Associations of adults’ perceived neighborhood environment with objectively-measured physical activity in 11 countries: The IPEN Adult study

Purpose: Environmental changes have been identified as potentially effective population-level physical activity (PA) promotion strategies. However, good quality multi-site evidence to guide international action aimed at developing activity supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively-measured PA outcomes; between-site differences in such associations; and, the extent to which perceived environmental attributes explain between-site differences in PA.

Methods: This was a cross-sectional study conducted in 16 cities located: Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and USA. Study participants were 6,968 adults residing in administrative units stratified by socio-economic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed average weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min/week of MVPA).

Results: Most perceived neighborhood attributes were positively associated with the two PA outcomes in single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix – access were significant predictors of both PA outcomes in the fully-adjusted models. All perceived neighborhood attributes were associated, in the expected direction, with between-site differences in the total effects of the perceived environment on PA outcomes.

Conclusions: Residents’ perceptions of attributes of their neighborhood environment that facilitate walking were positively associated with objectively-measured MVPA and meeting the guidelines for cancer/weight gain prevention at the within- and between-site levels. Associations were similar across study sites, supporting international recommendations for designing built environments that facilitate PA.