Preventive Medicine 49 (2009) 21–23
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Preventive Medicine j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / y p m e d
A multi-site comparison of environmental characteristics to support workplace walking Nicholas D. Gilson a,⁎, Barbara Ainsworth b, Stuart Biddle c, Guy Faulkner d, Marie H. Murphy e, Ailsa Niven f, Andy Pringle g, Anna Puig-Ribera h, Afroditi Stathi i, M. Renée Umstattd j a
The University of Queensland, Australia Arizona State University, USA Loughborough University, UK d University of Toronto, Canada e University of Ulster, Northern Ireland, UK f Heriot-Watt University, UK g Leeds Metropolitan University, UK h Universitat de Vic, Spain i University of Bath, UK j The University of Alabama, USA b c
a r t i c l e
i n f o
Available online 14 May 2009 Keywords: Workplace Walking Environment Audit
a b s t r a c t Objective. This study assessed the environmental characteristics of ten universities, comparing the extent to which physical infra-structures are able to support a route-based walking intervention. Method. Following protocol standardization between and within sites, major pedestrian routes at main suburban campuses in seven countries (Australia, Canada, England, Northern Ireland, Scotland, Spain and the United States) were audited by researchers using an established inventory (March–June 2008). The inventory assessed key characteristics (e.g. size and employee number) and nine specific items (pedestrian facilities, vehicle conflicts, crossings, route-maintenance, walkway width, roadway buffer, universal accessibility, aesthetics and cover), scored on a five-point scale (1 = very poor; 5 = excellent). Item scores for each route, were combined and weighted, to provide indicators of low (score of 20–39), fair (score of 40–69), or good (score of 70–100) physical infra-structure support. Results. Sites varied in area (range of 7–1000 acres) and employee numbers (range of 700–7500 employees). Audits reported good support for route-based walking at seven sites (overall route score range = 72.5 ± 13.9–82.2 ± 17.4), fair support at two sites (overall route score of 69.1 ± 11.7 and 61.7 ± 14.6), and low support at one site (overall route score of 22.1 ± 7.3). Conclusions. Study methods highlight a valuable audit process, while findings identify the need to improve aspects of physical infra-structure at sites where the built environment may be less conducive for route-based walking. © 2009 Elsevier Inc. All rights reserved.
Introduction
steps/day more than students from another campus, with differences attributed to the built environment (Sisson et al., 2008). We have recently produced the framework for a multi-site intervention, which aims to increase route-based walking and reduce chronic disease risk for staff in university communities (Gilson et al., in press). Our framework identifies the fundamental role environmental characteristics play in facilitating worksite walking interventions. This brief report assesses these pre-intervention characteristics, comparing the extent to which physical infra-structures at our ten university sites are able to support a route-based walking initiative.
The health benefits of brisk, sustained walking have recently been re-iterated (Tudor-Locke et al., 2008). The workplace represents an effective context through which this type of physical activity can be promoted. For example, single site studies have shown that encouraging employees to engage in route-based walking increases workday step counts and reduces risk factors for chronic disease (Gilson et al., 2007; Chan et al., 2004). Environmental characteristics strongly influence walking opportunities (Saelens and Handy, 2008). Within the educational sector, a recent study found students attending one campus walked 3620
Method
⁎ Corresponding author. School of Human Movement Studies, Faculty of Health Sciences, The University of Queensland, Australia. Fax: +61 7 3365 6877. E-mail address:
[email protected] (N.D. Gilson).
