Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents
Abstract
:1. Introduction
- (1)
- There are sociodemographic differences in perceived neighbourhood walkability, physical activity, and body mass index (BMI) in South African adolescents residing in low-income areas when compared to those residing in middle/high-income areas and;
- (2)
- The perceptions of neighbourhood walkability attributes are significantly associated with levels of physical activity and body mass index (BMI) in South African adolescents.
2. Methods
2.1. School Selection
2.2. Participants
2.3. Ethical Considerations
2.4. Measurements
2.5. Anthropometry
2.6. Questionnaires
Demographic Variables
2.7. Physical Activity Questionnaire
Perceived Neighbourhood Environment Features
3. Data Analysis
4. Results
5. Discussion
5.1. Main Findings and Comparison with Existing Literature
5.2. Strengths and Limitations
5.3. Recommendations and Policy Implications
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Low Residential Income Area [N = 92] | Middle/High Residential Income Area [N = 51] | Total [N = 143] | p-Value |
---|---|---|---|---|
Age | 15 (14,16) | 15 (14,16) | 15 (14,16) | 0.34 |
Sex N (%) | ||||
Male | 28.0 (30.4) | 22.0 (43.1) | 50.0 (35.0) | |
Female | 64.0 (69.6) | 29.0 (59.6) | 93.0 (65.0) | 0.13 |
Waist circumference (cm) | 69.6 (67.1,76.2) | 68.2 (63.3, 73.1) | 69.4 (65.2, 75.4) | 0.03 * |
Body mass index (percentile) | 73.0 (51.4, 90.6) | 56.7 (23.8, 72.7) | 65.7 (43.5, 87.9) | 0.01 * |
Met physical activity recommendation(yes)N (%) | 45.0 (48.9) | 29.0(56.9) | 74.0 (51.7) | 0.36 |
Domains of physical activity (minutes/week) | ||||
Physical education activities (MVPA) | 60.0 (30.0, 60.0) | 45.0 (30.0, 60.0) | 50.0 (30.0, 60.0) | 0.22 |
Informal activities (MVPA) | 60.0 (0.0, 190.5) | 72.5 (18.8, 337.5) | 60.0 (0.0, 220.0) | 0.23 |
School sports (MVPA) | 60.0 (0.0, 120.0) | 120.0 (0.0, 242.5) | 60.0 (0.0, 150.0) | 0.001 * |
Club sports (MVPA) | 40.0 (0.0, 175.0) | 30.0 (0.0, 195.0) | 30.0 (0.0, 180.0) | 0.67 |
Active transport (MVPA) | 0.0 (0.0, 200.0) | 0.0 (0.0, 30.0) | 0.0 (0.0, 120.0) | 0.07 |
Chores | 657.5 (336.3, 1021.8) | 378.0 (117.5, 741.3) | 570.0 (250.0, 960.0) | 0.001 * |
Total MVPA | 407.5 (191.3, 695.0) | 455.0 (295.0, 840.0) | 430.0 (210.0, 765.0) | 0.12 |
Neighbourhood walkability domains | ||||
Residential density | 5.0 (2.0, 5.0) | 5.0 (3.0, 5.0) | 5.0 (3.0, 5.0) | 0.39 |
Access to services and places (land-use mix) | 2.9 (2.4, 3.3) | 3.1 (2.7, 3.4) | 3.0 (2.6, 3.4) | 0.02 * |
Land-use diversity | 2.6 (2.2, 2.8) | 3.0 (2.6, 3.5) | 2.7 (2.3, 3.0) | <0.001 * |
Street connectivity | 3.0 (2.1, 3.2) | 3.0 (2.4, 3.2) | 3.0 (2.2, 3.2) | 0.30 |
Places for walking, cycling, and playing | 2.5 (2.2, 2.8) | 2.9 (2.7, 3.2) | 2.7 (2.3, 3.0) | <0.001 * |
Aesthetics | 2.4 (1.9, 2.8) | 3.0 (2.4, 3.5) | 2.5 (2.1, 3.0) | <0.001 * |
Safety from crime | 2.3 (1.8, 3.0) | 3.3 (2.5, 3.8) | 2.8 (2.0, 3.5) | <0.001 * |
