Community planning to promote physical activity among children:
W hat are the links between the built environment and PA?
What works to promote PA in children?
Bosön 14 September, 2011
Johan Faskunger
PhD Physical Activity & Public Health
johan.faskunger@proactivity.se
Come on! Lets
move!
It’s great fun…
Physical activity
is healthy…
Coronary heart
disease, cancer,
diabetes, bl a bl a
bl a…
Government assignment, 2006- 2010. Can be downloaded from:
www.fhi.se
www.fhi.se
- Samhällsplanering för ett aktivt liv
(Faskunger)- Barns miljöer för fysisk aktivitet (Faskunger)
- På väg mot bättre förutsättningar till aktiv transport
(Faskunger)- Äldres miljöer för fysisk aktivitet
(Bergman-Stamblewski)Physical activity among school children
Sufficiently active (1 h/dag):
• 22 % of 11-year old boys
• 20 % of 11-year old girls
Fewer are active among the older kids:
• 10 % of 15-year old boys
• 10 % of 15- year old girls
Swedish National Institute of Public Health, 2006
Physical activity: not only good for weight control!!!
PA PA Weight control Weight control
Physical activity: Not only good for weight control!!!
PA PA
Quality of life Quality of life Kompetence Kompetence
Balance Balance Strength Strength Goal setting Goal setting
Overcome challenges Overcome challenges
Coordination Coordination Energy expenditure Energy expenditure Community cohesion Community cohesion
Excitement Excitement Networking Networking
Play Play
Societal changes:
Trends for kids:
* Less active transport to school
* Freedom of movement diminished
* High media exposure
* Less ”spontanidrott”
* Less time spent outdoors
* High share of kids involved in sports
• Early 1980’s: 94 % of 7-9 year-olds were allowed to walk on their own to school (Spolander, 1985)
• Year 2000: 77 % (Markör AB, 2001)
•Year 2006: 58 % (Vägverket, 2006)
Trends in active transport for kids:
Barn (7-9 år) s om får gå utan vuxe ns s älls k ap till re s pe k tive m ålpunk t
0 20 40 60 80 100 120
Skola Fritidshem Lekplatser Idrottsplatser Simhall/badplats Grönområde Lekkamrater Bibliotek Affär Bio
Andel
1981 1983 2000 2003
Share of kids that are allowed to travel on their own to different destinations. Comparison of different time periods. Sources: Krister Spolander 1981 och 1983, ARS 2000 och Markör 2003
Barns miljö för fysisk aktivitet:
Kids need more than just separate places (playgrounds) to develop skills, motor
abilities, be physically active and discover their neighbourhood and their town/city!
Very few children in Sweden today have a safe route to school for walking and
cycling(Reneland, 2004)
Intervention: Number of studies: Evidence: Applicability:
Ecological approaches with many settings and actions at the same time
10 Strong evidence Effective in different settings and groups
Stand-alone media- och information campaigns
3 No or weak evidence May be important early in an intervention to raise community and political awareness
Health education 13 Insufficient evidence,
conflicting results
More research needed
P.E. in schools 16 Strong evidence Effective in different
settings and groups
Kahn et al (2002) The effectiveness of interventions to increase physical activity: A systematic review. Am J Prev Med. 22 (45): 73 – 107.
What works?
Intervention: Number of studies: Evidence: Applicability:
Community interventions
9 Strong evidence Effective in different settings and groups
Behaviour change 20 Strong evidence Effective in different
settings and groups Creating a supporting
environment (built and social) and policy
12 Strong evidence Effective in different settings and groups
Kahn et al (2002) The effectiveness of interventions to increase physical activity: A systematic review. Am J Prev Med. 22 (45): 73 – 107.
What works?
Sufficient evidence that schools is an effective setting to promote physical activity in kids:
WHO Regional Office for Europe (2006) What is the evidence on school health promotion in improving health or preventing disease and, specifically, what is the effectiveness of the health promoting schools approach? Köpenhamn.
”Health promotion in schools can improve children’s health and well-being. Among the most effective
programmes are those that promote mental health,
healthy eating and physical activity”
Built
environment &
physical activity
Built environment and physical activity among children (1):
Parks, playgrounds: +++++++
Sports- and exercise facilities: +++++++
Access to sports- and play equipment: ++++++ 0 0
Access to toilets and water to drink: ++
Attractive surroundings: ++
Limstrand, T (2008) Environmental characteristics relevant to young people’s use of sports facilities: a review. Scand J Med Sci Sports 18
Built environment and physical activity among children (2):
Good accessibility in general: +++00
Convenient and safe to cycle: +++0
Plenty of sidewalks: ++0
High access to public transport: ++
Limstrand, T (2008) Environmental characteristics relevant to young people’s use of sports facilities: a review. Scand J Med Sci Sports 18
Built environment and physical activity among children (3):
High costs to participate: - - - - -
Living in segregated neighbourhood: - -
Long distances: - - - -
High traffic volume, few zebra crossings: - - - +
Perceived unsafe environments and places: - - - 0 0 0 0 0
Limstrand, T (2008) Environmental characteristics relevant to young people’s use of sports facilities: a review. Scand J Med Sci Sports 18
NICE (2008). Promoting and creating built or natural environments that encourage and
support physical activity:
Traffic calming Increase in walking, cycling, childrens play outdoors, substantial decrease in crashes
Building multi-use trails Increase in walking and cycling Zoning Increase in walking, possibly in cycling as well
Building cycle infrastructure Increase in cycling, decrease in crashes
Building safe schoolways for walking and cycling Increase in walking and cycling
Change the streetscape Increase in walking, time spent outdoors in children increases
NICE (2006, 2008) Interventions that use the environment to encourage physical activity. London, NHS.
NICE (2008). Promoting and creating built or natural environments that encourage and
support physical activity:
Renew parks Increase in walking, higher awareness of parks as resource for PA Motivational signs/banners in stairs 200-400 % higher use of stairs
Painted patterns in school ground Increase in PA and play(up to 4 weeks)
Measures to build new and improve existing infrastructure for walking and cycling is very cost-effective. Cost-benefit 1:11.
NICE (2006; 2008) Interventions that use the environment to encourage physical activity. London, NHS.
”Näridrottsplats”, Mölndal in the Gothenburg region
Perceived safety:
•Perceived safety is a very important factor for PA outdoors, especially among kids, elderly and women
• Crime and incivilities may affect negatively, but still low understanding and little evidence
• Lack of lighting, street lights
• Traffic volume and high speed are the most common reasons why people feel unsafe
• Measures in the built environment can dramatically
improve safety and perceived safety - traffic-calming
and separate cycle paths in particular
Traffic calming – narrowing the road…
Traffic calming – speed bumps…
Traffic calming – ”woonerf”…
Traffic calming – roundabouts…
Number of severely injured and killed in traffic, comparison Gothenburg and
Stockholm 1990-2007
SCB, SIKA och Vägverket
Number of severely injured and killed cyclists in Gothenburg and Stockholm
1990-2008
SCB, SIKA och Vägverket
Gothenburg: 8 billion kr saved!!!
• Cost for traffic crashes+falls 2000-2007: 15 billion kr
• Traffic calming: 170 mkr
• Increased maintenance: 30 mkr
• 110 deaths and 2400 severe injuries prevented
• Savings = 8 billion kr
Trafikkontoret i Gbg (2009) Historik, kunskap och analys för trafiksäkerhetsprogram 2010-2020