Participating institutions were major, regional universities in Australia (The University of Queensland), Canada (University of Toronto), England (Leeds Metropolitan University; Loughborough University; University of Bath), Northern Ireland (University of Ulster), Scotland (Heriot-Watt University), Spain (Universitat de Vic) and
0091-7435/$ – see front matter © 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.ypmed.2009.05.001
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N.D. Gilson et al. / Preventive Medicine 49 (2009) 21–23
Table 1 Level of physical infra-structure and site characteristics, ranked (1 = most developed; 9 = least developed) relative to mean (SD) overall score for routes at ten university sites from seven countries (20–29 = low; 40–69 = fair; 70–100 = good; March–June 2008). Rank
University and country
Status
Overall score mean (SD)
Size (acres)
Students (n)
Employees (n)
Number of routes (n)
Route step counts mean (SD)
1 2 3 4 5 6 7 8 9 10
Uvic, Spain Bath, England Toronto, Canada Alabama, USA H.W., Scotland Leeds, England Qld., Australia Loughb., England Ulster, N. Ireland Arizona, USA
Good
82.2 (17.4) 81.0 (12.2) 80.5 (9.3) 76.5 (12.6) 73.3 (14.8) 72.8 (10.5) 72.5 (13.9) 69.1 (11.7) 61.7 (14.6) 22.1 (7.3)
7 200 316 1000 200 100 282 473 116 660
8000 13,023 50,709 25,580 6800 12,969 34,280 15,539 23,000 9300
671 2614 7500 3021 1600 1045 4655 3111 3000 700
10 21 23 26 12 28 21 17 10 13
822 (392) 1022 (742) 474 (158) 1090 (628) 521 (272) 187 (80) 654 (705) 574 (202) 398 (201) 645 (310)
Fair Low
the United States (Arizona State University; The University of Alabama). Each institution was represented by a principal investigator, who was also a member of our collaboration, who had expressed an interest in running an employee intervention at their respective university (academic year 2009–10), as part of an evolving, international collaboration. Overall project coordination was provided by the first author. Audits were undertaken at the main campus of each institution, where interventions were taking place. Principal investigators were asked to define their main campus in terms of its position (inner city, suburban or rural setting), size (hectares) and student/staff numbers and identify the number and length (step counts; Yamax SW-200 pedometer) of major, outdoor pedestrian routes acting as staff thoroughfares between buildings and facilities. Physical infra-structure was evaluated using a validated, established inventory (Dannenburg et al., 2005) that assessed nine items scored on a five-point scale (1 = very poor; 3 = acceptable; 5 = excellent). High importance items were described as “pedestrian facilities, vehicle conflicts and crossings”, with medium importance items termed “route-maintenance, walkway width, roadway buffer, universal accessibility and aesthetics”. The last item descriptor of “shade” was categorized as low importance and we changed this item to “cover”, which we considered to be more applicable to our study, given that site audits were taking place in countries with hot and colder climates. Prior to full audit, principal researchers agreed on protocol and scored digital recordings of three routes from different sites, posted on the internet. Comparability was assessed by Spearman's rank correlation and inter-site reliabilities for routes found to be high (rho = 0.71–0.94). High inter-site reliability was replicated within sites, with teams (the principal researcher and at least one other local researcher) independently evaluating a local route prior to full audit. These intra-site scores were then compared within teams and this process continued until values were comparable (difference of no more than ±1 on each inventory item). Site audits took place between March and June 2008 and typically took two weeks to complete. Once full audits were completed, item scores for each route at each site were combined and weighted (using inventory guidelines [Dannenburg et al., 2005; Table 2), to provide indicators of low (score of 20–39), fair (score of 40–69), or good (score of 70–100) physical infra-structure support. Route scores were summed and averaged to provide an overall site score and data inputted into a standardized Excel template by site teams. Principal investigators at each site then forwarded these files electronically to the coordinating investigator, where descriptive statistics for sites were collated and compared.
Results Table 1 provides an overview of audit data. Sites varied in area (range of 7–1000 acres) and employee numbers (range of 700–7500 employees). The number and length of major pedestrian routes were
also diverse; there was a range of 10–28 identified routes, with lengths ranging from 187 to 1090 step counts. Out of ten sites surveyed, seven reported good physical infrastructure to support route-based walking (overall route scores ranged from 72.5 ± 13.9 to 82.2 ± 17.4). Two sites provided fair support (overall route score of 69.1 ± 11.7 and 61.7 ± 14.6) and one low support (overall route score of 22.1 ± 7.3). Table 2 describes individual item scores for sites and highlights areas where physical infra-structure characteristics were less than acceptable (rating of 1.0–2.9). Two items were of general concern for the group; seven sites rated “roadway buffer” as either very poor or poor; eight sites provided these ratings for “cover”. Of those two sites that provided fair support for walking, three (site rank 8 — “crossings, roadway buffer and cover”) and five inventory items (site rank 9 — “walkway width, roadway buffer, universal accessibility, aesthetics and cover”) were rated as unacceptable respectively. For the single site that provided low overall support for walking (site rank 10), only “route-maintenance, walkway width and universal accessibility” were rated as acceptable. Discussion Our demographic data shows that universities typically employ large numbers of people and host even larger numbers of students — they therefore have the potential to engage a large cross-section of society in physical activity through walking. Student initiatives are important from a health promotion perspective, yet university academic and administrative employees are in particular need of intervention. Recently published data from three of our sites in Australia, Spain and England, highlight that some employees within these occupation groups accumulate as little as 5000 daily steps (Gilson et al., 2008). Route-based walking within the workplace plays an important role in countering this level of inactivity (Gilson et al., 2007) and overall, the findings of this ten site audit indicate that our university campuses are generally well-suited to support such an intervention strategy.
