it includes open spaces, footpaths, cycle lanes, parks, trails.<ref>Renalds, A; Smith T; Hale, P (2010). "A Systematic Review of Built Environment And Health". Family and Community Health.'''33:''' 68-78.</ref> The emphasis on the role of built environment is necessary as encouraging people to be more physically active in an environment that is not supportive is less likely to be effective.  
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Physical activity can be classified into four domains of life that describe how people spend their time: recreational, occupational, transport and household activities. Recreational and transport physical activity are relevant to and driven by the built environment features.<ref>Pratt M, Macera CA, Sallis JF, O'Donnel M, Frank LD. Economic interventions to promote physical activity: application of the SLOTH model. Am J Prev Med.2004;27 suppl 3:136-145.</ref> Physical activity is promoted by the built environment through walkable neighborhoods, presence of sidewalks, walking paths and bike paths and presence of recreational and sports infrastructure including parks, pools, playgrounds, and sport clubs.  
Physical activity can be classified into four domains of life that describe how people spend their time: recreational, occupational, transport and household activities. Recreational and transport physical activity are relevant to and driven by the built environment features.<ref>Pratt M, Macera CA, Sallis JF, O'Donnel M, Frank LD. Economic interventions to promote physical activity: application of the SLOTH model. Am J Prev Med.2004;27 suppl 3:136-145.</ref> Physical activity is promoted by the built environment through walkable neighborhoods, presence of sidewalks, walking paths and bike paths and presence of recreational and sports infrastructure including parks, pools, playgrounds, and sport clubs.  


Using the built environment as an intervention for improving physical activity offers numerous advantages. Diverse to individual level approaches, developing a supportive environment has the potential to achieve biggest reach for long term, population-wide improvements in physical activity levels and facilitate behavior change maintenance.<ref>Kwansnicka D, Dombrowski SU, White M, Sniehotta F. Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychol Rev. 2016;10:277-96.</ref>  Also,physical activity interventions that reach a large numbers of people over a sustained period of time are often more cost effective than individual level interventions.<ref>Wu S, Cohen D, Shi Y, Pearson M, Sturm R. Economic Analysis of physical activity interventions. ''Am J Prev Med''. 2011;40(2):149-58.</ref>  
Using the built environment as an intervention for improving physical activity offers numerous advantages. Diverse to individual level approaches, developing a supportive environment has the potential to achieve biggest reach for long term, population-wide improvements in physical activity levels and facilitate behavior change maintenance.<ref>Kwansnicka D, Dombrowski SU, White M, Sniehotta F. Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychol Rev. 2016;10:277-96.</ref>  Also, physical activity interventions that reach a large numbers of people over a sustained period of time are often more cost effective than individual level interventions.<ref>Wu S, Cohen D, Shi Y, Pearson M, Sturm R. Economic Analysis of physical activity interventions. ''Am J Prev Med''. 2011;40(2):149-58.</ref>  


== Features of Built Environment ==
== Features of Built Environment ==
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4.      Community environment: mostly contextual features of the environment such as aesthetics, cleanliness, traffic, crime safety or community support or cohesion.
4.      Community environment: mostly contextual features of the environment such as aesthetics, cleanliness, traffic, crime safety or community support or cohesion.


Features of the built environment that has been found to correlate with physical activity levels include mixed land use, population density, street connectivity, and physical infrastructure including footpaths.<ref>Gebel K, Bauman AE, Petticrew M. The physical environment and physical activity: a critical appraisal of review articles. ''Am J Prev Med''. 2007;32(5):361-9</ref> These features have the potential to influence both recreational and travel related physical activity. For instance, certain features of the neighborhood environment- sidewalks, streetlights, and terrain might make recreational activity more appealing. Meanwhile, other characteristics such as residential density, proximity to destinations and grid like street patterns might make it easier or more pleasant to walk or bicycle for transportation.
Specific features of the built environment that has been found to correlate with physical activity levels include mixed land use, residential density and street connectivity.<ref>Gebel K, Bauman AE, Petticrew M. The physical environment and physical activity: a critical appraisal of review articles. ''Am J Prev Med''. 2007;32(5):361-9</ref><ref name=":2" /><ref name=":3" /><ref name=":0" />These features have the potential to influence walking for recreational and travel related physical activity. For instance, presence of sidewalks, streetlights might make recreational activity more appealing. Meanwhile, proximity to destinations and grid like street patterns might make it easier or more pleasant to walk or bicycle for transportation.


