Background
Regular physical activity has been shown to prevent major non-communicable diseases and improve physical and mental health [
1,
2]. Current recommendations for children and adolescents are to accumulate a minimum of 60 min of moderate to vigorous physical activity each day [
3]. However, most adolescents do not achieve the recommended level of physical activity in the United Kingdom (UK) [
4]. Addressing this lack of physical activity is particularly important because adolescence marks a key transition period during which life-long health behaviours start forming [
5].
Amongst the multiple levels of hypothesised determinants of physical activity, proximal factors, such as exposure to the neighbourhood environment, are more amenable to modification and thus a potential target for public health interventions [
6]. Younger adolescents (10–14 years) are particularly likely to be affected by the neighbourhood environment as this is where they spend the majority of their free time [
7‐
9].
In the UK, the evidence has indicated that ethnic minorities and more deprived populations are at higher risk of physical inactivity. These populations, who may spend a greater proportion of their time in their residential neighbourhood [
10], are also expected to be more affected by negative aspects of their neighbourhood social and physical environment, such as crime and disorder [
11‐
13].
While associations between objective measures of the built environment and physical activity have been intensively studied [
14], perceptions of the neighbourhood environment have been less well explored [
15,
16]. Instead of considering perceptions as proxies for more objective measures, current research suggests that there are differences between these two types of environmental exposure [
17,
18]. Perceptions may be affected by physical characteristics of the surroundings, but also by a variety of personal characteristics such as gender, social and cultural norms and values and socio-economic circumstances [
17]. It has therefore been suggested that perceptions of the neighbourhood environment may be more proximal to health behaviour than objective measures, and mediate some of its influences [
19]. Perception measures often target features of the neighbourhood that are intrinsically qualitative – such as fear of crime, aesthetics or quality of neighbourhood infrastructure (e.g. parks) – and are therefore difficult to capture using objective measures. As a result, the recent literature has indicated that objective measures and perceptions of the neighbourhood environment are complementary predictors of physical activity behaviours [
17]. Whereas objective measures are more likely to capture the direct influence of neighbourhood physical characteristics, perceptions are the results of a complex interplay between the physical environments, social and intra-individual processes.
Past research has indicated that some perceptions of the neighbourhood environment are correlated with several domains of physical activity, despite the diversity of measures and approaches used. The most consistent association appears to be between perceived access to destinations and walking and other physical activity in adults [
20‐
23], and between perceived access to recreational facilities and leisure-time physical activity in both adults and young people [
24‐
26]. Reasonably consistent associations were also found between perceived connectivity and walking in adults [
20,
26]. Other perceptions of the neighbourhood have shown mixed results and most perceptions were understudied in young people [
24,
25].
Several additional gaps remain in the literature. First, there is currently little understanding as to whether younger adolescents own perceptions of their neighbourhood environment, as opposed to those of their parents, are relevant in predicting physical activity behaviours. Second, gender differences have not been systematically documented despite well-established differences in the amount and types of physical activity between boys and girls. Third, most of the literature is based on cross-sectional studies, which provide little insight as to whether physical activity might change as a result of changes in perceptions [
26]. Fourth, the current literature is dominated by North American and Australian studies. More research is needed in the UK in order to corroborate results obtained in other settings and to explore potentially important contextual differences. Fifth, deprived and ethnic minority populations have been little studied, despite the fact that they are generally at greater risk of physical inactivity and are more likely to be more exposed to less supportive neighbourhood environments. Lastly, despite a growing recognition that different features of the environment affect different domains or forms of physical activity [
18], few empirical studies have systematically investigated associations between features of the neighbourhood environment and domains or forms of physical activity such as walking to school, walking for leisure and leisure sport activities. As a result, the current literature still lacks robust understanding of what specific aspects of physical activity are influenced by what perceptions of the environment.
In this paper we use the Olympic Regeneration in East London (ORiEL) study to test the plausibility of alternative hypotheses on how measures of neighbourhood perceptions might influence three common forms of physical activity (walking to school, walking for leisure, and outdoor physical activity) in a deprived and ethnically diverse young adolescent population. We assessed the plausibility of three hypotheses about the nature of the longitudinal associations between perceptions of the neighbourhood environment and physical activity: do we observe a general association over time? (question 1); does the accumulation of perceptions predict physical activity at follow-up? (question 2); do trajectories of perceptions and physical activity co-vary? (question 3). We further investigate the moderating role of gender in these associations.