Table 2 Mean (SD) inventory item scores (1 = very poor; 3 = acceptable; 5 = excellent), relative to site rankings (March–June 2008), for routes at ten university sites from seven countries. Rank
1 2 3 4 5 6 7 8 9 10
Status
Good
Fair Low
University and country
Uvic, Spain Bath, England Toronto, Canada Alabama, USA H.W., Scotland Leeds, England Qld., Australia Loughb., England Ulster, N. Ireland Arizona, USA
Inventory item scores High importance
Medium importance
Low importance
Facilities
Vehicles
Crossings
Maintenance
Width
Buffers
Access
Aesthetics
Cover
4.6 3.9 4.4 4.4 3.9 3.3 3.9 3.2 3.7 2.5
3.9 (0.9) 4.5 (0.9) 3.8 (1.1) 3.7 (1.1) 3.8 (1.0) 4.1 (0.8) 3.6 (1.3) 3.5 (0.9) 3.1 (1.0) 1.9 (0.6)
4.3 4.5 4.3 4.2 3.8 3.6 3.9 2.9 3.5 2.5
4.4 (1.0) 4.8 (0.5) 4.7 (0.6) 4.1 (0.5) 4.1 (0.7) 4.8 (0.4) 4.9 (0.4) 4.8 (0.4) 3.1 (1.4) 3.4 (1.0)
4.5 (0.7) 4.4 (1.0) 4.7 (0.6) 4.1 (1.0) 4.0 (1.0) 3.3 (0.8) 3.2 (0.9) 3.6 (1.0) 2.6 (0.7) 3.0 (0.9)
4.3 (1.1) 3.5 (1.5) 2.8 (1.7) 2.8 (1.3) 4.0 (0.9) 2.3 (1.5) 2.5 (1.4) 2.9 (0.6) 2.7 (1.3) 1.2 (0.8)
3.6 (1.6) 2.9 (1.3) 4.4 (1.1) 4.1 (1.0) 2.8 (1.2) 3.9 (1.0) 4.0 (1.0) 3.6 (1.0) 2.9 (1.0) 3.4 (1.5)
3.9 (0.9) 4.4 (0.7) 3.8 (1.1) 3.3 (1.0) 3.8 (0.8) 4.3 (0.9) 3.6 (1.0) 3.7 (0.9) 2.8 (1.0) 2.6 (0.9)
4.0 (0.7) 3.3 (0.7) 2.2 (1.0) 2.9 (1.0) 1.8 (1.1) 2.6 (1.0) 2.7 (1.0) 2.9 (0.8) 2.6 (0.5) 1.5 (0.8)
(0.8) (1.0) (0.7) (0.9) (1.0) (0.7) (1.1) (0.8) (1.2) (1.1)
(0.8) (0.5) (0.9) (0.9) (0.9) (0.8) (1.2) (0.9) (1.2) (1.1)
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However, as audit scores testify, some sites are more suited than others. The challenge will now be to consider how our collaboration can reflexively adapt to these limitations, so that some partner sites are not disadvantaged — this is especially applicable to those three campus environments rated as providing fair or low environmental support. Inventory item scores offer valuable information on where principal investigators need to focus efforts and resources to improve campus infra-structure. During this process, our collaboration will aim to re-evaluate the relative importance of individual items to specific sites, rather than applying the generic labels provided by the inventory (Dannenburg et al., 2005). This is appropriate considering the diversity of campus environments and practical, in that particular items (such as cover for example), will be more important for some, while less important for others. Liaison with institutional management will be a pre-requisite for development of physical infrastructure, regardless of which items individual sites target — the need for principal researchers to work effectively with key university decision makers is therefore a project priority, given that these individuals are the gatekeepers for effective change within workplaces (Plotnikoff et al., 2005). Beyond the immediate needs of our initiative, study methods describe a valuable audit process. Reports on impact and outcome evaluations are common in the physical activity literature, with less attention paid to intervention planning and environmental diagnosis — in this regard the processes described are timely, given that they will be useful to others interested in designing effective workplace walking interventions. Our audit was completed at ten different sites in seven countries with satisfactory inter and intra-site reliability; standardizing auditors, both between and within sites, was achieved successfully through the creative use of internet technology and the sharing of best practice and expertise. Large international collaborations, such as our own, are increasingly likely with physical inactivity emergent on a global scale (Kirsten et al., 2006). As our findings demonstrate, it is important that these collaborations under-
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take pre-intervention audits, in an effort to account for the specific needs and challenges of divergent partner sites. Conclusions This study assessed the environmental characteristics of ten university sites, prior to a route-based walking intervention. Methods describe a valuable audit process which could be used for other multisite intervention projects. Findings showed campus physical infrastructure to be generally supportive of route-based walking, while highlighting areas where some sites might target efforts and resources to maximize intervention impact. Conflict of interest statement The authors declare that there are no conflicts of interest.
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