== Walkable Neighborhoods ==
== Walkable Neighborhoods ==
The extent to which the built environment is friendly to the presence of people living, shopping visiting, enjoying or spending time in the area is termed “Walkability.”<ref>Abley, Stephen. “Walkability Scoping Paper” 21 March 2005. Retrieved 4/21/08</ref> A walkable neighborhood is one that is densely populated, where several businesses and services are present, where the streets are well connected to facilitate easily connection by pedestrians. High urban sprawl is characterized by low land use density, low residential density, absence of a downtown and less street connectivity. Walking, cycling and public transport are made impractical with high urban sprawl and as such are associated with sedentary lifestyles.  
The extent to which the built environment is friendly to the presence of people living, shopping visiting, enjoying or spending time in the area is termed “Walkability.”<ref>Abley, Stephen. “Walkability Scoping Paper” 21 March 2005. Retrieved 4/21/08</ref> A walkable neighborhood is one that is densely populated, where several businesses and services are present, where the streets are well connected to facilitate easily access by active transportation. Walking and cycling facilities like sidewalks, crosswalks, and bike lanes are also present in a walkable neighborhood. High urban sprawl is characterized by low land use density, low residential density, absence of a downtown and less street connectivity. Walking, cycling and public transport are made impractical with high urban sprawl and as such are associated with sedentary lifestyles.
* Residential density refers to the number of residential units per unit of land area. It means more destinations such as shops, services, and public transport stops nearby.<ref>Lee C, Moudon AV. Correlates of walking for transportation or recreation purposes. J Phys Act Health. 2006;3S77-S98.</ref> <ref name=":4">Saelens BE, Sallis JF, Frank LD: Environmental correlates of waking and cycling: findings from the transportation, urban design and planning literatures. Ann Behav Med 2003, 25: 80-91.</ref>
* Land use mix diversity refers to the level of integration within an area of different types of uses for physical space. this includes residential, office, retail, industry and public space.<ref name=":4" />
* Street connectivity refers to  the ease of travel between two points which is directly related to characteristics of street design. It's characterized by many interconnected streets.<ref name=":4" />
* Accessibility refers to the ease by which desired places or activities can be reached and refers to the land use system and transportation system.<ref>Handy SL: Evaluating neighborhood accessibility: possibilities and praticalities. Journl of transportation and statistics 2001, 4: Dec.</ref>
The design and maintenance of neighborhoods, streets, parks and people’s perception of those places based on qualities such as aesthetic appeal and perceived safety can affect physical activity in adults and youths. For leisure walking, the perceived aesthetics- visual appeal or pleasantness of an environment- and safety from crime and traffic can affect walking.  


Studies relating attributes of neighborhood environments and physical activity particularly within the U.S, Australia and a few European nations found that walkable neighborhoods characterized by high density, well connected grid-like street networks and accessible and diverse destinations within walking distance<ref name=":0" /><ref>Heath GW, Brownson RC, Miles R, Powell KE, Ramsey LT: Task Forceon Community Preventive Services. The effectiveness of urban design and land use and transport policies to increase physical activity:  systematic review ''J Phys Act Heal'' 2006,3:S55-S76.</ref> were associated with active transportation, particularly walking for transport.<ref name=":0" /><ref>Ewing R, Cervero R: Travel and the Built Environment. J Am Plan Assoc 2010, 76:265-294.</ref>
Studies relating attributes of neighborhood environments and physical activity particularly within the U.S, Australia and a few European nations found that walkable neighborhoods characterized by high density, well connected grid-like street networks and accessible and diverse destinations within walking distance<ref name=":0" /><ref>Heath GW, Brownson RC, Miles R, Powell KE, Ramsey LT: Task Forceon Community Preventive Services. The effectiveness of urban design and land use and transport policies to increase physical activity:  systematic review ''J Phys Act Heal'' 2006,3:S55-S76.</ref> were associated with active transportation, particularly walking for transport.<ref name=":0" /><ref>Ewing R, Cervero R: Travel and the Built Environment. J Am Plan Assoc 2010, 76:265-294.</ref> Additionally, access to parks and recreation facilities shows significant associations with recreational physical activity.<ref>Kaczynski AT, Henderson KA (2007).Enviromental correlates of physical activity: a review of evidence about parks and recreation ammenities Leisure Sciences; 29: 315-54.</ref> The presence of existing and new public transportation options in neighborhoods appears associated with greater physical activity.<ref>MacDonald JM, Stokes RJ, Cohen DA, Kofner A, Ridgeway GK: The effect of light rail transit on body mass index and physical activity. Am J Prev Med 2010, 39:105-112.</ref><ref>Besser LM, Dannenberg AL: Walking to public transit:steps tp meet physical activity recommendations. Am J Prev Med 2005, 29:273-280.</ref>
 
