challenges for active transport to school in urban and rural new … · 89.1% 11.8% distance(km)...
TRANSCRIPT
1
Challenges for Active Transport to School in Urban and Rural New Zealand:
Insights from the BEATS Research Programme
Associate Professor Sandy MandicActive Living Laboratory
University of Otago
Email: [email protected]
TALES Symposium 2019 | Dunedin, New Zealand | 13 Feb 2019 www.otago.ac.nz/active-living
Teamwork | Curiosity | Creativity | Excellence
Areas of research
• Physical Activity• Public Health• Transport• Built Environment• Sustainability
Exercise science
Exp
ert
ise
Geographic information
science(GIS)
Childrenand health
geographies
Behavioural medicine;
Research methods
Māori health
Geographies of transport
andmobilities
Education
Public health; Community
interventions
SandyMandic
AntoniMoore
Christina Ergler
EnriqueGarcía John
Spence
Anna Rolleston
Debbie Hopkins
Susan Sandretto
Kirsten Coppell
Michael Keall
Biostatistics
Physical activity and health
BEATS Team 2018: Multidisciplinary Expertise
Advisory Board Members:
Gavin Kidd, Gordon Wilson (Dunedin Secondary Schools’ Partnership)
Nick Sargent (Dunedin City Council)
Greame Rice (NZ Transport Agency)
Janet Stephenson (Centre for Sustainability)
Frank Edwards (Māori) and FinauTaungapeau(Pacific) community representatives
Physicalactivityand health
promotion
BEATS Research Programme
Report 2013-2018
Now available on the BEATS Study website:
www.otago.ac.nz/beats
Want to know more?
Sign up for Active Living Laboratory Newsletter:
https://goo.gl/jtqdAo
New Zealand Physical Activity Report Card for Children and Adolescents 2018
Indicator Grade
Overall physical activity D-
Organized sport participation B
Active play C+
Active transportation C-
Sedentary behaviours D
Physical fitness INC
Family and peers C-
School B-
Community and environment B
Government B+
Grade indicators: A=81%-100%; B=61%-80%; C=41%-60%; D: 21%-40%; F=0%-20%; N/A=Not applicable; INC=incomplete/insufficient data.
Smith M et al. (2018) Full report.doi: 10.17608/k6.auckland.7295882
Weight Status and Physical Activityin New Zealand Adolescents
National Survey of Children and Young People Physical Activity and Dietary Behaviour in NZ. 2007/08
Age (years)
Mee
ting
PA
gui
delin
es (
%)Underweight
3.2%
Healthy weight69.6%
Overweight20.5%
Obese6.8%
Source: BEATS Study (2014/2015)1,300 Dunedin adolescents
(measured heights and weights)
Mandic et al. Am J Health Behav. 2017;41(3):266-275
2
Physical Activity (PA) in Dunedin Adolescents
Accelerometer assessment of physical activity (n=314)
Sedentary activities: ~9.6 hrs/day (70%)
Light physical activity: ~3.2 hrs/day (25%)
Moderate-to-vigorous physical activity:
~1.0 hrs/day (<10%)
Average daily activity profile:
39.2% met PA guidelines(45.6% boys, 36.0% girls; p=0.101)
Kek CC et al. J Sport Health Sci. (in press)
Guidelines:≥60 min per day
Average: 4.2 ± 2.1 days/week
17.9% met PA guidelines
Mandic et al. Am J Health Behav. 2017;41(3):266-275
Self-reported physical activity
(n=1,300)
Ministry of Transport. (2015). 25 years of New Zealand travel: New Zealand household travel 1989–2014. Wellington: Ministry of Transport.