Results
Physical activity prevalence declined over time (Table
1). The prevalence of walking to school was 77.5% at wave 1 and slightly decreased at each subsequent wave (wave 2 = 76.5%; wave 3 = 76.0%). The prevalence of walking for leisure was 40.1% at wave 1 and decreased to 34.3% at wave 2 and 29.9% at wave 3. Outdoor physical activity was highest at wave 1 (79.3%) and decreased to 76.1% at wave 2 and 70.0% at wave 3. Outdoor physical activity was higher in boys, walking for leisure higher in girls, and no gender differences was observed in walking to school (Additional file
2).
Table 1Characteristics of the study participants by wave, 2012–2014 (n = 2260)
Exposures |
Perceived bus stop proximity | | | | 10.4 |
% Further away | 25.5 | 20.7 | 18.8 | |
% 1–5 min | 74.5 | 79.3 | 81.2 | |
Perceived traffic safety | | | | 13.4 |
% Low | 10.5 | 10.4 | 9.9 | |
% Medium | 31.3 | 35.4 | 34.0 | |
% High | 58.2 | 54.2 | 56.1 | |
Perceived street connectivity | | | | 18.8 |
% Low | 22.1 | 20.1 | 19.8 | |
% Medium | 56.8 | 56.7 | 59.6 | |
% High | 21.1 | 23.2 | 20.6 | |
Enjoyment of neighbourhood for walking/cycling | | | | 12.6 |
% Strongly/slightly disagree | 23.5 | 25.6 | 25.5 | |
% Slightly agree | 33.8 | 39.2 | 43.0 | |
% Strongly agree | 42.7 | 35.2 | 31.5 | |
Feeling safe (personal safety) | | | | 15.1 |
% Strongly disagree | 10.1 | 10.3 | 9.4 | |
% Slightly disagree | 16.8 | 15.3 | 15.6 | |
% Neither agree nor disagree | 24.0 | 23.5 | 22.6 | |
% Slightly agree | 23.6 | 25.2 | 27.2 | |
% Strongly agree | 25.6 | 25.8 | 25.3 | |
Outcomes |
% walking to school | 77.5 | 76.5 | 76.0 | 4.9 |
% walking for leisure | 40.1 | 34.3 | 29.9 | 10.0 |
% reporting outdoor physical activity | 79.3 | 76.0 | 70.0 | 14.5 |
Covariates |
% Girls | 43.6 | – | – | 0.0 |
Ethnicity | | | | 0.0 |
% White: British | 16.9 | – | – | |
% White: Mixed | 8.4 | – | – | |
% Asian: Indian | 3.8 | – | – | |
% Asian: Pakistani | 3.8 | – | – | |
% Asian: Bangladeshi | 14.9 | – | – | |
% Black: Caribbean | 4.9 | – | – | |
% Black: African | 11.1 | – | – | |
% Other | 36.2 | – | – | |
% with health condition | 42.4 | 39.3 | 41.0 | 10.9 |
% receiving free school meals at wave 1 | 37.7 | – | – | 2.0 |
Family affluence | | | | 3.9 |
% Low | 10.7 | 7.0 | 5.0 | |
% Medium | 53.3 | 50.6 | 51.1 | |
% High | 36.0 | 42.4 | 43.9 | |
Perceptions of the neighbourhood environments had relatively stable distributions, despite important within-person changes over time (see Additional file
3 and Additional file
4 for illustration). Perceptions of bus stop proximity slightly increased after wave 1, and the prevalence of high enjoyment of neighbourhood for walking/cycling (i.e. ‘strongly agree’) gradually decreased from 42.7 to 31.5% between wave 1 and wave 3. Low perceived street connectivity and high personal safety were higher for boys (Additional file
2). Table
1 describes the key socio-demographic characteristics of the sample. In general, the sample was ethnically diverse (only 16.9% were White British and 36.2% were classified as ‘Other’) and relatively deprived (37.7% received free school meals at wave 1; 36.0–43.9% had high family affluence).
Walking to school
Results from the pooled model (question 1) indicates no evidence of an association between perceptions of the neighbourhood and walking to school (Table
2). Alternative hypotheses about cumulative impact (question 2) and trajectories (question 3) confirm the absence of associations with walking to school (Table
3). The inclusion of interaction terms between gender and each measure of perception of the neighbourhood indicates no evidence that gender moderates the associations.
