School of Hygiene and Preventive Medicine, University of Bologna, Italy.
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy.
Ann Ig. 2021 Jan-Feb;33(1):67-85. doi: 10.7416/ai.2021.2409.
Sedentary lifestyle is spreading among children living in urban settings. Recent studies in urban health investigated the effects of built environment on children's physical activity, focusing on the concept of "walkability", an index of how much an area is conducive to walking and active transportation. We decided to browse the literature in order to review all possible tools and methods by which walkability has been evaluated and measured.
We conducted a qualitative review of the literature in agreement with PRISMA guidelines, searching three medical databases for papers published between January 1994 and July 2017. Inclusion criteria were: primary studies, population ≤18 years and exposure variable as an assessment of walkability or built environment.
We retrieved 1,702 articles and included 195 of them in the final review. Most of the studies were cross-sectional (n=188, 96.4%). We identified two possible approaches and four main tools to address walkability measurement. A subjective method approach was used in 71 studies (36.4%), an objective method in 87 (44.6%). Only 37 studies (19.0%) used both. Main tools were survey (n=70, 35.9%), Geographic Information System (GIS) (n=64, 32.8%), street audits (n=11, 5.6%) and Walk-score™ (n=3, 1.5%). Forty-six studies (23.4%) used mixed methods. Environmental variables' assessment and definition was found to vary greatly by method of choice.
We found a high degree of heterogeneity regarding methods and measurements of walkability. A standard approach regarding tools and environmental variables' choice and definition will be advisable in order to allow comparisons among studies. Also, more longitudinal studies are needed.
久坐的生活方式在居住在城市环境中的儿童中蔓延。最近对城市健康的研究调查了建筑环境对儿童身体活动的影响，重点关注“可步行性”的概念，即一个地区有利于步行和积极交通的程度。我们决定查阅文献，以回顾评估和测量可步行性的所有可能工具和方法。
我们根据 PRISMA 指南进行了文献的定性回顾，在三个医学数据库中搜索了 1994 年 1 月至 2017 年 7 月期间发表的论文。纳入标准为：主要研究，人群≤18 岁，暴露变量作为可步行性或建筑环境的评估。
我们检索到 1702 篇文章，并最终纳入了 195 篇进行综述。大多数研究为横断面研究（n=188，96.4%）。我们确定了两种可能的方法和四种主要的工具来解决可步行性测量问题。71 项研究（36.4%）采用主观方法，87 项研究（44.6%）采用客观方法。只有 37 项研究（19.0%）同时使用了这两种方法。主要工具是调查（n=70，35.9%）、地理信息系统（GIS）（n=64，32.8%）、街道审计（n=11，5.6%）和步行评分（Walk-score）™（n=3，1.5%）。46 项研究（23.4%）采用了混合方法。发现根据选择的方法，环境变量的评估和定义差异很大。为了便于比较研究，建议采用一种关于工具和环境变量选择和定义的标准方法。此外，还需要更多的纵向研究。