1989/1990 2010-2014
2.5 million vehicles
3.4 million vehicles
72% car travel 78% car travel
755 deaths 294 deaths
1h/day travel(28 min driving)(10 min walking)
1h/day travel(32 min driving)(8 min walking)
Travel to school:21% driven26% walking19% cycling
Travel to school: 32% driven27% walking3% cycling
Built Environment andTransport-Related Physical Activity
www.designedtomove.org
Built Environment and Transportation
• Walkable community design
– Density
– Connected streets
– Mixed land uses
– Access to transit
• Pedestrian & bicycle facilities
– Access; Connectivity
– Design; Quality; Safety
• Perceived environment: accessibility and convenience
Sallis SF et al. Circulation. 2012;125:729-737http://www.houselogic.com/home-advice/green-living/make-my-neighborhood-more-walkable/
http://switchboard.nrdc.org/blogs/kbenfield/how_communities_can_support_wa.html
• Investigates:
– transport to school habits,
– the neighbourhood environment and
– physical activity habits
in Otago adolescents. www.otago.ac.nz/beatsMandic S et al. BMJ Open. 2016; 6:e011196
BEATS Research Programme at Otago BEATS Research Programme Framework:Ecological Model for Active Transport
Individual
Social/Cultural Environment
BuiltEnvironment
PolicyEnvironment
SociodemographicsBehaviour
Motivations/barriers
Social supportSocial norms
Walkable community design
Pedestrian & bicycle facilities
School policy for ATSSchool’s road safety
procedures
Adapted from Sallis JF et al. Circulation. 2012;125:729-737
Mandic S et al. BMJ Open. 2016; 6:e011196
3
Research Methodology
Survey Maps; GIS Analysis Physical Activity
Focus groups
Adolescents & Parents
Adolescents
Anthropometry
School bag weightAdolescents, Parents, Teachers
Interviews
School Principals
Mandic S et al. BMJ Open. 2016; 6:e011196
BEATS Research Programme (2013-2022)
URBAN RURAL
BEATS Study
(2014-2017)(Dunedin)
BEATS Rural Study
(2018-2019)(Rural Otago)
BEATS Natural Experiment
(2020-2022)(Dunedin)
11 Schools1014 Adolescents
78 Parents2 Principals
12 Schools1780 Adolescents
355 Parents14 Teachers12 Principals
Urban versus rural
BEATS Cultural Study (2018-2019; in progress)
Exercise Science
PublicHealth
TransportBuilt
EnvironmentEducation
Partnerships: City Council CommunityAcademia Schools
Disciplines & impact areas:
Significance
Understanding influences of multiple factors will enable the scientific community, policy makers, regional planners, and health promoters to address barriers to active transport to school
Generating important information for key stakeholders for planning future school-, neighbourhood- and city/town-wide built environment changes to encourage active transport to school
If effective, population level initiatives aimed to ↑ physical activity across all groups such as pedestrian and/or cycling infrastructure construction/ improvements will contribute to improving health and wellbeing of communities
Involvement of the key stakeholders facilitates the generation of usable data, relevant to the local contextand generalisable to other areas, and the incorporation of new knowledge into policy and future initiatives
BEATS Research Programme 2013-2018: Overview
BEATS Study(Dunedin; 2014-2017)
BEATS Rural Study(Rural Otago; 2018-2019)
BEATS Natural Experiment(Dunedin;
2020-2022)
Subject to funding
11 Schools1014 Adolescents
78 Parents2 Principals
12 Schools1780 Adolescents
355 Parents14 Teachers12 Principals
BEATS Cultural Study
(Dunedin & Bay of Plenty;2018-2019)
In progress
Exercise Science Public Health Transport Built Environment Education
Partnerships: City Council CommunityAcademia Schools
Disciplines & impact areas:
The CatalystProject
(Rural Otago; 2020)
Subject to funding
Transport sector
Members:• 10 Investigators• Advisory Board members• Research staff • Research students• Collaborators
Team’s expertise:• Exercise sciences• Public health• Physical activity promotion• Behavioural medicine• Biostatistics
• Māori Health• Geographies of transport• Children geographies• Geographic Information Science • Education
Research team:
Research data collection:
• Survey• Anthropometry• Accelerometers• Focus group/interview• Mapping
Adolescents
Projects:
Parents Teachers /
Principals
• Built environment analysis (Geographic Information Science)
• Environmental scan of school neighbourhoods
Spin-off projects:• Evaluation of cycle skills training programme (2015-2017)• Examining cycle skills training content and delivery (2017-2018)• BEATS Study Symposium (2014; 2016; 2018)• The Active Living and Environment Symposium (2017; 2019)