Table 2General associations of perceptions of the neighbourhood environment with walking to school across the 3 waves (n = 2260)
Perceived bus stop proximity | Further away | 1.00 | | 0.140 | 1.00 | | 0.177 | 0.890 |
1–5 min | 0.89 | [0.77,1.04] | | 0.90 | [0.78,1.05] | | |
Perceived traffic safety | Low | 1.00 | | 0.505 | 1.00 | | 0.369 | 0.501 |
Medium | 1.11 | [0.93,1.33] | | 1.13 | [0.94,1.36] | | |
High | 1.10 | [0.92,1.32] | | 1.14 | [0.94,1.38] | | |
Perceived street connectivity | Low | 1.00 | | 0.303 | 1.00 | | 0.245 | 0.863 |
Medium | 1.10 | [0.95,1.27] | | 1.10 | [0.95,1.28] | | |
High | 1.14 | [0.96,1.36] | | 1.16 | [0.97,1.40] | | |
Enjoyment of neighbourhood for walking/cycling | Strongly/slightly disagree | 1.00 | | 0.446 | 1.00 | | 0.189 | 0.456 |
Slightly agree | 1.02 | [0.89,1.18] | | 1.00 | [0.86,1.17] | | |
Strongly agree | 0.94 | [0.81,1.09] | | 0.89 | [0.75,1.05] | | |
Feeling safe (personal safety) | Strongly disagree | 1.00 | | 0.770 | 1.00 | | 0.700 | 0.841 |
Slightly disagree | 1.14 | [0.92,1.42] | | 1.14 | [0.91,1.42] | | |
Neither agree nor disagree | 1.04 | [0.85,1.27] | | 1.02 | [0.83,1.27] | | |
Slightly agree | 1.06 | [0.86,1.31] | | 1.07 | [0.85,1.34] | | |
Strongly agree | 1.08 | [0.88,1.34] | | 1.11 | [0.89,1.40] | | |
Table 3Associations of cumulative perceptions of the neighbourhood environment and trajectories of perceptions with walking to school (n = 2260)
Cumulative perceptiona |
Perceived bus stop proximity | 0.92 | [0.81,1.04] | 0.171 | 0.91 | [0.80,1.04] | 0.169 | 0.857 |
Perceived traffic safety | 1.01 | [0.94,1.09] | 0.772 | 1.04 | [0.97,1.13] | 0.278 | 0.938 |
Perceived street connectivity | 1.03 | [0.95,1.12] | 0.514 | 1.04 | [0.96,1.13] | 0.315 | 0.647 |
Enjoyment of neighbourhood for walking/cycling | 0.97 | [0.90,1.04] | 0.359 | 0.96 | [0.88,1.04] | 0.295 | 0.849 |
Feeling safe (personal safety) | 0.98 | [0.95,1.02] | 0.324 | 0.99 | [0.95,1.03] | 0.699 | 0.867 |
Trajectory of perceptionb |
Perceived bus stop proximity | 1.06 | [0.93,1.02] | 0.367 | 1.07 | [0.94,1.23] | 0.319 | 0.956 |
Perceived traffic safety | 0.96 | [0.88,1.04] | 0.323 | 0.97 | [0.89,1.06] | 0.496 | 0.365 |
Perceived street connectivity | 1.01 | [0.93,1.10] | 0.828 | 1.02 | [0.93,1.11] | 0.716 | 0.862 |
Enjoyment of neighbourhood for walking/cycling | 0.96 | [0.89,1.02] | 0.196 | 0.96 | [0.89,1.03] | 0.240 | 0.605 |
Feeling safe (personal safety) | 0.99 | [0.91,1.01] | 0.606 | 1.00 | [0.95,1.04] | 0.890 | 0.944 |
Walking for leisure
Results from the pooled model indicate some evidence that perception of proximity to a bus stop is associated with less walking for leisure (adjusted OR = 0.89; 95% CI: 0.78–1.02) (Table
4). There is also some evidence that increased personal safety is associated with more walking for leisure (
p-value = 0.034). In particular, adolescents who feel very unsafe (i.e. ‘strongly disagree’) had lower odds of walking for leisure compared to the other groups. The adjusted OR of slightly disagree vs. strongly disagree is 1.28 (95% CI: 1.02–1.62; p-value = 0.033) and the OR of slightly agree vs. strongly disagree is 1.31 (95% CI: 1.04–1.65; p-value = 0.020).