Additionally, access to parks and recreation facilities shows significant associations with recreational physical activity.<ref>Kaczynski AT, Henderson KA (2007).Enviromental correlates of physical activity: a review of evidence about parks and recreation ammenities Leisure Sciences; 29: 315-54.</ref> The presence of existing and new public transportation options in neighborhoods appears associated with greater physical activity.<ref>MacDonald JM, Stokes RJ, Cohen DA, Kofner A, Ridgeway GK: The effect of light rail transit on body mass index and physical activity. Am J Prev Med 2010, 39:105-112.</ref><ref>Besser LM, Dannenberg AL: Walking to public transit:steps tp meet physical activity recommendations. Am J Prev Med 2005, 29:273-280.</ref>


==  Relationship between Physical Activity and Built Environment ==
==  Relationship between Physical Activity and Built Environment ==
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The presence of sidewalks and bike paths in neighborhoods promotes active transportation particularly when several destinations- business, schools etc are located close to homes and the routes linking them encourage biking, walking and public transit. Availability, proximity and quality of public open spaces and parks encourage people to be physically active during leisure time.
The presence of sidewalks and bike paths in neighborhoods promotes active transportation particularly when several destinations- business, schools etc are located close to homes and the routes linking them encourage biking, walking and public transit. Availability, proximity and quality of public open spaces and parks encourage people to be physically active during leisure time.
The design and maintenance of neighborhoods, streets, parks and people’s perception of those places based on qualities such as aesthetic appeal and perceived safety can affect physical activity in adults and youths. For leisure walking, the perceived aesthetics- visual appeal or pleasantness of an environment- and safety from crime and traffic can affect walking.


Attractiveness of the neighborhood environment is also associated with recreational walking. Neighborhood aesthetics such as enjoyable scenery, pleasant neighborhood and attractive appearance
Attractiveness of the neighborhood environment is also associated with recreational walking. Neighborhood aesthetics such as enjoyable scenery, pleasant neighborhood and attractive appearance

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Introduction[edit | edit source]

The environment is integral to encouraging physical activity.[1]  The built environment is an aspect of the environment that is increasingly receiving research attention.[2]  Recommended levels of physical activity can be achieved by including activities such as walking, cycling as part of everyday life. This can be encouraged with a supportive built environment. Even though individual and social factors affect physical activity,[3] research has shown that a well-designed environment matters.[4][5][6] Public health professionals can advocate for policies to help shape the design of cities and suburbs in ways to encourage physical activity.

The built environment is defined as the part of the physical environment that is constructed or modified by human activity.[7] It includes homes, schools, workplaces, parks or recreation areas, green-ways, business areas and transportation systems.[8] In public health, a built environment refers to physical environments that are designed with health and wellness as integral parts of communities and it includes open spaces, footpaths, cycle lanes, parks, trails.[9] The emphasis on the role of built environment is necessary as encouraging people to be more physically active in an environment that is not supportive is less likely to be effective.

Physical activity can be classified into four domains of life that describe how people spend their time: recreational, occupational, transport and household activities. Recreational and transport physical activity are relevant to and driven by the built environment features.[10] Physical activity is promoted by the built environment through walkable neighborhoods, presence of sidewalks, walking paths and bike paths and presence of recreational and sports infrastructure including parks, pools, playgrounds, and sport clubs.