Research outputs (as of Feb 2019):15 Journal articles
1 Book chapter103 Conference abstracts
38 Technical reports
25 Seminar presentations for academic audiences
21 Seminar presentations for non-academics
BEATS Research Programme (2014-2018)
Dunedin City (2014-2017)
12 Secondary schools (100% school recruitment rate) 11 Secondary schools
(73% school recruitment rate)
Dunedin
Otago Region(2018-2019)
BEATS Study BEATS Rural Study
Otago Secondary Schools Supporting BEATS (23 out of 27 schools; 85%)
Dunedin (2014/15)(12 out of 12 school)
Rural Otago (2018)(11 out of 15 school)
Total sample of adolescents (n=2,656)
4
Spin OffProjects
Evaluations of Cycle Skills
Training
(2015-2017)
Cycle Skills Training Content
and Delivery
(2018-2019)
BEATS Study Symposia
2014 | 2016 | 2018
2nd 2019
1st 2017
(2020)
Comprehensive Dissemination of Research Findings
Last updated: Feb 2019
Journal articles
Conference abstracts
Technical Reports SymposiaPresentations
BEATS Research Programme Outputs to Date
38 Published(including 4
progress reports)
2 Keynotes3 Invited
25 Academic21 Non-academic
3 Local(2014; 2016; 2018)
2 International (2017; 2019)
15 Published2 in review
6 in preparation1 Book chapter
28 International21 National
54 Local
BEATS Research Programme Findings (2014-2018)
Transport to School Habits across OtagoTotal sample
(n=2,656)
15.2%
55.0%
29.8%
Active Transport
Motorised + Active
Transport
Motorised Transport
No significant difference across urbanisation settings
Mandic S et al. (abstract). ISBNPA 2019 (Accepted)
Among adolescents ineligible for subsidised school bus
(living within 4.8 km from school)
38.8%47.9%
58.5%
0%
20%
40%
60%
80%
100%
Main urbancentre
Semi urbanareas
Ruralsettlements
Active transport to school
p<0.001
89.9% liked how they travel to school
78.9% had a bicycle at home
75.8% had 2+ vehicles at home
Threshold distance for walking to school:
≤2.25 kmSensitivity: 85%Specificity: 86%
AUC: 93%
Threshold Distance for Walking and Cycling to School in Adolescents
1.3-2.5 km
≤4.0 km
Pocock T et al. Health & Place. 2019;55:1-8
≤2.3 km ≤4.0km Beyond4.0km
n=1,475(boarders excluded)
31.7%
53.4%(31.7% + 21.7%)
46.6%
Walkable and Cycleable Distance to Secondary School in Dunedin
Average distanceto secondary school
in Dunedin:
6.2 ± 7.4 km
5
Within walkable distance: 32%
(range: 6% to 64%)
Walking to school rates: 26%
(range: 12% to 47%)
Walkable and Cycling Distancesto Dunedin Secondary Schools
Within cycling distance: 53%
(range: 37% to 79%)
Cycling to school rates: 1.5%
(range: 0% to 7%)
Transport to School Habits across Otago
Source: BEATS Study and BEATS Rural Study (n=2,656)
Optimal distance for walking to school
≤ 2,25 km
Sensitivity: 85%Specificity: 86%
AUC: 93%
89.1% 11.8%
Dis
tan
ce(k
m)
3.7 3.26.2
0
2
4
6
8
10
Main urbancentre
Semi urbanarea
Ruralsettlements
Median distance to school (km)
p=0.037
Significant difference across urbanisation settings
Distance to schoolPro
babi
lity
of w
alki
ng
to s
cho
ol
Pocock et al. Health and Place (in press)
(≤4.8 km)
Mandic S et al. (abstract). ISBNPA 2019 (Accepted)
39%55% 50% 46% 45% 41% 39% 38% 35% 30% 30% 26%
17%
0%
25%
50%
75%
100%
URB Bay Que Log Tai JMc Col Kin OB StH Kai Kav OG
Rates of Active Transport to School(Living ≤4.8 from school; boarders excluded)
*Most of the time / All of the time
Urban (n=897)
48%62%
51% 45% 42% 41% 35%
0%
25%
50%
75%
100%
S-URB Cro Tok MtA WG SO StK
Semi-urban (n=457)
59% 65% 62% 60% 56% 50%
0%
25%
50%
75%
100%
RUR BMC Law Cai Rox Man
Rural (n=81)
1% 5% 3% 3% 3% 1% 1% 0% 0% 0% 0% 0% 0%0%
25%
50%
75%
100%
URB Tai Log Kai Kin OB Bay Col JMc Kav OG Que StH
Rates of Cycling to School(living ≤4.8 from school; boarders and mixed modes excluded)
Urban (n=897)
16%32% 22%
6% 3% 2% 0%0%
25%
50%
75%
100%
S-URB MtA Cro Tok StK SO WG
Semi-urban (n=457)
10% 15% 12% 11%0% 0%
0%
25%
50%
75%
100%
RUR Law BMC Rox Man Cai
Rural (n=81)
WanakaCromwell
Transport to School and Physical Activity in Dunedin Adolescents
Chiew Ching Kek
Motorized Transport (n=185)
Active and Motorized Transport
(n=56)
Met physical activity guidelines
Physical activity differences by transport mode were observed:
• In girls but not boys
• On school days but not weekend days
• Only during school commute time
Active Transport
(n=73)
47.9% 46.4% 33.5%
Kek CC et al. J Sport Health Sci. (in press)
Both active transport and combined active and motorized transport to/from school are potential avenues to increase daily physical
activity in adolescents, particularly in adolescent girls.