Table 4General associations of perceptions of the neighbourhood environment with walking for leisure across the 3 waves (n = 2260)
Perceived bus stop proximity | Further away | 1.00 | | 0.050 | 1.00 | | 0.086 | 0.760 |
1–5 min | 0.88 | [0.78,1.05] | | 0.89 | [0.78,1.02] | | |
Perceived traffic safety | Low | 1.00 | | 0.372 | 1.00 | | 0.298 | 0.709 |
Medium | 0.90 | [0.75,1.08] | | 0.90 | [0.75,1.09] | | |
High | 0.88 | [0.74,1.05] | | 0.86 | [0.71,1.04] | | |
Perceived street connectivity | Low | 1.00 | | 0.149 | 1.00 | | 0.267 | 0.964 |
Medium | 1.15 | [0.99,1.34] | | 1.13 | [0.97,1.32] | | |
High | 1.10 | [0.93,1.31] | | 1.09 | [0.91,1.31] | | |
Enjoyment of neighbourhood for walking/cycling | Strongly/slightly disagree | 1.00 | | 0.360 | 1.00 | | 0.534 | 0.353 |
Slightly agree | 1.02 | [0.89,1.17] | | 1.02 | [0.88,1.18] | | |
Strongly agree | 1.10 | [0.95,1.27] | | 1.09 | [0.92,1.29] | | |
Feeling safe (personal safety) | Strongly disagree | 1.00 | | 0.068 | 1.00 | | 0.034 | 0.881 |
Slightly disagree | 1.28 | [1.03,1.59] | | 1.28 | [1.02,1.62] | | |
Neither agree nor disagree | 1.09 | [0.88,1.34] | | 1.09 | [0.87,1.36] | | |
Slightly agree | 1.24 | [1.01,1.54] | | 1.31 | [1.04,1.65] | | |
Strongly agree | 1.11 | [0.90,1.38] | | 1.18 | [0.93,1.49] | | |
Results indicate that cumulative perceptions are not associated with walking for leisure at wave 3 (Table
5). The trajectory analysis provides some indication that increased stop proximity is associated with decreased odds of walking to school over time (
p = 0.049).
Table 5Associations of cumulative perceptions of the neighbourhood environment and trajectories of perceptions with walking for leisure (n = 2260)
Cumulative perceptiona |
Perceived bus stop proximity | 1.00 | [0.89,1.14] | 0.939 | 0.98 | [0.86,1.12] | 0.798 | 0.844 |
Perceived traffic safety | 1.02 | [0.95,1.09] | 0.596 | 1.04 | [0.95,1.13] | 0.384 | 0.761 |
Perceived street connectivity | 1.04 | [0.95,1.14] | 0.379 | 1.05 | [0.95,1.15] | 0.354 | 0.471 |
Enjoyment of neighbourhood for walking/cycling | 0.99 | [0.93,1.05] | 0.721 | 1.00 | [0.92,1.08] | 0.943 | 0.829 |
Feeling safe (personal safety) | 0.98 | [0.95,1.02] | 0.319 | 1.00 | [0.96,1.04] | 0.827 | 0.918 |
Trajectory of perceptionb |
Perceived bus stop proximity | 0.87 | [0.76,1.05] | 0.053 | 0.86 | [0.74,1.00] | 0.049 | 0.932 |
Perceived traffic safety | 0.98 | [0.90,1.07] | 0.725 | 0.98 | [0.90,1.08] | 0.707 | 0.334 |
Perceived street connectivity | 1.00 | [0.91,1.10] | 0.962 | 1.00 | [0.91,1.10] | 0.971 | 0.240 |
Enjoyment of neighbourhood for walking/cycling | 1.02 | [0.95,1.09] | 0.665 | 1.02 | [0.95,1.11] | 0.583 | 0.260 |
Feeling safe (personal safety) | 1.00 | [0.90,1.11] | 0.994 | 1.00 | [0.95,1.05] | 0.942 | 0.992 |
None of the models provide evidence that gender moderates any of these associations.
Outdoor physical activity
The pooled model for a general association indicates weak evidence (
p-value = 0.077) that better perception of street connectivity increases the odds of outdoor physical activity (Table
6). The odds of outdoor physical activity for those with high perception of street connectivity are 1.27 (95% CI: 1.03–1.57) times higher compared to those with low perception. Other measures of perceptions indicate no evidence of association in the adjusted model.