Using the built environment as an intervention for improving physical activity offers numerous advantages. Diverse to individual level approaches, developing a supportive environment has the potential to achieve biggest reach for long term, population-wide improvements in physical activity levels and facilitate behavior change maintenance.[11] Also, physical activity interventions that reach a large numbers of people over a sustained period of time are often more cost effective than individual level interventions.[12]

Features of Built Environment[edit | edit source]

Built environment features that are hypothesized to be associated with recreational activity have been divided into four categories;

1.      Recreational resources: walking trails, biking trails, parks and open spaces

2.      Land use characteristics: residential and employment density, land use mix (types of buildings, services and businesses in the community), street connectivity (grid pattern, cul-de-sac and loop holes) and proximity of destinations (shops, employment and services) to residences.

3.      Neighborhood form characteristics: availability of sidewalks and street light

4.      Community environment: mostly contextual features of the environment such as aesthetics, cleanliness, traffic, crime safety or community support or cohesion.

Specific features of the built environment that has been found to correlate with physical activity levels include mixed land use, residential density and street connectivity.[13][2][6][7]These features have the potential to influence walking for recreational and travel related physical activity. For instance, presence of sidewalks, streetlights might make recreational activity more appealing. Meanwhile, proximity to destinations and grid like street patterns might make it easier or more pleasant to walk or bicycle for transportation.

Walkable Neighborhoods[edit | edit source]

The extent to which the built environment is friendly to the presence of people living, shopping visiting, enjoying or spending time in the area is termed “Walkability.”[14] A walkable neighborhood is one that is densely populated, where several businesses and services are present, where the streets are well connected to facilitate easily access by active transportation. Walking and cycling facilities like sidewalks, crosswalks, and bike lanes are also present in a walkable neighborhood. High urban sprawl is characterized by low land use density, low residential density, absence of a downtown and less street connectivity. Walking, cycling and public transport are made impractical with high urban sprawl and as such are associated with sedentary lifestyles.

  • Residential density refers to the number of residential units per unit of land area. It means more destinations such as shops, services, and public transport stops nearby.[15] [16]
  • Land use mix diversity refers to the level of integration within an area of different types of uses for physical space. this includes residential, office, retail, industry and public space.[16]
  • Street connectivity refers to the ease of travel between two points which is directly related to characteristics of street design. It's characterized by many interconnected streets.[16]
  • Accessibility refers to the ease by which desired places or activities can be reached and refers to the land use system and transportation system.[17]

The design and maintenance of neighborhoods, streets, parks and people’s perception of those places based on qualities such as aesthetic appeal and perceived safety can affect physical activity in adults and youths. For leisure walking, the perceived aesthetics- visual appeal or pleasantness of an environment- and safety from crime and traffic can affect walking.

Studies relating attributes of neighborhood environments and physical activity particularly within the U.S, Australia and a few European nations found that walkable neighborhoods characterized by high density, well connected grid-like street networks and accessible and diverse destinations within walking distance[7][18] were associated with active transportation, particularly walking for transport.[7][19] Additionally, access to parks and recreation facilities shows significant associations with recreational physical activity.[20] The presence of existing and new public transportation options in neighborhoods appears associated with greater physical activity.[21][22]

Relationship between Physical Activity and Built Environment[edit | edit source]

Street connectivity is a major built environment feature that could have direct influence on physical activity, particularly walking. Well connected street networks create more and shorter routes to destinations and also ease walking from place to place. Grid streets designs assists pedestrian movement with two inherent characteristics; frequent intersections and orthogonal geometry.

Proximity makes walking, cycling and public transport to access jobs, services and schools achievable. Placing residential and commercial areas in close proximity helps to reduce reliance on private motor vehicles while encouraging active transportation.

The presence of sidewalks and bike paths in neighborhoods promotes active transportation particularly when several destinations- business, schools etc are located close to homes and the routes linking them encourage biking, walking and public transit. Availability, proximity and quality of public open spaces and parks encourage people to be physically active during leisure time.

Attractiveness of the neighborhood environment is also associated with recreational walking. Neighborhood aesthetics such as enjoyable scenery, pleasant neighborhood and attractive appearance

For leisure walking, the perceived aesthetics- visual appeal or pleasantness of an environment- and safety from crime and traffic can affect walking.[5][23]

A built environment that is safe, attractive, promotes easy access to healthy food, and variety of opportunities to be physically active in their daily lives is considered conducive to the adoption of healthy lifestyles.