Safety from traffic | 2.7 (2.0, 3.0) | 2.8 (2.3, 3.3) | 2.7 (2.0, 3.2) | 0.04 * |
Personal safety | 3.0 (2.7, 3.3) | 3.3 (2.7, 3.7) | 3.0 (2.7, 3.3) | 0.19 |
Stranger danger | 3.0 (2.3, 3.9) | 3.0 (2.7, 4.0) | 3.0 (2.7, 4.0) | 0.26 |
Walkability index | −0.1 (−0.6, 0.2) | 0.3 (−0.0, 0.6) | 0.0 (−0.3, 0.4) | <0.001 * |
Variables | Female N = 93 | Male N = 50 | Total N = 143 | p-Value |
---|---|---|---|---|
Age (years) | 15 (14, 16) | 15 (14, 16) | 15 (14, 16) | 0.74 |
Waist circumference (cm) | 69.4 (64.4, 76.6) | 70.5 (67.2, 73.5) | 69.4 (65.2, 75.4) | 0.56 |
Body mass index (percentile) | 70.8(48.8, 91.7) | 58.5 (36.5, 73.3) | 65.7 (43.5, 87.9) | 0.005 * |
Met MVPA recommendation(yes) N (%) | 40.0 (43.0) | 34.0 (68.0) | 74.0 (51.7) | 0.004 * |
Domains of PA (minutes/week) | Median (IQR—25–75th percentile) | |||
Physical education activities (MVPA) | 50.0 (30.0, 60.0) | 50.0 (30.0, 60.0) | 50.0 (30.0, 60.0) | 0.90 |
Informal activities (MVPA) | 45.0 (0.0, 170.0) | 142.5 (60.0, 397.5) | 60.0 (0.0, 220.0) | <0.001 * |
School sports (MVPA) | 60.0 (0.0, 120.0) | 75.0 (00.0, 180.0) | 60.0 (0.0, 150.0) | 0.09 |
Club sports (MVPA) | 0.0 (0.0, 120.0) | 110.0 (00.0, 315.0) | 30.0 (00.0, 180.0) | 0.003 * |
Active transport (MVPA) | 0.0 (0.0, 150.0) | 0.0 (00.0, 26.3) | 0.0 (0.0, 120.0) | 0.07 |
Chores and casual work (PA) | 625.0 (300.0, 1062.0) | 392.0 (196.3, 690.0) | 570.0 (250.0, 960.0) | 0.03 * |
Total MVPA (including active transport) | 345.0 (167.5, 677.5) | 567.5 (348.8, 843.8) | 430.0 (210.0, 765.0) | 0.001 * |
Neighbourhood walkability domains | ||||
Residential density | 3.0 (1.0, 5.0) | 3.8 (1.0, 5.0) | 5.0 (3.0, 5.0) | 0.45 |
Access to services and places (land-use mix) | 2.9 (2.6, 3.4) | 3.0 (2.5, 3.3) | 3.0 (2.6, 3.4) | 0.98 |
Land-use diversity | 2.6 (2.2, 3.0) | 2.8 (2.6, 3.2) | 2.7 (2.3, 3.0) | 0.01 * |
Street connectivity | 3.0 (2.3, 3.2) | 2.8 (2.2, 3.3) | 3.0 (2.2, 3.2) | 0.64 |
Places for walking, cycling, and playing | 2.7 (2.3, 3.9) | 2.6 (2.3, 2.9) | 2.7 (2.3, 3.0) | 0.72 |
Aesthetics | 2.5 (2.1, 3.1) | 2.5 (2.2, 3.0) | 2.5 (2.1, 3.0) | 0.83 |
Safety from crime | 2.8 (2.0, 3.5) | 2.5 (2.0, 2.5) | 2.8 (2.0, 3.5) | 0.36 |
Safety from traffic | 2.8 (2.0, 3.5) | 2.7 (2.1, 3.0) | 2.7 (2.0, 3.2) | 0.79 |
Personal safety | 3.0 (2.7, 3.3) | 3.0 (2.6, 3.3) | 3.0 (2.7, 3.3) | 0.30 |
Stranger danger | 3.0 (2.3, 4.0) | 3.0 (2.7, 4.0) | 3.0 (2.7, 4.0) | 0.92 |
Walkability index | 0.01 (−0.3, 0.4) | 0.08 (0. 3, 0.5) | 0.0 (−0.3, 0.4) | 0.50 |
Total MVPA (ß, 95% CI) | p-Value | Active Transport (ß, 95% CI) | p-Value | Informal Activities (ß, 95% CI) | p-Value | School Sport MVPA (ß, 95% CI) | p-Value | Club Sport (ß, 95% CI) | p-Value | |
---|---|---|---|---|---|---|---|---|---|---|
Neighbourhood walkability domains | ||||||||||
Residential density | −0.50 (−2.28, 1.26) | 0.57 | −1.36 (−2.72, −0.00) | 0.05 | −0.24 (−1.94, 1.46) | 0.78 | 0.12 (−1.24, 1.46) | 0.87 | 1.24 (−1.04, 2.58) | 0.70 |