Perceptions of Distance to School(among adolescents living ≤4.8 km from school)
Mandic S et al. (abstract). ISBNPA 2019 (Accepted)
28%
8%0%
0%
20%
40%
60%
80%
100%
Main urbancentre
Semi urbanareas
Ruralsettlements
It is too far to walk to school.
37%
20%12%
0%
20%
40%
60%
80%
100%
Main urbancentre
Semi urbanareas
Ruralsettlements
It is too far to cycle to school.
*p<0.001 *p<0.001
6
Adolescents’ Perspective
Mandic S et al. Journal of Transportation and Health. 2017: 4:294-304.
BEATS Student Survey (n=764)(adolescents living ≤4 km from school)
The Tale of Two New Zealand CitiesDunedin
(n=430)
38.4%
47.2%
1.9%
Christchurch (n=373)
16.9%
50.9%
17.7%
Living ≤4 km from school
Age (years)15.0 ± 1.6
44.9% boys55.1% girls
Age (years)14.3 ± 1.6
62.7% boys37.3% girls
Frater et al. Transp Res F: Traff Psych Behav. 2017;49:205-214
Dominant influence
Attitude Subjective norm
Future interventions should consider interpersonal factors, the social needs of adolescents and adolescents’ cycle skills
Dr Jillian Frater
(Canterbury)
Adolescents’ Perceptions of Route to Schoolfor Walking or Cycling
n=753(non-boarders; living ≤4km from school)
Convenienceof being driven to
school by someoneon the way to
something else
Too much traffic
35.6%
Too many hills
32.9%
Dangerous crossing(s)
32.4% 52.9%
Boring route
33.3%
Mandic S et al. Journal of Transportation and Health. 2017: 4:294-304.
Parental Barriers to Active Transport to School
Convenienceof trip chaining
Fewer barriers for walking compared to cycling
Future interventions should address parental barriers for active transport to school (especially for cycling).
Mandic S et al. (Abstract); OERC Symposium 2016 and ISBNPA 2017.
68.8%68.1% 65.5% 60.8%
57.3% 37.2%
66.4%
41.6%
Perceptions of Safety(among adolescents living ≤4.8 km from school)
Mandic S et al. (abstract). ISBNPA 2019 (Accepted)
It is unsafeto walk to school.
12% 9% 0%0%
25%
50%
75%
100%
Urban Semi-urban
Rural
It is unsafe to cycle to school.
*p<0.006
Adolescents’concerns
Parentalconcerns
(reported by adolescents)13% 8% 3%
0%
25%
50%
75%
100%
Urban Semi-urban
Rural
40%23%
5%0%
25%
50%
75%
100%
Urban Semi-urban
Rural
31%15% 4%
0%
25%
50%
75%
100%
Urban Semi-urban
Rural
*p<0.006 *p<0.001
*p<0.001
Perceptions of Cycling to School(From Student and Parental Focus Groups)
• Perceived safety:– A complex range of factors including:
• Features and perceptions of the built environment
• Traffic safety (including behaviours of other road users)
• Previous cycling experiences (including accidents)
• Adolescents’ cycling skills and on-road experiences
• Implicit messages
• Social normsHopkins D and Mandic S. International Journal of
Sustainable Transportation 2017;11(5):342-356
Dr Debbie Hopkins(Oxford)
7
Cycle Skills Training: Perceptions and Evaluation
Mandic S et al. Transport Res F Psychol Behav. 2016;42:217-226
39% of adolescentsCycle skills training could make adolescents
safer in traffic
Mrs Charlotte Flaherty (DCC)
73% of parentsInterventions should capitalize on this interest
Mandic S et al. J Transp Health. 2017;6:411-419
Evaluation of Cycle Skills Training Programme in Dunedin (2015-2017)
https://www.odt.co.nz/news/dunedin/action-urged-get-more-cycling-school
Mandic et al. J Trans Health. 2018;8:271-282 Mandic et al. J Trans Health. 2018;9:253-263
(BEATS Spin-off project)
Cycle Skills Training (CST) Intervention
Mandic S et al. J Trans Health. 2018; 8: 271-282Mandic et al. J Trans Health. 2018; 9: 253-263
Effects of Cycle Skills Training (CST) in Children
Traffic-Free CST
(n=164)
Traffic-Free + On-Road CST
(n=265)
To achieve behavioural change, additional interventions may be necessary.