Table 6General associations of perceptions of the neighbourhood environment with outdoor physical activity across the 3 waves (n = 2260)
Perceived bus stop proximity | Further away | 1.00 | | 0.639 | 1.00 | | 0.946 | 0.674 |
1–5 min | 0.96 | [0.82,1.13] | | 0.99 | [0.83,1.19] | | |
Perceived traffic safety | Low | 1.00 | | 0.490 | 1.00 | | 0.182 | 0.012 |
Medium | 0.99 | [0.80,1.22] | | 1.02 | [0.82,1.29] | | |
High | 0.92 | [0.75,1.14] | | 0.90 | [0.71,1.14] | | |
Perceived street connectivity | Low | 1.00 | | 0.222 | 1.00 | | 0.077 | 0.719 |
Medium | 1.05 | [0.90,1.23] | | 1.15 | [0.97,1.36] | | |
High | 1.18 | [0.98,1.42] | | 1.27 | [1.03,1.57] | | |
Enjoyment of neighbourhood for walking/cycling | Strongly/slightly disagree | 1.00 | | 0.042 | 1.00 | | 0.270 | 0.809 |
Slightly agree | 0.93 | [0.80,1.07] | | 0.95 | [0.81,1.11] | | |
Strongly agree | 1.10 | [0.94,1.29] | | 1.07 | [0.89,1.29] | | |
Feeling safe (personal safety) | Strongly disagree | 1.00 | | 0.324 | 1.00 | | 0.507 | 0.697 |
Slightly disagree | 1.06 | [0.83,1.34] | | 1.12 | [0.86,1.46] | | |
Neither agree nor disagree | 0.95 | [0.75,1.19] | | 0.96 | [0.75,1.23] | | |
Slightly agree | 1.06 | [0.84,1.33] | | 1.09 | [0.84,1.41] | | |
Strongly agree | 1.13 | [0.91,1.41] | | 1.09 | [0.85,1.39] | | |
The inclusion of interaction terms between gender and perceptions of traffic safety indicates strong evidence that gender moderates the associations between traffic safety and outdoor physical activity (p-value = 0.012). Gender-specific results (Table
7) indicate that boys with medium or high perception of traffic safety have higher odds of outdoor physical activity compared to those with low perception of traffic safety (ORs = 1.53 (95% CI: 1.10–2.11) and 1.21 (95% CI: 0.89–1.64) respectively). In girls, the association takes the opposite direction: the odds of outdoor physical activity are lower if the perception of traffic safety is medium (OR = 0.79 (95% CI: 0.56–1.03)) or high (OR = 0.74 (95% CI: 0.52–0.96)) compared to low.
Table 7Gender-specific general adjusted associations of perceptions of the neighbourhood environment with outdoor physical activity across the 3 waves (n = 2260)
Boys |
Low | 1.00 | | 0.002 |
Medium | 1.53 | [1.10,2.11] | |
High | 1.21 | [0.89,1.64] | |
Girls |
Low | 1.00 | | 0.147 |
Medium | 0.79 | [0.56,1.03] | |
High | 0.74 | [0.52,0.96] | |
Alternative hypotheses about cumulative impact and trajectories of perceptions do not provide evidence of associations with outdoor physical activity (Table
8). There is weak evidence that trajectories of perceived proximity to a bus stop and street connectivity were differently associated with changes in outdoor physical activity for boys and for girls (
p-values = 0.095 and 0.091, respectively). In boys, change in street connectivity was positively associated with change in outdoor physical activity (OR = 1.20 (95% CI: 1.01–1.41)); while in girls, change in perceived bus stop proximity was positively associated with change in outdoor physical activity (OR = 1.25 (95% CI: 1.99–1.57)) (Additional file
5).
