1School of Population Health, University of South Australia, Adelaide, South Australia, AUSTRALIA; 2Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, AUSTRALIA; 3Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, JAPAN; 4School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AUSTRALIA; 5School of Sport Sciences, Waseda University, Tokyo, JAPAN; 6School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, AUSTRALIA; 7School of Population Health, The University of Queensland, Brisbane, Queensland, AUSTRALIA; 8Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, AUSTRALIA; 9School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Western Australia, AUSTRALIA; and 10Central Clinical School, Monash University, Melbourne, Victoria, AUSTRALIA.
Med Sci Sports Exerc. 2015 Jun;47(6):1204-10. doi: 10.1249/MSS.0000000000000528.
Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance.
Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments.
Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working.
Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.
支持步行的环境举措是预防非传染性疾病的关键，但相关证据主要来自横断面研究。我们研究了与步行相关的邻里环境特征，包括横断面相关特征和前瞻性相关特征。
数据来自澳大利亚糖尿病、肥胖和生活方式研究，于 2004-2005 年（基线）和 2011-2012 年（随访）收集。在研究期间未搬离居住地的参与者（n=2684 人，基线时年龄为 30-77 岁）被分为常规步行者（每周步行 5 次或以上）和非步行者。将常规步行者分为停止步行者和继续保持常规步行者。回归分析考察了常规步行和步行维持与邻里目的地和行人环境感知属性之间的关系。
基线时的常规步行与商店（优势比[OR] = 1.13，95%置信区间[CI] = 1.04-1.22）、多种替代路线（OR = 1.12，95% CI = 1.01-1.23）、公园或自然保护区（OR = 1.13，95% CI = 1.02-1.26）、自行车或步行道（OR = 1.08，95% CI = 1.00-1.17）和步行安全感（OR = 1.18，95% CI = 1.01-1.38）的供应显著相关。常规步行的维持与多种替代路线的供应相关（OR = 1.19，95% CI = 1.03-1.38）。有许多替代路线和步行道与未工作或已停止工作者的步行维持有关。
发现邻里目的地（商店和公园）和行人环境（替代路线、步行道和免受犯罪侵害的安全）与常规步行相关，但只有行人环境属性与常规步行的维持有关。需要前瞻性研究提供进一步证据，以确定可能支持步行维持的其他邻里环境属性。