Cycling-related knowledge
… in parks/reservesSelf-perceived confidence to cycle
… on the road… to school
Pre-training Post-training
Cycling behaviours and preferences
Improved
(1-6weeks)
Rates of cycling to school
Cycling as a preferred modeof transport to school
Improved
Improved
No change
Improved
Improved
Improved
No change
No change(3.1% to 2.4%)
Increased(10.6% to 12.5%)
No change(33.8% to 34.1%)
No change(44.3% to 45.7%)
Pre-training Post-training
Mandic et al. J Trans Health. 2018; 8: 271-282
Cycle Skills Training (CST) in Adolescent Girls
Traffic-Free CST
(n=43)
Traffic-Free + On-Road CST
(n=74)
Future CST programs should be tailored to adolescents’ needs and preferences.
Cycling-related knowledge
… in parks/reservesSelf-perceived confidence to cycle
… on the road… to school
Pre-training Post-training
Cycling behaviours and preferences
Improved
Rates of cycling to school
Cycling as a preferred modeof transport to school
Improved
No change
Improved
Improved
No change
No change(0% to 0%)
No change(0% to 0%)
No change(10.8% to 10.8%)
Pre-training Post-training
(1-10 weeks)
No change
No change
No change(4.1% to 5.4%)
Mandic et al. J Trans Health. 2018;9:253-263
Enablers of Cycling to School:Adolescents’ Perspective
Cycle-friendlyuniform
41.4% 40.1%
Safer bike storageat school
Slower traffic
36.4%
Bus bike racksfree of charge
26.2% 32.7%
Bike ownership Cycling withouta helmet
22.1%
n=764(non-boarders;
within ≤4km)
Mandic S et al. Journal of Transportation and Health. 2017: 4:294-304.
Cycle Helmet Legislation as a Barrier to Cycling to School
774 Adolescents living ≥4 km from school (BEATS Study; Dunedin) Molina-García et al. (2018) J Transp Health. 11, 64-72
Adolescents would cycle to school more if helmet use was not mandatory
Recommendations:
Design educational interventions to influence adolescents’ attitudes towards the use of helmets. • Could be offered
as part of cycle skills training
22%
Significant factors:
• Distance to school • Māori and other ethnicities (vs. NZ European)
• Cycling to school is ‘not cool’• Cycling often with friends• Boring route to school• Cycling as a great way to exercise (+)
8
Active transport users were less likely to report heavy
school bags
School Bag Weight as a Barrier
682 Adolescents and 331 parentsBEATS Study (Dunedin) Mandic S et al. (2018) Children. 5:129
Adolescents:School bag perceived as a barrier to active transport to school
68% of parents58% for walking66% for cycling
Full bag weight:
5.6 kg (± 2.1 kg)
9.3% (± 3.9%) of adolescents’
body weight
37.9% Above10%
of body weight
Actual school bag weightsdid not differ by mode of
transport to school.
Being Driven to School: Adolescents’ Perspective
Olivia Eyles
Dr Christina Ergler
(Otago)
Positives Negatives
Eyles O et al. 2018. (Abstract) BEATS Study Symposium.
Bus to School – or Not?Isobelle
LaneDr Christina
Ergler (Otago)
Lane I et al. 2018. (Abstract) BEATS Study Symposium.