Table 8Associations of cumulative perceptions of the neighbourhood environment and trajectories of perceptions with outdoor physical activity (n = 2260)
Cumulative perceptiona |
Perceived bus stop proximity | 0.95 | [0.86,1.06] | 0.377 | 0.94 | [0.83,1.07] | 0.331 | 0.900 |
Perceived traffic safety | 1.03 | [0.97,1.09] | 0.332 | 1.00 | [0.93,1.08] | 0.988 | 0.535 |
Perceived street connectivity | 0.99 | [0.93,1.06] | 0.873 | 1.03 | [0.96,1.11] | 0.398 | 0.816 |
Enjoyment of neighbourhood for walking/cycling | 1.03 | [0.99,1.07] | 0.165 | 1.01 | [0.95,1.08] | 0.730 | 0.510 |
Feeling safe (personal safety) | 1.05 | [1.01,1.08] | 0.006 | 1.02 | [0.98,1.07] | 0.278 | 0.825 |
Trajectory of perceptionb |
Perceived bus stop proximity | 1.11 | [0.95,1.29] | 0.192 | 1.11 | [0.93,1.32] | 0.248 | 0.095 |
Perceived traffic safety | 0.94 | [0.86,1.04] | 0.230 | 0.94 | [0.84,1.04] | 0.222 | 0.828 |
Perceived street connectivity | 1.08 | [0.98,1.18] | 0.112 | 1.07 | [0.97,1.19] | 0.172 | 0.091 |
Enjoyment of neighbourhood for walking/cycling | 1.02 | [0.94,1.10] | 0.622 | 1.02 | [0.93,1.11] | 0.737 | 0.527 |
Feeling safe (personal safety) | 1.01 | [0.9501.14] | 0.640 | 1.01 | [0.96,1.07] | 0.734 | 0.956 |
Discussion
In this paper we examined whether five measures of perceptions of the neighbourhood – bus stop proximity, traffic safety, street connectivity, enjoyment of the neighbourhood for walking/cycling, and personal safety – were associated with three common forms of physical activity, after controlling for individual socio-demographic characteristics. The physical activity outcomes analysed were walking to school, walking for leisure and outdoor physical activity. Analyses indicate little evidence that changes in perceptions of the neighbourhood are important predictors of younger adolescent physical activity. Specifically, walking to school was not associated with any of the five measures of perceptions. There was some evidence that greater perceived proximity to bus stops is associated with a small decrease in the probability of walking for leisure. The degree of evidence was somewhat stronger when the exposure was operationalised as a trajectory of within-adolescent change. This means that a within-individual increase in perceived proximity to a bus stop is associated with a higher probability of ceasing walking for leisure over time. Results also indicate that poorer perception of personal safety decreases the probability of walking for leisure. There was some indication that better perception of street connectivity is associated with more outdoor physical activity. Finally, despite evidence that physical activity outcomes and some perceptions differ by gender, we found very little evidence that the associations between perceptions of the neighbourhood and physical activity differed by gender.
Despite the limited number of studies on associations between perceptions of the neighbourhood and adolescent physical activity, these results provide evidence to support the argument that perceptions of the neighbourhood are not a major factor in explaining physical activity and its change over time [
24,
25,
42]. Although few studies have been previously conducted in deprived multi-ethnic adolescent populations [
43], these results might be surprising in light of some literature that suggests that deprived populations are expected to be more affected by some aspects of their neighbourhood such as disorder and crime neighbourhood [
11].
Perceptions of proximity to bus-stops appeared to be relevant for some forms of physical activity. It was expected that perception of closer proximity to a bus stop would decrease the odds of walking to school, given that adolescents younger than 16 year old can travel by bus for free in London [
44]. A negative association was observed, but it did not reach significance. However, a significant negative association was found between within-individual change in perception of bus stop proximity and change in walking for leisure. This association could indicate shift in behaviour during adolescence toward greater independent mobility and associated increased awareness of the residential neighbourhood. Previous studies have indeed indicated that the introduction of free buses in London has been associated with a reduction in the number of trips by walking, but has at the same time allowed adolescents to reach other destinations [
45]. It might therefore be that an increase in bus use as adolescents get older and become more independent might be associated with the replacement of walking for leisure by other forms of activities.
Findings on the associations between crime-related safety and physical activity deserve to be discussed in light of the literature [
24,
46‐
48]. Compared to general neighbourhood safety, it is hypothesised that fear of crime, stranger danger and personal safety – all three involving emotions and anxiety – are stronger predictors of physical activity by bringing about self or parental constraint on outdoor physical activities, including walking [
49]. These associations have been confirmed in qualitative studies [
50] and are expected to be particularly relevant in deprived populations, which are more at risk of crime-related safety problems [
11]. Despite these theoretical expectations, we only found some evidence of an association between the MESA item on personal safety (‘I feel safe walking in my neighbourhood, day or night’) and walking for leisure. This corroborates the inconsistent results observed in previous, mostly cross-sectional, quantitative investigations [
37,
48,
51‐
56]. Differences in the outcome measurement, exposure measurement (parents’ perceptions vs. adolescents’), study design (longitudinal vs. cross-sectional) or study setting do not appear to explain inconsistencies found in the current quantitative literature.
