Are environmental perceptions and walkability related to health behaviors in children?

Purpose: To analyze associations between environmental perceptions and health behaviors between children from low (LWA) and high walkability areas (HWA).

Methods: This cross-sectional study includes 102 children (11.6+/-0.7y) from Porto (Portugal) living in areas with high and low GIS-based walkability. Moderate to vigorous physical activity (MVPA) and sedentary time was measured with accelerometer; built environment perceptions were accessed by questionnaire. Active commuting to school (ACS) and food intake were self-reported. Statistics include Qui-square, t-test and logistic regression analyses.

Results: No differences were found in sedentary and MVPA time between children from LWA and HWA, however children from HWA used ACS more frequently. Children from LWA were more likely to ACS if they perceived more safety (OR=2.79, IC 0.01-0.68). Perceptions of easy access to shopping, public transportation and friends’ houses as well as perceptions of graffiti walls significantly differ between walkability groups. Better accessibility to shopping and public transports was found in HWA while children from LWA considered easier access to friends’ houses. Participants from LWA also perceived better neighborhood aesthetics (less graffiti). Interestingly, children from HWA had significantly higher food intake than children from LWA.

Conclusions: In HWA proximity to destinations may not be enough to improve MVPA particularly by ACS. On the other hand this easy access may contribute to high food intake (shopping food courts, fast food restaurants, candy shops). In LWA as distances are bigger, focus on increasing ACS by improving neighborhood safety can be an important health promotion strategy.

Grant PEst-OE/SAU/UI0617/2011, PTDC/DES/099018/2008- FCT/FCOMP-01-0124-FEDER-009573, SFRH/BD/70513/2010.