Access to services and places (land-use mix) | 0.56 (−0.42, 3.19) | 0.54 | 0.52 (−0.88, 1.92) | 0.46 | 0.74 (−1.01, 2.49) | 0.41 | −0.34 (−1.73, 1.04) | 0.63 | −1.05 (−2.43, 0.33) | 0.14 |
Land-use diversity | 1.39 (0.54, 3.60) | 0.13 | −0.88 (−2.28, 0.52) | 0.21 | 0.89 (−0.86, 2.63) | 0.32 | 0.89 (−0.50, 2.27) | 0.21 | 2.31 (0.93, 3.69) | 0.001 * |
Street connectivity | 0.54 (−1.11, 2.20) | 0.52 | −0.77 (−2.09, 0.51) | 0.24 | 0.68 (−0.92, 2.28) | 0.40 | 1.56 (0.29, 2.83) | 0.02 * | −0.39 (−1.65, 0.88) | 0.55 |
Places for walking, cycling, and playing | −0.67 (−2.65, 1.32) | 0.51 | 0.21 (−1.33, 1.74) | 0.79 | −1.63 (−3.56, 0.29) | 0.95 | 0.46 (−1.06, 1.99) | 0.55 | 0.58 (−0.94, 2.09) | 0.45 |
Aesthetics | 1.02 (−1.23, 3.27) | 0.37 | −1.17 (−2.91, 0.58) | 0.19 | 0.88 (−1.30, 3.06) | 0.43 | 1.40 (−0.33, 3.13) | 0.11 | 0.71 (1.01, 2.43) | 0.41 |
Safety from crime | −1.33 (−3.67, 1.02) | 0.63 | −0.97 (−2.78, 0.85) | 0.29 | −0.29 (−2.56, 1.98) | 0.80 | −0.92 (−2.72, 0.88) | 0.32 | −0.14 (−1.94, 1.65) | 0.87 |
Safety from traffic | 0.02 (−2.20, 2.23) | 0.99 | 0.32 (−1.39, 2.03) | 0.71 | 0.87 (−1.28, 3.01) | 0.43 | 0.06 (−1.65, 1.75) | 0.95 | −1.33 (−3.02, 0.37) | 0.12 |
Personal safety | −0.39 (−2.32, 1.54) | 0.69 | −0.71 (−2.21, 0.79) | 0.35 | 0.41 (−1.46, 2.29) | 0.66 | −0.06 (−1.54,1.43) | 0.94 | −1.75 (−3.23, −0.28) | 0.02 * |
Stranger danger | 0.87 (−1.36, 3.10) | 0.44 | 0.77 (−0.96, 2.49) | 0.38 | −1.17(−3.33, 0.99) | 0.29 | 0.76 (−0.95, 2.47) | 0.38 | 1.40 (−0.31, 3.11) | 0.11 |
Walkability index | 0.73 (−0.85, 2.32) | 0.36 | −2.05(−3.29, −0.81) | 0.001 * | 0.63 (−0.90, 2.16) | 0.42 | 1.83 (0.62, 3.05) | <0.001 * | 1.05 (−0.23, 2.33) | 0.11 |
Total MVPA (ß, 95% CI) | p- value | Active Transport MVPA (ß, 95% CI) | p-Value | Informal MVPA (ß, 95% CI) | p-Value | School Sport MVPA (ß, 95% CI) | p-Value | Club Sport MVPA (ß, 95% CI) | p-Value | |
---|---|---|---|---|---|---|---|---|---|---|
Neighbourhood Walkability Domains | ||||||||||
Residential density | −0.75 (−2.51, 1.00) | 0.82 | −1.08 (−2,44, 0.29) | 0.12 | −0.66 (−2.32, 0.99) | 0.43 | −0.04 (−1.38, 1.30) | 0.95 | 0.97 (−0.39, 2.32) | 0.16 |
Access to services and places (land-use mix) | 0.77 (−1.03, 2.56) | 0.47 | 0.26 (−1.14, 1.65) | 0.72 | 1.10 (−0.59, 2.79) | 0.20 | −0.13 (−1.50, 1.24) | 0.85 | −0.87(−2.25, 0.51) | 0.22 |
Land-use diversity | 0.40 (−1.53, 2.34) | 0.55 | −0.17 (−1.67, 1.34) | 0.83 | −0.39 (−2.22, 1.43) | 0.67 | −0.02 (−1.49, 1.46) | 0.98 | 2.15 (0.66, 3.64) | 0.05 * |
Street connectivity | 0.53 (−1.13, 2.18) | 0.31 | −0.57 (−1.86, 0.72) | 0.38 | 0.58 (−0.98, 2.13) | 0.47 | 1.29 (0.03, 2.56) | 0.04 * | −0.38 (−1.65, 0.90) | 0.56 |
Places for walking, cycling, and playing | −0.64 (−2.61, 1.33) | 0.47 | 0.25 (−1.29, 1.78) | 0.75 | −1.58 (−3.44, 0.27) | 0.09 | 0.21 (−1.29, 1.71) | 0.79 | 0.80 (−0.71, 2.32) | 0.30 |