Two general factors might explain why few associations were observed between perceptions of the neighbourhood and physical activity. First, the measures of physical activity used are not specific to a specific location (e.g. park, neighbourhood), which can lead to an underestimation of the associations with perceptions of the neighbourhood [
18,
25]. Although the study of different forms of physical activity (i.e. walking to school, walking for leisure and outdoor physical activity) is already an extension of the field compared to existing studies [
25], the use of location-specific measures of physical activities is likely to increase the consistency of the results, as illustrated by some recent cross-sectional studies [
37,
39]. Second, younger adolescents’ perceptions of the neighbourhood might simply not matter for physical activity. In this study, within-adolescent perceptions of the neighbourhood substantially varied over time. This could indicate that younger adolescents aged 12–14 years old do not have a well-formed perception of their environment, and that their behaviours might still depend more on their parents and their parents’ perceptions of the neighbourhood. Esteban-Cornejo et al. [
37] showed that North American adolescents of a similar age tended to have different traffic-related and crime-related safety perceptions than their parents. The authors suggested that most parental perceptions were associated with some forms of physical activity, whereas adolescents’ perceptions were unrelated.
An important element of this paper has been the exploration of different ways of conceptualising the exposure-outcome association – as a general association, an association with exposure accumulation, and an overall association between trajectories. Measuring the general prediction of exposure had the greatest power to detect associations as they use both longitudinal and cross-sectional sources of information [
41,
57], whereas the latter two approaches restricted the analyses to within-individual change. The findings reported here suggest that there is no evidence to support the hypothesis that the accumulation of past and current perceptions of the environment has an impact on current physical activity. We also found very limited evidence to support the hypothesis that the overall trend in perception of the environment is associated with the trend in physical activity. This might reflect the fact that within-adolescent perceptions of the neighbourhood environment measured were not consistent and fluctuated over time. The modelling strategies outlined in this paper could nevertheless be relevant for future analyses in different contexts.
Strengths and limitations of this study
To our knowledge this is one of the first large-scale studies to longitudinally examine associations between perceptions of the neighbourhood environment with three validated measures of adolescent physical activity in UK and appropriate statistical methods to account for non-independence of observations and item non-response. The Y-PAQ questionnaire allowed for the study of three common types of physical activity, and thus explored how different aspects of physical activity were associated with perceptions of the neighbourhood environment.
A further advantage of the current study was the use of large-scale ethnically diverse sample population. The study had a high response rate (87% at wave 1) and retention rate (73%), which is consistent with best practice in other school-based cohorts [
58].
This research also has limitations. Physical activity measured by the Y-PAQ is self-reported and might therefore be subject to recall and social desirability biases [
59]. However, the use of objective physical activity measure was not practically possible given the size of the study. The Y-PAQ questionnaire does not have situational reference [
60] and did not capture where the reported activity was taking place (e.g. garden, neighbourhood, parks). Such information would be valuable to better understand what aspects of the neighbourhood matter for specific types of activities.
As large-scale studies of ethnically diverse populations are rare in the field, especially in the UK, the ethnic diversity of the ORiEL study is a major strength. However, the super-diversity of the ORiEL sample was a limiting factor because over 200 ethnic categories were self-reported for minor groups [
61], which restricted the ability to study ethnic differences in the associations between perceptions of the neighbourhood environment and physical activity. The study results presented here are therefore not generalisable as East London is a specific place with a super-diverse population with few comparators. However findings may be transferable to similar populations in urban settings.
Although the ORiEL study is one of the few large longitudinal studies to investigate the determinants of physical activity, its short period of follow-up (3 waves; 2 years) might have restricted the ability to detect longitudinal associations. Nonetheless, this study was conducted in a context of a dynamic urban setting, in which the population under study experienced accelerated physical, economic and social transformation of their residential neighbourhood, which are likely to bring about larger and faster changes in perceptions of the neighbourhood environment than would be normally observed.
As with other observational studies, we were unable to assess true causal relationships. Reverse causality could account for our findings.
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