Larouche R, Sarmiento O L, Broyles S T, Denstel K D, Church T S, Barreira T V, Chaput J-P, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert E V, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Standage M, Tremblay M S, Tudor-Locke C, Zhao P, Katzmarzyk P T
Children's Hospital of Eastern Ontario Research Institute , Ottawa, Ontario, Canada.
School of Medicine, Universidad de los Andes , Bogotá, Colombia.
Int J Obes Suppl. 2015 Dec;5(Suppl 2):S89-99. doi: 10.1038/ijosup.2015.25. Epub 2015 Dec 8.
Previous research consistently indicates that children who engage in active school transport (AST) are more active than their peers who use motorized modes (car or bus). However, studies of the correlates of AST have been conducted predominantly in high-income countries and have yielded mixed findings. Using data from a heterogeneous sample of 12 country sites across the world, we investigated the correlates of AST in 9-11-year olds.
The analytical sample comprised 6555 children (53.8% girls), who reported their main travel mode to school and the duration of their school trip. Potential individual and neighborhood correlates of AST were assessed with a parent questionnaire adapted from previously validated instruments. Multilevel generalized linear mixed models (GLMM) were used to examine the associations between individual and neighborhood variables and the odds of engaging in AST while controlling for the child's school. Site moderated the relationship of seven of these variables with AST; therefore we present analyses stratified by site.
The prevalence of AST varied from 5.2 to 79.4% across sites and the school-level intra-class correlation ranged from 0.00 to 0.56. For each site, the final GLMM included a different set of correlates of AST. Longer trip duration (that is, ⩾16 min versus ⩽15 min) was associated with lower odds of AST in eight sites. Other individual and neighborhood factors were associated with AST in three sites or less.
Our results indicate wide variability in the prevalence and correlates of AST in a large sample of children from twelve geographically, economically and culturally diverse country sites. This suggests that AST interventions should not adopt a 'one size fits all' approach. Future research should also explore the association between psychosocial factors and AST in different countries.
以往研究一致表明，采用积极的学校出行方式（AST）的儿童比使用机动化出行方式（汽车或公交车）的同龄人更活跃。然而，关于AST相关因素的研究主要在高收入国家开展，且结果不一。我们利用来自全球12个国家不同地点的样本数据，调查了9至11岁儿童AST的相关因素。
分析样本包括6555名儿童（53.8%为女孩），他们报告了上学的主要出行方式和上学行程时长。采用一份根据先前经验证的工具改编的家长问卷，评估AST潜在的个体和社区相关因素。使用多水平广义线性混合模型（GLMM），在控制孩子所在学校的情况下，检验个体和社区变量与采用AST几率之间的关联。地点对其中7个变量与AST的关系具有调节作用；因此，我们按地点分层进行分析。
各地点AST的患病率在5.2%至79.4%之间，学校层面的组内相关系数在0.00至0.56之间。对于每个地点，最终的GLMM包含了不同的AST相关因素集。行程时间较长（即≥16分钟与≤15分钟相比）与8个地点较低的AST几率相关。其他个体和社区因素在3个或更少的地点与AST相关。
我们的结果表明，来自12个地理、经济和文化多样的国家不同地点的大量儿童样本中，AST的患病率和相关因素存在很大差异。这表明AST干预措施不应采用“一刀切”的方法。未来的研究还应探讨不同国家心理社会因素与AST之间的关联。