New Zealand’s Systematic Meta Analysis
Ikeda E et al. J Transp Health. 2018;9:117-131
Higher rates of active transport to school:
• When distance to school is <1.3 km compared to greater distances• In boys versus girls• In medium decile compared to high decile schools• In home neighbourhoods with higher versus lower street connectivity
Pocock T et al. Health & Place. 2019;55:1-8
• School locations:
• Small-to-medium urban areas (6 schools)
• Rural settlements (5 schools)
• Adolescents’ perceptions of the school neighbourhood environment
• Subsample: Modified NEWS-Y Questionnaire for school neighbourhoods
School Neighbourhoods and Active Transport to School
• Environmental scan of school neighbourhoods
• GIS analysis of school neighbourhood built environment
• Adolescents’ perceptions of the route to school
Tessa Pocock
Schools in an urban centre (Dunedin)
BEATS Rural Study (2018)
White B et al. (abstract) TALES Symposium 2019
Brittany White
Maps with route to schooln=740
1,462 digitized segments347 (24.3%) marked as ‘unsafe’
Adolescents perceptions of ‘unsafe’ segments:
50.2% Built environment characteristics (roads, intersections, lack of footpaths)
39.6% Traffic safety (vehicles, traffic)
25.5% Personal safety (people, dogs, street lighting)
6.3% Other (weather-dependent, winds, glare)
Rodda J et al. BEATS Symposium 2016 (Abstract)
A/Prof Antoni Moore
Dr Judith Rodda
9
School Choice and Transport to School
Mr Gordon Wilson (DSSP)
Dr Susan Sandretto
Mandic S et al. Journal of School Choice. 2018;12(1):98-122
Comments from students and
parents
Social connections
Programmes and
facilities
Co-ed status
Positive feedback about school:
51.9% Students 51.3% Parents
Reasons for school
choice
50.7% Friends enrolled
35.1% Sibling(s) went or enrolled
27.0% Parents attended
68.6% Preferred co-ed
25.3% Preferred single-sex school
52.3% Facilities
46.3% Sports programmes
33.0% Cultural programmes
n=1,465
(boarders excluded)
Other
7.3% Other reasons
Proximity
36.5% Closest school to home
Adolescents’ perspective Negative feedback
from people at closest school:
8.0% Students 8.4% Parents
Mandic S et al. Journal of School Choice. 2018;12(1):98-122
Implications of School Choice Decisions on Active Transport to School
Mandic et al. Journal of Transport and Health.
2017; 6:347-357
Adolescents (n=797)(Special character (integrated) schools and schools with zoning excluded)(Students from 6 out of 12 Dunedin secondary schools (50%) included in the analysis)
Without school zoning,51.3% of adolescents
enrolled in the closest school.
Distance
Importance of school proximity to home
Co-educational school status
Peer feedback
Closest school
Distant school
46.5% 8.8%
School choice has implications for education, health, transport and
environment
40.3% 68.8%
Baseline data (BEATS) (2014/2015) (12 schools)
Follow-up data (2020/2021) (≥10 schools)
Exposure areas:
Cycling and pedestrian
infrastructure construction 2014-2018
(6 ‘exposure’ schools)
Control areas:
No change (no new
infrastructure construction)
(6 ‘control’ schools)
J
A
F
HIE
C
B K
GL
‘Exposure’ schools: Pedestrian infrastructure‘Exposure’ schools: Cycling infrastructure
‘Control’ schools
D
Cycling infrastructure constructed since 2014
Next Challenge:BEATS Natural Experiment (2020-2022)
Online survey
GISAnalysis
Physical activity
(40-50 studentsper school)
School bag weights
Height &weight
Mapping route& school
neighbourhood(30 students per school)
Focus group
(6-8 studentsper school
Environmental scan ofschool
neighbourhoods
Additional activities
Data collection at schools(120-150 students per school; 1 school period)
Built environment analyses
BEATS Natural Experiment: AssessmentsSummary: Factors Influencing Active
Transport to School in Otago Adolescents
Individual
Social/Cultural Environment
BuiltEnvironment
PolicyEnvironment
Sociodemographic characteristics
Preferences, IntentionPerceptionsCycle skills
Social supportSocial norms
School decile/SES
Distance to schoolBuilt environment features
Perceptions of safety
School choice policySchool uniforms
Cycling helmet legislation
Adapted from Sallis JF et al. Circulation. 2012;125:729-737
Mandic S et al. BMJ Open. 2016; 6:e011196
Future research:
• Urban versus rural settings
• Walking versus cycling• Understanding local
context
10
Policy Implications
• Different interventions and approaches are required for increasing rates of walking versus cycling to school
• Different interventions are required in urban versus rural settings
• Minimise adolescents’ and their parents’ safety concerns related to walking and cycling to school
• Promote mixed modes of transport to school when relying solely on active transport is not feasible
• Encourage and support evaluations of the effectiveness of active transport-related infrastructure changes in short-, medium- and long-term
• Consider implications of other relevant policies such as education policies related to school choice, school uniforms and school bag requirements