Safety from crime | −1.19 (−3.56, 1.19) | 0.56 | −1.11(−2.96, 0.74) | 0.24 | 0.02 (−2.22, 2.25) | 0.99 | −1.19 (−3.00, 0.62) | 0.20 | 0.39 (−1.45, 2.21) | 0.68 |
Safety from traffic | −0.04 (−2.22, 2.15) | 0.92 | 0.49 (−1.21, 2.19) | 0.57 | 0.71 (−1.35, 2.77) | 0.50 | −0.05 (−1.72, 1.62) | 0.95 | −1.47 (−3.15, 0.22) | 0.09 |
Personal safety | 0.08 (−1.86, 2.02) | 0.42 | −1.09 (−2.60, 0.42) | 0.16 | 1.04 (−0.79, 2.86) | 0.26 | 0.43 (−1.05, 1.91) | 0.57 | −1.69 (−3.18, −0.19) | 0.03 * |
Stranger danger | 0.62 (−1.59, 2.83) | 0.98 | 1.00 (−0.72, 2.72) | 0.25 | −1.58 (−3.66, 0.51) | 0.14 | 0.09 (−0.98, 2.39) | 0.41 | 1.10 (−0.60, 2.80) | 0.20 |
Aesthetics | 0.81 (−1.45, 3.06) | 0.25 | −0.13 (−2.74, 0.77) | 0.27 | 0.66 (−1.47, 2.78) | 0.54 | 0.12 (−0.81, 2.63) | 0.30 | 0.97 (−0.77, 2.71) | 0.27 |
Walkability index | 0.29 (−1.47, 2.04) | 0.75 | −1.53 (−2.92, −0.13) | 0.03 * | 0.18 (−1.52, 1.83) | 0.85 | 0.84 (−0.51, 2.19) | 0.22 | 1.14 (−0.29, 2.56) | 0.12 |
Variables | BMI Unadjusted (ß, 95% CI) | p-Value | BMI Adjusted (ß, 95% CI) | p-Value |
---|---|---|---|---|
Neighbourhood Walkability Subscales | ||||
Residential density | −0.02 (−0.21, 0.16) | 0.81 | −0.01 (−1.19, 0.17) | 0.89 |
Access to services and places (land-use mix) | 0.07 (−0.12, 0.26) | 0.47 | 0.05 (−0.13, 0.24) | 0.57 |
Land-use diversity | −0.11 (−0.29, 0.08) | 0.27 | 0.04 (−0.15, 0.24) | 0.67 |
Street connectivity | −0.14 (−0.32, 0.03) | 0.10 | −0.14 (−0.30, 0.03) | 0.12 |
Places for walking, cycling, and playing | −0.09 (−0.30, 0.120) | 0.39 | −0.07 (−0.27, 0.13) | 0.51 |
Safety from crime | −0.02 (−7.20, 6.14) | 0.88 | 0.02 (−0.22, 0.27) | 0.85 |
Safety from traffic | 0.06 (−0.17, 0.29) | 0.61 | 0.05 (−0.17, 0.27) | 0.65 |
Personal safety | 0.16 (−0.04, 0.36) | 0.12 | 0.09 (−0.11, 0.29) | 0.38 |
Stranger danger | −0.05 (−0.29, 0.18) | 0.65 | −0.05 (−0.27, 0.18) | 0.67 |
Aesthetics | −0.12 (−0.35, 0.12) | 0.33 | −0.05 (−0.28, 0.18) | 0.69 |
Walkability index | −0.25 (−0.57, 0.07) | 0.12 | 0.03 (−1.58, 2.19) | 0.75 |
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Wayas, F.A.; Smith, J.A.; Lambert, E.V.; Guthrie-Dixon, N.; Wasnyo, Y.; West, S.; Oni, T.; Foley, L. Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents. Int. J. Environ. Res. Public Health 2023, 20, 2449. https://doi.org/10.3390/ijerph20032449
Wayas FA, Smith JA, Lambert EV, Guthrie-Dixon N, Wasnyo Y, West S, Oni T, Foley L. Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents. International Journal of Environmental Research and Public Health. 2023; 20(3):2449. https://doi.org/10.3390/ijerph20032449
Chicago/Turabian StyleWayas, Feyisayo A., Joanne A. Smith, Estelle V. Lambert, Natalie Guthrie-Dixon, Yves Wasnyo, Sacha West, Tolu Oni, and Louise Foley. 2023. "Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents" International Journal of Environmental Research and Public Health 20, no. 3: 2449. https://doi.org/10.3390/ijerph20032449