Subheading 5[edit | edit source]

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ Goldstein B. The environment and health:a conversation with CDC chief Jeffrey Koplan; tracing intersections between behaviour and environment fascinates this top health officer. Health Affairs 2002;21:179-184 [Pub Med]
  2. ↑ 2.0 2.1 Sallis JF, Floyd MF, Rodriguez DA, Saelens BE. Role of built environments in physical activity, obesity, and cardiovascular disease. Circulation. 2012;125(5):729-37
  3. ↑ Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of Physical Activity: Why are some physically active and others are not? Lancet 2012;380(9838):258-271.
  4. ↑ Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF. Measuring the built environment for physical activity: State of Science. Am J Prev Med.2009;36(4 Supplement):S99-S123.e12.
  5. ↑ 5.0 5.1 Ding D, Sallis JF, Kerr J, Lee S, Rosenburg DE. Neighborhood environment and physical activity among youth: A Review. Am J Prev Med.2011;41(4):442-455.
  6. ↑ 6.0 6.1 Sugiyama T, Leslie E, Giles-Corti B, Owen N. Physical activity for recreation or exercise on neighborhod streets: Associations with perceived environmental attributes. Health Place 2009;15(4):1058-1063.
  7. ↑ 7.0 7.1 7.2 7.3 Saelens BE, Handy SL. Built environment correlates of walking: a review. Med Sci Sport Exer. 2008;40(7 Suppl):S550-66.
  8. ↑ National Institute of Environmental Health Sciences 2004 p 2
  9. ↑ Renalds, A; Smith T; Hale, P (2010). "A Systematic Review of Built Environment And Health". Family and Community Health.33: 68-78.
  10. ↑ Pratt M, Macera CA, Sallis JF, O'Donnel M, Frank LD. Economic interventions to promote physical activity: application of the SLOTH model. Am J Prev Med.2004;27 suppl 3:136-145.
  11. ↑ Kwansnicka D, Dombrowski SU, White M, Sniehotta F. Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychol Rev. 2016;10:277-96.
  12. ↑ Wu S, Cohen D, Shi Y, Pearson M, Sturm R. Economic Analysis of physical activity interventions. Am J Prev Med. 2011;40(2):149-58.
  13. ↑ Gebel K, Bauman AE, Petticrew M. The physical environment and physical activity: a critical appraisal of review articles. Am J Prev Med. 2007;32(5):361-9
  14. ↑ Abley, Stephen. “Walkability Scoping Paper” 21 March 2005. Retrieved 4/21/08
  15. ↑ Lee C, Moudon AV. Correlates of walking for transportation or recreation purposes. J Phys Act Health. 2006;3S77-S98.
  16. ↑ 16.0 16.1 16.2 Saelens BE, Sallis JF, Frank LD: Environmental correlates of waking and cycling: findings from the transportation, urban design and planning literatures. Ann Behav Med 2003, 25: 80-91.
  17. ↑ Handy SL: Evaluating neighborhood accessibility: possibilities and praticalities. Journl of transportation and statistics 2001, 4: Dec.
  18. ↑ Heath GW, Brownson RC, Miles R, Powell KE, Ramsey LT: Task Forceon Community Preventive Services. The effectiveness of urban design and land use and transport policies to increase physical activity: systematic review J Phys Act Heal 2006,3:S55-S76.
  19. ↑ Ewing R, Cervero R: Travel and the Built Environment. J Am Plan Assoc 2010, 76:265-294.
  20. ↑ Kaczynski AT, Henderson KA (2007).Enviromental correlates of physical activity: a review of evidence about parks and recreation ammenities Leisure Sciences; 29: 315-54.
  21. ↑ MacDonald JM, Stokes RJ, Cohen DA, Kofner A, Ridgeway GK: The effect of light rail transit on body mass index and physical activity. Am J Prev Med 2010, 39:105-112.
  22. ↑ Besser LM, Dannenberg AL: Walking to public transit:steps tp meet physical activity recommendations. Am J Prev Med 2005, 29:273-280.
  23. ↑ Owen N, Humpel N, Leslie E, Bauman A, Sallis JF. Understanding environmental influence on walking: Review and Research Agenda. Am J Prev Med.2004;27(1):67-76
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